Florida Chiropractic Assistant Education and Continuing Education

• 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.

• Outline relatively common but sometimes challenging patient cases.
• Comprehend diagnostic and therapeutic considerations in multiple pathological conditions.
• Demonstrate knowledge of laboratory tests for alcoholic cirrhosis.
• Recite abnormal blood pressure parameters in malignant hypertension.

• Relate relatively common but sometimes challenging patient cases including myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Explain diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Give examples of diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Describe diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.

• Correctly assess the level of the lesion in case scenario questions.
• Identify the components of the neurological examination.
• Demonstrate a basic examination flow 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.

• Describe areas of concern in the history taking process
• List areas of concern in the mental status examination
• Identify and perform methods for eliciting a patient history
• Identify and perform methods for examining the patient’s mental status

• Identify the areas of proper placement of the stethoscope bell in order to auscultate various arteries and other vascular structures available in the head and neck.
• Perform palpation of the thyroid gland.
• Perform an examination of the cranial nerves.
• Evaluate the head and neck for signs of nervous system trauma.
• Draw out the visual pathways from retina to striate cortex of the occipital lobe.
• Associate patterns of visual field losses with various portions of optic pathway disease.
• List retinal areas to evaluate and associated parameters during the fundoscopic examination.
• Correlate disorders of eye position and movement with peripheral cranial nerve disease, internuclear ophthalmoplegia and gaze palsy’s.
• List current vertebrobasilar risk assessment options as well as the value and limitations of each.
• Outline the position of the Association of Chiropractic Colleges (ACC) in regard to vertebrobasilar ischemia (VBI) provocative testing in the chiropractic office.
• Identify suggested effects of elevated homocystine levels above 7.2 umol/L.
• Perform procedures recommended by the author to evaluate candidates for manipulative therapy.
• Summarize implications of neurological findings for lesions involving the cranial nerves or their central connections.

• Distinguish how orange juice can improve blood lipid profiles
• Discuss dietary aspects for the vegetarian athlete
• Identify the relationship between bromelain and acute inflammation
• Develop the anti-septic activity of tea tree oil
• Describe Probiotics

• Identify risk factors of cardiovascular disease
• Construct a list of appropriate food and food groups associated with cardiovascular disease prevention
• Evaluate various supplements that are beneficial in prevention and treatment of cardiovascular disease
• Differentiate various diets in regard to cardiovascular disease

• Discuss various diet and lifestyle factors involving hypertension
• Recognize the relationship between various minerals and hypertension
• Distinguish the nutritional aspects of various related cardiovascular conditions
• Identify the relationship between various herbs and peripheral vascular diseases

• Discuss the basics of herbal medicine
• Identify the conditions treated with herbs
• List the effects, indications and dosages for Bilberry, Black Cohosh, and Boswellia

• Discuss the mechanism and effects of Ginger, Ginkgo Biloba, Ginseng, Goldenseal, Gugulipid, Gymnena Sylvestre, Horse Chestnut, Lemon Balm, Licorice, Milk Thistle, Nettle, Passionflower, Psyllium, Pygeum, Senna, Shiitake, St. Johns Wort, Saw Palmetto, Tea Tree Oil, Tumeric, Valerian Root, and White Willow

• Demonstrate an understanding of the role of calcium and other minerals in osteoporosis
• Design a treatment protocol for the osteoporotic patient
• Create nutritional guidelines for the pregnant female
• Identify changes in vitamin and mineral requirements in pregnancy
• Review the nutritional changes that occur with lactation

• Understand proper growth rates and weight gain in early childhood
• Identify specific minerals involved in childhood nutrition
• Explain the stages of obesity development in childhood
• Review the importance and problems associated with childhood obesity
• Evaluate the role of fiber in childhood

• Identify the link between obesity and disease
• Understand body composition and assessment methods
• Design a practical weight loss diet program
• Perform obesity related calculations quick and easily in the office
• Recognize the role of exercise and other lifestyle factors that can influence obesity.

• Identify the challenges inherent in the diagnosis and management of patients with complex and chronic multi-factorial problems
• Associate a multitude of common symptomatic complaints with foundational metabolic disorders such as elevated total toxic load and "leaky gut"
• Apply a systematic approach to functional laboratory diagnostics and associate the findings with the need for specific therapeutic strategies using nutrients, botanical medicines, and nutraceutical compounds
• Demonstrate an ability to institute life-style modifications, such as dietary changes, stress management techniques, and exercise in the management of patients with complex chronic illness
• Measure your ability to assess, diagnose, and treat patients with fatigue-related disorders, vague gastrointestinal complaints, cognitive dysfunction, thyroid-adrenal problems, food intolerance, and more

• Identify the challenges inherent in the diagnosis and management of patients with complex and chronic multi-factorial problems
• Associate findings such systemic skin problems with foundational metabolic disorders
• Apply a systematic approach to functional laboratory diagnostics and associate the findings with the need for specific therapeutic strategies
• Discuss the modification of your approach to case management based on outcome-assessment
• Assess, diagnose, and treat patients with serious food allergy and sensitivity, dermatologic disorders, immune dysfunction, and persistent serious hypertension

• Identify various pathologies associated with increased toxicity and total oxidative stress
• Outline specific strategies of patient assessment to determine toxic load and individual hepatic detoxification capacity
• Discriminate between the various pathways of hepatic detoxification biochemistry and objectively assess each pathway
• Explain the use of specific nutrients, nutraceutical compounds, botanical medicines, and foods to lower oxidative stress
• Explore the benefits and complications of adjunctive therapies in the management of patients with elevated toxic load and poor detoxification capacity

• Identify common drug and nutrient interactions
• Identify herbal interactions
• Identify nutrient and nutrient interactions
• Recognize different toxicity levels for various nutrients
• To formulate treatment recommendations based a patient's medication intake.

• Identify how free radicals are formed and what parts of the body are affected.
• Determine the relationship between antioxidants and cardiovascular disease and cancer
• Discuss the role that vitamins, amino acids and herbs have in pain control.
• Examine inflammation and the pro-inflammatory state.
• Construct an anti-inflammatory diet
• Determine which vitamins, minerals and herbs are useful as natural anti-inflammatories.
• Identify the role of Proteolytic enzymes and inflammation and review sources of fatty acids.

• Frame the problem and basic epidemiology of chronic G.I. disorders
• Present evidence of linkage between chronic G.I. disorders with other common medical conditions
• Discuss the current hypothesis of associations between intestinal hyperpermeability and systemic illnesses
• Review cutting edge assessment tools and tests for G.I. disorders
• Outline and suggest rational and efficacious cutting-edge non-drug treatment interventions for functional G.I. disorders.

• Understand how muscle contraction occurs
• Review practical muscle physiology
• Determine how the body responds to exercise
• Discuss the role of hormones in regards to muscle
• Identify the components of proper assessment for physical fitness
• Review the main components of a weight training exercise program
• Identify various exercise training methods
• Discuss the practical aspects of body composition
• Review basic nutrition and how it relates to sport and exercise
• Determine the energy needs and energy balance of the athlete

• Define the common signs and symptoms leading to the diagnosis of Amyotrophic Lateral Sclerosis
• Utilize conventional and alternative lab test for Amyotrophic Lateral Sclerosis
• Learn about the conventional treatment options for ALS, including drug therapies and new drug research
• Utilize nutritional support strategies for ALS, including diet, and nutritional supplements
• Coordinate care with the Medical Profession for innovative drug strategies for ALS

• Review Age-Associated Mental Decline, including its symptoms, causes and innovative drug therapies
• Discuss and define nutritional support strategies for Age-Associated Mental Decline, including vitamins, hormones and antioxidants
• Outline innovative drug strategies for cognitive enhancement
• Apply nutritional support strategies for cognitive enhancement

• Discuss the interactions between nutritional supplements and diuretics, statins and anticoagulant drugs
• Discuss the interactions between nutritional supplements and antidepressants, antidiabetic medications, and antibiotics
• Discuss the interactions between drugs and the B vitamins, fat soluble vitamins
• Discuss the interactions between drugs and vitamin C, folic acid, PABA, progesterone, tyrosine, phenylalanine, and therapeutic oils

