1. Final Exam Review (NOT) = Not On Test
DIVERSIFED I
Final Exam Review
(NOT) = Not On Test

2. Manual Contacts (167) Pisiform Pollicus/Thenar Lateral Index
Can be used for recoil, lunge, and impulse hand heel
Pollicus/Thenar
Thumb is tucked, Chiropractic Arch
Lateral Index
Lateral aspect (in cervical) Prone & upine
Distal or Flat Thumb
Keep thumb adducted, (Upper Thoracic, Lower Cervical)
Modified Pollicus (Thenar)
1st Metacarpal phalangeal joint
Chiropractic Index
Thumb Pisiform
Double Thumb

3. Osseous Vertebral Contacts
Contact Points on Patient
Pelvis
PSIS (Most Often), ASIS, Sacral Ala/ Ischial Tuberocity (NOT)
Lumbar Spine
Spinous Process, Mamillary, IVD
Thoracic Spine
Spinous Process, Transverse Process, Rib
Lower Cervical (NOT)
Art. Pillars (capsule rotation), Lat. Aspect. Luschka Trauma
Upper Cervical (NOT)
Occiput, Mastoid, Atlas TP, C2 SP

4. HVLA: High Velocity, Low Amplitude
Speed and Specificity
Specific Osseous contact applied
Joint is taken to maximum resistance.
Specific Line of Drive (LOD) – forces directed and applied to joint
Move motor unit to voluntary end range
Sudden Load is applied, moving joint past its end range, creating cavitation.

5. Table Position - Prone Foot Piece elevated
Pelvic Piece at or below level of Greater Trochanter
Abdominal Piece is “UNLOCKED”
Head Piece level or slightly below.

6. Spinous Recoil Thrust Doctor’s Stance LOD – Anterio-Medially Execution
Faces in at 90° on same side of spinous laterality.
Pisiform Manual Contact
Doctor instructs Patient to turn head towards
LOD – Anterio-Medially
Execution
Lean in with (20-25 lbs) of pressure with flexed elbows
Quick Extension of Elbows – 1” with (60-65 lbs) of pressure with IMMEDIATE recoil

7. Lunge Thrust Doctor’s Stance LOD Execution Faces in at 45°
Any Manual Contact
Osseous Contact depends upon region of spine
LOD
Depends upon specific subluxation
Execution
Arms are fully extended, taking it to max resistance (55 lbs)
Front leg flexed, back leg extended
Transference of body weight from legs to extended arms
MISSING INFO GOES HERE

8. IMPULSE THRUST Doctor’s Stance LOD Execution Faces in at 45°
Any Manual Contact
Osseous Contact depends upon region of spine
LOD
Depends upon specific subluxation
Execution
Lean in with extended arms to max resistance (20-25 lbs)
Flex Elbows
For thrust, quickly contract pects and triceps, fully extending elbows
HOLD, then slowly release

9. Pelvic Accommodation STANDING SEATED
When the patient laterally flexes the Lumbar spine to the RIGHT:
PSIS - On the LEFT goes Posterior and Inferior
PSIS – On the RIGHT goes LEFT and Superior
SEATED
Patient flexes forward
PSIS’s go Posterior and Inferior
Patient extends backward
PSIS’s go Anterior and Superior
Goes Opposite to the direction the patient flexes/extends
Dr Filson might use the word “craniad” instead of ‘superior”

10. ARTHROKINEMATC REFLEX
Patient lies SUPINE, Grab by Ankles and Rotate
Internal Rotation - LEG SHORTENS
External Rotation – LEG LENGTHENS

11. Seated Evaluation (NOT)
Internal and external rotation with approximation and flaring of thighs
Flexion- Posterior Inferior
Extension- Superior Anterior
Motion Palpation

12. Sacrum Integral Parts of Pelvis “Keystone in an Arch”
Increased vertical load leads to an increase in SI joint surface bonding
Fracture will occur before dislocation
Supports Vertebral Column
Disperses weight from spine to pelvis
Transmits forces from lower limbs upward

