Sublux Midterm Flashcards
1
Q
__ refers to the measurement of the human individual. Used as an early tool of anthropology
A
Anthropometry
2
Q
What educates the patient about postural distortions/imbalances, indicates areas of biomechanical stress, insightful to chronic VSC areas, explains visually the muscular causes of pain, is an outcome measure for patient and other interested parties, and helps indicate/pinpoint pathologies?
A
the Postural Analysis
3
Q
When visualizing posture, it is important to use a frame of reference (such as a gridline) for __ and __?
A
reliability, reproducibility
4
Q
T/F: When visualizing posture, you should have a different examiner take measurements for the pre/posttest validity?
A
False. The same examiner should take the measurements pre/post test, then be confirmed by a 2nd examiner if so applicable.
5
Q
When visualizing posture, the findings should be documented from whose perspective?
A
The Patient’s perspective
6
Q
T/F: Patient stance during a postural analysis should be normal, neutral, and reproducible?
A
True. Also, best if the patient is gowned so that symmetry/asymmetry can be visualized accurately.
7
Q
This word was originally a nautical term utilized to describe a ship’s overall appearance or tendency to favor the starboard or portside?
A
List
8
Q
Which term means that posturally, a patient’s overall tendency will be to favor their right or left. From anterior view, what are the 2 reference points?
A
List; 2 reference points anteriorly are sternum & baseline
9
Q
Which term means to be in or to move into a sloping position? Posturally, this describes a patient’s “regional” tendency to break from an established vertical baseline.
A
Lean. Regional=Lean *Ant view should be recorded as right, left, neutral.
10
Q
When assessing Lean, what are the 3 regional areas we utilize from anterior view?
A
*upper 1/3: glabella-sternum *middle 1/3: sternum-pubic symphysis *lower 1/3: pubic symphysis-baseline
11
Q
When assessing head tilt (ant. view), what are the 3 reference points?
A
glabella-nose-chin
12
Q
When assessing thoracic tilt from anterior view, what is our reference point?
A
acromioclavicular joints. *Left thoracic tilt would be a shoulder lowered on the left side. Think of a marble rolling downhill, and that is the direction of the tilt.
13
Q
When assessing postural analysis from lateral view, what are the global list reference points?
A
AC joints-baseline
14
Q
How should we record the List on lateral view?
A
Anterior, Posterior, or Neutral
15
Q
On lateral lean, what are the 2 regions of reference points?
A
AC-trochanter, Trochanter-baseline
16
Q
On head carriage looking from the lateral view, what are our reference points?
A
EAM-AC joint *Classify as anterior or posterior head carriage
17
Q
Which clinical condition would give a “rounded back appearance” which utilizes Cobb Angles for the radiological mensuration?
A
thoracic kyphosis *hyperkyphosis (extremely rounded back like quasimodo-hunchback of notre dame) or hypokyphosis (not enough thoracic anterior curve)
18
Q
When assessing thoracic rotation from lateral view, what are the 2 reference points?
A
chest-back prominence
19
Q
Which clinical condition is the visualization of a “swayback”, an overly posterior curvature of the spine?
A
lumbar lordosis
20
Q
In posterior view, what are the 2 reference points for the overall List?
A
VP-baseline
21
Q
When looking at our patient from posterior view, we notice that we can see more of the left cheek and/or jaw. What would this be classified as?
A
Left head rotation *Use facial prominence (jaw or cheek)
22
Q
For head translation (post. view), what are the 2 reference points?
A
EOP-VP
23
Q
___ scoliosis is due to vertebral malformation or fused ribs during development?
A
Congenital
24
Q
__ scoliosis is caused by poor muscle tone, or paralysis due to diseases such as cerebral palsy (CP), muscular dystrophy, spina bifida, or polio?
A
Neuromuscular
25
__ scoliosis is of unknown cause?
Idiopathic
26
What is the most common type of scoliosis in adolescents?
Idiopathic scoliosis *more common in tall women
27
T/F: Scoliotic curves generally correct themselves during growth spurts?
False. Curves generally worsen during growth spurts.
28
Using this instrument (___) ,if either measure is 5 degrees or more, then consider referral to a scoliosis center.
scoliometer
29
Scoliometer readings of 5 degrees or more have high likelihood of Cobb angles greater than __ degrees on xray?
10 degrees
30
T/F: An increased Cobb Angle =worse scoliosis?
