1
Q
What is MOPI?
A
- Misalignment (of intervertebral articulations)
- Occlusion (of an opening: spinal canal or IVF)
- Pressure (on nerves)
- Interference (with transmission of mental impulses)
2
Q
What is a clear protocol?
A
Pre-checks
Prone checks
Seated checks
Standing checks
Supine checks
Listings
3
Q
Cervical syndrone fast unilaterally meaning?
A
C1
4
Q
Cervical syndrome fast bilaterally meaning?
A
Occiput
5
Q
Cervical syndrome Z flick meaning?
A
C2 or C3
6
Q
Cervical syndrome Short getting shorter?
A
C1 on C2
7
Q
Cervical syndrome slow balance meaning?
A
C5, C6 or C7
8
Q
Cervical syndrome leg shortens with ipsilateral head roatation bilatterally meaning?
A
BIlateral AS occupit
9
Q
C1 Prill test
A
Hands on heels get them to push up into them
10
Q
C2 prill test
A
Get them to push there feet out into your hands
11
Q
C3 prill test
A
Get them to push feet together
12
Q
C4 Prill test
A
Get them to push feet out into your hands
13
Q
C5 prill test
A
Push back in the upper arm (posterior proximal)
14
Q
C6 prill test
A
Puch back on lower arm (posterior distal)
15
Q
C7 prill test
A
Get them to push on fron of upper arm (anterior proximal)
16
Q
What does a positive derefield test indicate?
A
Same side PI, Opposite side Post Sacrum, AS Ilium or L5
17
Q
What does a negative derefield indicate
A
AI sacrum same side, Post sacrum opposite side,
AS ilium opposite side
18
Q
What does sacral restriction low on one side indicate?
A
Posterior sacral base on the low side, sacral apex rotation to the high side
19
Q
What does low bilaterally in sacral restriction indicate?
A
Base or apex posterior
20
Q
How does oedema occur in subluxation?
A
When vertebral subluxations are present and a spinal motion is compromised, the normal homeostatic processes may be compromised.
* This may result in a build-up of oedema in the facet joint that is referred to as periarticular oedema.
21
Q
Kinematics
A
The branch of mechanics that deals with pure motion, without reference to the masses or forces
involved in it.
22
Q
Osteokinematics
A
motion you can see; observable of range of motion of bones in space.
23
Q
Arthrokinematics
A
motion you can feel (palpate); unobservable articular motion between adjacent joint surfaces. Roll, glide and spin.
24
Q
What glide does spinal joint play examination involve?
A
Arthrokinematic
25
What is translatory motion?
one constant point on one surface is contacting new points or a series of points on the other surface
26
What is pure gliding?
two surfaces are congruent and flat or congruent and curved
27
What are the glides in joint play examinations?
* Normal glide = springy
* Partial glide = blocked
* Loss of glide = hard
28
What does the multifidi indicate?
Tight opp spinous laterality
29
What does posterior superior serratus indicate?
Tight opp spinous laterality
30
What does posterior inferior serratus indicate?
Tight opp spinous laterality
31
What does erector spinae indicate?
Tight on side of PI ilium or Inf sacrum
32
What does glute max indicate?
Tight on side of AI or PI sacrum
33
What does piriformis indicate?
Tight on side of post sacrum
34
What does sacroliac ligament indicate?
Oedema indications for PI/AS/In/Ex
35
What does sacrotuberous ligament indicate?
Tense unilaterally on side of PI ilium/Sacral anteriority
Tense bilaterally with sacral apex posteriorty
36
What does quadratus lumborum indicate?
Tight on side of PI Ilium
37
What does glute med and min indicate?
Tight on side of AS ilium
38
What does oedeme superior to PSIS indicate?
PI
39
What does oedema inferior to PSIS indicate?
AS
40
What does oedema medial to PSIS indicate?
EX
41
What does oedema lateral to PSIS indicate?
IN
42
What factors must you consider for gonstead nervoscope?
* Room temperature 21ºC ideal
* Client stress, sweaty, fidgety, skin lesions, hair, rashes, dry skin
* Must be done on skin
* Instrument care
* Delicate – don’t drop
* Gentle cleaning of probes with a soft brush
43
What are the common errors in scoping with a nervoscope?
* Air gaps in probes
* Too light/uneven pressure
* Too fast and inconsistent speed
* Not remaining perpendicular to spine or keeping spine in centre of probes
* Incorrect sensitivity
* Holding the probes
44
What is end feel in motion palpation?
* Each joint should have a normal springy end feel
* Incorrect end feel indicates pathology abnormality
45
What is the bone-bone end feel?
