• Describe the science behind chiropractic care
• Translate the intent of manipulative therapy to patients and other healthcare providers
• Describe the potential results of not having recommended chiropractic care
• Outline the different theories of the subluxation complex
• Justify the care you recommend based on electrodiagnostic, imaging, and laboratory studies

• Compare chiropractic maintenance care to symptom-guided care for patients with persistent or recurrent low back pain
• Investigate whether adding chiropractic care to usual medical care improves outcomes for military personnel suffering from low back pain
• Evaluate the research on the effectiveness of mobilization and manipulation for chronic non-specific low back pain
• Determine the effects of spinal manipulation on biochemical markers in humans
• Appraise the associations between chiropractic and primary care physician care in relation to acute lumbar disc herniation with early surgery

• This contains all courses with the educational objectives listed from Manipulation 117 through Manipulation 122

• Identify a sub-group of recurrent low back pain patients that might respond most favorably to a maintenance care schedule
• Summarize existing research literature on chiropractic maintenance care
• Investigate short-term changes in pain-pressure threshold (PPT) and temporal summation (TS) after lumbar spinal manipulation (SMT) compared to a credible sham intervention
• Determine whether cervical spinal manipulation leads to meaningful changes in vertebral and cerebral hemodynamics, compared to neutral or end-range neck rotation postures in adults with chronic neck pain
• Summarize the current state of the literature regarding the neurophysiological effects of high-velocity, low-amplitude spinal manipulative therapy (HVLA-SMT) in asymptomatic and symptomatic humans
• Critique the existing, sham-controlled literature evaluating the acute changes in autonomic nervous system (ANS) markers and function in patients receiving manipulation to spinal or peripheral joints

Hour 1

• Identify important spinal anatomy with relation to joint pain, degeneration and stabilization.
• Explain the efficacy of spinal manipulation (SM) for various clinical presentations
• Discuss current literature reviews regarding safety concerns and controversies with SM.
• Perform joint manipulative procedures to the spine and pelvis

 Hour 2

• Discuss common clinical anatomy related to the trunk and torso, with practically to joint manipulation.
• Examine the thoracic and lumbar spine through important clinical landmarks and topical anatomical structures.
• Perform alternative manipulative procedures to the spine and pelvis

 Hour 3

• Discuss common clinical anatomy related to the head, and neck.
• Examine the cervical spine through important clinical landmarks and topical anatomical structures.
• Perform joint manipulative procedures for cervical spine.
• Perform manipulative and mobilization procedures to the temporomandibular joints.

• Examine the effect of chiropractic manipulation on reaction and response time in combat-ready special operations forces qualified personnel
• Assess the influence of chiropractic care on the strength, balance, and/or endurance in active-duty United States military personnel
• Evaluate the impact of upper- vs lower-extremity chiropractic manipulation on postural sway and dual task performance
• Provide an update regarding the mechanisms of action for manual therapy, the impact of manual therapy on pain management, health care conditions for which manual therapy may be beneficial and treatment plans

Hour 1

• Review common foot and ankle anatomy.
• Evaluate the foot and ankle.
• Perform physical and neurological examinations and tests related to the foot and ankle.
• Identify uncomplicated common conditions during the evaluation of the foot and ankle.

 Hour 2

• Discuss evidence-based literature suggesting the practically of manipulation of the foot and ankle.
• Perform adjustments of the foot.
• Perform adjustments of the ankle.
• Utilize a speeder/toggle board for the foot.

 Hour 3

• Describe the impact of disturbances on the determinant factors of health in the structures of the foot and ankle
• Apply corrective and preventative measures to conditions affecting the health of the foot and ankle
• Utilize evidence-based low technology rehabilitative methods to manage patient care of common foot and ankle conditions.
• User strategies to address challenges patients have with adhering to rehabilitative programs.

Hour 1

• Review common hand, wrist and shoulder anatomy.
• Evaluate the hand write and shoulder.
• Perform physical and neurological examinations and tests related to hand wrist and shoulder.
• Identify uncomplicated common conditions during the evaluation of the hand wrist and shoulder

Hour 2

• Discuss evidence-based literature suggesting the practically of manipulation of the hand, wrist and shoulder.
• Perform adjustments of the hand.
• Perform adjustments of the wrist.
• Perform adjustments of the shoulder

Hour 3

• Describe the impact of disturbances on the determinant factors of health in the structures of the hand, wrist and shoulder
• Apply corrective and preventative measures to conditions affecting the health of the hand, wrist and shoulder
• Utilize evidence-based low technology rehabilitative methods to manage patient care of common hand, wrist and shoulder
• User strategies to address challenges patients have with adhering to rehabilitative programs.

• Summarize existing literature regarding the neurophysiological mechanisms of spinal manipulation for spine pain 
• Identify the beliefs, perceptions and practices of chiropractors and patients regarding benign adverse events after spinal manipulation and potential strategies to mitigate them
• Explore recent research pertaining to the importance or segmental pain and stiffness when targeting the application of spinal manipulation
• Assess the literature on the effect of SMT on acute neck pain, including pain, disability and quality of life measures and reported adverse effects
• Examine the evidence pertaining to the efficacy and effectiveness of spinal manipulation for preventing infectious disease and improving disease-specific health outcomes among patients with infectious disease

• Define and classify adverse events associated with manipulation and mobilization
• Review symptoms patients perceive as adverse
• Describe the incidence of severe adverse events among chiropractic recipients
• Outline adverse events in the pregnant and postpartum periods

• Describe the vertebral architectural distortion that predicts spinal imbalances. 
• Explain the factors involved in the etiology related to the primary components of the proprioceptor-cerebellar network. 
• Cite the law that establishes a classic chiropractic patient via radiograph. 
• Compare the classic manual osseous adjustment to Sensor-Based-Technique in regards to risk and effectiveness for reversing the cause of most chronic subluxations: An aberrant proprioceptor-cerebellar network feedback loop, (usually initiated by injury,) sustained through time by wedged vertebral bodies via Wolff's law, involving neuromuscular fixation engrams compensating for unlevel vertebral architecture. 
• Palpate the tendinous insertions of the paraspinal musculature in the areas of the spinous process tips and identify those areas that show tension, and demonstrate proper cross-friction massage at those points.

• Summarize our current understanding of biomechanical and biochemical processes that contribute to the development of discogenic back pain 
• Assess the possible association between receiving chiropractic spinal manipulation and the risk of subsequent cauda equina syndrome (CES) in adults with low back pain 
• Determine the impact of receiving chiropractic spinal manipulation on the odds of being prescribed Benzodiazepines for radicular low back pain 
• Establish if receiving chiropractic spinal manipulation following a radicular low back pain diagnosis influences the likelihood of subsequently receiving a gabapentin prescription 
• Examine the association between receipt of spinal manipulation and tramadol prescription among adults with a new diagnosis of radicular low back pain

History and Background

• Recognize the historical emergence of spinal manipulation (SMT) throughout numerous time periods and among different professions
• Outline the development of the chiropractic profession from the late 1800s to modern day
• Briefly review existing and historical models of spinal manipulative therapy (SMT)

What’s that sound?

• Distinguish cavitation from tribonucleation and explore the relevance of the popping sound with SMT.

 Mechanisms

• Integrate the concept of mechanotransduction into your understanding and appraisal of SMT mechanisms
• Outline different ways methods to provide mechanical stimulation during chiropractic treatment
• Explain what the evidence tells us about joint motion, gapping and location of popping sounds with SMT
• Explore contemporary areas of scientific inquiry into the neurophysiologic mechanism(s) of action for high-velocity spinal manipulation
• Describe how SMT may influence pain modulation
• Critique the evidence relating to the influence of SMT on blood biomarkers and immunity
• Discuss the potential brain and sensorimotor functional impacts of SMT
• Appreciate the relevance of spinal stiffness and the potential impact of SMT on spinal biomechanics
• Summarize existing evidence relating to the SMT and muscle function.

Clinical Considerations

• Describe clinical factors that could influence how SMT exerts its effect(s).
• Discuss existing evidence on the dose-response relationship between SMT and clinical outcomes.
• Recognize the importance of contextual factors, patient expectations and comfort in driving positive clinical outcomes.
• Briefly summarize existing research on studies evaluating SMT for non-spinal conditions.

Course Conclusion

• Propose an integrated, conceptual model of how SMT may exert its effects for our patients.
• Recognize that chiropractic care helps patients via many aspects of the clinical encounter.

• Review and comprehend COMAR Subtitle 43, Board of Chiropractic Examiners
• Cite and understand the code of ethics
• Perform acceptable advertising Board Hearings
• Understand Rules associated with Clinical Demonstrations, Record Keeping, Continuing Education requirements
• Apply appropriate administrative rules for Chiropractic Assistants
• Comprehend rules associated with Massage Therapy under the Chiropractic Rules

• Define Medical Error
• Discuss Medical Errors in the Context of Other Types of Error
• Illustrate the Scope of the Medical Error Problem
• List Serious Reportable Medical Events
• Define Key Events in the Field of Patient Safety
• Review the Epidemiology of Medical Error
• Describe the Taxonomy of Medical Error
• Identify commonly misdiagnosed conditions
• Identify populations of special vulnerability
• Review Types of Medical Errors
• Discuss Falls and Teamwork/Communication Errors and how to prevent them
• Summarize the following types of medical errors:
  1. medication errors
  2. handoff errors
  3. diagnostic errors
  4. healthcare acquired infections
  5. device associated infections
• List factors that increase the risk of the above medical errors
• Describe strategies to prevent the above medical errors

• Summarize the following types of medical errors:
  1. medication errors
  2. handoff errors
  3. diagnostic errors
  4. healthcare acquired infections
  5. device associated infections
• List factors that increase the risk of the above medical errors
• Describe strategies to prevent the above medical errors

• Recommend taking Medical Errors 202a and 202b prior to taking this course
• Summarize surgical errors and identify factors that increase the risk of surgical error as well as strategies to prevent them
• Discuss proper reporting of medical errors
• Enumerate the elements that comprise root cause analysis
• Describe strategies patients, providers, systems can use to reduce the risk of medical errors and improve patient health and safety
• Describe what to do when things go wrong

• Discuss the definition and scope of medical error
• Summarize the types of medical error
• Identify and describe ongoing safety research within the chiropractic profession
• Review the literature on the adverse events following chiropractic care
• Illustrate strategies to prevent common errors

Hour One:

• Discuss common medical errors made in the process of choosing diagnostic imaging for patients with cervical spine injuries
• Discuss the role of Clinical Prediction Rules and their role in preventing common errors in overutilization of radiographic studies in patients with cervical spine injuries
• Describe the Canadian C-Spine Rule, Canadian Head CT Rule and NEXUS Low-Risk Criteria, as well as their limitations and exceptions
• Review the literature supporting the use of Clinical Prediction Rules in the prevention of medical errors

Hour Two:

• Discuss limitations of plain film radiography in the evaluation of injured patients, and strategies to avoid medical errors due to inappropriate selection of imaging modalities
• Discuss relevant clinical indications for ordering advanced imaging studies in the evaluation of patients with cervical spine injuries
• Review common advanced imaging studies and their role in preventing medical errors of commission or omission
• Discuss the clinical relevance of recognizing loss of cervical motion segment integrity in the evaluation and management of injured patients