TRUE
31
When visualizing scoliosis, what are our 2 reference points?
spinous processes, scapular inferior angles (& prominency)
32
When assessing pelvic tilt, what are the 2 reference points?
iliac crests-PSIS's
33
If our patient has a Right pelvic tilt, which hip is lower?
the Right hip. Again, think the marble rolling downhill
34
When assessing pelvic rotation, what is our reference?
gluteal prominence
35
What is the most consistent way of performing a prone leg check?
the Hydraulic HyLo table
36
When assessing the prone leg check, which part of the shoe should we use?
either the "seam" of the shoe, or "like points" on both shoes
37
When doing the prone leg check, we are checking for asymmetry in which 3 structures?
1. inversion/eversion 2. foot flare 3. plantar flexion/dorsiflection
38
Steps in the prone leg check:
1. use consistent hand placement 2. apply slight headward pressure to remove "slack" in the shoe 3. flatten the foot so as to neutralize any inversion/eversion 4. do NOT torsion the tibia/femur 5. Visualize the deficient side while maintaining slight headward pressure 6. Record findings... example: 1/4" R/L
39
When in practice, what is the most important factor to base our procedures on?
******Patient preferences******
40
Research alone does not equal __?
evidence
41
When a new patient comes through the door, this is the order of assessment ideal to proceed in:
1. history/symptomatology 2. visualization (posture/leg check) 3. instrumentation 4. static/motion palpation 5. spinographic analysis
42
Which portion of the initial assessment (and ongoing assessments) provides us with a patient's concerns and guides our care plan? Here, we should shift the paradigm so we are not just alleviating pain, but the patient shares other concerns such as visceral functions and wellness/prevention habits. Hint: Dr. Bhogal spends a majority of his time as a clinician in this facet?
Patient History/symptomatology
43
Which portion of the assessment allows us to see biomechanical awareness and overall function based on their posture/mannerisms?
Visualization
44
What is the most cost effective method to objectifying neurological function?
instrumentation
45
Which portion of the assessment makes our work much easier and can be reproducible from one doctor to another?
Instrumentation
46
What portion of the assessment shows soft tissue changes relative to the VSC? It includes myopathology of muscle hyper/hypotonicity, tissue prominency and palpatory tenderness.
Static palpation
47
Which portion of the assessment shows kinematic changes relative to the VSC? It includes the kinesiopathology of the global ROM as well as intersegmental fixation.
Motion palpation
48
Which portion of the assessment utilizes spinal radiography/x-ray analysis to correlate motion palpation findings, postural distortions, and allows more specific adjusting by the DC?
spinography
49
A conservative and conscientious form of health care that concerns itself (primarily) w/the functional integrity of the nervous system is __?
Chiropractic (Bhogal's definition)
50
Homeostasis should be replaced by the word __?
homeodynamics *dynamic=movement, health. homeostasis implies staying the same. not what we want to illustrate to our patients.
51
An aberration (deviation from the norm) in biomechanical spinal anatomy, such that the functional integrity of the nervous system is compromised (compromised capacity to adapt to a stimulus) is a __?
subluxation (Bhogal's definition)
52
A __ __ is what the patient perceives; a pathophysiology.
subluxation syndrome
53
What is the love of wisdom?
Philosophy
54
Chiropractic wisdom tells us what?
The body is intelligent, self-regulating (innate intelligence), created by a universal intelligence, has a love/hate relationship with educated intelligence, and how well we utilize Educated facilitates the expression of Innate
55
Who authored the 33 principles?
Ralph W. Stephenson.
56
What are the 4 T's associated w/Chiropractic?
Thoughts, trauma, toxins, threshold (an individual's ability to adapt to life situations)
57
What are the 5 components of the Vertebral Subluxation Complex (VSC)?
1. Kinesiopathology 2. Myopathology 3. Neuropathology 4. Histopathology 5. Pathophysiology
58
Which part of the VSC is atypical position or motion?
Kinesiopathology
59
Which part of the VSC is muscular dysfunction resulting in hypo/hypertonicity?
Myopathology
60
Which part of the VSC is a dysfunction or disease of the nervous system?
Neuropathology
61
What is the most important tool in determining neuropathologies?
Instrumentation
62
Which part of the VSC is a disease or dysfunction at a cytological level?
Histopathology **Inflammation**
63
What part of the VSC includes functional changes associated w/disease or injury?
