I. Concepts of Chiropractic Principles - 3 Hours

A. Brief History of Chiropractic According to D.D. Palmer.
B. Principles of Chiropractic
1. Subluxation and Dis-Ease

a. Poisons
b. Trauma
c. Autosuggestion
2. Correlation of Cause

a. Lifestyle As Cause
b. Subluxation As Cause
c. Subluxation As Effect
C. Holistic Health Model for Chiropractic

1. Managing the Three Causes of Dis-Ease

a. Doctors' Responsibility
b. Patients' Responsibility

II. Patient Care and Clinical Management - 3 Hours

A. Ethical and Professional Principles
1. The Doctor-Patient Relationship
a. Rapport
b. Partnership for Health
B. Scientific Basis and Investigation
C. Patient Education and Wellness Principles
1. Lifestyle Strategies for the Patient (Behavior Modification)
a. 4 Laws of the Body
b. Spinal and Nervous System Hygiene
c. Basic Stress Management

III. Diagnostic Procedure and Practice - 5 Hours

A. Subluxation Analysis
1. Occipital Palpation
a. Explanation and Correlation to Level of Vertebral Sublimation Complex

This Subluxation Analysis Technique requires the Doctor to define the Superior Nuchal Line of the Occipital Bone. The center of this line is bisected by the bump of the Occipital Protuberance (E.O.P.) defining a left and right arc on each side of the skull. The left and right arcs are then divided into six equal spaces, beginning at the point over the Occipital Groove of the mastoid portion of the temporal bone on each side. Each space, on the tight and left sides, is consecutively numbered 1-6, moving medially to the E.O.P. These divisions, called Nerve Centers, correlate with the six systems of the body and are classified as Center 1, Center 2, Center 3, etc., with six Centers on each side of the Occipital Protuberance.

b. Demonstration of Palpable Occipital fibers and their related Neurological       Assessment
1. Spinal Levels Involved
2. Neurological Disturbance

A patient's spinal and nervous system condition is determined by palpating these Nerve Centers on first one side, and then me other. If the Doctor locates a tense or tender ligament in any of the Centers, there is most likely a neurological disturbance in that Nerve Center, and related vertebral subluxation in the spine. A slight pressure on the tense ligament will bring a protest from the patient, who immediately notices pain or tenderness in the involved Center. More than one Center may be tight or tender, and perhaps all Centers are tender. Find the Center(s) which are most affected and this becomes the primary finding.

c. Practice Session
2. Detection of Vertebral Subluxation Complex
a. Occipital Fiber Palpation Correlated to Spinal Levels
b. Integrating Neurological Analysis with Adjustment Technique
c. Integrating the Neurological Analysis with Standard Chiropractic Analysis Methods
1. Motion and Static Palpation
2. Postural Analysis
3. X-ray Spinography
4. Orthopedic-Neurological
5. Skin Temperature
6. Electro-physiological Procedures
7. Para Spinal Muscle Dysfunction
B. Neurological Assessment
1. Center l Glandular Disturbance
2. Center 1 Eliminative Disturbance
3. Center 3 Nerve Disturbance
4. Center 4 Digestive Disturbance
5. Center 5 Muscular Disturbance
6. Center 6 Circulatory Disturbance
C. Establishing a Diagnosis
D. Facilitate Neurological/ Biomechanical Recovery Through Appropriate Case Management

Example: A disturbance of the Glandular Center may affect Glandular functions of the body and can be detected in Center 1. On the left side, Center 1 is located immediately to the right of the Occipital Groove of the mastoid portion of the temporal bone, and on the right. Center 1 is immediately to the left of the Occipital Groove. In palpating the area, the doctor will feel a tense or taut ligament, which will elicit pain if pressed upon. If tenderness and the taut fiber are evident, Center 1 is disrupted. The patient may be suffering from Glandular dysfunction as well as pain, loss of motion or other neurologic disturbance. Look for the subluxation(s) in the spine which correlate to Center 1. Then are four primary vertebrae to examine for the Glandular Center:. Atlas; D1 - First Dorsal or Thoracic; L1 - First Lumbar, SI - Post Segment of the Sacrum. Find the major subluxation(s) and proceed with specific method of correlation.