• List the conditions commonly treated with medical marijuana.
• List the basic physiological mechanism that result from medical marijuana
• Explain the different cannabinol receptors known in human tissues
• Explain the benefits of cannabidiol vs. tetrahydrocannabinols
• List the specific physiological benefits for conditions commonly treated with medical marijuana
• Recognize the side effects and potential dangers of medical marijuana

• Cite the rate of physical and mental health disability amongst veterans
• Recognize the incidence and distribution of mental illness in the veteran population
• State the definition of Post-Traumatic Stress Disorder
• List the DSM-5 criteria for PTSD
• Explain the risk factors to developing PTSD
• Summarize the relationship between PTSD and chronic pain
• Outline screening strategies for PTSD
• Explain the Primary Care PTSD Screen (PC-PTSD)
• Describe approaches to the discussion of the results of screening with the patient and Family
• List the effects of PTSD on the family
• Summarize the psychological and pharmacological treatment for PTSD
• Define depression
• List the DMS-5 criteria for depression
• Recognize the signs and symptoms of depression
• Explain “Survivor Guilt”
• Identify the incidence of suicide amongst veterans
• List the risk factors for suicide generally and within the veteran population
• Recall the warning signs of potential suicidal behavior
• Outline the VA Risk Assessment Guide
• Describe the SAD PERSONS instrument
• List local and national resources available to physicians, families and individuals
• Define who is a veteran
• Assess veteran status based on active service, length of service, discharge status, service in war time versus peace time and service in the National Guard and Reserves
• Identify the benefits available for spouses, children and survivors of veterans
• Describe CHAMPVA
• Summarize the Veteran Administration “Caregiver Program”
• List mental health resources available to veterans and their families through the Veterans Administration and official State agencies

• List and define the components of the SINSS classification used for an upper quarter evaluation
• Recall two neurophysiological effects of upper quarter joint mobilizations
• Cite two indications for performing grade 1-2 joint mobilizations to the upper quarter
• Identify two conditions that would warrant performing grad 3-4 joint mobilizations to the upper quarter
• Enumerate 5 contraindications for performing joint mobilizations to the upper quarter State two specific diagnostic or impairment-based indications for performing a cervical distraction mobilization.
• Summarize the purpose for performing a posterior mobilization to the glenohumeral joint
• Paraphrase the clinical prediction rule used to determine the effectiveness of cervico-thoracic mobilizations for patient’s presenting with subacromial impingement.

• List and define the components of the SINSS classification used for a lower quarter evaluation
• Recall two neurophysiological effects of joint mobilizations as applied to the lower quarter
• Cite two indications for performing grade 1-2 joint mobilizations for the lower quarter
• Identify two conditions that would warrant performing grad 3-4 joint mobilizations for the lower quarter
• Enumerate 5 contraindications for performing joint mobilizations as applied to the lower quarter
• State two specific diagnostic or impairment-based indications for performing a lateral to caudal hip joint mobilization.
• Explain the purpose for performing a posterior to anterior proximal tibiofibular glide
• Provide two common indications for performing a medial patella mobilization technique

• Discuss the history behind the discovery of and development of releasing somatic dysfunction via positional release techniques via the work of Lawrence Jones, DO, George Goodheart, DC and others
• Discuss the basic concepts of how the body responds to stress and trauma  according to Irvin Korr and how slackening the dysfunctional muscle and joint tissues works to restore normal function.
• Apply anatomy and kinesiology as a means of finding and unwinding somatic dysfunction.
• Include the learned techniques into your practice.
• Compare and contrast the rapid thrust vs. positional release modes of releasing subluxations or somatic dysfunction. 

• Summarize the muscle spindle, specifically, the anatomy and physiology of the spindle subcomponents and how it regulates function of skeletal muscle.
• Breakdown the neural reflex mechanisms of the muscle spindle and appreciate how these mechanisms operate in both somatic function and dysfunction.
• Explain the hypothesis of the “facilitated segment” aka somatic dysfunction, explained both in terms of neurology and by analogies so as to be clear to both the doctor and the patient
• Identify somatic dysfunction via locating tender points and learn the mechanism of slackening in order to relieve the tender point reactivity and restore normal function to the muscle and joint.
• Identify and correct tender point locations and positional releases.

• Define the basic principles of MRI imaging as it relates to the musculoskeletal system.
• Summarize current criteria utilized to identify Lumbar pathology and the appropriate lexicon utilized in neuroradiology to assist the Doctor of Chiropractic in interpreting studies ordered.
• Identify normal anatomy of the lumbar spine on MRI images.
• Differentiate gross pathology associated with the most common MRI presentations associated with general Chiropractic practice.
• Assess the necessity of MRI imaging for lumbar pathology, with an understanding of the pathophysiology of the degenerative process associated with lumbar spine aging

Hour 1:

• Describe the tensegrity model as it relates to biomechanics from a cellular to organism level.
• Define fascia, including anatomical lines and physical properties.
• Describe the Dural Fascial Kinetic Chain and its relationship to Adverse Mechanical Tension (AMT) on the spine and CNS.
• Describe the clinical relevance of biotensegrity, and how to apply these updated architectural and biomechanical principles to the delivery of chiropractic adjustments.

Hour 2:

• Explain the impact of chronic stress
• Recognize common signs and symptoms of sympatheticotonia during initial patient presentation.
• Outline the diagnostic process for sympatheticotonia, including both testing and interpretation.
• Summarize clinical considerations for the patient with sympatheticotonia.

Hour 3:

• Recognize and describe the common signs and symptoms of imbalance during initial patient presentation.
• Outline and demonstrate testing procedures for imbalance.
• Describe clinical interpretation of test results for imbalance.
• Make referral for imbalance when appropriate.

Hour 4:

• Describe statistical incidence and association with head and neck trauma
• Be able to recognize in clinical practice the common signs and symptoms of head and neck trauma
• Outline the diagnostic process for head and neck trauma, including both testing and interpretation.
• Summarize clinical considerations for the patient with head and neck trauma

• This contains all courses with the educational objectives listed for NeuroFascial Integration 201 - 203

Hour 1:

• Describe layered components of restrictions including updated osseous, muscular, and fascial relational anatomy.
• Describe how to palpate muscle tension versus fascial adhesion versus fascial tension lines.
• Differentiate between osseous restriction, muscular tension, and fascial restriction as they relate to spinal motion restriction.
• Use palpatory findings to select technique application for adjustments that last longer by addressing mechanical root cause and encourage parasympathetic dominance at rest.

Hour 2:

• Describe the difference between static misalignments and dynamic spinal restrictions (joints incapable of full range of motion).
• Differentiate with palpation both static and dynamic spinal restrictions.
• Describe neurological information gathered from palpation, including dysesthesia, hyperesthesia, reactive erythema, temperature differentials, and other signs.
• Palpate the patient with chronic pain, trauma history, and/or sympatheticotonia without triggering sympathetic bracing.

Hour 3:

• Describe the Oxford Grading Scale for manual muscle testing.
• Describe interpretation of manual muscle testing findings, including differentials for clinical significance of findings other than normal.
• Demonstrate manual muscle testing of major postural muscles.
• Apply manual muscle testing as pre- and post-clinical intervention measures during adjustment visits and to track change during review examination.

Hour 4:

• Describe the relevance of clinical history as it relates to chronic stress and trauma.
• List specific questions to assess for sympatheticotonia.
• List specific questions to assess for indications of head and neck trauma
• Determine appropriate individualized examination procedures based on history answers.

Hour 1:

• List the relevant indications to assess using cross-crawl patterning.
• Describe testing procedures to determine specific cross-crawl pattern issues
• Describe testing procedures to assess for signs of sympatheticotonia.
• Describe testing procedures to assess for signs of imbalance.

Hour 2:

• Perform seated functional range of motion testing with segmental and curve analysis.
• Perform standing functional range of motion testing with segmental and curve analysis.
• Describe fascial considerations to modify common orthopedic tests (including straight leg raise, supine apparent arm length inequality, bilateral prone knee flexion, and soto hall).
• List the orthopedic exam procedures specifically relevant to Fascial Kinetic Chain tension.

Hour 3:

• Describe clinical considerations in terms of safety of providing care (knowing when to adjust and when NOT to adjust).
• Define what is “primary” (including considerations of “cause” as well as “least stressful point of access” to determine what to adjust or otherwise apply therapeutic input).
• Recognize patterns of and describe gestalt clinical interpretation for sympatheticotonia.
• Recognize patterns of and describe gestalt clinical interpretation for adverse mechanical tension in the Fascial Kinetic Chain
• Describe patterns of peripheral nerve interference found through synthesis of clinical history and exam procedures.

Hour 4:

• Summarize the concept of an initial Therapeutic Trial of care, including reasoning behind it and how to complete this extension of initial assessment in order to customize patient care.
• Describe considerations for technique selection (including where to start, how intensely to adjust, and how to adjust).
• Explain reasoning behind initial frequency of care, and how/when/why to modify this frequency.
• Describe the considerations for projecting response to care and prognosis.
• Summarize guidelines for patient home care recommendations, including considerations for movement and rest, ergonomics, nutrition, and referrals when appropriate.

• Demonstrate skills to properly perform a patient interview
• Properly record a chief complaint
• Perform a neurological examination of the head and neck
• Perform a mental status examination

• This course contains all content from Neurological Exam 101 through 107. Please see educational objectives for those courses

• Cite anatomy and function of the cranial nerves
• Examine the twelve cranial nerves during a clinical examination
• Discuss disorders of cranial nerves

• Perform and chart a neurological examination of the voluntary motor system and the somatic sensory system
• Apply results of the examination findings in the differential diagnosis of patients
• Describe the three neuron pathway involved with sensorineural innervation
• Discuss multimodal sensations

• Perform an appropriate examination of the reflexes, including deep tendon, superficial, visceral and pathological reflexes
• Describe the anatomy associated with reflexes
• Properly grade and record reflexes
• Interpret the Results of Reflex Testing

• Perform an examination of the systems involved with Movement and Coordination
• Discuss cerebellar anatomy
• Differentially Diagnose by applying clinical signs of cerebellar dysfunction
• Recognize cerebellar syndromes by their anatomical areas
• Apply specific principles of examination to improve the Chiropractic Spinal Examination
• Describe specific procedures of the spinal examination

• Perform a clinical assessment of pain and function
• Explain the psychophysiological profile of pain patients
• Discuss the treatment of pain

• Maintain proper records of neurological examination in the SOAP format
• Write narrative reports reflecting the neurological examination
• Apply an outline of fundamental procedures in performing a complete chiropractic neurological examination

• Identify the neurological aspects of manipulation
• Review the basics of cellular physiology as it relates to manipulation
• Discuss action potentials and synapses
• Evolve an understanding of receptors
• Describe nociception and effects of manipulation

• Further elucidate the neurological aspects of manipulation
• Discuss nociceptive input to the spinal cord
• Review mechanoreceptors and their fibers
• Identify the relationship of mechanoreceptors with endorphin/enkephalin
• Analyze the history of referred pain patterns

• Describe axonal degeneration in inflammatory neuropathy
• Construct criteria for diagnosis of multiple sclerosis
• Discuss the use of antioxidant therapy in neurologic disease
• Review the sensory innervation of the SI joint
• Identify mechanoreceptor control of shoulder musculature

