Education

Clinical Chiropractic: The Elbow and Forearm

By Frank M. Painter|November 14, 2011|Diagnosis, Education|

Clinical Chiropractic: The Elbow and Forearm

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 8 from RC’s best-selling book:

“Clinical Chiropractic: Upper Body Complaints”

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 8: The Elbow and Forearm

CLINICAL BRIEFING

Functional Considerations

The arm and forearm are joined by a joint that serves as both a hinge and a pivot. The semilunar notch of the ulna is hinged with the hyperboloid trochlea of the humerus. The proximal head of the radius pivots with the spherical capitulum of the humerus and glides against both the proximal and distal ends of the ulna.

The distal end of the humerus can be viewed as two columns: a larger one medially that articulates with the semilunar notch of the ulna, and a smaller one laterally that articulates with the head of the radius. The pulley-like trochlea apparatus has:

(1) a depression at the front that lodges the coronoid process of the ulna and

(2) a depression at the rear that holds the olecranon process of the ulna when the elbow is extended.

The olecranon process restricts hyperextension of the elbow and protects the ulnohumeral articulation posteriorly. The concave head of the radius glides against the spherical capitulum of the humerus. The capitulum and trochlea are separated by a bony crest that fits into the opening between the proximal ulna and the radius and serves as a fixed rudder to guide elbow motion. The elbow flexors originate from the medial epicondyle, and the extensors originate from the lateral epicondyle. This structural arrangement should be visualized during examination to discriminate normal from abnormal articular motion.

The basic range of elbow joint motion involves elbow flexion (135°) and extension (0°), and forearm supination (90°) and pronation (90°). If a motion block is found in active motion, passive motion should be checked and the type of restriction and its degree noted.

Clinical Analysis

The elbow joint was not made to be used as an organic battering ram, but it often is: purposefully in sports; by accident in falls. For this reason, the vast majority of elbow disorders has trauma as their origin or precipitating factor. (more…)

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General Factors Involved in Vitamin and Mineral Deficiencies

By Frank M. Painter|November 13, 2011|Diagnosis, Education, Nutrition, Supplementation|

General Factors Involved in Vitamin and Mineral Deficiencies

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 the Appendix from RC’s best-selling book:

“Symptomatology and Differential Diagnosis”

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.

General Factors Involved in Vitamin and Mineral Deficiencies

Several general factors are involved in vitamin and mineral deficiencies. For example, abnormal loss and utilization or subnormal absorption, intake, storage, or transport, singularly or in combination, may readily lead to symptoms of nutritional deficiency.

See Table A.1.

You may also find value reviewing the:

Nutrient–Drug Depletion Charts

Agents Contributing to Vitamin, Mineral, and Other Nutrient Deficiency Symptoms

Drugs and nutrients often have adverse interactions. Drugs usually interfere with normal cellular nutrition by:
(1) depressing the central appetite center,
(2) decreasing normal blood levels (eg, excessive excretion),
(3) interfering with the nutrient’s storage or metabolism,
(4) developing a chemical antagonism (eg, inactivate),
(5) increasing the action of ingested antivitamins or antiminerals, or
(6) destroying intestinal bacteria necessary to synthesize the nutrient.

See Tables A.2, A.3, and A.4.
(more…)

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The Posterior Neck and Cervical Spine

By Frank M. Painter|November 12, 2011|Cervical Spine, Diagnosis, Education|

The Posterior Neck and Cervical Spine

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 5 from RC’s best-selling book:

“Symptomatology and Differential Diagnosis”

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 5: The Posterior Neck and Cervical Spine

Introduction

With the important exception of neurologic and vertebral artery syndromes, most of the disorders witnessed in the posterior aspect of the neck are musculoskeletal conditions. Of particular significance are the symptom complexes of cervical arthritis, deformities, disorders of muscle tone, IVD syndromes, spondylosis, vertebral subluxation, tumors, and the effects of trauma. It is helpful to keep in mind that tumors of the cervical spine are usually secondary and that chronic degenerative disc disease and congenital anomalies may be asymptomatic for many years.

Functional Considerations

Nowhere in the spine is the relationship between the osseous structures and the surrounding neurologic and vascular beds as intimate or subject to disturbance as it is in the neck. Many peripheral nerve symptoms in the shoulder, arm, and hand will find their origin in the brachial plexus and cervical spine.

The gross mechanical function of the neck is determined by analysis of joint motion and muscle strength.

EVALUATING JOINT MOTION OF THE NECK

Gross joint motion is roughly screened by inspection during active motions. When a record is helpful, it is usually measured by goniometry. The prime movers and accessories responsible for voluntary joint motion in the cervical region are shown in Table 5.1.

EVALUATING MUSCLE STRENGTH OF THE NECK

Muscle strength is recorded as from 5 to 0 or in a percentage and compared bilaterally whenever possible. The major muscles of the neck, their primary function, and their innervation are listed in Table 5.2.

Structural and Neurologic Considerations

The healthy posterior neck provides stability and support for the cranium, a flexible and protective spine for movement, balance adaptation, and housing for the spinal cord and vertebral artery. From a biomechanical viewpoint, primary cervical subluxation syndromes may reflect themselves in the total habitus; from a neurologic viewpoint, insults may manifest throughout the motor, sensory, and autonomic nervous systems. Unlike the lumbar region, cervical disc herniations are not frequently associated with severe trauma; however, traumatic nerve root or cord compression has a high incidence in this area.

A general classification of musculoskeletal disorders of the neck is shown in Tables 5.3, and the function of the nerves of the cervical plexus and the brachial plexus is shown in Tables 5.4 and 5.5.