Pathophysiology **Patient education crucial at this step**
64
What is the system devised by the Centers for Medicare and Medicaid Services (CMS) to validate the necessity of chiropractic care through either x-ray or physical examination?
the P.A.R.T system
65
What does the P.A.R.T. system stand for?
P-pain/tenderness A-asymmetry/misalignment R-range of motion abnormality T-tissue/tone changes
66
Which portion of the PART system uses observation & documentation, palpation or percussion, a visual analog scale (pain 1-10), audio confirmation, and a pain questionnaire to inquire about the patient?
P-pain/tenderness
67
Which portion of the PART system allows us to observe patient posture or analyze gait, describe the misaligned vertebrae, and using x-rays, CAT scans or MRI's to identify misalignments?
A-asymmetry/misalignment
68
Which portion of the PART system shows increased/decreased flexibility via observation, motion palpation, x-rays, or goniometers or inclinometers for specific measurements?
R-range of motion abnormality
69
Which portion of the PART system has visible changes like spasm, inflammation, swelling, rigidity, palpable edema, documented instrument findings, and **documented leg length, scoliosis contracture, and strength/length of muscles that relate?
T-tissue tone changes **tests for length/strength**
70
Which part(s) of the VSC correlates to asymmetry/misalignment and ROM abnormality of the PART system?
Kinesiopathology
71
Which part(s) of the VSC correlates with pain/tenderness, asymmetry/misalignment, and tissue/tone changes of the PART system?
Myopathology, Neuropathology, Histopathology
72
A method of using one's hands to feel and assess several parameters that govern the mobility and health of tissues located near or on the body's surface. It facilitates the analysis of soft or bony tissue structures within the body. What is being described?
Static palpation
73
Static palpation is insightful to what parts of the VSC?
Kinesiopathology (position/motion), myopathology (tonicity), histopathology (cytological/inflammation/edema)
74
Static palpation is insightful to what parts of the PART system?
P-pain/tenderness A-asymmetry/misalignment T-tissue/tone changes
75
T/F: Static palpation is best utilized before instrumentation?
False. Static palpation is best utilized AFTER instrumentation. An instrumentation "break" will guide our area of static assessment
76
In terms of turgidity, give examples of places where you would find normal turgidity, hyperturgidity, and hypoturgidity?
.normal turgidity: middle of palm -hyperturgidity: thenar pad; feels spongier than it should -hypoturgidity: back of hand; feels elastic, flaccid, loose; think of elderly skin w/loss of fluid; "tenting"
77
In static palpation, we utilize both active light tough and deep tough, always going from least invasive to most invasive. What are the 3 areas for active light touch?
Active light tough: sudoriferous changes, turgidity changes, surface tonicity
78
In static palpation, we utilize both active light tough and deep tough, always going from least invasive to most invasive. What are the 3 areas for deep touch?
Deep touch: tissue prominency, palpatory tenderness, deep tonicity changes.
79
In active light touch, __ glands are located all over the integument and secrete a blood plasma metabolite called __ for thermal regulation. These glands help us determine which portion of active light touch?
eccrine; sweat .Sudoriferous changes
80
Innervation to eccrine glands is through the __ by cholinergic & adrenergic fibers
SNS
81
T/F: When checking for sudoriferous changes, we should NOT deform the skin as we only are checking for heat/moisture on the surface?
True.
82
Sudoriferous changes are associated w/which part of the VSC?
neuropathology
83
Oily, greasy, slippery, sweaty, clammy, or tacky texture can indicate __?
an acute VSC
84
Dry, scaly, flaky, or rough skin texture can indicate __?
a chronic VSC
85
Intrinsic pressure or resistance offered by a cell or tissue is called __?
Turgidity
86
An accumulation of interstitial fluid (ISF) under the skin usually results to altered homeostasis, injury, or inflammation is called __?
edema aka "palpable sponginess"
87
Changes in muscle tone perceived as contracture, spasm, tightness, fullness, or being rope-like describe this term.
Tonicity
88
Turgidity is correlated w/which part of the VSC?
Histopathology (inflammation)
89
Surface tonicity is associated w/which part of the VSC? Which part of the PART system?
Myopathology; T-tissue/tone changes
90
What is the most invasive step of static palpation where we elicit minor pain in the patient?
Deep touch
91
Generally a palpable prominence in the paravertebral gutter due to an osseous misalignment and facet prominence is describing what?