• Evaluate the basics of nerve conduction
• Comment on recording action potentials
• Review NCV/EMG recording issues
• Identify the diagnostic usefulness of H-reflex and F-response
• Construct differential diagnosis with Nerve Conduction

• Define the use of Co-Enzyme Q as preventive treatment for migraines
• Discuss the modular headache theory
• Describe the neurovascular aspects of cluster headaches
• Identify the nutritional etiology of headache and ataxia
• Review the relationship of migraines and menstruation

• Describe the effect of chiropractic on motor control
• Discuss theories of how movements are chosen
• Discuss how movements are sequenced, and skills are learned
• Develop a motor control examination for your practice
• Distinguish components of the motor assessment

• Describe an approach to the assessment and diagnosis of functional symptoms in neurology
• Outline an approach to the management of functional symptoms in neurology
• Discuss concepts in neuropathic pain

• Explore current understanding of pain concepts, physiology and theories behind neuropathic pain
• Discuss in detail the relevant neurological anatomy and functional neurology
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to pain receptors and neural integration
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to neural plasticity, articular neurology, and mechanisms of pain

• Explore current understanding of pain concepts, physiology and theories behind neuropathic pain and allodynia
• Discuss the importance of the neurological implications of a nerve injury
• Describe mechanisms of neural plasticity
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to neural plasticity, articular neurology, and mechanisms of pain

• Summarize the anatomy and hemodynamics of the upper cervical spine and brain
• Discuss the nature of the pathophysiological changes common in arterial dissection
• Outline the various forms and limitations of the bedside examination and laboratory tests and diagnostic imaging
• Develop criteria for necessity of evaluation procedures (physical, orthopedic, neurologic)
• Justify the development and significance of recognition and management of vascular accidents
• Integrate current considerations regarding risk factors and therapeutic intervention

• Discuss common conditions that are associated with neuropathy
• Identify presenting signs and symptoms in patients that would lead to examination for neuropathy
• Differentiate different conditions that can present with signs and symptoms similar to neuropathy
• Measure and interpret blood chemistries to demine the possible cause of neuropathy in a patient
• Prepare a comprehensive diagnostic and management strategy for patients with neuropathy
• Comprehend and be able to assess relative to neuropathy, drug-nutrient interactions in patients
• Breakdown possible contributions of poly-pharmacy to the development and or maintenance of the neuropathic condition in their patients
• Appraise risk factors for complications such as neuropathy and diabetic ulcers in patients with elevated blood sugar
• Order and interpret neuropathy screening tests for patients with symptoms of neuropathy
• Devise a strategy to reduce risk factors of neuropathy and translate this strategy into a treatment plan for the patient
• Choose and apply biomarker lab tests to manage patients with neuropathy
• Provide basic interpretation of  nerve conduction and EMG findings for patients
• Discuss the use of medications in neuropathy and explain their  mechanisms  of action
• Advise patients on possible side effects of neuropathy medications
• Use Tinel's Sign as a diagnostic procedure and translate these findings into optimal location for therapy in neuropathy patients

• This contains all courses with the educational objectives listed from Neurology 115 through Neurology 116

• Contrast historical versus neuroanatomical theories of acupuncture
• Describe the 4 basic mechanisms of acupuncture analgesia.
• Identify and utilize the local, segmental and central effects of acupuncture for neuropathy pain control
• Combine nutraceutical substances that may enhance the effectiveness of acupuncture
• Prepare a comprehensive acupuncture point prescription for maximum analgesic effects in patients suffering from neuropathy 
• Contrast real versus placebo acupuncture and discuss the pitfalls in placebo controlled trials
• Utilized knowledge of the effects of acupuncture on GABA, Glutamate & 5HTP to maximize acupuncture analgesia in neuropathy patients
• Utilize basic pharmacognosy to support and enhance the neurotransmitter effects of acupuncture
• Apply sensory stimulation techniques to promote Neurotrophic factors in nerve repair and regeneration
• Apply the basic science of acupuncture as a bridge to non-invasive neuromodulation in neuropathy patients

• This contains all courses with the educational objectives listed from Neurology 116 through Neurology 124

• Relate the effects of voltage gated sodium and calcium channels to the development of neuropathy
• Draw the pathways specific of TRPs, NaV 1.8 and CaV 3.2 ion channels in the nervous system
• Understand the application of selective NaV 1.8 and CaV 3.2 channel blockers in patients with neuropathy
• Discuss basic science research that links ion channels with the signs and symptoms of neuropathy
• Utilize the neurobiology of the Rubber Hand phenomena to treat patients with peripheral neuropathy.
• Discuss various ion channels and their roles in neuron hyper-excitability related to neuropathy
• Utilize natural substances that modulate ions channels related to neuropathy
• Differentiate the roles of Protein Kinase C and Aldose Reductase  in neuropathy
• Identify potential signaling pathways that are targets of neuromodulation through natural substances
• Prepare a comprehensive natural-substance management strategy for patients with neuropathy

• This contains all courses with the educational objectives listed from Neurology 117 through Neurology 121

• Discuss how insulin signaling abnormalities can directly and indirectly contribute to neuropathy
• Utilize natural substances that modulate insulin signaling pathways
• Differentiate the roles of Endocannabinoid receptors in pain processing versus recreation “High”
• Create a strategy to modulation Endocannabinoids receptors with legal natural substances for pain relief
• Understand the role of Nerve Growth Factors (NGF) in the development of symptoms of neuropathy and also the role of NGF promoting natural substances which may stimulate repair and regeneration.

• Utilize natural substances as neurotransmitter based treatments for neuropathy.
• Identify GABA modulating substances and their effects on GABA metabolism and GABA receptors
• Utilize natural substances that modulate Glutamate metabolism and receptors
• Differentiate the roles of GABA, Glutamate and Glycine receptors in pain processing
• Create a strategy to modulation neurotransmitter receptors using natural substances for pain relief

• Compared and contrast usual transcutaneous nerve stimulation techniques (TENs) with techniques of non-invasive neuromodulation using High Voltage Pulsed Galvanic stimulation
• Identify the anatomical location of electrode placement for central and peripheral non-invasive neuromodulation techniques
• Differentiate various forms of peripheral versus central non-invasive neuromodulation techniques
• Discuss the theory of application and be able to apply techniques of non-invasive neuromodulation in practice.
• Create a strategy for neuromodulation of the patient suffering from neuropathy
• Identify appropriate choices of non-invasive neuromodulation techniques for a patient suffering from neuropathy.
• Breakdown risk versus benefits of neuromodulation and be able to discuss them with the patient suffering from neuropathy
• Appraise a neuropathy patient and construct a comprehensive neuropathy treatment plan which includes non-invasive neuromodulation techniques
• Breakdown and discuss the investigational nature of non-invasive neuromodulation techniques and understand the importance of obtaining written informed consent before proceeding with non-invasive neuromodulation in neuropathy patients
• Comprehend the basic electronics of non-invasive neuromodulation techniques.

• Discuss stimulation parameters for using High Voltage Galvanic stimulation for neuromodulation
• Identify optimal ranges for pulse-width, milli-AMPs, phase and other parameters of electrical stimulation
• Differentiate and choose optimal types of electrical stimulation (TENS vs. HVG) for clinician applications
• Draw out the neuro-anatomical pathways of vagal nerve stimulation and use this information to guide appropriate use of vagal nerve stimulation in clinical practice
• Discuss the investigational nature of tVNS, potential risk-benefits, with patients and construct a treatment plan using tVNS with a properly informed and consenting patient.

• Understand the differences and similarities between TENs, low voltage and high voltage galvanic and be able to use this knowledge to select the most appropriate type to stimulation for use in ts-DC applications
• Apply precautions, other safety considerations and informed consent when administering high voltage galvanic stimulation for non-invasive spinal cord stimulation.
• Craft evidence-based treatment strategies using ts-DC stimulation for pain control and modulation of both ascending sensory and descending motor pathways based on recently published literature on central nervous systems effects of direct current stimulation.
• Be able to select optimal electrode placement for ts-DC based on clinical presentation of the patient
• Understand the basic technique for non-invasive Stellate Ganglion transcutaneous stimulation and its possible application for sympathetic maintained pain.

• Discuss the history of GVS and the historic use of GVS as diagnostic procedure.
• Identify the effects of GVS on the nervous system and use this information to construct an effective clinical protocol for his/her patient
• Apply GVS as an adjunct procedure to assist in balance rehabilitation.
• Understand and apply GVS as part of a comprehensive strategy for the treatment of neuropathic pain syndromes.
• Create a treatment protocol in terms of electrode placement, intensity, duration and precautions for the use of GVS in clinical practice.

• Communicate the risks, potential benefits and the investigational nature of tDC with a potential patient for the purpose of securing a written informed consent prior to treatment
• Understand the similarities and differences between low voltage direct current and high voltage pulsed galvanic and how to apply knowledge of their polarity specific effects in clinical neuromodulation
• Identify brain targets for neuromodulation and construct a therapeutic electrode montage, treatment protocol in terms of intensity, duration, frequency and dose of tDC 
• Explain the theory of tDC as it relates to pain modulation based on contemporaneous scientific literature
• Apply tDC  as an adjunct procedure to assist in intractable pain relief

• Compared and contrast galvanic vestibular stimulation and Tone Burst Vestibular Stimulation in the treatment of the balance impaired patient.
• Apply the polarity specific effects of the anode and cathode on the vestibular system for amelioration of common balance impairments.
• Identify the anatomical location of electrode placement for Galvanic Vestibular Stimulation.
• Create a treatment strategy using Tone Bursts based on physiological pairing of semicircular canals.
• Apply Specific Tone Protocols based on Saccule versus Utricle dysfunction in balance impaired patients.

• Recognize Traumatic Brain Injury (TBI) in your chiropractic patients
• Summarize the prevalence in your patient population
• Identify the type of patient that presents with TBI
• Explain why a chiropractor needs to differential diagnose TBI patients
• Compile correlations of TBI inciting factors with your patient presentations
• Demonstrate the pathology that occurs with TBI
• Classify the grades of TBI and discriminate what can be treated conservatively
• Identify the incidence of injuries that commonly cause TBI
• Evaluate the probability of TBI in your patient
• Describe the many different types of evaluations, in the field, in the office and upon referral
• Implement in-office Screening Tools and apply diagnostic criteria
• Identify the risk of post-concussive syndrome
• Detect patients with “Brain Cognitive Reserve”
• Identify Second Impact Syndrome
• Assess the value of MRI
• Identify Chronic Traumatic Encephalopathy
• Integrate the current concepts of conservative treatment
• Design Cognitive Rehab
• Provide appropriate patient advice, treatment or referral options

Hour 1 - 5

• Recognize Traumatic Brain Injury (TBI) in your chiropractic patients
• Summarize the prevalence in your patient population
• Identify the type of patient that presents with TBI
• Explain why a chiropractor needs to differential diagnose TBI patients
• Compile correlations of TBI inciting factors with your patient presentations
• Demonstrate the pathology that occurs with TBI
• Classify the grades of TBI and discriminate what can be treated conservatively
• Identify the incidence of injuries that commonly cause TBI
• Evaluate the probability of TBI in your patient
• Describe the many different types of evaluations, in the field, in the office and upon referral
• Implement in-office Screening Tools and apply diagnostic criteria
• Identify the risk of post-concussive syndrome
• Detect patients with “Brain Cognitive Reserve”
• Identify Second Impact Syndrome
• Assess the value of MRI
• Identify Chronic Traumatic Encephalopathy
• Integrate the current concepts of conservative treatment
• Design Cognitive Rehab
• Provide appropriate patient advice, treatment or referral options

Hour 6

• Define the trophic model
• Describe the pathology of trophic model to your patients
• Apply the trophic model of subluxation into clinical practice
• Detect signs & symptoms that correlate with the trophic model
• Extrapolate the model to patient care, especially maintenance manipulative therapy.

