Education

The Longitudinal Neurologic Systems

By Frank M. Painter|April 5, 2013|Chiropractic Education, Clinical Decision-making, Diagnosis, Education, Evaluation & Management, Neurology|

The Longitudinal Neurologic Systems

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 3 from RC’s best-selling book:

“Basic Principles of Chiropractic Neuroscience”

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 3: The Longitudinal Neurologic Systems

This chapter succinctly describes the basic structure and function of the six major longitudinal systems; viz, the sensory, motor, visceral, vascular, consciousness, and cerebrospinal fluid systems.

As we begin this chapter, it might be well for the reader to subjectively grasp the significance of the motor and sensory systems as far as possible. One exercise in this is to imagine that you had become unconscious and someone has placed you in a remote dark empty cellar, far beyond any source of environmental sound. The first thing you realize is that you are a total sensory and motor paralytic from the neck caudad. You are unable to move even a fingertip because your motor system is not functioning. Because there is no feeling, you do not know whether you are recumbent or tied in a chair. Your vision is normal, but there is no light. Your hearing is normal, but there is no sound. Your taste buds are functional, but there is nothing to eat or drink. Your olfactory organs are functional, but there are no detectable odors. There is little left except thought and memory.

After a time in this predicament, thoughts undoubtedly arise such as, “I wish I had really looked at the beauty of the world when I had a chance. I wish I had listened to the music of the masters and even the birds in my backyard when I had a chance. I gulped down so many delicious meals. I had a beautiful garden, but I rarely took time to appreciate its design and fragrance. I even failed to take time to appreciate the texture of my own clothes. I was in such a hurry to go nowhere that was more important. I missed so much.”

OVERVIEW

The human nervous system is a marvel in organizing and adapting to internal and external environmental changes:

(1) The receptors and afferent neurons of the visceral and somatic input systems are necessary to detect internal and external environmental changes.

(2) The visceral efferent neurons and the muscles of the motor output system must be stimulated if action is to be taken.

(3) The integrative system serves as intermediary stations via a complex arrangement of interneurons whose synapses control impulse strength and signal direction from the sensory system to the motor system.

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Sports Management: Introduction to Sports-related Health Care

By Frank M. Painter|April 2, 2013|Chiropractic Care, Clinical Decision-making, Education, Sports|

Sports Management: Introduction to Sports-related Health Care

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 1 from RC’s best-selling book:

“Chiropractic Management of Sports and Recreational Injuries”

Second Edition ~ Wiliams & Wilkins

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 1: Introduction to Sports-related Health Care

If you were to ask the average coach about the responsibilities of an athlete, he would most likely reply that he or she was to conduct one’s self to the credit of the team, play fair, obey the officials, keep in training, be a credit to the sport, follow the rules, and enjoy the game: win or lose. This is the rhetoric commonly spooned to the naively inclined. If it were true, fewer sports injuries would be suffered.

With rare exception, even the Little Leaguer is commonly taught to WIN, drilled to disguise foul play from the eyes of the referees and umpires. Even in so-called noncontact sports, emphasis is often placed on getting the other team’s stars out of the game without causing injury to your own team. While conditioning is emphasized, the motivation is frequently on the preservation of a potential winning season rather than on prevention of a personal injury to a human being.

These words are harsh, but realistic. Yet, doctors handling athletic injuries must have a realistic appraisal of sports today if they are in good conscience to properly evaluate disability and offer professional counsel.

The Art of Evaluation

All people participating in vigorous sports should have a complete examination at the beginning of the season; and re-evaluation is often necessary at seasonal intervals. Re-evaluation is always necessary with cases where the candidate has suffered a severe injury, illness, or had surgery.

Evaluation begins with questioning. Because of drilled routine, any doctor is well schooled in the taking of a proper case history. But with an athletic injury, both obvious and subtle questions often appear. How extensive was the preseason conditioning? How much time for warm up is allowed before each game or event? What precautions are taken for heat exhaustion, heat stroke, concussion, and so forth? Does the coach make substitution immediately upon the first sign of disability for proper evaluation? How adequate is the protective gear? How many others on the team have suffered this particular injury this season?

Who, what, when, where, how, and WHY? These are the questions which must be answered before any positive course of health care can be extended. A detailed history of past illness and injury is vital. In organized sports, an outline of the regimen of training should be a part of the history, as well as a record of performance. Most sports will require a detailed locomotor evaluation of the player. Special care must be made in evaluating the preadolescent competitor because of the wide range of height, weight, conditioning, and stages of maturation. A defect may bar a candidate from one sport but not another, or it may be only a deterrent until it is corrected or compensated. Many famous athletes have become great in spite of a severe handicap.

The Physician’s Responsibilities (more…)

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For CAs: The Language of the Health-Care Professions

By Frank M. Painter|March 31, 2013|Chiropractic Care, Chiropractic Education, Education, Evidence-based Medicine|

For CAs: The Language of the Health-Care Professions

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 4 from RC’s best-selling book:
“The Chiropractic Assistant”

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 4: The Language of the Health-Care Professions

When more than one person is involved in any task, good communication is basic for success. Thus, a sound foundation in chiropractic terminology is an important functional skill to be possessed by any chiropractic assistant. It is a requisite to becoming an important asset to the office.