IV. Optimize Health Through Chiropractic -1 Hour

A. Holistic Health and Healing Through Chiropractic Lifestyle
B. Practical Application of Mind-Body Science in Chiropractic
c. The Image of Health Through Chiropractic: A contemporary Wellness Model

1. THE GLANDULAR CENTER: In the Hypophysis (Pituitary).

The hypophysis (pituitary) is the master gland of the endocrine system. Like the nervous system, the endocrine system is regulatory. The endocrine glands are the so-called ductless glands that produce the hormones that regulates activities throughout the body.1 The hypophysis has an adult diameter of about 1 cm and an approximate mass of 0.8 gm. It consists of two entirely separate divisions: theadenohypophysisandtheneurohypophysis. The neurohypophysis does not produce any hormones, but stores oxytocin and ADH, which are secreted as neurosecretions by the anterior hypothalamus and transported via nerve fibers to the neurohypophysis. The adenohypophysis, known as "the leader of the endocrine orchestra," secretes at least seven hormones: the growth hormone, somatrophin (STH); adrenocorticotrophin (ACTH); thyrotrophin (TSH); lactogenic hormone (prolactin); follicle-stimulating hormone (FSH); luteinizing hormone (LH), or interstitial cell-stimulating hormone (ICSH); and melanocyte-stimulating hormone (MSH).2 Brain cell activity may be modified through thoughts, emotions, and suggestion.

2. THE ELIMINATIVE CENTER: Includes portions of the medulla, pons, hypothalamus, hypophysis, pituitary stalk, fourth ventricle, & cerebrum.

The Sinuses, Lungs & Bronchi

The center for inspiration lies in the upper two-thirds of the medulla oblongata and extends into the pons. The pons varolii contains fibers that connect the medulla and the cerebrum with the upper portions of the brain.3 Inspiration involves the contraction of the diaphragm and the external intercostal muscles. The diaphragm is innervated by the phrenic nerves, which originate at the third, fourth, and fifth cervical levels, where they synapse with axons from the medulla.4

The Urinary Tract

Parasympathetic fibers from the vagus innervate the kidneys, but have no effect on renal blood flow or urine production. Renal blood flow is regulated by thoracolumbar sympathetic supply. The kidneys also display autoregulation.5 Antidiuretic hormone (ADH) from the posterior lobe of the hypophysis (pituitary) controls water regulation of the kidneys and thus urinary output. Osmoreceptors (nerve cells) in the supraoptic nucleus of the hypotbalamus respond to the extracellular fluids surrounding them and fire impulses through neurons in the pituitary stalk to the neurohypophysis, stimulating the posterior lobe to release ADH.6 Adrenocortical and gonadal steroids also control sodium and potassium excretion. Hormones from the parathyroids affect calcium and phosphate excretion. The urinary bladder is activated by stretch receptors that generate impulses, via the visceral afferent neurons in the pelvic nerves, to the sacral part of the spinal cord. Thus parasympathetic neurons are activated and the detrusor muscle (part of the bladder wall) contracts, the internal urinary sphincter relaxes, and urine is expelled.7

The Large & Small Intestines

Intestinal peristalsis is regulated by sympathetic and parasympathetic fibers in the basic nerve plexuses. The sympathetic inhibits; the parasympathetic stimulates.8 Innervation of the alimentary canal all of the organs from mouth to anus are served by bom sympathetic and parasympathetic fibers. Sympathetic fiber are transmitted by the splanchnic sacral nerves (pelvic splanchnic branches) and the vagus.9 The dorsal motor nucleus of the vagus is found in the floor of the fourth ventricle of the brain.10

The Skin

Each spinal nerve has a pattern of ultimate distribution referred to as segmental or dennitomal, at least as far as its cutaneous fibers are concerned. The term segmental refers to the fact that the longitudinal extent of spinal cord to which a pair of right and left spinal roots is attached comprises a segment of the cord. The term dermatome refers to skin, and a dennatome is the area of skin supplied by the sensory fibers of a single dorsal root through the dorsal and ventral rami of its spinal nerve.11 The receptors in skin and subcutaneous tissues can be categorized as mechanoreceptors, thermoreceptors, and nociceptive (pain) receptors. All of these are sometimes grouped under the term exteroceptive, because they are usually stimulated by changes in the external environment.123.