• Define the trophic model
• Describe the pathology of trophic model to your patients
• Apply the trophic model of subluxation into clinical practice
• Detect signs & symptoms that correlate with the trophic model
• Extrapolate the model to patient care, especially maintenance manipulative therapy.

Hour 1

• Identify and recite all components of the neurological examination 
• Outline basic peripheral and central nervous system pathways that are clinically relevant to the bedside (ambulatory) neurological examination.
• Perform an examination of the cranial nerve and somatic motor system, including aspects of strength, tone and volume.

Hour 2

• Perform an examination of the cranial nerve and somatic sensory system, including sensory testing of deep and superficial CNS pathways.
• Perform an examination of the reflex system, including testing of deep, superficial, visceral and pathological reflexes.

Hour 3

• Perform an examination of the movement, balance and coordination systems, including tests of cerebellar function.
• Demonstrate an examination flow and performing tests taking the patient from sitting to standing, to the supine and prone positions.
• Summarize implications of neurological findings for lesions in various parts of the central nervous system.
• Summarize implications of neurological findings for lesions in various parts of the peripheral nervous system.

Hour 1

• Identify and recite all components of the neurological examination 
• Outline basic peripheral and central nervous system pathways that are clinically relevant to the bedside (ambulatory) neurological examination.
• Perform an examination of the cranial nerve and somatic motor system, including aspects of strength, tone and volume.

Hour 2

• Perform an examination of the cranial nerve and somatic sensory system, including sensory testing of deep and superficial CNS pathways.
• Perform an examination of the reflex system, including testing of deep, superficial, visceral and pathological reflexes.

Hour 3

• Perform an examination of the movement, balance and coordination systems, including tests of cerebellar function.
• Demonstrate an examination flow and performing tests taking the patient from sitting to standing, to the supine and prone positions.
• Summarize implications of neurological findings for lesions in various parts of the central nervous system.
• Summarize implications of neurological findings for lesions in various parts of the peripheral nervous system.

• Identify the domains of and concepts within motor control
• Outline some research on chiropractic's influence on motor control
• Discuss principles of motor control and rehabilitation applied to practice

• Relate the effects of chemotherapy to the development of neuropathy.
• Draw the pathways specific to Lamina I versus Lamina V sensory pathways.
• Discuss basic science research that links Na, Ca and TRPA1 ion channels with hyper-excitability of sensory neurons.
• Apply Lo-TENs over acupuncture points known to down regulate TRPA1 and PKC for the treatment of neuropathy.
• Utilize natural substances that modulate ions channels related to neuropathy.

• Obtain the most appropriate diagnostic tests  for their patients suspected of suffering from small fiber neuropathy
• Implement the use of serum biomarkers for the management of small fiber neuropathy
• Utilize hair analysis for heavy metals, in cases of chemotherapy induced peripheral neuropathy
• Implement a nutritional detox strategy for the elimination of heavy metals in patients suffering from peripheral neuropathy
• Institute a nutritional strategy to elevate NAD+  or to down regulate NAMPT to protect axons from degeneration in cases of peripheral neuropathy.

• Discuss how small fiber nerve dysfunction may contribute  to painful conditions commonly seen in chiropractic practice.
• Apply the Thermal Grill to evoke Conditioned Pain Modulation and Offset Analgesia to relieve neuropathy pain.
• Utilize techniques to treat deafferentation pain.

• Draw the components of the Central Autonomic Network
• Relate the effects of brain lateralization and asymmetry to sympathetic-parasympathetic balance and tone.
• Apply the technique of High Voltage Galvanic stimulation to create a non-invasive Stellate Ganglion Block.
• Apply Lo-TENs to transcutaneously perform Vagal Nerve Stimulation.

• Formulate a viable alternative treatment for chemotherapy induced neuropathy.
• Offer guidance to patients on how they may prevent or reduce the severity of chemotherapy induced neuropathy.
• Utilize various forms of nervous system  stimulation as a substitute for  acupuncture.
• Apply techniques for determining where nerves are attempting to heal and formulate a treatment strategy designed to accelerate nerve repair.
• Choose the most beneficial type of stimulation and the optimal locations where stimulation should reduce  symptoms and promote nerve repair in chemotherapy induced neuropathy.

• Define physiological lesion & functional lesion
• Differentiate an anatomical pathology from physiological pathology
• Recognize the debate on it’s validity
• Apply the defined lesions to current known brain pathologies
• Illustrate the physiological lesion in known cord pathologies
• Demonstrate how the lesions can be measured
• Examine the applications to manipulative therapy
• Investigate clinical application
• Evaluate the validity of the theory to chiropractic applications.

• List common symptoms and physical examination findings that are seen with concussions and mild traumatic brain injuries.
• Recognize red flags and referrals needed in patients diagnosed with concussion.
• Implement tools like the CDC’s Acute Concussion Evaluation into the patient interview.
• Utilizef advanced imaging and diagnostic testing used for the diagnosis of concussion and pathologies that resemble concussion.
• Identify specific findings from the patient interview and examination that led to the diagnosis of other co-occurring pathologies

• Recall classifications of neurodevelopmental disorders.
• Itemize the four-step approach to management of ADHD.
• Administer sensorimotor integration techniques – Interactive Metronome.
• Assess balance and posture and implement rehabilitation.
• Observe eye movement abnormalities and implement therapeutic protocols.

• Classify a Parkinson's disease patient using the H and Y scale
• Formulate a specific treatment plan for musculoskeletal symptoms experienced by an individual patient.
• Use the Parkinson's Autonomic Rating Scale to formulate a treatment plan for non-motor symptoms of Parkinson's disease.
• Recognize and utilize the three main staging and scoring scales of the conditions.
• Utilize the three major components of the Unified Parkinson's Disease Rating Scale to formulate a specific treatment plan for your patient.
• Understand how the autonomic scoring scale for Parkinson's overlaps and interacts with the Unified Parkinson's Disease Rating Score.
• Combine the rating scales to formulate a stage for disability for the Parkinson's patient.
• Utilize the United Parkinson's Rating Scale to craft a patient-specific rehabilitation program.
• Recognize Parkinsons and refer to appropriate healthcare providers as indicated.

• Develop a comprehensive understanding of common biomarkers relative to Parkinson's disease patients.
• Explore the utility of Cystatin C relative to Parkinson's patients
• Analyze the newly released Neurofilament Light Chain biomarker and its role in Parkinson's disease patients.
• Examine the role of glial cells in the pathophysiology of Parkinson's disease and investigate the potential of the S100B protein as a biomarker for tissue damage in Parkinson's disease patients.
• Gain insights into the significance of glial cells in the pathophysiology of Parkinson's disease and evaluate the efficacy of the S100B protein as a biomarker for tissue damage in individuals suffering from Parkinson's disease.
• Make appropriate referrals to Medical Doctors for Parkinsons Patients

• Apply knowledge of alpha synuclein metabolism to formulate targets for patients suffering with Parkinson’s Disease based on studies of the effect of natural substances on alpha synuclein pathology.
• Match specific herbal and natural formulas to target precise defects in the pathological metabolism of alpha synuclein in Parkinson’s Disease.
• Map out the complex life cycle of alpha synuclein with specific emphasis on known defects that create pathological inclusion bodies in neurons of Parkinson’s Disease patients.
• Recognize natural substances for their potential to reverse pathology related to misfolded alpha synuclein molecules.

• Apply an understanding of NAD+  metabolism to formulate therapeutic targets for patients suffering with Parkinson’s Disease based on  studies of the effect of natural substances on neurodegeneration.
• Match specific herbal and natural formulas to target precise pathways related to neuroprotection.
• Formulate Parkinson’s Disease specific strategies to suppress SARM1 and DLK neurodegeneration pathways.
• Discuss the similarities between alpha synuclein molecules and prion proteins.

• Apply neurotrophic factors to formulate therapeutic targets for patients suffering with Parkinson’s Disease based on  studies of the effect of natural substances on neurotrophic enhancement.
• Match specific herbal and natural formulas to target precise neurotrophic pathways.
• Map out the function of BDNF, GDNF, CDNF, MANF and Nurr-1 related to the proliferation, migration, maturation and functional connection of neural stem cells.
• Utilize specific natural substances for their potential to reverse pathology related to Parkinson’s Disease through the stimulation of neurogenesis.

• Apply available non-invasive neuromodulation techniques to formulate therapeutic targets for patients suffering with Parkinson’s Disease based on the latest studies.
• Match specific non-invasive neuromodulation techniques to target precise physical impairments in Parkinson’s Disease patients.
• Discuss the physiological effects of non-invasive neuromodulation techniques and their applications to the care of Parkinson’s Disease patients.
• Use vagal nerve stimulation, galvanic vestibular stimulation,  transcutaneous spinal cord stimulation, rhythmic auditory stimulation and other neuromodulation techniques to assist in the rehabilitation of Parkinson’s Disease patients.

• Use the function of various deep brain structures  to formulate treatment strategies for patients suffering with Parkinson’s Disease based on the latest studies.
• Match specific non-invasive  techniques to target precise deep brain structures  in Parkinson’s Disease patients.
• Discuss the physiological effects of deep brain activation techniques and their applications to the care of Parkinson’s Disease patients.
• Apply specific techniques related to activation of the Pedunculopontine, Globus Pallidus, Subthalamic Nucleus  and VIM to the rehabilitation of patients wih Parkinson’s Disease.

• Explore cutting-edge cognitive rehabilitation techniques that enhance brain function and recovery.
• Develop personalized strategies to address individual cognitive challenges and improve overall mental agility.
• Gain clinically applicable experience with innovative tools and technologies that support cognitive rehabilitation practices.
• Foster a collaborative learning environment to share insights and best practices for effective cognitive rehabilitation.

• Implement evidence-based strategies to enhance emotional regulation and coping mechanisms for managing hypomimia in individuals with Parkinson's disease.
• Apply advanced techniques for drooling management to promote patient comfort and maintain dignity during activities of daily living.
• Design and instruct patients in effective swallowing exercises to ensure safe and efficient oral intake during meals and hydration.
• Facilitate the strengthening of facial muscles and expressions to improve non-verbal communication and social engagement for Parkinson's patients.

• Explain the neurophysiological basis of motor deficits in Parkinson's disease, focusing on basal ganglia dysfunction and its impact on fine motor control and gait.
• Evaluate evidence-based interventions for improving hand dexterity in Parkinson's patients, including task-specific training and emerging technologies like virtual reality.
• Analyze the neuroscientific principles behind gait rehabilitation strategies, such as external cueing and dual-task training, and their effects on neural plasticity in Parkinson's disease.
• Design a comprehensive rehabilitation program that integrates hand dexterity and gait interventions, considering the latest research on neuroplasticity and motor learning in Parkinson's disease.