Tissue prominency
92
Tissue prominency aka?
bony prominency
93
What type of pain would we find in tissue prominency?
sclerotogenous pain
94
Which part of the VSC is tissue prominency correlated with?
Kinesiopathology
95
In deep touch of static palpation, which procedure uses firmly applied pressure in an I-S and P-A direction on the spinous processes that our instrumentation readings have found? After this, bilateral L-M pressure is applied to the same spinous process
Palpatory tenderness
96
Besides spinous processes, what is the other most common area used for palpatory tenderness and tissue prominency?
Transverse processes
97
Which part of the VSC is palpatory tenderness correlated with?
Kinesiopathology
98
Which type of pain is pertaining to ligaments, tendons, discs, periosteal, or zygapophyseal structures?
sclerotogenous pain
99
What type of pain is deep, nondescript pain that is unlocalized?
sclerotogenous pain
100
Which part of deep touch is utilized when the thumb tip or thumb pad firmly "strums" the paraspinal muscles in all regions of the spine? If pain is elicited on this, or if hypertonicity is noted, it is a reliable indicator of a component part of the VSC.
Deep tonicity changes
101
Myotogenous pain is correlated with which deep touch procedure?
Deep tonicity changes
102
What pain is arising in muscle bellies, musculotendinous junctions, and tendon insertions?
myotogenous pain
103
Which pain is more localized, more superficial, and feels like a "ropelike" muscle?
myotogenous pain
104
Deep tonicity changes are associated with which part of the VSC?
myopathology
105
Kinesiopathology is correlated with which parts of deep touch?
tissue prominency, palpatory tenderness
106
Neuropathology is associated w/which active light touch?
sudoriferous changes
107
Histopathology is associated w/which active light touch?
turgidity changes
108
Myopathology is associated w/which active light and deep touches?
surface tonicity, deep tonicity changes
109
Instrumentation is associated w/which portion of the VSC?
neuropathology
110
Instrumentation satisfies which portion of the PART system?
T-tissue/tone changes
111
The purpose of __ is to objectify neurological functions and target areas for further assessment?
instrumentation
112
Limitations of instrumentation include: examiner reliability is initially __, clinical presentation of the __, and __ variability?
low (improves w/technology, practice); epidermis; physiologic variability (like dermatomes/neuropathies)
113
During instrumentation, what are some different clinical presentations of the epidermis?
burn/sunburn, blemish/acne, infection, fever, perspiration
114
Perspiration for instrumentation can be bad because it leads to __?
IR (infrared) scatter- hard to pick up accurate readings on sweaty/clammy skin
115
Instrumentation is assessing __ function as a reflection of aberrant (out of the norm) neuromodulation.
vasomotor
116
This instrument is an infrared paraspinal thermal imaging system which is gathering information in the first 5mm of the epidermis?
TyTron C-3000
117
Which portion of the ANS functions without an antagonist, regulates smooth muscle, and affects the tunica media of a vessel?
sympathetic nervous system
118
Why was the tomato blushing?
Because he saw the salad dressing ahahahahahaa :)
119
What are the 2 types of thermoregulation for instrumentation?
Core control (takes over when ambient control cannot keep up) and ambient control
120
Which form of control in thermoregulation is dermatome specific, is the first line of defense when temperature changes, and begins w/sensory input from the skin?
ambient control
121
In ambient control, which receptors (warm/cold) are myelinated, and which ones are unmyelinated?
Warmth receptors are unmyelinated. Cold receptors are myelinated for saltatory conduction (which is why we tend to feel cold faster than we feel warm).
122
In the neurologic pathway, the afferent sensory input enters the cord and synapses in the __ horn at the __ of __?
Dorsal. Tract of Lissauer
123
Which tract in the neurologic pathway sorts between pain and temperature?
Tract of Lissauer
124
After the Tract of Lissauer, the next synapse is from gray matter to white matter to become the __ __ Tract?
Lateral Spinothalamic Tract
125
The Lateral Spinothalamic Tract ascends to the brain carrying the cutaneous message and terminates at the __ __ Nucleus of the __?
Ventral Posterolateral Nucleus; thalamus
126
Which structure in the brain functions as a sorting relay center?
Thalamus
127
The thalamus synapses to which Brodmann areas?