3. THE NERVOUS CENTER: In the Cerebrum.

The cerebrum is concerned with sensations or the interpretation of sensory impulses; and all voluntary muscular activities. It is the seat of consciousness and the center of the higher mental faculties.13 The cerebrum is composed of the cerebral hemispheres and the diencephalon.14 It is the largest portion of the brain, representing seven-eights of its weight The cerebrum contains the nerve centers that govern all sensory and motor activities, as well as poorly defined areas that determine reason, judgement, memory, learning, language, intelligence, and emotions.15 Human behavior is related to the relative massive size of the forebrain. The volume of the neocortex also correlates with higher level functions (e.g. speech mechanisms, various perceptive mechanisms, motor skills, and upright posture), and with hemisphere specialization, a uniquely human feature in which the right and left hemispheres differ significantly in function.16

4. THE DIGESTIVE CENTER: In the Floor of fourth ventricle.

Innovation of the alimentary canal all the organs from mouth to anus is served by both sympathetic and parasympathetic fibers. Sympathetic fibers are transmitted by the splanchnic nerves from the sympathetic trunk. Parasympathetic fibers issue from the sacral nerves (pelvic splanchnic branches) and the vagus.17 The dorsal motor nucleus of the vagus is found in the floor of the fourth ventricle of the brain.1*

5. THE MUSCULAR CENTER: Portions of the Cerebrum, the Cerebellum, and the Reticular Formation of Brain Stem.

Various centers in the cerebrum19 and certain portions of the reticular formation of the brain stem, particularly the red nuclei and certain vestibular and reticular nuclei are important in the control of muscular activity. Then* axons descend as rubrospinal, reticulospinal, and vestibulospinal tracts to the spinal cord. All motor tracts in the central nervous system, no matter what their origin, are directed toward motor cells in the brain stem and spinal cord.20

6. THE CIRCULATORY CENTER: Includes the Vasomotor center in medulla and portions of the spinal cord, the pons, the hypothalamus, and the cerebral cortex.

Circulation in the body is primarily controlled through cardiac regulation and vasoconstriction from the vasomotor center in the medulla oblongata.21 The cardiac and aortic sinuses monitor arterial blood and send their neural feedback to the medulla, which responds accordingly.22 The neurons affecting vasoconstriction and vasodilation are coordinated at many levels of the nervous system, including the spinal cord.23 The pons also affects circulation,24 as do the higher centers of the brain, the cerebral cortex, and the hypothalamus. Stimulation of the posterior or anterior hypothalamus produces an increased or decreased cardiac and vasomotor activity. Stimulation of the motor areas of the cerebral cortex not only produces movement but also vasodilatation in the contracting muscles with vasoconstriction elsewhere. Many emotions, which involve the cerebral cortex and hypothalamus, are accompanied by significant alterations in blood pressure.25

Bibliography:

1. Langtey, LL, Ira R. Telford, John B. Christonsen. Dynamlc Anatomy, 3rd Ed., McGraw-Hill: The Blaktiston Division, New York. 1969, pp. 726-727.
2. Jacob, Stanley W., Clarice Ashworth Franoone, Structure and Function In Man, 3rd Ed., W.B. Saunders Company, Phladelphia, 1974, pp. 484-485
3. Thomas, Ctayton L, ed., Tabar's Dictionary, 15th Ed, FA Davis Company, Philadelphia, 1985, p. 1347. 4. DynamicAnatomy, p. 550
4. Ibid, p. 693
5. Ibid, p. 710
6. Ibid. p. 704
7. Ibid, p. 624
8. Ibid. p. 613
9. Gardner. Ernst, Fundamentals of Neurology, 6th Ed., W.B. Saunders Company, Philadelphia, 1975, p. 302.
10. Ibid, p. 168
11. bid, p. 223
12. Tabor's Dictionary, p. 300
13. Fundamental's of Neurology, p. 374
14. Structure and Function, p. 219
15. Fundamental's of Neurology, pp. 374-375
16. Dynamic Anatomy, p. 613
17. Fundamentals of Neurology, p. 302
18. Dynamic Anatomy, p. 296
19. Fundamentals of Neurology, p. 201
20. Dynamic Anatomy, p. 489
21. Ibid. p. 490
22. Ibid, p. 489
23. Fundamentals of Neurology, p. 336
24. Dynamic Anatomy, pp. 491-492

Thursday
March 11, 2010

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