|1st cervical:||Has no spinous process. The transverse processes are just below and in front of the tips of the mastoid processes.|
|2nd cervical:||Has the first spinous process below the occiput.|
|3d. cervical:||The spinous process is very difficult to palpate, since it lies beneath the overlapping spinous process of the axis, and can be felt only when the neck is flexed.|
|4th cervical:||The spinous process is the third that can be palpated when the neck is flexed.|
|5th cervical:||The fourth palpated when the neck is flexed.|
|6th cervical:||The spinous process is directly above the vertebra prominens.|
|7th cervical:||Easily recognized by the great length of its spinous process.|
|1st dorsal:||The spinous process is in line with the superior portion of the spine of the scapula.|
|2nd dorsal:||The spinous process corresponds with the head of the third rib.|
|4th dorsal:||The spinous process is opposite the junction of the first and second parts of the sternum.|
|5th dorsal||Easily determined by counting upward from the 7th D.|
|6th dorsal:||Directly above the sevent h.|
|7th dorsal:||The spinous process corresponds to the inferior angle of the scapula when the subject is sitting with the arms hanging at the sides, and half an inch above when the subject is lying prone.|
|8th dorsal:||Directly below the 7th dorsal.|
|9th dorsal:||The second from the 7th dorsal.|
|10th dorsal:||The spinous process is on the level of the ensiform cartilage of the sternum.|
|11th dorsal:||First below the 10th dorsal.|
|12th dorsal:||The spinous process corresponds to the head of the last rib.|
|1st lumbar||Recognized by counting upward from the 4th lumbar.|
|2nd lumbar||Recognized by counting upward from the 4th lumbar.|
|3rd lumbar||Directly above the 4th lumbar.|
|4th lumbar||The spinous process is situated at the level of a line drawn between the iliac crests.|
|5th lumbar||Directly below the 4th lumbar and above the sacrum.|
DEFINE AND DESCRIBE A SPINAL SEGMENT.
A spinal segment is that part of the cord contained between two sets of roots. Each segment must be regarded as a unit endowed with motor, sensory, trophic, vasomotor, and reflex functions in respect to the parts supplied by the roots of the nerves which emerge from and enter it. A segment is named from the nerve-roots which take their origin from it, and not from the vertebra with which it corresponds.
NAME THE SYMPTOMS AND SIGNS OF VERTEBRAL
NAME THE VARIOUS FORMS OF SUBLUXATIONS.
- Right lateral
- Left lateral
- Right posterior
- Left posterior
- Right inferior
- Left inferior
These are classed as simple subluxations. In addition there may exist combinations of two or more simple subluxations, constituting compound subluxations.
GIVE A METHOD OF PALPATION OF THE SPINOUS PROCESS.
In palpating the tips of the spinous processes one may commence either in the lumbar region and pass upward, or begin with the first thoracic vertebra and pass downward. In palpating the spinous processes each one should be felt and the exact point of position of its tip marked on the skin overlying it.
GIVE METHOD OF PALPATION OF THE TRANSVERSE PROCESSES.
In palpating the transverse processes it is advised to use the tips of the first three fingers of each hand; one finger being placed on a transverse process in such a manner as to enable the palpator to make comparison between three vertebrae.
NAME THE VARIOUS POSITIONS FOR THE PURPOSE OF MAKING SPINAL ANALYSIS.
The erect position, the prone position, the dorsal position, and the Adams position.
DESCRIBE THE METHODS USED TO DETERMINE THE EXACT NATURE OF SUBLUXATIONS.
Inspection: By this we note the following points:
Palpation: By which we note the following points:
X-Ray: To verify the findings of inspection and palpation.
GIVE THE POSITIONS OF THE SPINOUS AND TRANSVERSE PROCESSES IN EACH FORM OF SUBLUXATION.
Antero-Inferior subluxation: The spinous process is displaced upward and backward. The transverse processes are displaced forward and upward to the same degree on each side.
Postero-inferior subluxation: The spinous process is displaced downward and forward. The transverse processes are displaced backward and downward to the same extent on either side.
Posterior subluxation: The spinous process is displaced backward. The transverse processes are displaced backward to the same extent on each side.
Anterior subluxation: The spinous process is displaced forward. The transverse processes are displaced forward equally on each side. Inferior subluxation: The spinous processes of two vertebrae are approximated, that of the subluxated vertebra downward upon the vertebra below. The transverse processes on both sides of two vertebrae are approximated.
Right and left inferior subluxation: The spinous process is displaced toward the side away from the side compressed. The transverse process is displaced downward on the compressed side, while that of the other side is raised.
Lateral subluxation: The spinous process is displaced to one side. The transverse process projects laterally in the cervical region, and in the thoracic region the transverse processes on one side is drawn away from the line of the spinous processes, while on the other side it approaches this line.
Right or left posterior subluxation: The spinous process is displaced slightly to one side. The transverse process of one side is forward, while on the side on which the subluxation exists it is displaced posteriorly.
Kyphotic subluxation: The spinous processes are displaced and the distance between them increased. The transverse processes are displaced posteriorly and separated.
Lordotic subluxation: The spinous processes are displaced anteriorly and set close to each other. The transverse processes on both sides are displaced forward and approximated.
Scoliotic subluxation: The spinous processes are displaced laterally. The transverse processes are displaced to the side, and rotation of the vertebrae is frequently present.
DEFINE SPINAL ADJUSTING.