• Define the criteria for diagnosing chronic fatigue syndrome
• Outline the causes of chronic fatigue syndrome
• Summarize the relationship between chronic fatigue syndrome and the endocrine system
• Discuss natural therapies that may be helpful for CFS patients
• Describe the relationship between neurotransmitters and chronic fatigue syndrome

• Adequately frame the problem and basic epidemiology of cardiovascular disorders (CVD)
• Present evidence of the relationship between obesity, insulin resistance, inflammation, stress and CVD
• Summarize the standard medical and laboratory evaluation techniques and why they may only screen for approximately 50% of people at significant risk for CVD
• Appraise the latest laboratory evaluations, including Lp (a), Apo A1, Apo B, hs-CRP, homocysteine, fibrinogen, AA/EPA, LDL-subclass and others to determine CVD risk
• Critique the current dietary, lifestyle, nutritional supplement, nutraceutical, and herbal strategies as therapeutic management options to reduce CVD risk and for the treatment of those who already have cardiovascular issues, including: high cholesterol and dyslipidemia, genetic susceptibilities, chronic inflammation, coagulation abnormalities, and insulin resistance-related risk factors

• Generate a list of disorders associated with gluten sensitivity
• Describe to patients where gluten is likely to be found and which foods are generally safe for a gluten sensitive patient
• Interpret journal articles or general publication articles in the light of the history of gluten sensitivity diagnosis
• Critique articles and authors who claim that celiac disease is the only proven form of gluten reaction
• Detect and differentiate chronic gluten reactions in patients from other causes of inflammation and disease

• Describe the historical context of celiac understanding
• Document reasons why celiac disease is nearly always misdiagnosed
• Present valid arguments from cited literature how celiac disease is an autoimmune condition
• Defend recent scientific advances for the leaky gut syndrome
• Discuss reasons why celiac disease is a global concern, not just an American issue.

• Identify which supplements are commonly used in exercise and sport
• Determine the benefits and risks of individual ergogenic aids
• Discuss the role that individual vitamins have in exercise and sport
• Examine the role that individual minerals have in exercise and sport
• Investigate the value of sport drinks
• Ascertain when fluids are most beneficial in sport
• Apply how exercise effects the immune system
• Review the positive and negative effects of exercise
• Identify the role of antioxidants in sport and exercise

• Identify which supplements are commonly used in exercise and sport
• Ascertain the rationale of using specific individual sport supplements
• Differentiate between fact and fiction of the supplement in relation to sport and exercise
• Determine the practical use in sport for individual supplements
• Determine the benefits of individual ergogenic supplements
• Examine the risks associated with individual supplements
• Investigate the value of specific supplements via studies
• Define contraindications and interactions with the supplement
• Recommend the correct dose of the supplement for sport and exercise

• Identify various energy systems of the body and how they relate to exercise and sport
• Theorize which energy system is used for a specific sport event/activity
• Summarize the physiology of fat, protein and carbohydrate metabolism and utilization in exercise and sport
• Understand the relationship between the energy systems and various exercise parameters
• Create a diet protocol for the athlete prior to their sport or exercise activity
• Determine and understand the timing of meals in exercise and sport
• Outline a useful program for a person to maximize carbohydrate stores
• Theorize how glycemic index can affect exercise and sport activity
• Ascertain differences between food variables and how they affect exercise and sport performance

• Review nutritional supplements useful for weight loss.
• Discuss the research for conjugated linoleic acid for weight loss.
• Outline the associations between thyroid function and weight loss.
• Summarize dietary supplements that increase thermogenesis.

• Differentiate various nutrition assessment techniques.
• Determine which body fat/composition technique is most appropriate for the individual.
• Calculate essential measurements for weight loss patients.

• Appraise the reviewed research studies for salient elements of bias.
• Describe the sensitivity and specificity of common food sensitivity tests.
• Identify the effect of common natural interventions for IBS.
• Compare results of the low FODMAP diet to conventional dietary approach for IBS.
• Differentiate between clinical and statistical significance in natural medicine interventions for IBS
• Grade the magnitude of effect size for natural medicine interventions.
• Interpret the effect size of an intervention as it relates to the numbers needed to treat for benefit.
• Identify the risk of bias level for studies included in a systematic review on yoga for IBS.

• Discuss the role of diet in causing and preventing various diseases, particularly chronic diseases.
• Describe methods used to assess nutrition status.
• Explain how dietary recommendations are formulated.
• Incorporate nutritional information into clinical practice and advise patients about eating for optimum health as well as using dietary change as a therapeutic intervention
• Evaluate the benefits and risks of nutritional recommendations for specific health conditions through an analysis of the existing scientific and clinical evidence

Hour 1 - 3

• Discuss the role of diet in causing and preventing various diseases, particularly chronic diseases.
• Describe methods used to assess nutrition status.
• Explain how dietary recommendations are formulated.
• Incorporate nutritional information into clinical practice and advise patients about eating for optimum health as well as using dietary change as a therapeutic intervention
• Evaluate the benefits and risks of nutritional recommendations for specific health conditions through an analysis of the existing scientific and clinical evidence

Hour 4

• Investigate the importance of nutrient deficiencies
• Review the role of essential nutrients in human health
• Analyze the interaction between nutrients and various illnesses
• Ascertain the role herbs have in health and disease
• Understand drug and nutrient interactions

• Investigate the importance of nutrient deficiencies
• Review the role of essential nutrients in human health
• Analyze the interaction between nutrients and various illnesses
• Ascertain the role herbs have in health and disease
• Understand drug and nutrient interactions

• Identify the etiology and pathology of arthritis.
• Outline a diet that is helpful in the treatment of arthritis.
• Apply specific supplements to an arthritic condition.

• Review the risk factors and mechanisms of heart disease.
• Identify the parts of a proper diet to prevent heart disease.
• Evaluate various supplements that are beneficial in prevention and treatment of heart disease.

• Recall various foods with high amounts of Flavonoids and briefly relate their impact health
• Indicate the basic chemical structural similarities and differences of Flavonoids
• Relate potential benefits of combining Flavonoids, and ways of improving their bioavailability and efficacy
• Explain why some Flavonoids may be effective according to their chemical structure, specifically in a study for neuroprotection
• Discuss Flavonoid use and neuromuscular treatment considerations
• Integrate knowledge of Flavonoids and biochemical pathways to prescribe individualized nutrition treatments to your patients and appreciate the potential for overprescribing too many competing herbs
• Examine and demonstrate how and why Green Tea extract may play an inclusive role in health

• This contains all courses with the educational objectives listed in Nutrition 157 and 158

• Quantify the prevalence rates of patients using opioids and herbal products
• Demonstrate the significance to the chiropractor of interactions between different herbs and common prescription drugs
• Discuss the at risk populations for interactions including the pregnant, and elderly populations
• Record and list the most common interactions of common food and herbal products
• Record and list the effects of the common interactions of common heart medication and herbal products
• Demonstrate evidence that supports the use of health care providers assessing patients for these interactions.
• Discuss the role of the chiropractor in the role of identifying these interactions.
• Illustrate several books, and smart phone based electronic applications to make the process of identification easier for a chiropractor and patient.
• Evaluate common case scenarios

• Define very low carb (ketogenic), low carb, and moderate carbohydrate diets
• Describe the proposed mechanism of how low carbohydrate diets may improve outcomes
• Summarize the evidence supporting low and very low carbohydrate diets in diabetes management
• Critique the arguments for the long-term use of ketogenic diets

• Understand the importance of normal bowl defense mechanisms
• Develop a nutritional treatment for candidiasis and gut flora imbalances
• Examine the importance of fiber on human health
• Design a nutritional treatment program for constipation and diarrhea

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.
• Examine the concept of health and aging
• Determine an appropriate lifestyle to increase the chances of living longer
• Analyze various diets and dietary patterns that play a role in aging
• Ascertain which foods are of greater benefit in regards to aging and longevity
• Develop an appropriate anti-aging diet
• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.