If a CA’s duties include taking dictation of case histories, examination findings, or narrative reports, she must know how to record scientific terms in shorthand and know how to spell them accurately. A good medical dictionary will be an important reference. Even if dictation is not required, she still must know what the doctor means when certain terms are used. He will expect his assistants to have a fundamental grasp of commonly used medical terms, abbreviations, and acronyms.

Do not enter this study lightly. On the other hand, do not let yourself be appalled by the formidable and specialized vocabulary used in health care. The learning of professional terms will not come overnight. It will extend the entire length of your career as new and unfamiliar words are confronted.

THE UNIVERSAL LANGUAGE OF HEALTH CARE: WHY IT IS NECESSARY

It would not be unusual if you found many words used in the first three chapters of this program strange or at least unknown. When you undertake the transposition from lay person to chiropractic assistant, you are faced with an entirely new language that must be mastered so the transition be successful. The most efficient method to accomplish this is by securing an understanding of basic word roots, prefixes, and suffixes used in the formation of technical words and gaining an understanding of the meaning of commonly used abbreviations and acronyms. Study and repetitive use is the way to mastery.

A fundamental knowledge of anatomy (structure) and physiology (function) will be of great assistance in learning terminology. A basic understanding of human anatomy and physiology is offered in the following chapter. This chapter will prepare you for the terminology of those and other clinical subjects. While professional terms may at first seem strange, you will see their purpose in this and following chapters.

PHONETICS: THE QUICK WAY TO GRASP MEANINGS (more…)

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Clinical Biomechanics: Mechanical Concepts and Terms

By Frank M. Painter|January 6, 2013|Chiropractic Care, Clinical Decision-making, Diagnosis, Education, Evaluation & Management, Spinal Manipulation|

Clinical Biomechanics: Mechanical Concepts and Terms

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 2 from RC’s best-selling book:

“Clinical Biomechanics:
Musculoskeletal Actions and Reactions”

Second Edition ~ Wiliams & Wilkins

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 2: Mechanical Concepts and Terms

All motor activities such as walking, running, jumping, squatting, pushing, pulling, lifting, and throwing are examples of dynamic musculoskeletal mechanics. To better appreciate the sometimes simple and often complex factors involved, this chapter reviews the basic concepts and terms involved in maintaining static equilibrium. Static equilibrium is the starting point for all dynamic activities.

Energy and Mass

Biomechanics is constantly concerned with a quantity of matter (whatever occupies space, a mass) to which a force has been applied. Such a mass is often the body as a whole, a part of the body such as a limb or segment, or an object such as a load to be lifted or an exercise weight. By the same token, the word “body” refers to any mass; ie, the human body, a body part, or any object.

Energy

Energy is the power to work or to act. Body energy is that force which enables it to overcome resistance to motion, to produce a physical effect, and to accomplish work. The body’s kinetic energy, the energy level of the body due to its motion, is reflected solely in its velocity, and its potential energy is reflected solely in its position. Mathematically, kinetic energy is half the mass times the square of the velocity: m/2 X V524. In a closed system where there are no external forces being applied, the law of conservation of mechanical energy states that the sum of kinetic energy and potential energy is equal to a constant for that system.

Potential energy (PE), measured in newton meters or joules, is also stored in the body as a result of tissue displacement or deformation, like a wound spring or a stretched bowstring or tendon. It is expressed mathematically in the equation PE = mass X gravitational acceleration X height of the mass relative to a chosen reference level (eg, the earth’s surface). Thus, a 100-lb upper body balanced on L5 of a 6-ft person has a potential energy of about 300 ft-lb relative the ground.

The Center of Mass

The exact center of an object’s mass is sometimes referred to as the object’s center of gravity. When an object’s mass is evenly distributed throughout, the center of mass is located at the object’s geometric center. In the human body, however, this is infrequently true, and the center of mass is located towards the heavier, often larger, aspect. When considering the body as a whole, the center of mass in the anatomic position, for instance, is constantly shifted during activity when weight is shifted from one area to another during locomotion or when weight is added to or subtracted from the body.

The term weight is not synonymous with the word mass. Body weight refers to the pull of gravity on body mass. Mass is the quotient obtained by dividing the weight of a body by the acceleration due to gravity (32 ft/sec524). Each of these terms has a different unit of measurement. Weight is measured in pounds or kilograms, while mass is measured by a body’s weight divided by the gravitational constant. The potential energy of gravity can be simply visualized as an invisible spring attached between the body’s center of mass and the center of the earth. The pull is always straight downward so that more work is required to move the body upward than horizontally (Fig. 2.1).

