The 4-Star Clinical Assistant

© 1997-1998 R. C. SCHAFER, DC, PhD, FICC



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Table of Contents

1. Introduction To A Rewarding Career -19

Who Are Involved in Administering Chiropractic Health Care? -19
   The Doctor of Chiropractic -19
   The Chiropractic Assistant -20
   The Clinical Assistant -20
   The Certified Chiropractic Assistant -20
Health-Care Education in America -21
   Medical Education -21
   Modern Chiropractic Education and Professional Development -21
   Professional Requirements -21
   Clinical Experience -24
   Academic Accreditation -24
   Postgraduate Continuing Education -24
Forms of Chiropractic Practice -25
   Solo Practice -25
   Specialty Practice -25
   Partnership -25
   Associate Practice -26
   Corporate Practice -26
   Group Practice -26
2. The Important Role Of The Chiropractic Assostant -27
Basic Qualifications of a Chiropractic Paraprofessional -27
   Not Everyone Can Qualify -28
   Assigned Duties -29
   Role of the Clinical Assistant -29
   Foresight -31
   Professional Appearance -31
Acquainting Yourself with the Doctor's Practice Goals -31
Developing Your Contribution and Assuring Career Growth -32
   Health-Team Consciousness -33
   Creativeness and Adaptability -33
   Efficiency Consciousness -34
   Emergency Situations -34
   Continuing Education -35
3. The Health-Service Role Of The Doctor Of Chiropractic -37
Diagnostics: The Art of Deciding What Is Wrong -37
   Background -37
   Overview of the Diagnostic Process -38
Therapeutics: The Art of Correcting What Is Wrong -40
Rehabilitation: The Art of Aiding Natural Healing Processes -42
   Nutritional Considerations -42
   Autointoxication -43
   Food Alteration -43
   Physiologic Needs -44
   Posture and Physical Fitness -44
Counseling: The Art of Preventive Therapy and Enhancement -47
General Practice and Specialized Interests -48
   Pain and Preventive Care -48
   Common Complaints -48
   Resistance to Disease -49
   Sports Injuries -50
   Prenatal and Postnatal Care -50
   Pediatric Care -51
   Professional Groups -51
4. The Language Of The Health-Care Prpfessions 53
The Universal Language of Health Care: Why It Is Necessary -53
   Phonetics: The Quick Way to Grasp Meanings -53
   How the Words Are Formed -54
   Common Latin and Greek Word Roots -55
   Common Latin and Greek Prefixes -63
   Common Latin and Greek Suffixes -70
   Singulars and Plurals -72
   Traditional Style -72
   Modern Style -75
Common Anatomical Terms -76
   Terms of Patient Position -76
   Terms of Direction and Location -77
   The Planes of the Body in Biodynamics -77
   Structural Motion -77
   Describing Positions in Space -78
   Axes -79
   Linear and Circular Motion -80
   Degrees of Joint Movement Freedom -80
   Combined Movements -81
   Plane Motion -81
   The Instantaneous Axis of Rotation -82
   Out-of-Plane Motion -82
   Terms of Motion -82
Common Diagnostic and Procedural Terms -86
   Background Review -86
   Terminology -87
5. Understanding The Human Body -91
Body Systems and Landmarks -91
   The Ten Systems -91
   Body Cavities -92
   The Abdominal Quadrants -93
   The Thoracoabdominal Membranes -93
The Skeletal System -94
   Skeletal Functions and Divisions -94
   General Bone Structure and Classes -94
   Shape -95
   Long Bone Features -95
   Bone Marrow -95
   Landmarks -96
   The Skull and Face -96
      The Cranial Bones -96
      The Facial Bones -97
   The Vertebral Column -97
      Vertebral Structure -97
      Spinal Curves -98
      Classification of Vertebrae -98
   The Thorax -98
   The Shoulder Girdle and Upper Limbs -99
   The Pelvis and Lower Limbs -99
   Joints (Articulations) -101
      Joint Movements -101
      Bursae -102
The Muscular System -102