• Develop an appropriate nutrition program for an ulcer
• Identify the importance of diet in Celiac’s disease (non-tropical sprue)
• Outline a nutrition program for a patient with lactose intolerance
• Design a nutrition treatment program for GERD
• Examine the role of nutrition and supplements in irritable bowel syndrome

Hour 1

• Recognize normal cognitive and memory lapses and signs of declining cognition.
• Differentiate the assessment tools and the pros & cons of each
• Review evidence-based dietary patterns and specific foods that impact cognition
• Review additional evidence-based lifestyle factors that contribute to cognition
• Summarize dietary supplements which may impact cognition

Hour 2

• Recognize 5 categories of early aging
• Identify nutrient deficiencies associated with aging
• Examine epigenetics in aging, specifically COMT and MTHFR
• Review stress physiology and its contribution to aging
• Review contributions of microbiome to healthy physiology and aging

• Identify behaviors associated with artificial sweeteners
• Examine the main artificial sweeteners used in the United States
• Determine why artificial sweeteners are used in the food industry
• Summarize the general risks associated with artificial sweeteners
• Evaluate the benefits and risks of Neotame and Advantame

• Identify the benefits and risks of Saccharin
• Discover the benefits and risks of Acesulfame potassium
• Summarize the benefits and risks of Sucralose
• Differentiate Aspartame benefits and risks
• Critique the current research on artificial sweeteners and cancer risk
• Explain the effect of artificial sweeteners on the gastrointestinal environment
• Interpret the research on artificial sweeteners and blood sugar

• Distinguish between the negative and positive effects on obesity, weight control and artificial sweeteners
• Identify the natural sweeteners that are generally recognized as safe
• Evaluate the effectiveness and safety of Stevia
• Determine the effectiveness and safety of Luo han guo (Swingle fruit or monk fruit extract)
• Analyze the effectiveness and safety of Thaumatin

• Review exercise physiology principles and techniques
• Analyze various exercise prescription principles
• Identify appropriate carbohydrate – fat – and protein recommendations
• Develop meal timing and fluid guidelines for the athlete

• Review the signs and symptoms of neuroinflammation and the processes that drive neurodegeneration.
• Identify the neurological signs and symptoms of long COVID and apply research-based protocols.
• Utilize dietary improvements and selected supplements to reduce neuroinflammation.
• Treatment protocols on testing to identify gut barrier and gut-brain axis imbalances.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Understand the effect of bacterial toxins originating in the gut on the gut-brain axis as a key to neurological disorders pathogenesis.
• Assess intestinal and blood-brain barrier dysfunction for better managing chronic neurological disorders.
• Understand new functional nutritional strategies for longevity.
• Incorporate leading-edge protocols for extending healthspan and longevity.
• Clarify the effects of intermittent fasting on immunity and longevity.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Integrate optimal lifestyle adaptations in diet, exercise, and supplement protocols to enhance neuroplasticity and improve quality of life.

• Understand basic concepts of health
• Identify the health spectrum
• Investigate the various facts associated with aging
• Investigate the various theories of aging

• Explain the basic principles of nutrigenomics, focusing on the interaction between nutrition, genetics, and health outcomes, with an emphasis on conditions like headaches.
• Analyze how single nucleotide polymorphisms (SNPs) and other genetic variations impact nutrient metabolism and their potential role in triggering headaches, such as those linked to impaired methylation.
• Examine the mechanisms by which a lack of essential nutrients (e.g., magnesium, B vitamins) contributes to headaches, and how nutrigenomics can inform targeted nutritional interventions.
• Design tailored dietary strategies based on genetic testing results, addressing deficiencies or imbalances that may exacerbate headache conditions.
• Assess the benefits and limitations of using nutrigenomic testing to guide clinical decision-making for headache management and prevention, highlighting the importance of personalized nutrition in improving patient outcomes.

• Discuss healthy habits vs. genetics in healthy aging.
• Review the importance of evolutionary biology in determining healthy habits.
• Name and Define the “legs” of the Epidemiological Triad.
• Emphasize the “Host Health Leg” in the practice of chiropractic.
• Explain the history of the mitochondria as a synergistic organelle with its own genetic material.
• Outline the basics of mitochondrial physiology and the clinical interventions to affect mitochondrial function.
• Explain why modern humans should take 5 supplements.
• Give an overview of what these supplements do physiologically and the risks associated with their deficiency.
• Explain the greatest impact of magnesium on neurophysiology and energy production.
• Identify the forms and discuss the protocols for magnesium supplementation.
• Outline the evolutionary biology of omega-6/omega-3 ratios in inflammation and infection.
• Summarize the importance of omega-3 derived molecules call resolvins for health and disease prevention.

• Explain basic concepts of health
• Identify the health spectrum
• Investigate the various facts associated with aging
• Determine the difference between sickly aging and normal aging
• Investigate the various theories of aging

• This contains all courses with the educational objectives listed from Nutrition 201 to Nutrition 212

• Recognize the most common theory of aging
• Determine the risks associated with being sedentary
• Identify the effect of exercise on the cardiovascular system
• Describe how exercise affects cholesterol and cancer
• Examine the various components of an exercise program

• Differentiate the relationship between various stress reducing techniques
• Identify how social relationships, religion and prayer can affect health and aging
• Investigate the negative and positive factors from consuming alcohol
• Recognize how alcohol affects nutrition
• Identify how smoking affects health

• Identify the relationship between nutrition and smoking
• Investigate the relationship between second hand smoke and nutrition
• Identify various smoking cessation techniques
• Identify the role of antioxidants and free radicals
• Examine the relationship between antioxidants and heart disease

• Determine the relationship between diet, cancer, and the environment
• Identify various antioxidants that can affect cancer
• Describe how caloric restriction affects longevity
• Explore basic concepts of weight control and obesity
• Recognize how obesity affects overall health and promotes disease

• Identify various dietary patterns and habits
• Determine how diet patterns affect health and promote disease
• Explore the typical American diet pattern
• Review the vegetarian diet pattern
• Analyze the Mediterranean diet pattern and its components

• Identify why fruits and vegetables are anti-aging foods
• Determine how fruits and vegetables offer health benefits
• Select what components of fish have positive effects on health
• Investigate how fish affects cardiovascular disease and cancer
• Identify how garlic affects health and inhibits disease

• Recognize the beneficial components of yogurt
• Identify how yogurt can affect the immune system
• Define what prebiotics are and how they affect health
• Describe how chocolate can promote health and longevity
• Explore how tea can positively affect health and decrease disease risk

• Determine the relationship between a daily multiple vitamin and health
• Analyze how growth hormone can promote health and possibly slow aging
• Explain the risk versus benefit of using testosterone and melatonin
• Recognize the role of DHEA and DHEA-S on health and longevity
• Identify the main concepts of an anti-aging strategy

• Assess the association between opioid use and chiropractic treatment for LBP
• Demonstrate the potential for chiropractic care to reduce the use of prescription opioids in patients with spinal pain
• Summarize two papers exploring the effects of utilization and availability of chiropractic services on opioid usage and medical services
• Evaluate the impact of chiropractic utilization on the use of prescription opioid use in Medicare beneficiaries aged 65 and over with spinal pain
• Describe the comparative risk of treatment escalation in patients with neck pain between recipients of spinal manipulation and nonrecipients of spinal manipulation

• This contains all courses with the educational objectives listed from Ortho 102 through Ortho 117.

• Describe neck anticipatory control with pain
• Describe lateralized fatigue with unilateral neck pain
• Assess head and trunk motion during neck manipulation
• Identify neuromuscular dysfunction in neck pain patients
• Outline exercises for the rehabilitation of neck neuromuscular dysfunction

• Discuss the biomechanical, physiological and psychological evidence for the use of back belts
• Identify and describe recent recommendations and findings for the use of back belts.
• Discuss the principle of affordances and how they relate to environmental constraints (such as a back belt) and posture.