• Analyze normal postural control mechanisms and identify common postural abnormalities associated with Parkinson's Disease. 
• Explain the pathophysiology of Parkinson's Disease and its impact on functional mobility and balance. 
• Evaluate evidence-based rehabilitation strategies and interventions for managing postural instability in individuals with Parkinson's Disease.
• Demonstrate understanding of the clinical assessment tools used to measure postural control and track rehabilitation progress in Parkinson's Disease patients.

• Discuss briefly the relevant brain anatomy and functional neurology with focus on the frontal lobe and motor cortex.
• Describe the anatomy and physiology of the human brain cortex as it relates to the basic tenants of chiropractic and to spinal subluxation.
• Identify key anatomical components of the frontal lobe and motor cortex.
• Discuss some of the pioneers in neuroscience underscoring their individual contributions.
• Draw basic neurological pathways associated with the frontal lobe and motor cortex.
• Relate function of the frontal lobe and motor cortex to various associated disease conditions.

• This allows you to purchase all 12 hours of 201 level courses. Please see the educational objectives listed for each individual 201 module

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss briefly the relevant neurological anatomy and functional neurology
• Describe in detail the anatomy and function of the components of the human skull with attention to aspects which may be important to the chiropractic physician
• Explore the current role of clinical neurology for the practicing chiropractor
• Describe in detail the anatomy and function of the components of the human spine with attention to aspects which may be important to the chiropractic physician

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss relevant neurological anatomy of the central nervous system, exclusive of the cortex
• Summarize relevant functional neurology of the central nervous system exclusive of the cortex
• Illustrate the clinical presentation resulting from disease of the various brain and cord areas
• Outline various categories for spinal cord lesions
• Organize findings of central nervous system disease by anatomical location and clinical presentation

• Observe a doctor patient encounter where the patient is a paraplegic
• Explore the relevant issues and action protocols involved in acute spinal cord disease
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Summarize relevant functional neurology of the spinal cord

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss relevant neurological anatomy of the spinal cord
• Summarize relevant functional neurology of the spinal cord
• Illustrate the clinical presentation resulting from disease of the various cord areas
• Outline various categories for spinal cord lesions
• Organize findings of spinal cord disease by anatomical location and clinical presentation

• Discuss relevant neurological anatomy and function of the meninges
• Discuss relevant neurological anatomy and function of the arterial and venous CNS circulation
• Discuss relevant neurological anatomy and function of the cerebrospinal fluid (CSF) circulation
• Illustrate the clinical presentation resulting from disease of the various areas
• Outline various categories for vascular CNS lesions
• Utilize a Grand Rounds type case presentation

• Properly record a chief complaint
• Demonstrate skills to properly perform a patient interview
• Perform a neurological examination of the head and neck
• Perform a mental status examination
• Cite anatomy and function of the cranial nerves
• Examine the twelve cranial nerves during a clinical examination
• Discuss disorders of cranial nerves
• Discuss, in detail, aspects of neural ischemia and Cervical Spinal Manipulation
• Overview cerebrovascular anatomy and hemodynamics
• Describe pathophyiological mechanisms in vascular injuries
• Clinically test a patient to evaluate predisposition
• Recognize postadjustment vertebrobasilar insufficiency and review case studies

• This allows you to purchase all 26 hours of 202 level courses. Please see the educational objectives listed for each individual 202 module

• Observe a doctor patient encounter where the patient is a young female with a primary complaint of a balance problem
• Improve the history taking process in an actual clinical setting
• Develop improved patient examination techniques
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Observe a doctor patient encounter where the patient is a middle aged female with a primary complaint of upper extremity paralysis.
• Improve the history taking process in an actual clinical setting
• Develop improved patient examination techniques
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint.

• Observe a doctor patient encounter where the patient is a young female with a generalized headache without any specific area of pain
• Improve the history taking process in an actual clinical setting
• Develop improved patient examination techniques
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Observe a doctor patient encounter where the patient is a young female with a primary complaint of tremor
• Explore the history taking process in an actual clinical setting
• Observe patient examination techniques
• Summarize relevant clinical findings
• Illustrate the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Observe a doctor sort through a difficult history in a patient encounter where the patient is a female with multiple and unusual complaints
• Explore the history taking process in an actual clinical setting
• Observe patient examination techniques
• Summarize relevant clinical findings
• Illustrate the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Explore basic principles of the patient interview
• Discuss briefly the relevance of maintaining good history taking procedures
• Describe in detail the benefits of history questionnaires
• Explore different types of patient historians and as strategy for dealing with each type
• Describe specific area constituting a complete patient interview

• Explore basic principles of the mental status examination
• Discuss briefly the relevance of maintaining good history taking procedures
• Describe in detail the need for a mental status assessment
• Explore different techniques and a strategy for dealing with mental status problems
• Demonstrate specific methods of implementing the Mini-Mental State Examination.

• Explore basic principles of the physical examination of the face, head and neck
• Discuss briefly the relevance the physical examination prior to the neurologic examination
• Describe in detail rational and procedure for observation, auscultation, palpation and percussion
• Visualize patient problems and deformities that might go un-noticed by a casual observer
• Demonstrate specific methods of implementing a brief orthopedic examination of the cervical spine.

• Define specific terminology including organic disease, non-organic disease, functional disease, somatoform disease, malingering and others
• Discuss the distinction between somatoform disorders (hysteria) and malingering
• Describe patient presentations and examination techniques which are useful in somatoform disorders of the special senses
• Elaborate on the somatic manifestations of somatoform disease in motor and sensory presentations
• Explore caveats of diagnosing somatoform disorders
• Discuss completely the performance and usefulness of in office "credibility" tests used to unveil non-organic disorders
• Define and describe aspects of the malingering patient

• Describe the reasons for using an ophthalmoscope in the clinical bedside examination
• Define and contrast the Pan-Optic ophthalmoscope from the common ophthalmoscopes
• Discuss common settings and features of the ophthalmoscope
• Define methods of describing findings in the fundus of the eye\
• Identify and define common systemic and local pathologic processes that may be encountered in the course of the ophthalmoscopic examination.

• Outline methods used and estimations as to the incidence of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia
• Review and describe cerebrovascular anatomy and hemodynamics
• Discuss proposed patho-physiological mechanisms believed responsible for subsequent vertebrobasilar ischemia
• Review and discuss past and present scientific literature to explore the evolution of what we think we know about the process of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia
• Explore issues and examination procedures related to patient assessment as well as vertebrobasilar ischemia recognition and proper diagnosis
• Define and contrast currently suggested procedures  and develop a vertebrobasilar ischemia plan of action
• Explore various perspectives and reveal bias in both public media and biomedical journals
• Identify and define new theoretical concepts and prophylactic therapies

• Perform and chart a neurological examination of the voluntary motor system and the somatic sensory system
• Apply results of the examination findings in the differential diagnosis of patients
• Describe the three neuron pathway involved with sensorineural innervation
• Discuss multimodal sensations
• Perform an appropriate examination of the reflexes, including deep tendon, superficial, visceral and pathological reflexes
• Describe the anatomy associated with reflexes
• Properly grade and record reflexes
• Interpret the Results of Reflex Testing

• Observe doctor patient encounters that focus on aspects of the complete neurological examination
• Explore the history taking process in an actual clinical setting
• Observe patient examination techniques
• Identify the key components of a complete neurologic examination
• Review major aspects of the examination under each component of the clinical neurologic examination
• Observe doctor patient encounters that focus on evaluation of the mental status of the patient.  

• Observe doctor patient encounters that focus on evaluation of the patient's complaint
• Observe doctor patient encounters that focus on aspects of the complete neurological examination
• Explore the history taking process in an actual clinical setting
• Observe patient examination techniques
• Identify the key components of a complete neurologic examination
• Review major aspects of the examination under each component of the clinical neurologic examination

• Observe doctor patient encounters that focus on evaluation of the patient's complaint
• Observe doctor patient encounters that focus on aspects of the complete neurological examination
• Explore the history making process in an actual clinical setting
• Observe patient examination techniques
• Identify the key components of a neurologic examination of diplopia
• Review information regarding evaluation of diplopia.

• This allows you to purchase all 22 hours of 203 level courses. Please see the educational objectives listed for each individual 203 module

• Identify the components of the neurological examination
• Demonstrate a basic examination flow and performing tests taking the patient from sitting to standing, to the supine and prone positions
• Outline "Ferezy's MSR's" which is a pneumonic devise to help recall areas needing to be tested
• Summarize implications of neurological findings for lesions in various parts of the central nervous system
• Summarize implications of neurological findings for lesions in various parts of the peripheral nervous system.

• Outline the clinical anatomy of each of the cranial nerves and their origin from the diencephalon and brainstem
• Summarize clinical function of the corticobulbar pathways
• Relate information regarding the ocular system, including upper motor neuron, internuclear and lower motor neuron pathways
• Distinguish between central and peripheral lesions involving cranial nerve function
• Predict the location of lesions in the visual system by analyzing information from the clinical examination
• Identify cranial nerve nuclei in the brainstem and discuss their function
• Describe the clinical function of each of the cranial nerves
• Describe and demonstrate the clinical bedside examination of each cranial nerve
• Compare and contrast the effects of lesions involving voluntary, involuntary and emotional movements associated with the cranial nerves
• Discuss the various common clinical disorders which affect the cranial nerves
• Discuss common ophthalmoscopic findings, both normal and pathological, which may be observed on the ophthalmoscopic examination
• Identify anatomical and functional relationships which help explain multiple chiropractic concepts, including that of cervicogenic headache
• Differentiate between central and peripheral varieties of facial paralysis
• Break down the various tuning fork tests of hearing
• Differentiate between neuro-sensory and conductive hearing loss

• Describe the procedure for blind spot measurement by manual perimetry
• Contrast blind spot measurement by manual perimetry with automated perimetry
• Distinguish adequate test retest reliability, for both intra-examiner and inter-examiner reliability
• Recognize concepts of adequate test validity
• Identify relevant aspects of visual neuroanatomy and neuro-circuitry
• Review and assess various contentions elaborated in the paper "Changes in Brain Function after Manipulation of the Cervical Spine”

• Identify the basic anatomical pathways of central nervous system control mechanisms involved in voluntary movement of the body
• Identify the basic anatomical pathways of peripheral nervous system and neuromuscular control mechanisms involved in voluntary movement of the body
• Describe the evaluation of strength and the functional roles of muscles
• Discuss the categorizations and terminology used describing the various varieties of muscular contraction
• Review and assess concepts and skills necessary to perform an accurate bedside examination of the voluntary motor system
• View and identify patient video vignettes demonstrating lecture points
• Recognize examination procedures and signs to distinguish primary muscular disease (myopathy)
• Define and categorize involuntary movements
• Compare and contrast pathological from non-pathological involuntary movements

• Define and categorize types of patient reflexes commonly tested at the bedside examination
• Identify the basic anatomical pathways of central nervous system control mechanisms involved in the various reflexes that can be tested in the body
• Identify the basic anatomical pathways of peripheral nervous system control mechanisms involved in the various reflexes that can be tested in the body
• Describe the evaluation of the four basic types of testable reflexes
• Review and assess concepts and skills necessary to perform an accurate bedside examination of the reflex system
• View and identify patient video vignettes demonstrating lecture points
• Compare and contrast pathological from non-pathological reflex findings

• This allows you to purchase all 24 hours of 204 level courses.  Please see the educational objectives listed for each individual 204 course

