New York Chiropractic Continuing Education

• Describe pertinent differential diagnoses for facial pain 
• Breakdown the available interventions available for chronic pain secondary to temporomandibular disorders 
• Compare the effectiveness of two types of treatment – dry needling and upper cervical spinal manipulation versus interocclusal splint therapy, topical NSAIDs and TMJ mobilization for patients with temporomandibular disorder 
• Evaluate the comparative effectiveness of cervical versus combined cervico-craniomandibular manual therapy in patients with temporomandibular disorders (TMD)

• Develop a better understanding of the clinical course of low back pain across different pain durations and populations 
• Assess the literature linking hip biomechanics to low back pain 
• Outline prolonged standing pain developer characteristics and risk factors associated with standing-induced low back pain 
• Investigate the clinical and cost effectiveness of an individualized, progressive walking and education program for preventing recurrences of low back pain 
• Examine the effects of diagnostic labels for low back pain on patients’ perceived need for imaging and other aspects of their condition

• Update the 2013 Cochrane review and determine the current state of the literature on non-operative treatment for neurogenic claudication caused by lumbar spinal stenosis 
• Summarize a treatment algorithm for the management of lumbar spinal stenosis derived from and international expert Delphi consensus process 
• Identify the relevant clinical indicators and pertinent physical examination procedures that can assist in the identification of peripheral arterial diseases or lower limb blood flow limitations 
• Assess the value of adding spinal manipulation and electrical dry needling to standard physical therapy for lumbar spinal stenosis patients 
• Evaluate whether primary care patients with lumbar spinal stenosis symptoms benefit from programs designed for patients with non-specific low back pain

• Explain the origin of the vagus nerve, its anatomy, and its critical role in regulating bodily functions, including its connection to the sympathetic and parasympathetic nervous systems.
• Describe common causes of headaches and explore how the vagus nerve contributes to the pathophysiology of headache conditions.
• Discuss the science behind vagus nerve stimulation, its impact on neurological pathways, and its therapeutic benefits for treating headaches, epilepsy, treatment-resistant depression, reduced anxiety, and improved mood.
• Assess the efficacy and limitations of vagus nerve stimulation as a non-invasive treatment for headache reduction, referencing current research and clinical findings.
• Review the range of vagus nerve stimulation devices, from surgically implanted medical devices to over-the-counter options, and discuss their appropriate uses and considerations.

• Identify neurological, arterial and venous causes of Thoracic Outlet Syndrome and associated disorders.
• Assess between Thoracic Outlet Syndrome, Hyperabduction Syndrome and Costoclavicular Syndrome (as associated disorders) and their symptoms.
• Diagnose the neurological, muscular and bony structures associated with the cause of Thoracic Outlet Syndrome and associated disorders.
• Apply manual methods to the soft tissue structures in the treatment of Thoracic Outlet Syndrome and associated disorders.
• Apply the use of modalities to the soft tissue structures in the treatment of Thoracic Outlet Syndrome and associated disorders.

• Identify the different types of headaches, their triggers, and how they affect the nervous system, particularly through the trigeminal nerve and thalamus
• Examine how temporomandibular joint (TMJ) dysfunction can contribute to headaches and how chiropractic care can effectively address this issue
• Discuss how stress, poor posture, food choices, and other lifestyle factors can contribute to headaches, and how adjustments in these areas can improve symptoms
• Assess the benefits of chiropractic adjustments in reducing headache frequency and severity by improving spinal alignment and nerve function
• Provide guidance on selecting a chiropractor who specializes in TMJ-related headaches and other misalignment issues to achieve optimal patient outcomes.

Section 1: What is the Biopsychosocial (BPS) Framework?

• Discuss the importance of philosophical frameworks in clinical practice.
• Summarize prominent pain theories throughout history.
• Explain the origin of the biopsychosocial (BPS) model and critique the traditional application of the BPS approach.

Section 2: A Biopsychosocial Framework for Clinicians

• Outline best practices for the care of musculoskeletal pain.
• Breakdown the concepts of patient-centered care, shared decision making and brief action planning.
• Recognize the enactive approach as a modern application of the BPS model, incorporating humanism and empathy to foster a strong therapeutic alliance.
• Integrate evidence-based strategies to facilitate effective self-care strategies for your patients.
• Describe psychologically-informed care as a clinical construct
• Relate BPS framework concepts to your clinical approach for pain

Section 3: Practical Application of a Biopsychosocial/Humanistic Approach

• Fine tune your clinical processes to deliver a great patient experience.
• Leverage evidence-based techniques when receiving a patient’s history.
• Deliver a diagnosis and pain education in a BPS framework.
• Structure a treatment plan in collaboration with your patient.
• Identify strategies to manage pain flare-ups.

Section 4: Course Conclusion

• Summarize practical ways to enhance the use of BPS principles in your practice

• Apply thorough passive and active examination methods to soft tissue structures of the cervical spine, TMJ, thoracic spine and rib cage, lumbopelvic spine, and upper and lower extremities.
• Discern between scleratomal pain, dermatome pain and myofascial pain to assist in examination procedures and treatment outcome.
• Determine necessity for diagnostic imaging of soft tissue structures after acceleration/deceleration impact.
• Explain the best treatment options to your patient after complete examination is combined with their particular accident Movement Dynamics and forces upon the patient’s body at impact.
• Utilize examination findings in combination with Factor Analysis and complicating factors to best determine treatment plan and prognosis.