• Summarize the affects of low back health status on low back disorder risk
• Discuss the relation between lumbar curvature and LBP risk factors during postural loading
• Assess the relation between asymmetric lifting and spine loading
• Describe the differences in spine kinematics between LBP patients and normal controls
• Analyze the functional deficits that occur following low back disorders

• Summarize recommendations for backpack use
• Appraise recent research on backpacks and human health
• Discuss the effects of backpacks on musculoskeletal and non-musculoskeletal variables
• Describe current studies on backpack use in children: perceptions, load, biomechanics, physiology

• Learn current perspectives on which structures are strongly but variably linked to back pain
• Review the state-of-the art in low back disorders research applied to ergonomics
• Describe workplace design guidelines for asymptomatic and low back pain workers
• Determine the influence of exercise on lumbar spine disorders

• Identify common underlying causes of non-organic pain
• Recognize the eight Waddell signs of non-organic back pain
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to Waddell signs
• Encourage development and nurturing of skill sets in utilizing Waddell signs

• Determine the epidemiology of low back pain in children and adolescents
• Assess the risk factors associated with back pain in school children
• Outline the effect of an intervention to improve sitting habits in schoolchildren
• Assess the effects of reading a book or using a computer on neck and upper back muscle activity in children
• Review the diagnostic criteria of tension-type headaches in children

• Describe the basic principles of postural control
• Clinically assess postural control
• Outline a protocol of postural rehabilitation

• Examine the association between chiropractic spinal manipulation for newly diagnosed lumbar disc herniation and/or lumbosacral radiculopathy and the odds of lumbar discectomy over 1-year and 2-year follow-up periods 
• Evaluate the clinical outcomes and MRI changes in a cohort of patients who had surgery compared to conservative treatment for sequestered lumbar disc herniations 
• Summarize existing evidence relating to the reliability of the straight leg raise (SLR) and crossed SLR test in patients with suspected lumbar radicular pain 
• Establish the validity of the extended straight leg raise (ESLR) compared to findings on MRI 
• Recognize the effectiveness of neural mobilization interventions in improving pain, disability, and function in adults with low back and radicular pain

• Evaluate the test-retest, intra- and inter-examiner reliability of the body pain diagram for determining pain distribution and location for musculoskeletal conditions
• Summarize the current state of knowledge on neuropathic pain, with focus on how it differs from nociception
• Review of the current literature regarding the epidemiology, diagnosis and management of Complex Regional Pain Syndrome
• Explore central nervous system neuroplastic adaptations that may contribute to the pathophysiology of chronic conditions
• Differentiate symptoms and signs of central sensitization, peripheral neuropathic pain and nociceptive pain in patients with low back pain (with or without leg pain)

• Gain insight into the different types of pain
• Differentiate different sources of spinal pain
• Summarize the societal and clinical challenges of the pain patient
• Describe the difference between acute and chronic pain
• Provide an initial appreciation of alternative treatment options
• Understand the importance of chiropractic principles with the pain patient

• Evaluate the relationships among thoracic spinal stiffness, pain and muscle activity in healthy subjects and those with chronic thoracic pain
• Summarize updated chronic pain classification updates from the ICD-11
• Compare and contrast the clinical presentation and pathophysiology of Fibromyalgia (FM) and Myofascial Pain Syndrome (MPS)
• Summarize a clinical framework to sub-categorize pain patients based on an individual’s dominant pain etiology 
• Examine the effect of neural tissue management on pain and disability in patients with chronic musculoskeletal pain

• Outline a recent clinical guideline on the chiropractic management of chronic musculoskeletal pain 
• Identify a common set of recommendations from high-quality clinical guidelines that can be applied to a wide range of musculoskeletal pain conditions 
• Explore which target concepts are important to patients who improved following a pain science education intervention for persistent pain 
• Investigate whether untrained trait mindfulness is associated with differential responses to pain stimuli and whether these intrinsic differences reflect differential patterns of resting-state functional connectivity in the brain 
• Characterize the pain-based mechanisms of thoracic spinal manipulation and advance the preliminary validation of brain-based models as potential clinical biomarkers of pain

Hour 1

• Define interventional pain management and how it can be applied to help solve acute and chronic pain.
• Outline and critique different pain theories.
• Outline the Biopsychosocial model of chronic pain and explain why this model is the most comprehensive for acute and chronic pain management.
• Summarize how to integrate interventional pain management with conservative care for acute and chronic pain.

Hour 2:

• Describe common interventional pain management procedures and how to integrate them into a comprehensive plan of care.
• List the most utilized injections and when they are considered.
• Identify when a spinal cord stimulator may be considered and how it can aid conservative management.
• Explain the use of endoscopic procedures and when they may be utilized to treat acute and chronic pain.

• Explore chiropractic patients’ perceptions of discomfort, pain, and stiffness to determine if and how they differentiate among the concepts 
• Describe the relationship between the presence of an audible pop during spinal manipulative therapy and pain outcomes
• Evaluate the effect of spinal manipulation on pressure pain thresholds in a real-world clinical setting 
• Assess whether a 10-second one legged stance test can independently predict survival in middle and older aged men and women 
• Illustrate the relationship between physical activity levels and pain

• Relate the different neurophysiologic mechanisms to the development of chronic pain states. 
• Draw the pathways specific to Lamina I versus Lamina V sensory pathways.
• Discuss basic science research that supports the main theories of chronic/central pain syndromes.  
• Apply basic neurorehabilitation techniques to modulate chronic pain circuits.
• Develop treatment plans for chronic pin patients consistent with current pain models.

• This contains all courses with the educational objectives listed from Pain 116 through Pain 121

• Relate the effects of interoceptive dysfunction to the development of chronic pain.
• Draw the pathways specific to Lamina I versus Lamina V sensory pathways.
• Discuss how the interoceptive nervous system may relate to Functional Neurologic Symptom Disorder.
• Apply knowledge of how interoceptive dysfunction may negatively affect higher cortical functions.
• Design and utilize strategies that normalize interoception to improve intractable patient symptoms.

• Relate the effects of cold sensory deficit to chronic central pain states.
• Map the pathways specific to Lamina I versus Lamina V sensory afferents.
• Discuss basic science research that links C-Fiber subpopulations with hyper-excitability of sensory neurons.
• Apply techniques to gate pain processing through the Dorsal Insula/Anterior Cingulate pain switch.
• Utilize relationship between cold pathways and pain pathways to gate chronic pain.

• Identify the relationship between the ANS and chronic pain.
• Explore the cause of sympathetic maintained pain.
• Discuss the emerging role of the brain and spinal cord in CRPS.
• Apply non-invasive neuromodulation techniques for pain control.
• Formulate an effective treatment plan based on current knowledge.

• Relate the effects of failure within the DNIC to the development of chronic pain.
• Draw the pathways specific to ascending sensory and descending pain modulatory circuits.
• Apply knowledge of the DNIC, as it relates to chronic lower back pain.
• Discuss basic science research that links the PAG with the phenomena of offset analgesia and conditioned pain modulation.
• Formulate and apply treatment plans based on stimulation of the DNIC utilizing spinal cord stimulation, motor cortex activation and heterotopic noxious conditioning stimulation.

• Relate the effects of cingulate cortex activation on chronic pain suppression.
• Draw and identify regions of the cingulate cortex pertinent to pain and suppression.
• Discuss basic science research that links area’s 32, 24 and 25 with pain and its relief.
• Apply specific techniques to modulate cortical areas 32, 24, and 25 for pain suppression.
• Formulate and implement a treatment plan based on the M1-ACC pain model.