   Skeletal Muscle Function -102
   Muscle Structure and Motion -103
   Principles of Skeletal Muscle Action -104
The Skin -105
   Function -105
   Structure -105
   Temperature Regulation -106
The Circulatory System -107
   The Heart -107
      Structure -107
      Heart Chambers -108
      Function -108
      Nerve Control -109
   Blood Vessels -109
      Capillaries -110
      Veins -110
      Pulse -110
      Blood Pressure -111
   The Lymphatic System -111
   The Blood -113
      Functions -113
      Plasma -113
      Serum -114
      Demands -114
      Hemoglobin -114
      Leukocytes -114
      Platelets -115
   Empiric Systems -115
The Respiratory System -116
   The Nose -116
      Cilia -117
      The Air Sinuses -117
   The Pharynx -117
   The Larynx -117
   The Epiglottis -118
   The Trachea -118
   The Bronchi -118
   The Lungs -118
      Alveoli -119
      Pleurae -119
   The Physiologic Processes of Respiration -119
   The Mechanical Processes of Respiration -119
      Inhalation -120
      Exhalation -120
The Digestive System -120
   The Alimentary Canal and Accessory Organs -121
   The Teeth -121
   The Salivary Glands -122
      Salivation -122
   The Tongue -122
   The Pharynx -123
   The Esophagus -123
   The Stomach -123
      Gastric Juices -124
   The Small Intestine -124
   Mesentery -124
   The Pancreas -124
   The Liver -125
   The Gallbladder -125
   The Ileum -126
   The Large Intestine (Colon) -126
   The Rectum and Anus -127
   Digestion Time, Absorption, and Defecation -127
The Urinary System -128
   The Kidneys -128
      Nephrons -128
      The Ureters -129   
The Urinary Bladder -128
      The Urethra -129
      Urination -129
   The Nervous System -130
   Overview -130
      Neurons -131
      Neuroglia -131
   The Central Nervous System -132
   The Peripheral Nervous System -135
   The Autonomic Nervous System -137
The Special Senses -138
The Eye -139
   The Eyeball -139
   The Lens -140
   Aqueous Fluid -140
   The External Eye and Accessory Structures -140
   Extraocular Muscles -141
The Ear -141
   The External Ear -142
   The Middle Ear -143
   The Inner Ear -143
The Endocrine System -144
   The Thyroid -144
   The Parathyroids -144
   The Adrenals -145
   The Pituitary -145
   The Pancreas -146
   The Testes and Ovaries (Gonads) -146
The Genital System -147
   The Male Reproductive System -147
   The Female Reproductive System 149
The Building Blocks of the Systems -151
   Cells -151
   Tissues -152
   Organs -155
Chiropractic's Holistic Approach to Health -155
   Structure/Function Relationship-155
   Healing Forces-156
6. Medicolegal Considerations -158
Introduction -158
   The Legal System -159
Record Management -159
   Confidential Communications -160
   Office Procedures -162
   Medicolegal Reports -164
   Subpoenaed Records -166
   Record Ownership, Disposal, and Transfer -166
The Patient's Right to Privacy -168
   Typical Information Releases -168
   Unessential Observers -169
   Photographs -170
The Doctor-Patient Contract -170
   Professional Responsibilities -170
   The Professional Contract -171
Patient Consent and Its Legal Implications -172
   Simple Consent -172
   Informed Consent -173
   Related Factors -174
      Qualified Consent -174
      Written Consent -175
      Invalid Consent -175
      Quality of Care -176
      Medical Necessity - 176
      Objectives of Care -176
   Treating Minors and Incompetents -177
   Clinical Releases -177
Protection Against Malpractice Claims -178
   Background -179
   Professional Standards -181
   Common Causes of Suit -183
   Defensive Actions -186
      Human Relations -186
      Controlling Patient Quality -187
      Recognizing Basic Medicolegal Criteria -187
      Employing the Diagnostic Rationale -188