13. SACROILIAC DYSFUNCTION
Most often a SYMPTOM rather than a PRIMARY cause of distortion
Common cause of low back “ache”, but not usually responsible for severe low back pain
The total pelvis tips, sways, and rotates in accommodation to eccentric weight imposition upon it
Unequal weight into each S/I Joint – leads to abnormal gait
Pelvis consistently responds to changes in weight didtribution

14. SACROILIAC DYSFUNCTION
The two most common biomechanical reason for low back pain from Spinal Anatomy are : disk and z joints and more times than not SI is secondary to these problems
Common Causes of SI Dysfunction include:
Pregnancy
Trauma to SI Joint
Repeated Bouncing (Truck Drivers)
Runners (running and leaning one direction on track)

15. Sectional Towering
Lateral Movement of the Spine away from the open wedge.
BASE – Where Primary open wedge is located
APEX – Found at the top of the sectional towering, open wedge on opposite side
ANATALGIA – Leaning of body away from side of open wedge

16. ANTALGIC POSTURE To the patients LEFT
Sectional Tower will be to the patients LEFT
Side of “Open Wedge” or BASE of the sectional tower will be on the patients RIGHT

17. Sectional Towering
APEX
ADJUST HERE
APEX
BASE
APEX
BASE

18. (Lateral Flexion to the right)
TYPICAL SUBLUXATION
APEX
Rotation with Lateral Flexion
(Lateral Flexion to the right)
Spinous Rotates TOWARD side of open wedge
Body rotates POSTERIOR INFERIOR
BASE
INTO CONCAVITY

19. (Lateral Flexion Malposition on the right)
ATYPICAL SUBLUXATION
APEX
Rotation with Lateral Flexion
(Lateral Flexion Malposition on the right)
Spinous Rotates AWAY from side of open wedge
Body rotates SUPERIOR POSTERIOR
Common in Scoliosis
Into convexity
BASE

20. POSTURAL ANALYSIS Discovering Spinal Curvatures
Pelvic and Shoulder Unleveling
Scapular Prominence

21. RIB HUMP

22. Palpation of Vertebral Malpositions
For ROTATIONAL MALPOSITIONS:
Spinous Deviation
Mamillary prominence on the opposite side
For LATERAL FLEXION MALPOSITION
Appearance of the base of a sectional tower of the spine
May or May Not have deviation of spinous at the base where there is deviation, it may be toward or away from the side of “open wedge”
Side of body rotation will be side of prominent mamillary

23. Damaging Stresses on the IVD
#1 Flexion with Axial Rotation
Flexion
Excessive Axial Compression
Degenerative Changes

24. PARTS P=PAIN Doctor’s notes may reflect: Observation Percussion
Location
Quality
Intensity
Observation
Percussion
Provocation
Palpation
Visual Analog Scales
Pain Questionaires

25. PARTS A= Asymmetry/Alignment
Doctor’s Notes MUST reflect:
Sectional or Segmental level
Observation
Posture
Gait
Palpation or X-Ray evidence of:
Misalignment
Asymmetry

26. PARTS R= Range of Motion Abnormality
Doctor’s Notes MUST reflect:
Decrease or Increase of:
Active, Passive, or Accessory Joint motion
Verified by:
Motion Palpation
Stress X-Ray

27. PARTS T= Tissue, Tone, Texture, Temp
Doctor’s Notes MAY reflect:
Abnormal Changes in:
Skin
Fascia
Muscle
Ligaments
Identified By:
Observation
Palpation
Instrumentation
Length and Strength

28. PARTS S= Special Tests Doctor’s Notes MAY reflect:
Test Specific to a technique system

32. As of Jan 1, 2000 Medicare no longer requires subluxation to be demonstrated by x-ray. SOAP notes must document the subluxation with at least two (2) of the P.A.R.T.S. components, two of which must be “A” and “R”.