• Define and categorize types of patient sensation commonly tested at the bedside examination
• Identify the basic anatomical pathways of central nervous system control mechanisms involved in the various sensory systems that can be tested in the body
• Identify the basic anatomical pathways of peripheral and central nervous system control mechanisms involved in the various sensations that can be tested in the body
• Describe the evaluation of both superficial and deep sensory systems
• Review and assess concepts and skills necessary to perform an accurate bedside examination of the sensory system
• View and identify patient video vignettes demonstrating lecture points
• Compare and contrast pathological from non-pathological sensory findings

• Define the terms station, movement and gait
• Define and categorize types of motor systems utilized by the patient and how these are commonly tested at the bedside examination
• Identify the basic anatomical pathways of central and peripheral nervous system movement control of mechanisms involved in the various movement systems that can be tested in the body
• Describe in detail the evaluation of station, movement and gait
• Describe and demonstrate the phases of normal gait 
• Visualize normal and abnormal gait patterns
• Review and assess concepts and skills necessary to perform an accurate bedside examination of the station, movement and gait systems
• View and identify patient video vignettes demonstrating station, movement and gait lecture points
• Compare and contrast pathological from non-pathological station, movement and gait findings

• Define the terms communication, language, and a wide variety of descriptive terms for cortical language and knowledge impairments
• Review the functions classically associated with the cerebral cortex
• Categorize cortical deficits and associated patient conditions
• Identify neurological pathways used by the cerebral cortex
• Describe in detail concepts of lateralization of brain function and hemisphere "dominance" or "hemisphericity"
• Describe and demonstrate a schema to maintain a methodical approach to the patient with a communication disorder
• Visualize a patient with a "split brain disorder"
• Review and assess concepts and skills necessary to perform an examination of a patient with a communication disorder
• Compare and contrast loss of neurologic function at the level of the primary modality to disorders of the primary cortical receptive area as well as in the association cortex

• Define terms relevant to comprehending and performing various nervous system tests not typically a part of the motor, sensory and reflex examinations.
• Review various ancillary tests, including the purpose behind the test as well as test performance.
• Categorize ancillary neurological tests and explain their use and purpose.
• Identify, describe and discuss meningeal stretch tests.
• Identify, describe and discuss neurodynamic tests.
• Identify, describe and discuss nerve tension tests.
• Identify, describe and discuss peripheral nerve palpation and Tinel's sign.
• Identify, describe and discuss Dix-Hallpike test.
• Identify, describe and discuss pressure algometry and introduce the instruments to perform this test.
• Identify, describe and discuss sensory threshold testing and introduce the instruments to perform these tests.
• Discuss the nature and performance of tests used to diagnose defects in function of the neurovascular bundle in the upper and lower extremities (Thoracic Outlet Syndrome).
• Identify, describe and discuss use of the stethoscope and points to auscultate in the head and neck area

• Perform an examination of the systems involved with Movement and Coordination
• Discuss cerebellar anatomy
• Differentially Diagnose by applying clinical signs of cerebellar dysfunction
• Recognize cerebellar syndromes by their anatomical areas
• Apply specific principles of examination to improve the Chiropractic Spinal Examination
• Describe specific procedures of the spinal examination

• Define terms relevant to comprehending and performing various aspects of the mental status examination.
• Categorize the components of the mental status examination.
• Identify, define and discuss dementia and Disease of the Alzheimer's Type (DAT).
• Identify, define and discuss the five levels of consciousness.
• Define and discuss the components of the mental status examination.
• Compare and contrast dementia and depression.
• Discuss and describe methods of charting mental status examination findings.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with an acute onset of headache and facial paralysis
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with an acute onset of headache and facial paralysis
• Improve interpretation of relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with an acute onset of headache and facial paralysis
• Differentially diagnose patients with acute onset of headache and facial paralysis

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with an acute onset of post traumatic headache
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with an acute onset of post traumatic headache
• Improve interpretation of relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with an acute onset of post traumatic headache
• Differentially diagnose patients with acute onset of post traumatic headache

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with an acute onset of post traumatic neck pain and unusual “burping” upon neck manipulation
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with an acute onset of post traumatic neck pain and unusual “burping” upon neck manipulation
• Improve interpretation of relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with an acute onset of post traumatic neck pain and unusual “burping” upon neck manipulation
• Differentially diagnose patients with acute onset of post traumatic neck pain and unusual “burping” upon neck manipulation

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with a shoulder complaint
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a shoulder complaint
• Improve interpretation of relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with a shoulder complaint
• Differentially diagnose patients with a shoulder complaint

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with a sudden onset of dizziness, sensory complaints and ataxia
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a sudden onset of dizziness, sensory complaints and ataxia
• Improve interpretation of relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with a sudden onset of dizziness, sensory complaints and ataxia
• Differentially diagnose patients with a sudden onset of dizziness, sensory complaints and ataxia

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with shoulder and arm pain.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with shoulder and arm pain.
• Improve interpretation of relevant clinical findings in a patient with shoulder and arm pain.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with shoulder and arm pain.
• Differentially diagnose patients with shoulder and arm pain.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with a brachial plexus injury, severe arm pain and a “flail” upper extremity.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a brachial plexus injury, severe arm pain and a “flail” upper extremity.
• Improve interpretation of relevant clinical findings in a patient with a brachial plexus injury, severe arm pain and a “flail” upper extremity.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with a brachial plexus injury, severe arm pain and a “flail” upper extremity.
• Differentially diagnose patients with a brachial plexus injury, severe arm pain and a “flail” upper extremity.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with a tremor of the left upper extremity.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a tremor of the left upper extremity.
• Improve interpretation of relevant clinical findings in a patient with a tremor of the left upper extremity.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with a brachial plexus injury, severe arm pain and a tremor of the left upper extremity.
• Differentially diagnose patients with a tremor of the left upper extremity.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with chronic spasm of the muscles of the lower face and tongue.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a oromandibular dystonia.
• Improve interpretation of relevant clinical findings in a patient with oromandibular dystonia.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient oromandibular dystonia.
• Differentially diagnose patients with oromandibular dystonia.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting following treatment for a malignant nerve sheath tumor involving the L4 nerve root.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a malignant nerve sheath tumor involving the L4 nerve root.
• Improve interpretation of relevant clinical findings in a patient with a malignant nerve sheath tumor involving the L4 nerve root.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with a malignant nerve sheath tumor involving the L4 nerve root.
• Consider the differential diagnosis of patients with a malignant nerve sheath tumor involving the L4 nerve root.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting carpal tunnel syndrome (CTS) and chronic neck pain.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with carpal tunnel syndrome (CTS) and chronic neck pain.
• Improve interpretation of relevant clinical findings in a patient with carpal tunnel syndrome (CTS) and chronic neck pain.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with carpal tunnel syndrome (CTS) and chronic neck pain.
• Consider the differential diagnosis of patients with carpal tunnel syndrome (CTS) and chronic neck pain.
• Comprehend the principle of ongoing, medically necessary chiropractic treatment of a patient with carpal tunnel syndrome (CTS) and chronic neck pain.

• Evaluate two unrehearsed, real doctor/patient encounter; the first of a patient presenting with simultaneous radiculopathy, polyneuropathy and mononeuropathy and the second of a patient presenting with migraine headache and related trigeminal neuralgia.
• Develop improved skills in obtaining an accurate case history and performing an examination of patient’s presenting with radiculopathy, polyneuropathy and mononeuropathy, migraine headache and trigeminal neuralgia.
• Improve interpretation of relevant clinical findings of patient’s presenting with radiculopathy, polyneuropathy and mononeuropathy, migraine headache and trigeminal neuralgia.
• List the clinical presentations of various complaints and the approach to diagnosis of patient’s presenting with radiculopathy, polyneuropathy and mononeuropathy, migraine headache and trigeminal neuralgia.
• Consider the differential diagnoses of patient’s presenting with radiculopathy, polyneuropathy and mononeuropathy, migraine headache and trigeminal neuralgia.

• Evaluate an unrehearsed, real doctor/patient encounter involving an elderly women presenting with a sudden onset of lower extremity paralysis.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient presenting with a sudden onset of lower extremity paralysis.
• Improve interpretation of relevant clinical findings of patient’s presenting with a sudden onset of lower extremity paralysis.
• List the clinical presentations of various complaints and the approach to diagnosis of patient’s presenting with a sudden onset of lower extremity paralysis.
• Consider the differential diagnoses of presenting with a sudden onset of lower extremity paralysis.

• Evaluate two unrehearsed, real doctor/patient encounters; the first case is that of an adult male patient with multiple sclerosis.  The second case is that of an adult male with cerebral palsy.
• Develop improved skills in obtaining an accurate case history and performing an examination of patient’s presenting with multiple sclerosis and cerebral palsy.
• Improve interpretation of relevant clinical findings of patient’s presenting with multiple sclerosis and cerebral palsy.
• List the clinical presentations of various complaints and the approach to diagnosis of patient’s presenting multiple sclerosis and cerebral palsy.
• Consider the differential diagnoses of patient’s presenting with multiple sclerosis and cerebral palsy.

• This allows you to purchase all 24 hours of 205 level courses.  Please see the educational objectives listed for each individual 205 course

• List the electrodes necessary to perform in Electrodiagnosis nerve conduction study
• Describe the placement of the various electrodes in conduction studies of the median nerve at the wrist
• Draw a simple diagram of the carpal tunnel, defining the boundaries
• Itemize parts of a thorough chiropractic management plan for carpal tunnel syndrome

• List the differential diagnoses that may accompany various symptoms
• Describe various essential elements of the history taking process
• List several components of the mini mental status examination
• Itemize and describe several tests of cerebellar function
• Contrast and compare aspects of malingering and somatoform disorders
• Use proper language and nomenclature when producing a report for referring physicians
• Recognize aspects of functional illness

• Evaluate an unrehearsed, real doctor/patient encounter; regarding a case of an adult female patient who complains of lower back pain; pain radiating down her left lower extremity to her heel; weakness in her thighs; and unsteadiness.
• Develop improved skills in obtaining an accurate case history and performing a neurological examination of patient’s presenting with pain, weakness and unsteadiness.
• Improve interpretation of relevant clinical findings of patient presenting with pain, weakness and unsteadiness.
• List the clinical presentations of various complaints and the approach to diagnosis of patient’s presenting with pain, weakness and unsteadiness.
• Consider the differential diagnoses of patient’s presenting with pain, weakness and unsteadiness.

• List the differential diagnoses that may accompany various symptoms.  
• Describe various essential elements of the history taking process.
• List differential diagnoses for this and similar cases.
• Itemize and describe several tests of lower extremity motor and reflex function.
• Recognize a true extensor toe sign from an equivocal or false finding.
• Contrast and compare aspects of various disorders causing cervical spine myelopathy.   
• Use proper language and nomenclature when producing a report for referring physicians.
• Recognize aspects of spinal cord disease.

• List the differential diagnoses that may accompany various symptoms. 
• Describe various essential elements of the history taking process.
• Use proper language and nomenclature when discussing brain injury.
• Recognize aspects of so called “post concussion syndrome” or Mild Traumatic Brain Injury (mTBI).
• Recite levels of consciousness.
• Discuss scoring criterion when using the Glascow Coma Scale.
• Identify abnormal imaging findings associated with concussion on diffusion tensor tractography.
• Define and describe “myoclonic jerks”.