The replacement to their normal position of subluxated vertebrae for the purpose of relieving pressure upon the nerves, and thus restoring to the parts supplied by these nerves their proper innervation.
HOW IS A CHIROPRACTIC ADJUSTMENT ACCOMPLISHED?
By the application of a: definite thrust by the hands of the operator in contact with the affected vertebra.
WHAT IS THE IMMEDIATE EFFECT OF A CHIROPRACTIC THRUST?
A momentary relaxation of the ligaments of one side, permitting the ligaments of the opposite side which had been stretched beyond the limit of their elasticity, to return to their original condition.
DEFINE VERTEBRAL PALPATION.
Vertebral palpation consists in the use of the tactile sense to determine the number, position, relation, size, shape, and as far as possible the condition of, the segments of the spinal column, in order to discover the primary causes indicative of disease.
DEFINE NERVE TRACING.
Nerve tracing is that branch of palpation by which the tendernessof irritated spinal nerves is discovered and their paths demonstrated.
DEFINE ORGAN TRACING.
Organ tracing is that branch of palpation which deals with the outlining of the boundaries and surface markings of a tender organ or part.
WHAT NERVES ARE TRACEABLE?
Any spinal nerve may be traceable for at least a part of its course. The cranial nerves are not traceable, except the spinal portion of the spinal accessory and the terminal portions of the nerves to the face. The sympathetic trunks are not traceable, except perhaps in the neck. Only such nerves are traceable that are irritated and consequently swollen and tender. If a nerve is very heavily impinged, especially if the impingement is chronic, it is partially or wholly paralyzed and not traceable. If the heavy impingement be acute or if the impingement be light, nerve tracing is a real aid to diagnosis.
STATE BRIEFLY THE TECHNIC OF NERVE TRACING.
The operator, having made his vertebral palpation, may begin at some point in the body indicated by the symptoms of disease and, finding tenderness, follow the path of a nerve back to the spinal column where it is presumed to enter the intervertebral foramen. Or he may use palpation as a guide and follow the tender nerves outward, to their periphery. This is a better method. Use second finger of either hand as the palpating finger, choosing the hand which can be most conveniently used, as determined by the position of patient and part of the body to be examined. Reinforce this second finger by the pressure upon it of the first and third fingers and also, if desired, by the pressure of the thumb against it. Apply the tip of the palpating finger to the nerve with a motion such that it crosses the path of the nerve at right angles back and forth. Meanwhile, the probable path of the nerve must be kept in mind. As the finger crosses the nerve-path it makes steady and even pressure upon any structures beneath it. The motion of the hand is a semi-rolling motion, the finger tip probing for the tender spot. These tender spots should be noted and marked at about one inch intervals.
STATE THE CHIROPRACTIC HYPOTHESIS.
Chiropractic has accepted, as a convenient working hypothesis, that all disease in the human body is primarily made possible by injury to (stimulation or inhibition of) some part of the nervous mechanism.
WHAT ARE THE SERIES OF EVENTS THAT TAKE PLACE IN PRODUCTION OF DISEASE?
NAME SOME CONDITIONS THAT ACT AS SECONDARY CAUSES IN THE PRODUCTION OF DISEASE.
WHAT IS THE CHIROPRACTIC THEORY REGARDING SECONDARY CAUSES OF DISEASE?
None of the secondary causes can operate without previous subluxation. A subluxation may produce disease without the aid of any secondary cause.
WHAT IS THE CHIROPRACTIC CONCEPTION REGARDING THE CURE OF DISEASE?
That Nature is the only real curative agent and that we contain within our own bodies the possibilities of perfect normality. The Chiropractor assists the body by adjusting displaced structure and affording the body a free and unhindered opportunity for the exercise of its own healing powers.
STATE THE PROPER ORDER IN MAKING A CHIROPRACTIC EXAMINATION.
WOULD YOU ADJUST A CASE OF POTT'S DISEASE?
No, for fear that the affected vertebrae would fracture.
WOULD YOU ADJUST A PREGNANT WOMAN IN HER LAST TRIMESTER?
Absolutely. It will facilitate her labor by aiding the cervix to elax.
HOW CAN YOU DIAGNOSE AN ANKYLOSED VERTEBRA?
By moving the patient back and forth and sideways. If there is movement between the vertebra in question, and the one above and below; the vertebra is not ankylosed. If the interspaces between the vertebra are not changed by motion, ankylosis may be suspected.
HOW WOULD YOU DETERMINE A BENT SPINOUS?
If the vertebra in question is subluxated the transverse process on the opposite side will be palpable and appear higher than its fellows.
WHAT IS THE CHIROPRACTIC VIEW OF THE GERM THEORY AS THE CAUSE OF DISEASE?
That the germs are only capable of invading tissue void of proper nerve innervation. If the tissues are healthy, the germs will not be able to propogate and elaborate their toxins because healthy tissue is a poor culture media for their growth.
DEFINE A SPECIFIC ADJUSTMENT.
To adjust specifically the segment which enervates the organ diseased.
IS THE SEVENTH CERVICAL ALWAYS THE VERTEBRA PROMINENS?
Only in about 65% of the cases. The sixth cervical or the first dorsal may be vertebra prominens in the other 35% of the cases.
WHAT IS A MAL-ADJUSTMENT?
Is the driving of the vertebra in the wrong direction, increasing the already existing subluxation or causing subluxation of a properly aligned vertebra.