• Explain the complex multidimensional and individual specific nature of pain
• Present the theories and science for understanding pain
• Define the terminology for describing pain and associated conditions
• Describe the impact of pain on society
• Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain  
• Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess outcomes as appropriate for the clinical context and population.
• Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management
• Assess patient preferences and values to determine pain-related goals and priorities
• Demonstrate empathetic and compassionate communication during pain assessment

• Demonstrate the inclusion of patient and others, in the education and shared decision-making process for pain care
• Identify treatment options that can be assessed in a comprehensive pain management plan
• Explain how health promotion and self-management strategies are important to the management of pain
• Develop a pain treatment plan based on benefits and risks of available treatments
• Monitor the effects of pain management approaches to adjust the plan of care as needed
• Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence
• Develop a treatment plan that accounts for the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at end of life
• Describe the unique pain assessment and management needs of special populations
• Explain how to assess and manage pain across settings and transitions of care
• Describe the role, scope of practice, and contribution of the different professions within a pain management care team
• Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources
• Describe the role of the clinician as an advocate in assisting patients to meet treatment goals

• Determine why communication is imperative in clinical encounters
• Classify rights and responsibilities of the patient -provider partnership
• Recognize barriers and benefits regarding improved communication
• Apply numerous strategies to improve and solidify patient interactions
• Summarize how to fix the system so providers will provide better quality visits

• Identify the ways your conscious or unconscious bias toward patient characteristics may enter the clinical relationship
• Outline ways to improve your clinical communication with patients who are elderly, poor or ethnic minorities.
• Distinguish male and female patient communication styles and plan what to do when your patient wants a different gender provider
• Compare the way Jewish, Irish, Italian, and other cultures present differently as patients and prepare your communication style appropriately
• Internalize the seven ideal interpersonal traits patients want in their health care providers

• Recognize deceptive behaviors from other people and integrate these skills
• Use tips garnered from former CIA officers to separate truth from lies
• Determine motivations for patients to lie to health care providers
• Strategize ways to avoid being lied to by your patients and staff
• Assess the consequences of lying and how it compromises clinical relationships

• Explain the Four Habits of Highly Effective Clinicians
• Show the payoffs for each of the habits and provide examples
• Demonstrate how to avoid “Door Knob Concerns” and uncover hidden problems
• Specify barriers to patient communication and how to overcome them
• Describe action steps to incorporate better communication habits into practice immediately

• Modify explanations about risks, harms and benefits to avoid miscommunication to patients
• Apply research concepts such as sensitivity and specificity to outcomes communications
• Identify weak spots in clinical trials with regard to benefits and harms
• Implement the best practitioner action to build trust in patients
• Discover strategies for better communicating with low functional health literacy patients

Hour 1:

• Learn age-appropriate general health screening and health education for babies.
• Analyze through evidence the use of chiropractic manipulation for pregnant women.
• Identify normal growth, development and behavior and their assessment, as well as approaches to abnormalities for neonatals.
• Describe a typical pediatric examination on a neonatal.

Hour 2:

• Learn age-appropriate general health screening and health education for toddlers.
• Analyze through evidence the use of chiropractic manipulation for toddlers through young children.
• Identify normal growth, development and behavior and their assessment, as well as approaches to abnormalities from infancy through toddlers.
• Describe a typical pediatric examination on an infant 1-5 years old.

Hour 3:

• Learn age-appropriate general health screening and health education for adolescents.
• Identify the signs and symptoms of mild traumatic brain injury (through accident and sport) in children.
• Discuss and describe typical examination forms and outcome assessment tools used for the pediatric population.
• Evaluate through clinical cases and it’s management.

Hour 1

• Explain the necessity of evidence for infant healthcare
• Describe what mothers want from healthcare for their newborn?
• Outline the need for and development of the United Kingdom Infant Questionnaire
• Cite the outcomes of infant care in chiropractic practice and the adaptability of a parent-reported outcome measure to the infant population

Hour 1 

• Describe recommended health guidance for infants.
• Analyze evidence-based research with regards to the efficacy of spinal mobilization and soft tissue treatment in the infant.
• Develop a treatment plan in how to teach parents how to anticipate safety needs and promote healthy musculoskeletal practices for their babies.

 Hour 2

• Discuss important developmental changes that mark the transition from infancy to early childhood.
• Describe recommended health guidance for toddlers.
• Analyze the data surrounding chiropractic care for the toddler child, with a focus on spinal manipulation.
• Identify safety precautions that can be implemented in and outside of the office for toddlers.

Hour 3

• Discuss the developmental changes that mark the transition from the toddler to school-aged child.
• Describe recommended health guidance for preschoolers.
• Analyze the data surrounding chiropractic care for the school aged child, with a focus on spinal manipulation.
• Discuss the motor, verbal and neurological findings of developmental milestones in children.

• Compare the effectiveness of chiropractic spinal manipulation versus sham manipulation in children aged 7-14 with recurrent headaches.
• Outline current evidence on the functional changes associated with neck pain in adolescents.
• Investigate the role of chronic physical illness, mental health disorders and psychological conditions as potential triggers or risk factors for low back pain in children, adolescents, and young adults.
• Estimate whether carrying a heavier schoolbag (> 10% of bodyweight) is associated with a higher prevalence of low back pain in children between the ages 9 and 16.
• Examine the changes that are occurring in young athlete’s development and implications on movement, performance, and injury.

• Identify examples of traumatic spine, soft tissue and other commonly missed injuries
• Develop a post-traumatic diagnostic imaging algorithm and protocol 
  
• Recognize and develop an awareness for PI patient, carrier and attorney risks and liabilities
• Discuss several areas of PI documentation scrutiny including the causation statement

• Identify examples of traumatic spine, soft tissue and other commonly missed injuries
• Develop a post-traumatic diagnostic imaging algorithm and protocol 
  
• Recognize and develop an awareness for PI patient, carrier and attorney risks and liabilities
• Discuss several areas of PI documentation scrutiny including the causation statement

Hour 1 - PI Case Management Part 1

• Identify and avoid common PI history mistakes and liabilities
• Recognize many keys to a quality initial PI patient history
• Develop an awareness for the materials and tools necessary for a PI history
• Create a plan and protocol to improve the quality and thoroughness of the PI history

Hour 2 - PI Case Management Part 2

• Recognize common PI history red flags and contraindications 
• Identify symptoms and clinical history for two common PI traumatic injuries 
• Create a plan to identify and eliminate common patient errors pertaining to the PI history
• Develop an awareness for potential med-legal issues that can arise from a PI history

Hour 3 - How to Humanize Your PI Cases

• Create a protocol to consistently implement outcome assessments into PI cases 
• Recognize other options and opportunities available to humanize PI cases   
• Identify common outcome assessments utilized in PI cases
• Improve awareness of clinical decisions that can be made from humanizing cases

Hour 1 - Your Personal Injury History: Part 1

• Identify and avoid common PI history mistakes and liabilities
• Recognize many “keys’ to a quality initial PI patient history
• Develop an awareness for the materials and tools necessary for a PI history
• Create a plan and protocol to improve the quality and thoroughness of the PI history

Hour 2 - Your Personal Injury History: Part 2

• Recognize common PI history “red flags” and contraindications
• Identify symptoms and clinical history for two common PI traumatic brain injuries 
• Create a plan to identify and eliminate common patient errors pertaining to the PI history
• Develop an awareness for potential med-legal issues that can arise from a PI history

Hour 3 - Your Personal Injury Examination – Part 1

• Recognize the key elements of the Personal Injury post-traumatic examination
• Identify clinical contraindications and precautions prior to an examination
• Develop and map out a post-traumatic cervical spine examination protocol
• Identify and examine common motor vehicle crash shoulder conditions

Hour 4 - Your Personal Injury Examination – Part 2

• Discuss the critical components of a Personal Injury neurological examination
• Develop a traumatic brain injury examination screening protocol
• Recognize the documentation elements necessary in a PI physical examination
• Create a protocol for medical consultations, diagnostic imaging and testing

• Recognize the importance diagnostic imaging and testing in Personal Injury and trauma
• Summarize several of the common diagnostic imaging and testing available  
• Justify medical necessity and clinical rationale for imaging/testing in the treatment records
• Determine both a protocol and clinical necessity for plain film radiographs

• Recognize elements of Personal Injury case management
• Identify common inherent risk within PI case management    
• Summarize several insurance carriers concerns regarding PI case management   
• Discuss current PI case management issues in the med-legal arena

• Discover the importance of identifying case management issues early   
• Summarize emergency, urgent care and early intervention management  
• Recognize med-legal issues in the early providers management  
• Outline the application of home and self-care as part of case management

