Flashcards in Gonstead X-RAY Deck (139)
Recite Gonstead quote on intern wall.
First, spend all the time necessary to carefully and precisely find and correct a patient's problem. Do not be in a hurry. Check and re-check your x-ray, your palpation, instrumentation, and visualization. Second, remember that Chiropractic ALWAYS works. When it does not seem to, examine your application, but do not question the principle. Third, be prepared when demand for Chiropractic care increases. Study the spinal column and the nervous system every chance you get. Our future will be our results.
What are the 5 components of the Gonstead system?
4) Palpation- motion and static
What is the film size of full spine x-rays?
14" x 36"
What is the tube distance of the x-rays?
How should patient placement look for taking a full spine x-ray?
Should include ischia to occiput and the patient should have NO rotation
What are 4 reasons why we use full spine films?
1) Less radiation than sectionals
2) Provide accurate vertebral count
3) Provide full spinal contour representation for posture analysis with axial weight-bearing
4) Shows problems other than chief complaint
What are the 4 components of the Gonstead approach?
1) Patient Symptoms
2) Diagnostic References
3) Pinpoint and Establish
4) Decide Priority of Adjustment
What are the diagnostic references used in the Gonstead approach?
2) Motion and Static Palpation
4) Lab Tests if indicated
5) Nerve Tracking Chart
How can you pinpoint and establish subluxations according to the Gonstead approach?
1) Nervous systems
2) Specific vertebrae involved
3) Areas of spinal cord pressure
4) Vertebral listings for nerve root pressure
List the 8 differences between a spinal adjustment and spinal manipulation.
See page 10 in notes.
What are the 20 indications to x-ray?
6) Accurate Count
7) Segmental Relationship
8) Spinal Contour
9) Exact Relationship of Adjacent Segments
10) Specific Listings
11) Disc Condition
12) Disc Spatial Relationship to Level
13) Surrounding Tissues
14) Motion studies for Biomechanics of Disc Under Stress
16) Posture Analysis
17) Progress Changes
18) Patient Education
19) Court Cases (Legally must have)
20) Because every spine is different!
What are the 2 contradictions to x-ray?
2) Radiation Exposure
What is the allowable yearly dose for radiation workers?
How much radiation does one get from full spine x-rays, A-P and Lateral?
What are the 14 reasons to take a full spine x-ray over a sectional x-ray?
1) 2 Films
2) 3 Exposures
3) Less radiation
4) Less film cost
6) Full spinal contour
7) Exact relation of adjacent segments
8) Posture Analysis
9) Accurate Count of Segments
10) Good for patient who cannot stand for long periods
11) Much easier to read
12) Much easier to analyze
13) Less chance for mistakes
14) Better for patient education
What are the 3 considerations when the ilia are not equal on x-ray?
1) Pathological or congenital condition
2) Poor positioning on the x-ray
3) Misalignment of the pelvis
What does misalignment of the ilium cause?
A weight-bearing change which is compensated for by the sacrum and lumbar spine
What is the normal sacral angle?
Why does the lumbar curve change when the sacrum changes?
The sacrum is the base of the spine and the lumbars follow the movement of the sacrum
The ilium misaligns in relation to the sacrum at the ______________________.
What misalignments can occur at the SI joint?
What are the married listings?
ASIN and PIEX
Why do we call ASIN and PIEX married listings?
Because they have the same mechanical effects on the spine
When the ilium subluxates, what causes the ilium to stay in that direction?
Edema, the rest of the spine compensates
Will edema of the SI joint be in the same spot for each listing?
No, it will be in a different area of the joint for each listing
Is edema that occurs due to a ilium misalignment usually palpable?
Yes, in most cases but not all
What 3 structural changes are caused by a misaligned ilium? These can be seen in a postural assessment.
1. Change in gluteals and folds
2. Change in leg length while weight-bearing and prone
3. Foot flare and heel wear
Why is it important to remember that the ilium misaligns in a gliding motion and not by pivoting?
This helps us keep in mind where the edema is located and what line of correction needs to be used to adjust the bone properly.
What does the obturator look like in a AS ilium?
Dimension is decreased vertically