Newton’s Laws of Mechanics

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Clinical Biomechanics: General Spinal Biomechanics

By Frank M. Painter|January 3, 2013|Chiropractic Care, Clinical Decision-making, Education|

Clinical Biomechanics: General Spinal Biomechanics

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 6 from RC’s best-selling book:

“Clinical Biomechanics:
Musculoskeletal Actions and Reactions”

Second Edition ~ Wiliams & Wilkins

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 6: General Spinal Biomechanics

This chapter discusses the vertebral column as a whole and serves as a foundation for the following three chapters that consider the regional aspects of the spine and pelvis. Emphasis here is on gross structure, function, spinal kinematics, and other general biomechanical implications.

Background

The vertebral column is a mechanical marvel in that it must afford both rigidity and flexibility.

The Spine as a Whole

The segmental design of the vetebral column allows adequate motion among the head, trunk, and pelvis; affords protection of the spinal cord; transfers weight forces and bending moments of the upper body to the pelvis; offers a shockabsorbing apparatus; and serves as a pivot for the head. Without stabilization from the spine, the head and upper limbs could not move evenly, smoothly, or support the loads imposed upon them (Fig. 6.1).

Essentially because of its various adult curvatures, the bony spine is anatomically divided into the seven cervical vertebrae, the twelve thoracic vertebrae, the five lumbar vertebrae, and the ossified five sacral and four coccygeal segments. From C1 to S1, the articulating parts of these vertebrae are the vertebral bodies, which are separated by intervertebral discs (IVD’s), and the posterior facet joints. The IVD’s tend to be static weight-bearing joints, while the facets function as dynamic sliding and gliding joints.

WEIGHT DISTRIBUTION

The flexible vertebral column is balanced upon its base, the sacrum. In the erect position, weight is transferred across the sacroiliac joints to the ilia, then to the hips, and then to the lower extremities. In the sitting position, weight is transferred from the sacroiliac joints to the ilia, and then to the ischial tuberosities.

SPINAL LENGTH

About 75% of spinal length is contributed by the vertebral bodies, while 25% of its length is composed of disc material. The contribution by the discs, however, is not spread evenly throughout the spine. About 20% of cervical and thoracic length is from disc height, while approximately 30% of lumbar length is from disc height. In all regions, the contribution by the discs diminishes with age.

Development of the Spine

In brief, development occurs in three stages: mesenchymal, chondrification, and ossification.

MESENCHYMAL AND CHONDRIFICATION ORIGINS

Just prior to the 4th week of embryonic development, a vertebral segment begins to develop as paired condensations of mesenchyme (somites) around the longitudinal notochord and dorsal neural tube. One or usually two chondrification centers appear (6 weeks) in the centrum and begin to form a cartilaginous model surrounded by anterior and posterior longitudinal ligaments which are complete by 7-8 weeks. Chondrification centers also form in the neural arches and costal processes. A thick ring of nonchrondrous cells establishes the model IVD around the longitudinal string of beaded notochordal segments (Fig. 6.2). (more…)

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Introduction to Chiropractic Physiologic Therapeutics

By Frank M. Painter|November 10, 2012|Chiropractic Care, Diagnosis, Education, Physical Therapy|

Introduction to Chiropractic Physiologic Therapeutics

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 10 from RC’s best-selling book:

“Basic Chiropractic Procedural Manual”

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 10: Introduction to Chiropractic Physiologic Therapeutics

The use of physiotherapy and physical therapy to enhance the effects of the chiropractic adjustment in treatment can be significant in many cases. Superficial heat, diathermy, cold, microwaves, ultrasound, ultraviolet rays, galvanic and sinusoidal currents, traction, hydrotherapy, or therapeutic massage and exercise are among the therapies that may benefit the patient when properly applied. These procedures may help to reduce stiffness in joints, relieve tension, relax muscle spasm, and offer many other physiologic benefits.

Special precautions, however, must be observed when treating patients of advanced age. Special consideration must also be given to indications and contraindications, patient sensitivity, intensity, and duration of treatment.

Special caution must be used with patients that have heart and blood pressure problems, renal failure, diminished sensation or circulation, or an inability to tolerate heat or cold. For example, patients with Raynaud’s disease do not tolerate cold. Patients with other circulatory problems do not tolerate thermotherapy because they have less ability to dissipate the heat. Patients with a distinct loss of sensation will not realize if an area is being overheated or even being burned.

A patient’s tolerance cannot be the only guide to intensities and duration of treatment. Frequent checking, both visually for redness and by palpation to determine over heating, must be done during the treatment period. Reasonable examination, monitoring, and care by the doctor can avoid problems in most instances.

INTRODUCTION

Physiotherapy techniques are frequently used preparatory to the chiropractic adjustment to improve function, relieve spasm, minimize pain, and enhance circulation and drainage. They are often used before primary care to relax the patient and condition tissues, and posttherapy to relive pain and prevent deformities resulting from trauma or disease and to maintain what has been gained in treatment. There are also times when it may be considered primary therapy. Rehabilitation objectives are shown in Table 10.1. (more…)

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