Anomalies and Deformities

Gross anomalies are rarely seen in chiropractic practice unless well adapted to the individual’s life-style. Those cases that have biomechanical significance vary in severity from minor to severe and occur multiply or singly. The cause is purely genetic transmission in about 35% of cases, and the remainder is due to environmental factors or a mixture of genetic and environmental factors. (more…)

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Redefining the Rules: The CCE Changes Its Standards From Quantitative to Qualitative

By Frank M. Painter|September 14, 2011|Education|

Redefining the Rules: The CCE Changes Its Standards From Quantitative to Qualitative

The Chiro.Org Blog

SOURCE: Todays Chiropractic

By Randy Southerland

Early next year, chiropractic colleges across the nation will adopt a new set of accreditation standards. Significantly, this will be the first wholesale rewriting of the standards in more than three decades.

Set by the Council on Chiropractic Education (CCE), these rules define what programs must do to gain or maintain CCE accreditation. In a marked departure from past years, the standards will now allow greater freedom in how D.C. programs admit and educate students, while requiring more accountability for producing competent professionals. “It’s a change in the way institutions go about delivering education,” says Dr. Brian McAulay, executive vice president and provost at Life University.

The new standards, which take effect in January 2012, are less prescriptive, with fewer demands that programs offer specific courses or use particular teaching methods such as requiring D.C. students to deliver 250 adjustments. Rather, the standards reflect an emerging focus on setting and measuring learning outcomes for students. It’s a trend that has become commonplace in higher education nationally, but is only now being adopted by the chiropractic profession, according to McAulay.

“Rather than focusing on credit hours and the amount of time a student spends in a seat, an outcomes approach asks ‘What has a student actually learned?’” he explains. “This approach is about holding institutions accountable for being very clear on what the student is expected to learn, and then being very good at measuring and assessing whether that learning has taken place.”

The U.S. Department of Education charges accrediting agencies such as the CCE with periodically reviewing standards to ensure they reflect best practices in the profession and in the broader field of education. A team comprising personnel from CCE-accredited programs began this process in the summer of 2006. Its mission was to look at every aspect of the agency’s accrediting standards, and then bring them more in line with current thinking and practices in higher education. (more…)

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Fundamentals of Initial Case Management Following Trauma

By Frank M. Painter|July 15, 2011|Education|

Fundamentals of Initial Case Management Following Trauma

The Chiro.Org Blog

By Richard C. Schafer, DC, PhD, FICC

The following 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.

Without a doubt, no other health-care approach equals the efficacy of chiropractic in the general field of conservative neuromusculoskeletal rehabilitation.

For many centuries, therapeutic rehabilitation was a product of personal experience passed on from clinician to clinician. In the last 20 years, however, it has become an applied science. In its application, of course, much empiricism remains that can be called an intuitive art –and this is true for all forms of professional health care.

INTRODUCTION

The word trauma means more than the injuries so common with falls, accidents, and contact sports. Taber¹ defines it as “A physical injury or wound often caused by an external force or violence” or “an emotional or psychologic shock that may produce disordered feelings or behavior.” This is an extremely narrow definition for trauma can also be caused by intrinsic forces as seen in common strain. In addition to its cause being extrinsic or intrinsic, with a physical and emotional aspect, it also can be the result of either a strong overt force or repetitive microforces. This latter factor, so important in treating a unique patient’s specific pathophysiology, is too often neglected outside the chiropractic profession.

Taber¹ states rehabilitation is “The process of treatment and education that lead the disabled individual to attainment of maximum function, a sense of well being, and a personally satisfying level of independence. The person requiring rehabilitation may be disabled from a birth defect or from an illness. The combined effects of the individual, family, friends, medical, nursing, allied health personnel, and community resources make rehabilitation possible.” It is surprising that Taber excludes trauma as a prerequisite for rehabilitation for it is the most common factor involved.

Other authors define rehabilitation strictly in terms of exercise and restorative therapeutic modalities and regimens. Some limit the term to preventing or reversing the noxious effects of the inactivity or lessened activity associated with the healing process. While it is true that these definitions hold significant components of clinical reconditioning and restoration, the scope of rehabilitation means much more to the chiropractic physician. (more…)

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Introduction to the Dynamic Chiropractic Paradigm

By Frank M. Painter|June 14, 2011|Diagnosis, Education|

Introduction to the Dynamic Chiropractic Paradigm

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.

The following is Chapter 1 from RC’s best-selling:

“Motion Palpation”

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 THE DYNAMIC CHIROPRACTIC PARADIGM

Overview of the Dynamic Chiropractic Approach

This chapter presents an overview of the background and basic concepts of Dynamic Chiropractic. The normal motions of spinal and related articulations, general considerations of spinal fixations, the different types of fixations, the significant physiologic mechanisms associated, a comparison of traditional and modern definitions of the vertebral subluxation complex, and other basic concepts are summarized.

In 1936, a small group of Belgium chiropractors began what was to be a long research project. Its aim was to study what chiropractors refer to as a subluxation, which is traditionally defined as an incomplete dislocation, a displacement in which the articular surfaces have not lost contact, or a partially reduced (spontaneously) dislocation.

Outstanding within the Belgium group were Drs. H. Gillet and M. Liekens. These investigators, who have been involved in this study for more than half a century, soon found that the clinical phenomenon of subluxation was a great deal more complicated than the effects of the oversimplified picture of “a bone out of place” that has been commonly proposed since the turn of the century. Their findings reported in the Belgium Research Notes are a testimony to their skillful observations. Although the theory of “a displaced vertebra” contained enough truth within it to constitute a basic therapeutic approach that could be justified by large numbers of positive benefits witnessed empirically, it was not sufficient to serve as a scientific hypothesis. (more…)

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