Brodmann 3, 1, 2. Primary Somatosensory Cortex
128
If the thalamus doesn't synapse at the primary somatosensory cortex (BA 3, 1, 2), what other cortex does it synapse at?
Insular Cortex "Isle of Reil"
129
The insular cortex's anterior portion regulates __-__ function.
viscero-autonomic
130
What is another name for the anterior hypothalamic nucleus?
Adenohypophysis
131
The insula forwards sensory message to the __, which is the region for regulation of autonomic function?
Hypothalamus
132
The __ __ Nucleus becomes a descending autonomic tract which passes through the brainstem, then travels back to the original site of dermatomal thermoregulation with its' preganglionic sympathetic fiber?
Anterior Hypothalamic (adenohypophysis)
133
The preganglionic sympathetic fiber will synapse with the __ __ ganglionic chain?
sympathetic paravertebral
134
What are the 3 synapse outcomes of the preganglionic sympathetic fiber?
1. ascend to ganglion at a higher cord level 2. descend to ganglion at a lower cord level 3. Stay at the same ganglionic level
135
In terms of outcomes for the preganglionic sympathetic fiber, what is the MOST likely outcome for dermatomal thermoregulation?
It will stay at the same ganglionic level
136
The preganglionic sympathetic fiber will secrete which NT?
Acetylcholine (ACH)
137
ACH will (stimulate/inhibit) a nicotinic postganglionic fiber which will transmit __?
stimulate; epinephrine
138
Epinephrine secreted from the postganglionic fiber has what effect on other tissues?
excitatory; up-regulatory; epinephrine has no antagonist to counteract it, and it will cause constriction of the sympathetic nervous system, decreasing temp. while increasing force/pressure
139
Epinephrine will terminate at which portion of the muscle and have what effect on the vasculature?
Tunica media; constricts vasculature
140
What is a good way to describe heat swings as opposed to breaks?
Heat swings are normal and healthy; gentle, thermal shifts
141
The sympathetic nervous system is found at which spinal cord levels?
T1-L2/L3
142
How does the cervical spine receive sympathetic innervation if sympathetics are only found between T1-L2/L3?
The sympathetic chain extends upwards, reflecting the "core activity below", which supports pattern analysis (systemic).
143
Is break analysis considered segmental or systemic?
segmental
144
Is pattern analysis considered segmental or systemic?
systemic
145
Pattern analysis (systemic overview) is usually used in which instances?
For upper cervical techniques and progressive exams re-evaluating a patient's status
146
Which instrument is used primarily for segmental "break" analysis, costs approximately $600-$800, and assists in objectifying neurologic dysfunction?
Nervoscope
147
The nervoscope can be used for pattern analysis if connected to a recording unit called a(n) __?
analagraph
148
For our purposes, what is the sensitivity switch set to on the nervoscope?
medium
149
What will be observed as a gradual sweeping deflection of the nervoscope needle reflecting the gentle thermal shifts present on the skin's surface as a part of normal physiologic function?
Heat swing
150
T/F: a heat swing is generally multisegmental/multidermatomal?
TRUE
151
What will be observed as a rapid reproducible deflection of the nervoscope needle reflecting an atypical and unexpected thermal shift present over a neurological field (dermatome) as a part of dysfunctional physiology?
Break
152
T/F: Ideal acclimation occurs for 20 minutes for a patient before using the nervoscope on them?
False. Ideal acclimation is 10 mins
153
When doing a cervical glide, the patient should be seated where? What about a thoraco-lumbar assessment?
cervical: patient even w/back of the stool .thoraco-lumbar: patient slightly forward, about a hand-width from the back of the bench
154
T/F: The head should be flexed when running a cervical glide w/the nervoscope?
False. The chin should be tucked, the head should not be flexed.
155
Upon a cervical glide w/the nervoscope, the doctor's stance should be?
scissored stance @ 45 degrees or less with contact arm in line w/patient's spine, contact elbow close to the doctor's body, stabilization hand doing a hair sweep or supporting the head, a single hand grip on the instrument, and the lateral leg touching the lateral posterior side of the bench
156
When doing a cervical glide, the probes are __ or slightly __ if patient is petite/pediatric?
parallel; slightly inwards
157
Cervical glide commences at __ and will terminate __ up onto the occiput into the hairline.
T1; 1/2"
158
Cervical glide speed is __ seconds/segment for a total glide time of __-__ seconds?