- indicates that bone touching bone is limiting the ROM. Feels like pushing two wooden surfaces
together.
46
What is capsular end feel?
indicates that the joint capsule or ligaments are limiting the ROM. Feels like stretching a leather
belt.
47
What is muscle stretch end feel?
indicates that muscle tightness is limiting the ROM. Feels like stretching a bicycle tire inner
tube.
48
What is soft tissue approximation end feel?
indicates that subcutaneous tissues (muscle bulk, fat) are pushing against each other and limiting the ROM. Feels like squeezing two balloons together.
49
What is springy end feel?
Normal end-feel. Feels "bouncy" like you are compressing a spring.
50
What is empty end feel?
- indicates that the examiner did not reach the end feel (usually the client is not willing to allow
motion to end of range because of anticipated pain). Feels like the joint has more range available, but the client is purposefully preventing movement through the full ROM.
51
What is muscle spasm end feel?
A guarding phenomenon that protects a painful pathological joint. Gentle movement is met
with a sudden “twang’ of the muscle contracting
52
What does SCM indicate?
Side of posterior occiput
53
What does levator scap indicate?
Side of C1 laterlaity
54
What does superior oblique indicate?
Opposite side of C1 laterality
55
What does RCP major indicate?
Side of C2 body rotation
56
What does naterior scalenes indicate?
Side of C2 body rotation
57
What does inferior oblique indicate?
Side of C2 body rotation
58
What are the standing and supine checks?
- Pelvic motion palp
- Pelvic observation
- Supine leg length
- Cervical joint play
59
What does a higher gluteal fold indicate?
AS ilium listing
60
What does narrower side of glutes with gluteal bunching indicate?
Ex
61
What does wider side with gluteal flattening indicate?
In
62
What does supine leg length indicate?
Possible upper cervical (C0, C1, C2)
63
What is X-ray analysis for?
* Rule out any pathology and contraindications – always first
* Identify osseous structures
* Potential subluxation listings
64
What is in the pelvic x-ray analysis?
* Innominate height
* Innominate width
* Sacral width
* Pubic symph alignment
* Lumbar spine curve
* Disc wedging
* Obturator foramen appearance
65
What does a taller innominate indicate?
PI
66
What does a wider innominate indicate?
In
67
What does wider unilateral sacrum indicate?
Posterior
68
What is in the cervical x-ray analysis?
* Lateral mass width
* C1/2 alignment
* Para-odontoid space
* Neural ring alignment to F.M
* Spinous rotation
* Disc wedging
* Atlas angle
69
What does narrow para-odontoid space indicate?
Narrower on side of atlas anteriority
70
What does C1 TVP closer to mastoid on one side?
C1 laterality
71
What is the least mobile part of the spinal column??
Thoracic
72
What are the atypical vertebra of thoracic spine?
- T1 = resembles cervical vertebra
- T9-T12 = (T10-T12) resembles lumbar
73
What is the degrees of articular facets in the thoracic spine?
60 degrees towards the coronal plane
74
What is the average angle of the curve in the thoracic spine?
Kyphotic curve with an average angle of 45
75
How is the kyphotic curve maintained in the thoracic spine?
Vertebral bodies 2mm higher posteriorly than anteriorly
76
What is Scheuermann Disease?
Increased wedge shape of vertebra
77
What conditions can contribute to increased kyphosis in the thoracic spine?
- Scheuermann disease
- Osteoporosis
78
How do the ribs attach?
1-7 = attach to sternum anteriorly
8-10 = attach via costo-cartilage
11-12 = floating
79
Where should Dr be positioned when adjusting the thoracic spine?
Up the kyphosis = T9-T12
Plateau = T5-T8
Down the kyphosis = T1-T4
80
Where is the TVP for T1-T3?
The TVP is one interspinous space above and approximately 2.5 cm lateral to the spinous of the segment palpated
81
Where is the TVP for T4?
The TVP is 2.5 cm lateral to the upper 1/3 of the T3 spinous
82
Where is the TVP for T5-T9?
The TVP is two interspinous spaces and above approximately 2.5 cm lateral to the spinous of the segment palpated
83
Where is the TVP for T10?
The TVP of T10 is approximately 2.0 cm lateral to the spinous of T9
84
Where is the TVP for T11-T12?
The TVP is one interspinous space above and approximately 1.25 cm lateral to the spinous palpated
85
T3-T8 Crossed Pisiform without torque
86
T3 – T12 Double Thenar RP / LP
87
T3 – T12 Carver Bridge RP / LP
88
T1 – 4 Single Hand Pisiform RP / LP
89
C7 – T2 Spinous Thumb Push RP / LP / SpR / SpL
90
What is a body drop thrust?