• Recognize the importance of Personal Injury physical examination
• Outline the examination of common traumatic injuries and conditions       
• Summarize common examination tests and procedures associated with a PI examination    
• Demonstrate support for care and management with examination documentation

• Outline the preparation for traumatic injury care and case management 
• Summarize the application of passive and active modalities in traumatic injuries
• Develop a protocol for implementing active therapeutic procedures and clinical exercise       
• Identify common therapeutic and conservative care risks and mistakes

• Recognize the importance of diagnostic imaging in Personal Injury
• Summarize specific diagnostic imaging tests for common PI injuries  
• Identify several common clinical indicators for PI diagnostic imaging
• Develop a protocol for ordering and monitoring PI diagnostic imaging         

• Recognize the importance of humanizing traumatic patient injuries
• Demonstrate the general application of assessments and PI interrogatories
• Summarize the importance, applications and protocols of medical photography
• Interpret assessments and PI interrogatories for case management decisions

• Recognize the importance of Personal Injury co-management
• Design a process for finding providers for co-management consults and referrals
• Develop protocols for co-management with primary care providers
• Devise a plan to begin, apply and implement PI case management clinical decisions

• Determine options for co-management with pain management providers
• Identify co-management opportunities with orthopedic and neurology providers
• Develop documentation protocols to support co-management decisions
• Summarize and implement Personal Injury case management protocols and procedures

• Recognize the importance the 5 steps represent in PI cases      
• Develop a plan to identify common PI acute injuries and conditions
• Design an in-office process to improve consistency of documentation
• Identify and evaluate several acute injuries and conditions

• Estimate the risk for an association between exposure to neck pain from a motor vehicle accident and future neck pain
• Estimate the risk for an association between exposure to neck pain from a motor vehicle accident and future back pain
• Appraise the validity of employing a biomechanical approach to assess injury risk from minimal damage traffic crashes
• Assess which factors predict the risk of developing post-traumatic headache six months following a motor vehicle collision (MVC) in adult

• Define Fibromyalgia from an allopathic perspective
• Review historical treatment by traditional medical community
• Examine current allopathic theories and treatments
• Review signs and symptoms, demographics and presentation of the fibromyalgia patient
• Obtain an accurate diagnosis through labwork and history as it pertains to the fibromyalgia patient.
• Differentially Diagnosis adrenal fatigue, perimenopause, myofascial pain syndrome, chronic fatigue
• Determine the Labwork needed to evaluate a fibromyalgia patient
• Discuss the fibromyalgia patient’s point of view of symptoms and treatments
• Contrast the varying possible diagnoses from the alternative healer viewpoint
• Explain the Fibromyalgia “personality type”
• Create a team approach with other practitioners in the treatment of the fibromyalgia patient
• Determine the appropriate organic treatments that may be needed to treat the fibromyalgia patient including Gluten intolerance, Food allergies, and Supplementation
• Discuss Musculoskeletal treatments for fibromyalgia patients including Adjustments, Massage, and Prolo therapy
• Integrate appropriate exercise and home remedies for the fibromyalgia patient including 5 Tibetan Rites, Yoga, Walking, and swimming

• Recognize the signs and symptoms of an elbow disorder
• List appropriate exam procedures for differential diagnosis of elbow disorders
• Outline the different elements of a elbow exam
• Discuss the importance of “red flags” in the exam and evaluation of elbow complaints
• Summarize additional elbow tests that can be performed and under what conditions to use them

• Recognize the signs and symptoms of a shoulder disorder
• Be able to list differential diagnosis of shoulder disorders
• Outline the different elements of a shoulder exam
• Understand the importance of “red flags” in the exam and evaluation of shoulder complainants
• Be able to summarize additional shoulder tests that can be performed and under what conditions to use them

• Identify important chest and thorax landmarks in order to perform a lung examination.
• Summarize the various musculature associated with adult breathing mechanics.
• Demonstrate the differences between consolidation and effusion lung pathologies.
• Diagnose common adult lung pathologies with use of a medical history and full physical examination.

• Define the differences between visual fields and pathways.
• Recognize the three most common eye conditions and diseases affecting the cranial nerves seen within the chiropractic practice.
• Diagnose common eye diseases and conditions from a funduscopic examination.
• Propose management and co-management options for specific common eye conditions.

• Explain jurisdictional authority over school enrollment and pre-participation physical examinations
• List the common items required on a school enrollment and pre-participation physical examinations
• Outline the key components of the health history
• Identify normal values for vision and hearing acuity
• Calculate BMI and determine age appropriate percentile ranking
• Classify physical maturity using the Tanner Scale
• Assess immunization records for statutory compliance
• Indicate the difference in the level of detail required in the pre-participation exam versus the school enrollment physical
• Recognize the classifications of sports based on exertion required and level of contact
• Describe the process of clearing an athlete to resume training and competition
• Recognize the risk factors to sudden cardiac death syndrome
• Determine the association between risk factors and specific sports

• Recognize the elements and significance of the jugular venous pulse
• Know the physiology and sound of S1 and S2
• Know the physiology and sound of S3 and S4
• Identify systole and diastole by palpation and listening
• Describe heart murmurs
•  Hear and understand the mechanism of two common systolic murmurs

• Justify the addition of manipulative therapy to rehabilitation in the management of recurrent ankle sprain with functional instability
• Compare the effectiveness of plantar fascia-specific stretching to high-load strength training in patients with plantar fasciitis
• Examine the biomechanical mechanisms that may be involved in the foot-to-low back relationship, and how foot orthoses might be used to manage low back pain
• Outline the state of current clinical evidence regarding the use of manual therapies in the treatment of lateral ankle sprains
• Summarize relevant concepts for the diagnosis and management of ankle syndesmosis injuries

• Differentially diagnose prostate pathologies in individuals who present to your office with musculoskeletal pain,
• Differentiate various types of common prostate pathologies
• Expand understanding of prostate pathophysiology, including hormonal and biochemical implications
• Identify prostate pathology risk factors
• Identify the common pre-disposing factors for prostate pathologies that can ultimately mimic musculoskeletal complaints
• Interpret conventional prostate diagnostic procedures and identify protocols to evaluate and monitor prostate health and/or pathology
• Hone diagnostic skills by reviewing and analyzing patient case studies, inclusive of history, exam findings, lab test results for patients presenting with musculoskeletal complaints that may have underlying prostate pathologies

• Recognize the signs and symptoms of a wrist and hand disorder
• Be able to list appropriate exam procedures for a differential diagnosis of wrist and hand disorders
• Outline the different elements of a wrist and hand exam
• Discuss the importance of “red flags” in the exam and evaluation of wrist and hand complaints
• Be able to summarize additional wrist and hand tests that can be performed and under what conditions to use them

• Outline the current state of the literature on the etiology, diagnosis and management of frozen shoulder
• Clarify the influence of the spine on shoulder range of motion in middle-aged and elderly patients
• Assess the utility of three clinical tests evaluating subscapularis muscle function
• Utilize and integrate a simple clinical test to assist in distinguishing neck from shoulder pain
• Summarize the recent Clinical Practice Guideline (APTA) regarding the treatment of adhesive capsulitis

• Recognize the signs and symptoms of a mid-back disorder
• Be able to list differential diagnosis of mid-back disorders
• Outline the different elements of a mid-back exam
• Understand the importance of “red flags” in the exam and evaluation of mid-back complainants
• Be able to summarize additional mid-back tests that can be performed and the reasons why to use them

• Understand basic genetic and how this new field of medicine may impact your practice
• Learn and key common genomic medicine study type.
• Critically evaluate genomic medicine studies by identifying bias, evaluating effect size, and applying it to your patient.
• Understand the cardiovascular disease association between the SNPs ApoE, Kif6, and MTHFR.
• Consider how polymorphisms may impact the placebo effect.

• List five statistical references that relate to evidence based practice.
• List four Red flags that are pertinent in the evaluation component of treatment.
• Identify the five categories that pertain to possible spinal pain and referred pain.
• Describe two metabolic diseases that can affect the spine.