• This allows you to purchase all 20 hours of 206 level courses. Please see the educational objectives listed for each individual 206 module

• Compare and contrast neuronal cells from the neuroglial cells.
• Identify various types of neurons of the peripheral and central nervous system.
• Describe the types of neuroglial cells found in the central nervous system and peripheral nervous system.
• Categorize the types of mammalian nerve fibers by neuron a diameter, conduction velocity and susceptibility to compression.
• Describe the incidence and prevalence of dizziness as a complaint.
• Define the term “motor unit” from a clinical perspective.
• Compare and contrast type one and type two muscle fibers.
• Identify anatomical components and describe physiological function of the cell membrane.
• Define the terms summation and generator potentials.

• Define the terms “electrodiagnosis, nerve conduction study, needle electrode examination, late responses and evoked potentials”.
• Identify the various components of the action potential recording.
• Compare and contrast synaptic versus electrical nerve stimulation.
• Recite the components of the modern electromyographic machine.
• Describe the different types of electrodes used in an electrodiagnostic examination and include the purpose and benefits/drawbacks to each type.
• Categorize the types of electrodiagnostic testing.
• Discuss performance and use of electrodiagnostic testing, including conduction studies and latencies, late responses (including the “H” reflex and “F” wave) and evoked potentials.
• Properly order and interpret the results of electrodiagnostic testing.

• Define the terms “spasm, interexaminar and intraexaminer reliability, global myoelectric activity and muscle fatigue”.
• Identify the various components of the modern paraspinal electrode EMG machine. recording.
• Compare and contrast the use of surface electrodes in the traditional electromyographic examination versus the paraspinal surface electrode electromyographic examination.
• Recite several scientific studies regarding paraspinal surface electrode electromyographic, and strengths and weaknesses of each study.
• Describe tissue filtering, best ways to overcome it, and explain its significance in obtaining useful data.
• Recite the names of the paraspinal musculature organized by their depth, action and activation response.
• Discuss performance and utility of the test for the “flexion relaxation” phenomenon.

• This allows you to purchase all 12 hours of 207 level courses. Please see the educational objectives listed for each individual 207 module

• List several textbooks on electrodiagnostic medicine and discuss the benefits and limitations of each text.
• Recite several applications of electrodiagnostic medicine and discuss the utility of each of the tests performed.
• Describe the components required to perform an electrodiagnostic examination.
• Compare and contrast peripheral nerve injury classifications.
• Define some of the current terminology used in electrodiagnostic medicine.
• Compare and contrast the different types of electrodes used in electrodiagnostic medicine.
• Describe terminal motor latencies.
• Describe sensory and motor conduction velocities and studies.
• Describe electromyography.
• Discuss orthodromic and anti-dromic testing.
• Define motor unit potentials and discuss the normal and abnormal phases.
• Describe the varieties of evoked potentials and discuss the clinical utility of ordering each test.
• Describe the varieties of late potentials and discuss the clinical utility of ordering these tests.
• Identify the relevant neuroanatomy of the peripheral nervous system.
• Demonstrate median and ulnar nerves and the position of the various electrodes in common motor and sensory electrodiagnostic studies of the median and ulnar nerves.
• Discuss the conditions and circumstances when electrodiagnostic testing of the central nervous system may be beneficial or necessary.
• Describe the various electrodiagnostic procedures for the peripheral nervous system.
• Differentiate between motor unit potentials (MUP’s), fibrillations, positive sharp waves and sensory nerve action potentials (SNAP’s). 
• Contrast and compare electrodiagnostic tests for extremity complaints such as weakness and sensory loss.
• Define the role of electrodiagnosis in clinical practice.

• Compare and contrast Compound Muscle Action potential (CMAP), Sensory Nerve Action Potential (SNAP) and Motor Unit Potential (MUP).
• List the components of a spinal cord alpha motor neuron.
• Describe the basic structure of Schwann Cells and myelin.
• Discuss the role of Schwann Cells and myelin in action potential transmission.
• Recite the levels of the neuraxis which may be involved in disease that is detectable by electrodiagnostic testing.
• List the types and levels of nervous system compression.
• List common reasons and disorders for referral for electrodiagnostic testing.
• Describe a routine electrodiagnostic encounter.
• Demonstrate the position of electrodes in a typical median nerve study through the carpal tunnel.
• List the most common neuropathies of the upper and lower extremities.
• Compare and contrast typical electrodiagnostic findings for radiculopathy versus neuropathy. 
• Define and discuss the “Gold Standard” portions of the electrodiagnostic examinations.
• Discuss single fiber EMG.
• Identify the components of the needle EMG examination and discuss how various pathological conditions might be demonstrated by each component of the examination.
• Describe the morphology of positive sharp waves, fibrillations and motor unit potentials.
• Describe the morphology of positive sharp waves and fibrillations.
• Identify normal from abnormal patterns of muscular recruitment under minimal, moderate and maximal muscle contraction. 
• List various causes of radiculopathy.
• Discuss the history of radiculopathy through time.
• Contrast and compare various causes of radiculopathy.
• Discuss the need for and types of advanced imaging following abnormal findings on an electrodiagnostic examination.
• Discuss the utility of electrodiagnosis to the Doctor of Chiropractic.

• Recite relevant anatomy of the peripheral nervous system including the brachial plexus, upper limb nerves, lumbosacral plexus and lower limb nerves.
• Define and draw the brachial plexus.
• List the nerves of the upper limb.
• Compare and contrast the anatomy of the median and the ulnar nerves.
• Describe innervation of the major nerve branches of the major nerve divisions of the brachial plexus.
• Discuss the most common compressive lesions of the upper extremity involving the peripheral nervous system.
• List the muscles most commonly tested during EMG of the upper extremity.
• Define and draw the lumbosacral plexus.
• List the nerves of the lower limb.
• Discuss the most common compressive lesions of the lower extremity involving the peripheral nervous system.
• List the muscles most commonly tested during EMG of the lower extremity.
• Discuss the distinction between motor and sensory neural fibers and salutatory versus local circuit conduction.
• Compare and contrast the two types of compound potentials and discuss waveform morphology and parameters.
• Describe effects and patterns of demyelination.
• Describe the effects of axonal loss.
• Identify the electro-physiologic changes that may be noted in disease of the neuromuscular junction.
• Discuss late responses (F-waves and H-Reflexes) and describe the performance and clinical significance of each.
• Identify components involved in the tendon tap response.
• Thoroughly discuss all aspects of median and ulna nerve testing, including common congenital anomalies that are like to be encountered in the patient population.

• This allows you to purchase all 18 hours of 208 level courses. Please see the educational objectives listed for each individual 208 module

Hour 1

• Recite general information regarding incidents and prevalence of multiple sclerosis in the United States, the United Kingdom and Canada.
• Describe the pathophysiological process believed to be responsible for the most common types of multiple sclerosis.

Hour 2

• Recognize the common signs and symptoms of a patient presenting with demyelinating disease.
• Recognize typical lesions in the brain and spinal cord associated with multiple sclerosis on MRI studies.
• Define the McDonald criteria for the diagnosis of multiple sclerosis.

Hour 3

• Identify various blood tests for diseases that may mimic multiple sclerosis.
• Compare and contrast the category types of multiple sclerosis.
• Describe the common medical treatment for multiple sclerosis.

Hour 4

• Recite studies associated with complementary and alternative approaches to management of patients with multiple sclerosis.
• Synthesize a plan for the management of patients with multiple sclerosis.

Hour 1

• Recite statistics regarding the percentage of primary versus secondary tumors found in the central nervous system.
• Recognize the signs and symptoms of a patient with an intracranial or spinal canal tumor.

Hour 2

• Describe the pathophysiological process associated with neoplasia.
• Discuss the most common types of primary intracranial tumors, metastatic neoplasms and other spinal cancers.

Hour 3

• Identify advanced imaging studies of various types of nervous system tumors.
• Describe mechanisms of cerebrospinal fluid flow in their association with symptoms caused by intracranial tumors.

Hour 4

• Contrast and compare the signs and symptoms associated with tumors arising in various parts of the spinal cord.
• Discuss various forms of medical treatment for patients with nervous system tumors.

Hour 1

• Discuss the etiology of congenital conditions of the brain and spinal cord.
• Recite statistics regarding incidence and prevalence of neural tube defects.

Hour 2

• Describe common forms and categories of neural tube defects.
• Recognize various forms of neural tube defects at birth, in infant life as well as on advanced imaging studies.

Hour 3

• Identify defects of the cranial cervical junction including categorizing Chiari Malformation and discuss clinical significance and management of patients with Chiari Malformation I, II and III.
• Utilize plain film radiometrics to identify multiple forms of cranial cervical junction deformities.

Hour 4

• Discuss various congenital syndromes including Dandy-Walker Syndrome and Mobius Syndrome.
• Compare and contrast different types of developmental defects such as hydrocephalus, crainiosynostosis, achondroplasia, microcrania, and others.

• Define Neurodegeneration.
• Identify some of the core mechanisms of Neurodegeneration.
• Define and discuss oxidative stress and damage of neurons.
• List most common neurological illnesses thought to be due to long-term Neurodegeneration.
• Cite specific biochemical pathways to target therapeutically to slow down or reverse Neurodegeneration.
• Itemize common clinical findings in Parkinson’s disease, Alzheimer's disease, and multiple sclerosis.
• List the mechanisms involved in the neurodegenerative process.
• Define free radicals, articulate the issue with free radicals and describe their role in the neurodegenerative process.
• Discuss the role of glial cells in regard to Neurodegeneration.
• Itemize ways to increase the Nrf2 pathway.
• Discuss glutathione and list specific methods to increase glutathione levels.
• List dangers found in regard to genetically modified foods.
• Compare and contrast normal mitochondrial structure and function with dysfunctional mitochondria with attention to free radical damage to my no conjugal proteins and mitochondrial DNA.
• Discuss the therapeutic role of essential fatty acids (EFA's), Acetyl-L-Carnitine, and coenzyme Q-10.
• List and discuss methods for laboratory evaluation of systemic inflammation.
• Itemize issues associated with the "leaky gut" syndrome, including aspects of inflammation, relation to diabetes, and Zonulin.

Hour 1

• Describe the most common laboratory procedures used to diagnose infections of the central nervous system, including lumbar puncture indications, contraindications and complications.
• Recite characteristics and components of normal cerebrospinal fluid.

Hour 2

• Define the acquired immunodeficiency syndrome and how it affects the nervous system.
• Discuss Lyme disease, its vectors of transmission, pathogenesis, clinical presentation, clinical diagnosis and therapeutic options.
• Compare and contrast stage I, stage II and stage III Lyme disease.

Hour 3

• Identify multiple types of infections capable of producing spinal meningitis and encephalitis.
• Compare and contrast bacterial meningitis from viral meningitis.
• Discuss serious nervous system toxins such as tetanus and botulism.

Hour 4

• Discuss other nervous system infections including brucellosis, psittacosis, syphilis, tuberculosis, sarcoidosis, rickettsial, protozoan, viral and fungal infections of the nervous system.
• Recognize and act appropriately in cases of suspected Reye syndrome.
• Recite and perform appropriate universal precautions necessary to avoid the transmission of communicable diseases in the chiropractic practice.