• Determine the effect of chiropractic on movement time
• Assess the effects of spinal manipulation and ultrasound on chronic low back pain
• Describe heart rate variability as a measurement tool
• Assess the effects of chiropractic on heart rate variability

• Determine the effect of thoracic spine manipulation on autonomic output to the heart
• Review criteria for the diagnosis of cervicogenic headaches
• Describe a clinical assessment for cervicogenic headaches
• Assess the effects of chiropractic and spinal manipulation on cervicogenic headaches

• Describe spinal manipulation use by time, place, and person, identify predictors of the use of spinal manipulation
• Review cost-effectiveness of SMT compared to other treatment options for people with spinal pain of any duration
• Describe the current literature on patient-centered outcomes following a specific type of commonly used SM, high-velocity low-amplitude (HVLA), in patients with LBP
• Review the putative mechanical features of the subluxation and three theories that form the foundation for much of chiropractic practice

• Provide an overview of research on the effects of spinal manipulation on sensory processing, motor output, functional performance and sensorimotor integration
• Examine performance based outcome measures used in an attempt to objectively measure the ramifications of spinal manipulation
• Update knowledge regarding several physical characteristics of an applied SMT, and review what is known about the signaling characteristics of sensory neurons innervating the vertebral column in response to spinal manipulation
• Review the physiological evidence that spinal manipulation can impact visceral function

• Outline the limitations of a recent trial on preventive treatments including spinal manipulation for neck pain and how they contribute to our interpretation of the results of the study
• Interpret results of an important trial on spinal manipulation and exercise for neck pain
• Discuss recent evidence comparing spinal manipulation to mobilization for recent onset neck pain
• Use recent evidence to justify manipulating various spinal regions for patients with neck pain
• Critique the potential for chest and neck mobilizations to affect spirometric performance (breathing)

• Contrast Clinical Guideline-based care with usual medical care for acute low back pain
• Recognize the potential benefit of adding exercise prescription to spinal manipulation for low back pain
• Compare the effectiveness of spinal manipulation to McKenzie Method interventions for persistent low back pain
• Outline factors that may help predict improvement in patients seeking chiropractic care for low back pain
• Explain the benefits of evidence-based care for low back pain

• Compare the efficacy of standard medical care (SMC) alone versus chiropractic spinal manipulation + SMC for acute low back pain patients
• Discuss the value of a combined (pragmatic) chiropractic approach for treating low back pain
• Analyze the state of the research literature directly comparing spinal manipulation, exercise and acupuncture as treatments for low back pain
• Update your understanding of joint cavitation during side posture lumbar manipulation
• Critique the only study (to date) on maintenance care for low back pain including spinal manipulation

• Develop evidence-based chiropractic treatment recommendations for nonspecific (mechanical) neck pain in adults
• Discuss the clinical criteria justifying spinal manipulative therapy for neck pain
• Assess the relative effectiveness of spinal manipulative therapy and rehabilitative exercise for neck pain in seniors
• Describe the working mechanism of manual therapy in participants with chronic tension-type headache
• Examine the cerebrovascular hemodynamic response of cervical spine positions using MRI on the vertebral artery

• Critique the state of the evidence for manual therapy interventions in the treatment of cervical radiculopathy
• Compare two common interventions – spinal manipulation and nerve root injection – for patients with MRI-confirmed lumbar disc herniation
• Critique the state of the evidence for spinal manipulation (specifically) in the treatment of cervical radiculopathy
• Interpret the results of a cohort study of MRI-confirmed symptomatic cervical disc herniation patients treated with cervical manipulation
• Compare isolated cervical SMT versus a combination of cervical, cervico-thoracic and thoracic SMT in patients with chronic mechanical neck pain

• 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

• 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

• 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.

• 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

• 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

• 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

• 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

• 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.

• 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.

• 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

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

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

• 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.

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

• 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.

• 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

• 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.

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

• Relate relatively common but sometimes challenging patient cases
• Explain diagnostic and therapeutic considerations in thyroid disease
• Give examples of diagnostic and therapeutic considerations in drug toxicity
• Describe diagnostic and therapeutic considerations in diabetic neuropathy
• Demonstrate diagnostic and therapeutic considerations in vitamin deficiency

• Relate relatively common but sometimes challenging patient cases including vitamin B12 deficiency, metabolic conditions, drug toxicity, neuropathy, lymphoma and drug diversion.
• Explain diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.
• Give examples of diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.
• Describe diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.
• Demonstrate diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.

• This allows you to purchase all 5 hours of 213 level courses. Please see the educational objectives listed for each individual 213 module

• This allows you to purchase all 29 hours of 214 level courses. Please see the educational objectives listed for each individual 214 module

• Define professional ethics and morals
• Sensitize the DC to issues related to common ethical dilemma in chiropractic practice
• Discuss specific ethical considerations in situations and scenarios related to patients, former patients and society

• This allows you to purchase all 5 hours of 217 level courses. Please see the educational objectives listed for each individual 217 module

• Identify the correlation of resistance exercise and lipoprotein Patterns
• Discuss the effect of Boswellia on arthritis
• Review the effect of green tea on weight loss
• Establish the relationship of exercise and water replacement
• Identify the relationship of red wine and the cardiovascular system

• 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

• Review aspects of antioxidants and free radicals
• Discuss how silymarin can improve an alcohol-damaged liver
• Describe the connection/mechanism between atherosclerosis and vitamin E
• Identify research evidence between whole grains and disease
• Delineate the relationship of magnesium and hypertension

• 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 T Bilberry and Black Cohosh

• Identify the conditions treated with specific herbs
• List the effects, indications and dosages for Boswellia, Burdock Root, Bromelain, Calendula, Cascara sagrada, Cayenne, CBD (cannabis), Chamomile, Echinacea