Thrust is generated by acceleration of the doctors body weight through the adjustive contact
91
What is the main feature of the lumbar spine?
- Weight bear loads created by body weight and forces generated by lifting
- Trunk mobility
92
What does the kumbar vertebra look like?
* Bodies are kidney shaped
* IVF is triangular in shape
* Transverse processes are long and slender
* Spinous process short and broad
* Mammilary process is located on the superior posterior
edge of the superior articular process.
93
What is the facet orientation of the lumbar spine?
- Sagittal plane
94
What is spinal stenosis?
Narrowing of the canal in which the spinal cord sits
- Puts pressure on the nerves in the back
95
What is a laminectomy?
Surgical intervention for canal stenosis
96
What is the impact post laminectomy on the lumbar spine?
Decreased ability of the lumbar spine to resist torsion resulting in early failure
97
When does the lordotic curve begin to develop in the lumbar?
When child begins to sit
98
What is the average angle of lordotic lumbar curve?
40-60 degrees
99
What are the affects of anterior and posterior pelvic tilts on the lumbar lordotic curve?
Anterior = increase lumbar lordosis, therefore increase in weight bearing responsibility on facets
Posterior = Decrease in lumbar lordosis, increasing weight bearing responsibility on discs
100
L1 – L5 Lumbar Mamillary Push Sideposture
RP / LP
101
Sacrum Involved Side Up Side posture PR / PL
102
Sacrum Involved Side Down Side posture PR / PL
103
PI Ilium Sideposture R PI / L PI
104
AS Ilium Sideposture R AS / L AS
105
Who created gonstead?
Dr Clarence Gonstead
106
When did gonstead open his clinic?
1964
107
What did gonstead introduce to chiropractic?
- pelvic understanding
- x-ray full spine
- disc pathobiomechanics
108
What is the gonstead formula?
Find It, Accept It, Fix It, and
Leave It Alone
109
What does P mean in gonstead listing?
Posterior
110
What does La mean in the gonstead listing system?
La
111
What does T mean in the gonstead listing system?
Transverse process
112
What does M mean in gonstead listing system?
M
113
What is the first letter in the gonstead listing system?
Always P
114
What is the 2nd letter in the listing system?
Direction of spinous deviation R or L
115
What is the 3rd letter in the gonstead listing system?
Describes disc wedging S or I
116
What is the 4th letter of the gonstead listing system?
contact point
117
What does the 5th letter of the gonstead listing system?
If vertebra has moved significantly inferior
118
What is the segmental contact point taken?
Open side of wedge
119
What happens to annular fibres during forward bending?
Posterior annular fibres are susceptibel to tension and pressure and fail
120
In the Cervical spine when is a a –inf used?
Significant inferiority seen on the lateral x ray
121
What is the grading of intervertebral disc listings?
* D1 Swollen
* D2 – Thin at Posterior
* D3 – Very thin at posterior
* D4 – Total disc thin
* D5 – Total disc very thin
* D6 – Tatal disc extremely thin
122
What are the C2-C7 listings?
123
Full Gonstead Combined listings:
Segment – L5
Listing – PRS-M
Disc stage – D3
Technique – push
Table – PB
L5 PRS-M, D3, Push, PB
124
Full Gonstead Combined listings:
Segment – C7
Listing – PRS-inf
Disc stage – D4
Table – CC
C7 PRS-inf D4 CC
125
C2 PLI-La-Inf
126
C6 PRS-Inf
127
T1-T12 Listings?
128
L1-L4 Listings
129
L5 Listings
130
What shows that the cervical spine is is posterior?
- Flexion and extension MP
- Seperate and appear to move posterior
- In extension the SP will normally move forward and close together
131
What generates R or L in cervical?
- Rotation MP
The side of spine the spinoius process becomes more prominent is the side of spinous laterality
132
What generates S or I in cervical listings?
- Lateral flexion MP
The side of spine to which the SP travels furthest is the side of the open wedge
133
Where should the patient be seated in the cervical chair?
- Seated with hands on lap and legs extended in front
- Must be relaxed
134
Practitioner position for cervical chair?
- Directly behind patients
- Feet located within the legs of cervical chair
- Thrusting arm 90 degrees
135
What are the possible listings of an atlas?
* AR, AL
* ASR, ASL
* ASRA, ASRP
* ASLA, ASLP
* AIR, AIL
* AIRA, AIRP
* AILA, AILP
136