• This contains all courses with the educational objectives listed from Physical Diagnosis 166 through Physical Diagnosis 169

• Recognize and list four red flags for the cervical and shoulder girdle.
• Identify three medical conditions that may refer to the cervical spine but are non-musculoskeletal in origin and require a physician's intervention.
• Name and describe two CPR for the Cervical Spine.
• List two dural tests that are done for the nervous system in the Cervical region.

• Identify and describe two musculoskeletal issues of the thoracic region.
• List one dural test that is used to evaluate the thoracic region which will assist in determining normal neuromeningeal pathway mobility.
• List two CPR of the spine in the thoracic region that have good reliability and are effective in use.
• List and describe two vascular diagnoses which may relate to Thoracic Spine referred pain

• Identify two serious pathologies that appear to be related to the lumbar spine but are not.
• Describe three categories of pelvic fractures than may occur.
• Describe the objective differences between vascular claudication and neurogenic claudication.
• List the five screening tests for the pelvis and SI joint.

• Identify musculoskeletal anatomy pertinent to the abdominal exam.
• Identify the location of intra-abdominal contents relative to the abdominal wall and what is normally palpable.
• Recognize examination techniques used for inspection, auscultation, percussion and palpation of the abdomen.
• Name advanced techniques used to evaluate the acute abdomen.

• Describe thyroid anatomy and physiology. 
• Outline the pathophysiology of hypothyroidism, including possible causes and associated conditions.
• Identify signs and symptoms of hypothyroidism and hyperthyroidism.
• Demonstrate the typical thyroid exam performed in the chiropractor’s office.
• Review the usual and customary conservative and non-conservation management for common thyroid conditions.
• Discuss the role of the chiropractic spinal manipulation in care for patients with thyroid conditions.

• Identify vascular anatomy pertinent to the cardiovascular exam
• Interpret cardiovascular physiology as it relates to physical examination.
• Discuss characteristics of, and techniques used to evaluate, the pulse and blood pressure.
• Name advanced techniques used to evaluate peripheral artery disorders and conditions.

Hour 1

• Define Nonspecific Low Back/Neck Pain            
• Outline the subcategories of Nonspecific Spinal Pain
• Provide an overview of different techniques
• Analyze the anatomical source of the injury
• Examine Differentiate the functional or anatomical diagnosis

 Hour 2

• Produce a specific conservative treatment plan
• Measure the patient’s response to care.
• Neurological differential diagnosis via pain patterns
• Choosing the most appropriate type of manual therapy
• Provide Appropriate Documentation

• Compare the difference between angular and linear motion.
• List the limiting factors necessary for stability in respect to linear motion.
• List and describe the function of the limiting structures of the atlantooccipital joint and the atlantoaxial joint.
• Describe the path of the vertebral artery from the subclavian artery to the basilar artery
• List the three types of Atlantooccipital fractures.
• Describe five diseases that may compromise the stability of the cervical region and how.
• List and elaborate on the immune specific diseases that can affect the atlantoaxial joint.
• Summarize the normal growth of the cervical spine and craniovertebral region in children.
• Outline the details of IFOMPT Framework for Red Flags.
• Demonstrate three stability tests of the cervical region and interpret the results.
• Demonstrate a neurological scan to clear spinal cord and neurological dysfunction in the cervical spine.
• Apply a vigorous mandatory scan for all patients to rule out serious pathology of the cervical spine and the neurological system and be able to interpret the results.

• Recognize the importance of knowing and diagnosing a tremor.
• Define what is a tremor List some of the general symptoms of a tremor.
• Discuss the triggers that may exacerbate a tremor.
• Name the main categories of a tremor.
• Recall the subclasses of action tremor List the most common diseases and syndromes demonstrating each type of tremor.
• Differentiate the symptoms of Essential tremors (ET) and debate the current gold standard treatment plan of action.

• Recognize the signs and symptoms of a knee disorder.
• List differential diagnosis of knee disorders.
• Outline the different elements of a knee exam.
• Identify “red flags” during the evaluation of knee complaints.
• Summarize additional knee tests that can be performed and the reasons why to use them.

• Recognize and apply the diagnostic criteria for hypermobility spectrum disorders (HSD) including hypermobile Ehlers-Danlos Syndrome (hEDS).
• Outline the importance of blood pressure screening and review evidence-based recommendations for clinical practice.
• Appraise the evidence regarding nonpharmacological approaches used in the management of restless legs syndrome (RLS).
• Summarize a contemporary clinical framework for identifying red flags for four serious spinal pathologies that may present in chiropractic practice.
• Describe our contemporary understanding of the appropriate diagnosis and management of cervical spondylotic myelopathy (CSM).

• Investigate the effect of patient expectations on short-term, subjective improvement in recurrent or persistent low back pain patients.
• Determine whether the ritual of the history and physical examination results in meaningful change in pain and function for low back pain patients before any treatment is provided.
• Assess the potential negative effect of routine MRI reports on the perception of the patient and treatment outcomes and explore a method for improvement.
• Explore the level of association between kinesiophobia and pain, disability, and quality of life as well as its role as a prognostic factor in people with chronic musculoskeletal pain.
• Quantify the role of contextual effects in the nonpharmacologic treatment of knee osteoarthritis.

• Outline the congruence of the manual interventions used in clinical practice with the scientific evidence regarding the biomechanical aspects of degenerative disc disease (DDD) leading to pain.
• Compare the efficacy and cost-effectiveness of a stratified care model versus usual care for patients with sciatica.
• Assess the value of intervertebral disc degeneration detected in early adulthood as a predictor for progression of degenerative changes as well as low back pain symptoms and disability in middle age.
• Define deep gluteal syndrome and the deep gluteal space, as well as propose a general diagnostic pathway for this condition.
• Breakdown the utilization of conservative treatments used in lumbar disc herniation patients successfully treated nonoperatively versus unsuccessfully treated nonoperatively.

Hour 1 

• Document the patients history to include an accurate list of all herbal/dietary supplements and other medicinals they are taking and refer to their MD if there are any concerns that it will affect Chiropractic Care being considered
• Explain the concept of the use of simultaneous interventions to treat a single condition as it is relative to the patient history.

 Hour 2

• Discuss potential side effects of herbal/dietary supplement as components of history taking & physical exam procedures.
• Refer to Medical Doctor if you feel any signs or symptoms are related to any side effects of anything the patient is taking
• Give examples of how herbal/dietary supplement use may impact the history taking, physical exam procedures, and treatment plan.

Hour 3

• Describe pertinent patient medical history and physical examination procedures included in a comprehensive evaluation for conditions that may have been previously treated with surgical interventions
• Connect patient medical history and physical examination with evidence-based intervention/treatment plan of care to achieve best patient outcomes

Hour 4

• Identify evidence-based rehabilitation principles for patients whose history may include prior surgical intervention.
• Explain specific rehabilitation programs for each case based on documented evaluation findings

Hour 1

• Describe behavioral model for insomnia
• Explain why sleep quality is important
• Discuss sleep interventions as prevention for chronic musculoskeletal pain
• Discuss sleep interventions for chronic musculoskeletal pain

 Hour 2

• Ask the correct questions to assess sleep and sleep behaviors
• Identify factors to maladaptive sleep habits
• Discuss sleep efficiency and tracking progress
• Explain why rest in bed is not optimal
• Refer patients to appropriate healthcare providers for sleep dysfunction

• Increase awareness and recognition of statin intolerance in musculoskeletal patients.
• Learn the risk factors associated with Statin Associated Muscle Symptoms (SAMS).
• Identify the signs and symptoms of myositis/myopathy.
• Discuss the physiological process involved with SAMS and tests to confirm.