• This allows you to purchase all 15 hours of 209 level courses. Please see the educational objectives listed for each individual 209 module

• Define and discuss professional boundaries
• Define and discuss sexual misconduct
• Sensitize the D.C. To Issues Relating to Sexual Interaction with The Patient
• Discuss the problem of sexual misconduct, either real or perceived
• Define and discuss specific examination procedures
• Provide methods for recording examinations and incidents
• Discuss case of alleged sexual misconduct
• Discuss strategies to avoid misunderstandings that may lead to charges of sexual misconduct

• Recite the incidence and prevalence of Carpal Tunnel Syndrome.
• Discuss the cost of Carpal Tunnel Syndrome on society.
• Identify disorders and situations that Carpal Tunnel Syndrome.
• Describe the common symptoms of Carpal Tunnel Syndrome.
• Define the anatomical boarders of the Carpal Tunnel Syndrome.
• Differentiate the methods of Carpal Tunnel Release Surgery.
• Describe the scientific literature comparing different methods of Carpal Tunnel Release Surgery.

• Review items included in the State and American Chiropractic Association "Principles of Chiropractic Ethics".
• Define and distinguish between principles of philosophy, ethics and morality. 
• Explore the concept of "The Greater Good".
• Differentiate general concepts of what is right and wrong, from personal decisions of what is right and wrong.
• Define the term "Fiduciary Responsibility".
• Give examples of "Ethical Dilemmas" that might face a doctor of chiropractic and provide discussion of alternative thoughts.
• Discuss issues of “boundary crossings & violations” in regard to chiropractic practice.

• Recite the types of Thoracic Outlet Syndromes and identify which types are “real” and which are disputed.
• Demonstrate different clinical maneuvers designed to identify Thoracic Outlet Syndromes.
• Identify the anatomical structures thought to be responsible for entrapment in the various Thoracic Outlet Syndromes.
• Discuss the significance of the nine fibrous bands discussed by Roos.
• Describe the anatomical and physiological changes that are thought to occur post-accident, resulting in a traumatic variety of Thoracic Outlet Syndrome. 
• Differentiate the compressive causes of upper extremity paresthesia using orthopedic and neurological testing.
• Contrast and compare the resultant clinical profile expected with upper extremity compression of vascular structures versus compression of neural structures.
• Define and perform orthopedic and neurological tests used to determine upper extremity compression of neurovascular structures.

• Outline topography and discuss internal anatomy of the cortex.
• Illustrate and list functions of the various lobes of the brain.
• Identify and describe anterior and posterior intracranial circulatory patterns.
• Relate cortical anatomy with electrode placement when eliciting somatosensory evoked potentials.
• Identify irrigation distribution of all major intracranial arteries.
• Diagram irrigation to the levels of the spinal cord.
• Describe intracranial venous drainage of the skull and differentiate between dural sinuses, boney sinuses and cerebral veins.
• List areas of the cortex responsible for vision, hearing and touch and explain their interaction with the association cortex.
• Give examples traits and characteristics which are associated with hemisphere dominance.
• Define and differentiate the agnosias, such as apraxia, aphagia, etc.
• Define constructional apraxia, and discuss the clinical significance.
• Quantify the incidence of various types of neurovascular disease.
• Contrast and compare strokes from a vascular anatomical and etiology viewpoint.
• List and discuss choices for various forms of imaging based upon suspected stroke etiology.
• Identify treatable, untreatable and possible risks for cerebrovascular accident. 
• Identify medical and conservative options for treatment of cerebrovascular accident risk factors.

• Compare and contrast chiropractors of the 1940s with modern day chiropractors.
• Define neuropathy.
• Recite the major points related to chiropractic physical rehabilitation of neuropathy.
• Contrast and compare medical treatment of polio in the 1940s, to chiropractic treatment of polio at the same time.
• List potential reasons related to public hygiene which may account for disease epidemics.
• Discuss facts related to "Sister Kenny" in regard to her credentials, her claims, and her notoriety.
• Itemize the early chiropractic colleges and discuss Willard Carver school of thought and the "mixers".
• Critically evaluate the world health organization's campaign to eradicate polio.
• Discuss the ethics of herd immunity.
• Compare and contrast individual interests vs. societal interests.
• Discuss the types, risks and benefits of the inactive polio virus (injected).
• Discuss the risks and benefits of the oral polio virus (live, attenuated).
• List the types of wild polio virus.
• Define vaccine associated paralytic polio mile items (VAPP)
• Define circulating vaccine derived polio virus.
• Discuss the concepts of risk: benefit ratio.
• Discuss the transmission and pathophysiology and list the presenting signs and symptoms of a polio virus infection.
• List the different types of Polio virus infection.
• Quantify the various affects of the polio virus on different groups of individuals.
• Itemize ethical concerns regarding Dr. Jonas Salk.
• Graph the incidence of polio cases after other vaccines were introduced and after the definition of a polio diagnosis was altered.
• Discuss SV40 tainted vaccines.
• Define acute flaccid paralysis as it relates to new “non-polio” outbreaks.

• This allows you to purchase all 8 hours of 210 level courses. Please see the educational objectives listed for each individual 210 module

• Evaluate the subluxation complex and the chiropractic adjustment.
• Develop a working knowledge of the neurology of spinal joints and how this may be altered by a spinal subluxation complex.
• Consider the safety and effectiveness of chiropractic adjustments through a review of the scientific literature and understanding of a decline in literature integrity and literature bias.
• Consider the scientific literature regarding chiropractic adjustments and a measurable decrease in pain.
• List and identify the components of the synovial joint and spinal joint mechanoreceptors.
• Consider activities in and around the nervous system that occur after nerve tissue injury.
• Distinguish different levels of nervous system involvement in neuropathic pain, including the peripheral neuron, the dorsal root ganglia and the dorsal horn neurons, as well as concepts of descending inhibition.
• Analyze the goals and effects of the chiropractic adjustment on pain.
• Examine the scientific literature regarding the physiological effects of a subluxation and adjustment upon non-musculoskeletal systems.

• Explain how and why documentation of a subluxation is so important for Medicare patients in chiropractic practice.
• Compare and contrast the Medicare reimbursement of chiropractic providers vs. Medical and other providers for similar services.
• Describe payments made to chiropractors, calculate the actual dollars per visit and explain what portion of payments made are considered inappropriate as medically unnecessary according to a report issued by the Department Of Health And Human Services (HHS).
• Compare and contrast non-provider services, such as drugs and durable medical devices with costs associated with chiropractic care.
• Define requirements for chiropractic services to be covered by Medicare.
• List and discuss how a subluxation may be properly documented in the medical record for Medicare patients.
• Evaluate your understanding of subluxation compared to other chiropractic providers. 
• List the various types of subluxation which may be demonstrated on xray and are acceptable to Medicare.
• List the components of the physical examination which are required by Medicare to be demonstrated in order to verify the existence of a subluxation.
• Identify the specific requirements accepted by Medicare for the initial and subsequent visits of the chiropractic patient.

• This allows you to purchase all 23 hours of 211 level courses. Please see the educational objectives listed for each individual 211 module

• Perform a clinical assessment of pain and function
• Explain the psychophysiological profile of pain patients
• Discuss the treatment of pain
• Define spinal decompression therapy
• Demonstrate decompression table structure and use
• Describe the relevant anatomy of the lumbar spine
• Critically examine published reports of clinical outcomes of decompression therapy
• Present and discuss clinical outcomes of decompression therapy
• Determine spinal decompression table treatment protocols
• Define dizziness
• Define vertigo and other associated symptoms
• Discuss cervicogenic dysequilibrium
• Discuss diagnostic tests to determine the cause of vertigo
• Explore current understanding of pain concepts, physiology and theories behind neuropathic pain
• Discuss in detail the relevant neurological anatomy and functional neurology
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to pain receptors and neural integration
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to neural plasticity, articular neurology, and mechanisms of pain
• Explore current understanding of pain concepts, physiology and theories behind neuropathic pain and allodynia
• Discuss the importance of the neurological implications of a nerve injury
• Describe mechanisms of neural plasticity
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to neural plasticity, articular neurology, and mechanisms of pain
• Analyze current literature regarding spinal adjustments, and break down concepts, physiology and theories behind chiropractic treatment
• Appraise new and existing ideas related to mechanisms involved whereby chiropractic spinal adjustments might effect the vascular and nervous system
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to chiropractic adjustments, neural plasticity, articular neurology, and mechanisms of pain
• Explore current understanding of pain physiology and theories behind neuropathic pain, allodynia and proposed treatment using chiropractic adjustments

• Explore current role of the art and science of obtaining a relevant patient history at the bedside
• Discuss and demonstrate relevant neurological examination procedures required to examine and diagnose pathological conditions of the nervous system
• Outline considerations regarding the relationship of the upper cervical spine and headache
• Summarize characteristics of several clinical headache syndromes, emphasizing recognition and differential diagnosis of pathological conditions
• Illustrate levels of the central and peripheral nervous system and relate that to the clinical presentation resulting from disease of the various brain and cord areas
• Outline and organize various categories for headache

• Define vertigo and differentiate vertigo in the "dizzy" patient population
• Identify disorders that cause dizziness and vertigo.
• Discuss modes of presentation, providers consulted and other aspects.
• Differentiate primary and secondary dizziness.
• Understand aspects of serious and other uncommon causes of dizziness.
• Describe basic anatomy and physiologic function of components of the vestibular system.
• Demonstrate and comprehend performance of the Dix-Hallpike and Eply Maneuvers.
• Define and diagnose Benign Positional Paroxysmal Vertigo (BPPV).
• Perform a bedside examination for evaluation of the dizzy patient.

• Describe the incidence and prevalence of dizziness as a complaint.
• Define the term vertigo from a clinical perspective.
• Identify anatomical components and describe physiological function of the vestibular system.
• Perform a brief bedside examination for basic evaluation of the dizzy patient.
• Categorize varieties of conditions causing dizziness and identify which are likely to be amenable to conservative care.
• Compare and contrast the function of the utricle, saccule and semicircular canals.

• Describe the anatomical structures involved and the overall significance of the Dix-Hallpike Maneuver.
• Perform the Dix-Hallpike Maneuver.
• Describe the anatomical structures involved and the overall significance of the Epley Maneuver.
• Perform the Epley Maneuver.
• Compare and contrast the use of the Dix Hallpike and the Roll Test.
• Discuss in detail the proper use of various vestibular function tests (past pointing, veering, balance, gait, etc.), Swivel Chair Test, Swinging Stool Test, Semont Procedure and the Brandt-Daroff exercises.
• Perform vestibular function tests (past pointing, veering, balance, gait, etc.), Swivel Chair Test, Swinging Stool Test, Semont Procedure and the Brandt-Daroff exercises.

• Evaluate a case of an adult female patient who presents with facial spasms and other complaints including facial weakness, slurred speech, and drooling.
• Differentiate central causes of facial spasm from central causes of facial spasm.
• Consider the effect of chiropractic adjustments on intracranial arterial function.
• Develop improved skills in obtaining an accurate case history and performing a neurological examination of patient’s presenting with facial spasms.
• Improve interpretation of relevant clinical findings of patients presenting with facial spasms.
• List the differential diagnoses to consider in a patient presenting with facial spasms.
• Identify portions of the brainstem, origins of the cranial nerves and the relationship between arteries and cranial nerves at the brainstem.

• This allows you to purchase all 19 hours of 212 level courses. Please see the educational objectives listed for each individual 212 module