      Determining Treatment Methods -189
      The Postexamination Conference -191
      Monitoring Progress -191
      Consultations and Referrals -192
      Keeping Up with the Times -193
      Working Within the Law -194
      Maintain Accurate Clinical Records -194
   Vicarious Liability -195
Dangerous Situations -198
   Emergency Cases -198
   Warranties: Actual and Implied -199
   Binding Contracts -200
   Careless Case Dismissal -200
   Accusations of Abandonment -202
   Infection and Contagious Diseases -204
   Unethical Conduct -204
   Failure to Report or Advise -205
Criminal Behavior -205
   Misrepresentation -206
   Fraud -206
   Gross Negligence -207
   Assault and Battery -207
   Malicious Injury -208
   Manslaughter and Murder -208
Court Actions -208
   Defensive Appearances -208
   Depositions -210
7. Introduction To Duties Of A Clinical Assistant -212
The Assistant in a Clinical Role -213
   Interpersonal Relationships in the Clinical Setting -213
   Legal Aspects of Clinical Health Care -215
   Laws Governing Licensure -218
General Characteristics of Technical Assistants -219
   Basic Attributes -219
   Classification of Procedures -221
Accident Prevention in the Office -222
   Promoting a Safe Environment -222
Measuring and Reporting Clinical Data -223
   Observation of Patients -224
   Recording Initial Case History Data -226
Maintaining a Hygienic Environment -230
   Disease and Injury -230
   Classification of Injuries -231
   Microorganisms -232
   Classification of Pathogenic Organisms -233
   Body Defenses Against Pathogenic Organisms -234
   Body Reactions to Disease and Injury -235
   Psychodynamic Pain Control -239
   The Prevention of Aids Transmission -239
Chiropractic Pediatrics -240
Chiropractic Geriatrics -243
   The Aging Process -243
   The Assistant's Approach -246
8. Typical Functions Of A Clinical Assistant -248
Assisting the Disabled Patient -248
   Applied Biomechanics -248
   The General Scope of Orthopedics -250
   Assisting with the Orthopedic Patient -252
   General Emergency Protocols Following Injury -253
   Fractures -257
Understanding the Patient in Pain -257
   False Notions About Pain -258
   The Components of Pain -259
   Types of Pain -259
   Pain Classifications -259
   Assisting the Patient in Pain -263
Assisting During Physical Examinations -264
   Basic Instruments -265
   General Objectives -265
   Typical Protocol -266
   Summary Review: Typical Preparation Checklist -269
   Assisting with a Spinal Examination -270
   Assisting with a Vaginal (Pelvic) Examination -270
Recording Vital Signs -271
   Temperature -271
   The Pulse -274
   Respiration -276
   Blood Pressure -277
Assisting with Basic Laboratory Tests -279
   Hematology -279
   Urinalysis -284
   Glossary of Common Tests and Their Abbreviations -285
Chiropractic Physiologic Therapeutics -285
   The Rationale -286
   The Stages of Healing -287
   Types of Applications -289
   Maintenance of Equipment -290
Therapeutic Nutrition and Dietary Assistance -290
   Case Management Fundamentals -291
   Effects of Food Processing and Storage -292
   Teaching Healthy Dietary Habits -292
   Dietary Supplementation -294
Assisting in the X-Ray Department -295
   Why Doctors of Chiropractic Use Roentgenography -296
   Basic Principles of Radiology -297
   Dangers of X-Radiation to Patients -298
   Personnel Monitoring -300
   Patient Preparation -301
   Film Information: Patient -304
   Film Information: Part and Position -305
   Radiographic Terms of Position -306
   Patient Positioning Routines -306
   Record Keeping and Filing -307
   Film and Film Handling -309
   Film Processing -310
   Removal of Stains from White Fabrics -310
   Care of the Skin -312

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