Hour 1

• Compare the similarities and differences between EDS and HSD in both diagnosis and clinical presentation
• Summarize the history of the diagnosis and classifications of EDS and HSD
• Discuss the scales/outcome measures commonly used with EDS and HSD patients
• Identify common comorbidities and complications of EDS and other HSD
• Name potential differential diagnoses for these conditions
• Recognize common patient presentations of individuals with EDS and HSD

 Hour 2

• Develop a history taking protocol (including subjective complaints) for this patient population
• Identify possible precautions and referral protocols 
• Recognize and address common postural faults seen in EDS and HSD patients
• Determine treatment methods and other self/home-care recommendations for this population
• Develop exercise modifications and exercise progression strategies in the context of EDS/HSD
• Formulate appropriate activity recommendations and management strategies

• Discuss the use of electrotherapy to control pain
• Establish parameters for wobble board rehabilitation of the ankle
• Describe how SI manipulation affects anterior knee pain
• Discuss the use of post-fracture manipulation
• Construct therapeutic exercises for patients with lumbar spinal stenosis

• Describe ideal pad placement for interferential therapy
• Discuss increasing muscle strength in the elderly
• Construct screening procedures and treatment for the TMJ
• Relate the evaluation and treatment of whiplash
• Review rehabilitation of ankle injuries

• Explain that the key to increased utilization of ultrasound lies in chiropractic providers knowledge and training
• Recognize the ultrasound procedure, its benefits, effects, proper application, and potential outcomes
• Point out precautions and contraindications affiliated with ultrasound
• Internalize a level of knowledge and comprehension of diathermal principles
• Develop skill sets when rendering ultrasound (continuous or pulsed) therapy

• Discuss the unique properties of lasers and their clinical applications
• Identify indications and contraindications to cold laser therapy
• List parameters and protocols of cold laser therapy
• Evaluate the current body of low level laser therapy clinical research
• Explain the advantages and disadvantages of using cold laser therapy

• Identify principles, indications and contraindications for ultrasound, heat, cold and electrical modalities with a focus on the upper extremity
• Utilize clinical guidelines for applying ultrasound, heat, cold and electrical modalities with a focus on the upper extremity
• Recognize and discuss the clinical efficacy and safety parameters of ultrasound, heat, cold and electrical modalities with a focus on the upper extremity

Hour 1

• Discuss the history of elastic taping.
• Define the anatomy of fascial layers in the human body, and how the mechanotransduction concept relates to the use of elastic taping.
• Recognize the most common indications and contraindications for the use of elastic tape within the manual therapist’s practice.
• Describe the application process of elastic taping .

Hour 2

• Discuss the evidence providing support of the use of elastic taping
• Outline various conservative management options for taping musculoskeletal problems
• Construct a treatment plan for a typical patient with acute traumatic swelling
• Apply specific taping techniques for certain biomechanical dysfunctions

Hour 3

• Describe and demonstrate the application of elastic taping procedures for carpal tunnel syndrome
• Describe and demonstrate the application of elastic taping procedures for biomechanical low back pain
• Describe and demonstrate the application of elastic taping procedures for shoulder stabilization
• Describe and demonstrate the application of elastic taping procedures for knee osteoarthritis

• Examine the relationship between hip flexibility and patellofemoral pain
• Summarize the evidence pertaining to the efficacy of manual and physical therapies for the management of Patellofemoral Pain Syndrome
• Outline the possibility of a continuum existing between patellofemoral pain and patellofemoral osteoarthritis
• Discuss the evidence regarding prevalence, diagnosis and management of patellar tendinopathy
• Review the most common clinical tests used to determine balance in those with knee OA a clinical setting

• Outline the innovation of the therapy
• Summarize the Physics behind the modality
• Describe the interaction of LLLT with live tissue
• Detect the contraindications & precautions
• Assess the different LLLT devices.
• Comprehend the different types of LLLT available
• Optimize the LLLT parameters for improved outcomes
• Apply LLLT in a manner that optimizes your treatment
• Explain the physiological effects to your patients
• Examine the current clinical evidence

• Appraise the combination of pain neuroscience education and exercise or motor control training to alter ‘pain memories’ associated with chronic pain
• Assess the relationship between vibration training and muscle strength and bone mineral density in older adults
• Measure the effects of whole-body vibration (WBV) training on balance and strength in elderly patients suffering from diabetic neuropathy who are at high risk of falls
• Examine the effectiveness of unimodal and multimodal physical therapies for base of thumb osteoarthritis
• Explore the evidence on the effects of manual therapy for the treatment of plantar heel pain

• Review sensory-motor control and rehabilitation
• Discuss aerobic exercise for LBP patients
• Describe muscle training of the hip, abdominal and paraspinal muscles
• Identify how aerobic exercise improves motor performance in the elderly
• Distinguish the effects of different training styles on the cross-sectional area of paraspinal muscles

• Describe the contribution of hip vs. spinal motion
• Distinguish poor motor patterns of hip and low back movements and what to do about it
• Differentiate the role of exercise for neck disorders and determine what type of exercise works
• Delineate the neural adaptations to exercise and apply towards rehabilitation
• Describe current issues in low back rehabilitation (such as can low back tissues heal within a few weeks)

• Describe the long term course of LBP
• Describe neuromuscular impairments following LBP
• Differentiate the effects of pain on the neuromuscular system
• Discuss the models that explain the nature of motor problems with pain
• Differentiate and discuss the potential sources of LBP

• Identify and describe the major factors influencing muscular strength
• Assess the chiropractic influences on strength
• Identify and discuss the strength training principles
• Illustrate components of a training session
• Apply training principles into a practical strength program

• Define proprioception and describe how it is measured
• Discuss proprioception from a rehabilitative perspective
• Examine ankle, knee and shoulder proprioception and rehabilitation
• Examine spinal proprioception and sensorimotor training
• Summarize rehabilitation recommendations for proprioceptive deficits

• Illustrate basic principles of cardiovascular exercise
• Discuss the mechanisms of cardiovascular responses to exercise
• Discuss the acute effects of exercise on the cardiovascular system
• Discuss the training effects of exercise on the cardiovascular system

• Summarize the effect of training on the fatigue of multifidi muscles
• Discuss which muscles are involved in stabilization exercises
• Assess the relation between low back pain and clinical instability
• Describe a study implementing manipulation and stabilization exercises for chronic LBP
• Introduce the concept of functional restoration vs. physical therapy for LBP

• Describe the early health care utilization for occupational low back pain
• Determine which factors are important in predicting outcome after a spinal stabilization exercise program
• Assess lumbar disc surgery rates before and after implementation of nonsurgical spine clinics
• Determine whether kinematic compromise can be used to predict spine loading in low back pain (LBP) patients under realistic lifting efforts in a workplace
• Determine the effects of subacute LBP and limitation of the straight leg raise on lumbar and hip kinematics during sit-to-stand and its reverse

• Summarize the effect of whiplash on neck muscle strength
• Discuss the effects of manipulation vs. mobilization on head and neck pain in whiplash patients
• Assess the effects of thoracic manipulation in whiplash patients
• Describe a study predicting the response of neck pain patients to neck strengthening exercise
• Introduce the smooth pursuit neck torsion test and its application in whiplash disorders

• Identify the anatomy of upper motor neuron tract systems and discuss the functionality of upper motor neuron tract systems
• Explain the effects of a spinal cord injury
• Discuss the anatomy and functionality of regions of the brain
• Describe complications post injury of brain and spinal cord injury
• Describe standard treatment procedures prior to rehabilitation of brain and spinal cord injured patients
• Explain the difference between neurological deficit rigidity versus disuse atrophy/spasm of spinal cord and head injured patients
• Describe treatment options for rehabilitation of spinal cord and head injured patients
• Explain treatment methods to transition C curve locomotion to S curve locomotion
• Explain treatment methods for atrophy and spasm
• Discuss most current curative research for spinal cord and head injured patients

• Outline the anatomy of cervical spine proprioception
• Review clinical studies investigating cervical spine proprioception
• Assess existing literature on the reliability of cervical spine joint position sense
• Assess the effect of spinal adjustments/manipulation on cervical spine proprioception

• Summarize the central role of muscle protein in whole-body metabolism and muscle mass
• Outline the role of skeletal muscle metabolism in health and disease (such as diabetes, obesity, osteoporosis)
• Describe the role of hormones for influencing muscle metabolism and health
• Identify the catabolic and anabolic mediators of muscle metabolism
• Specify ways to maximize muscle mass and metabolism to promote wellness