3; 18-21 seconds total
159
Confirmed cervical breaks are marked __ (above/below) mid thermocouple well outside of the glide path.
1/4" below
160
T/F: When starting the cervical glide, the bowl should be superior to the barrels?
TRUE
161
In the T/L spine glide, probes are __ or __ __ if patient has a larger frame?
parallel; wide open
162
T/L glide commences at __ and will terminate at __?
C7; S2
163
T/L glide speed is __ seconds/segment, smooth and continuous for a total glide time of __-__ seconds?
2; 35-38
164
Confirmed T/L breaks are marked __ (above/below) mid thermocouple well outside of the glide path?
1/2" above
165
When recording positive instrumentation findings, be sure to document which 3 things?
Segmental level involved, direction of the break, and amplitude (increments of deflection) ex: T4/R/3
166
Between occiput-C1, the general break location is marked where?
between the 2 segments
167
Between C2-T3, the general break location is marked where?
the interspinous space below. ex: C3 (break) C4: The break most likely belongs to C3
168
At which segmental fields is the general break location at its own spinous level?
T4; T10-T12
169
Between T5-T9, the general break location is marked where?
the interspinous space above. ex: T6 (break) T7: The break most likely belongs to T7 (we found the break in the space above the segment that is actually subluxated, so T7 is our culprit)
170
The Tytron C-3000 is primarily used for pattern analysis or break analysis?
Pattern analysis (systemic); popular w/upper cervical techniques
171
The Tytron C-3000 is a paraspinal thermal imaging system using infrared technology for what?
relative skin temperature (multiple sites) and direct skin temperature (one segment)
172
T/F: Tytron C-3000, and instrumentation in general, is regarded well by 3rd-party payers?
TRUE
173
What are 3 disadvantages of the Tytron C-3000?
Doesn't work well in cold, can cause IR scatter, and cost is $3,000-$5,000
174
The Tytron C-3000 is insightful about which components of the VSC and PART systems?
Neuropathology, histopathology; T-tissue/tone changes
175
T/F: When using a Tytron C-3000, the scanner barrels are placed directly on the skin?
False. Scanner barrels never touch the skin, only the rollers do.
176
When using the Tytron C-3000, the scan commences at __ and terminates __?
S2; at the base of the occiput (bony ridge)
177
What is the glide speed when using a Tytron C-3000?
1 sec/segment
178
T/F: When using a Tytron C-3000, the hair sweep has to be done on the fly.
TRUE
179
When using the Tytron C-3000, every scan that is run is accompanied by a __ __ reading, which provides more specific info. about the upper cervical complex?
mastoid fossa
180
When doing the fossa reading w/Tytron C-3000, which barrel goes in both the right fossa and the left fossa? You commence by pressing which key on the keyboard? How many degrees celsius is clinically significant?
Right barrel: "F" key; .5 degrees C
181
Which system of analysis takes into consideration that thermal shifts on the surface of the skin occur as a part of normal physiology?
Pattern analysis
182
If it's found that the patient has a diminished dynamic adaptability, it can be correlated with __ dysfunction and a compromised ability to adapt.
autonomic
183
The "gold standard" when using the Tytron C-3000 is to take _ scans over a _ hour period with the scans spaced apart as evenly as possible.
3; 24 ex: should be down at Hour 0, 12, and 24
184
T/F: Once a pattern has been established for a patient using the Tytron C-3000, each subsequent scan on each visit is compared to that pattern to determine if an adjustment is appropriate?
TRUE
185
What are the 3 scan outcomes of the Tytron C-3000?
Pattern, Adaptive, Stress
186
In which scan outcome of the Tytron C-3000 is the patient subluxated and should be given an adjustment?
Pattern scan=no adaptation
187
In which scan outcome of the Tytron C-3000 is the patient probably not subluxated and probably doesn't need an adjustment?
The adaptive scan because their body is reacting the way it should
188
Which scan outcome of the Tytron C-3000 is strange and atypical, possibly resulting from emotional stress, physical stress, drugs (prescription & recreational) and caffeine?
the Stress scan
189
A perfect adaptive scan w/the Tytron C-3000 would resemble which structure that sooooo makes us despise Faruqui?
a double helix
190
Name the instrument used mainly for the segmental approach.
Nervoscope
191
Name the instrument mainly used for pattern analysis (systemic approach).
Tytron C-3000
192
Why is Pete gay?
No one knows.
