Table of Contents

Sample Key Words and Phrases 24
Distributor's Policy 39
First Edition's Editorial Board of Review 41
Note to Professional Readership 42
Foreword 43
Preface 45

Part I: Introduction

1. AN INTRODUCTION TO THE PRINCIPLES OF CHIROPRACTIC

Nature and Science 47
Chiropractic Has Grown on a Foundation of Principles 48
Historical Perspectives 48
The Greek Influence 49
Hippocrates 50
Euryphon 52
Herodicus and Serapion 53
Galen 53
Historic Influence on Modern Thought 54
Today's Challenges 55
The Effect of Commercial Promotion 55
Social Consequences 57
The Effects of Blind Faith 57
The Holistic vs the Traditional Approach 59
An Epidemiographic Perspective 60
The Role of Poor Hygiene 60
The Role of Acquired Resistance 61
Pasteur 62
The Role of Cleanliness and Social Reform 62
Semmelweis 62
Lister 63
Misdirected Credit 63
The Need for an Informed Public 64
Semantics 65
Scope of Practice 67
Education in the Healing Arts 68
Principles 69
Historic Principles of Chiropractic 69
The Tangible vs the Intangible 72
Pertinent Concepts of Science and Philosophy 74
The Goal of Chiropractic Health Care 75
Time and the Healing Process 77
A Biopsychosocial Model 79
The Chiropractic Approach 80
Intraprofessional Harmony 81
Concluding Remarks 81
Bibliography 82

2. GENERAL PRINCIPLES OF CLINICAL NEUROLOGY

Overview 84
The Evolution of Neurologic Theory 85
    Early Foundations 85
    Contemporary Developments 86
Scientific Theories and Principles of Chiropractic 86
Basic Principles 87
Clinical Efficiency 88
Neurologic Aspects of Homeostasis 89
Neurologic Aspects of Immunogenesis 90
Pain Control by Spinal Manipulation 92
Basic Neuroembryology 92
The Neural Tube 93
Longitudinal Differentiation 93
Transverse Differentiation 93
Peripheral Differentiation 94
Somites 95
Basic Neurocytology 95
The Neuron 95
Considerations 96
Terminology 97
Neuroglia 97
Astrocytes, Ependymal Cells, and Microglia 97
Oligodendroglia, Schwann Cells, and Myelination 98
Connective Tissue 99
Electric Changes in Axons 100
The Functional Parts 100
The Impulse Flow 101
Chemical Synaptic Inhibition and Extrication 105
Electric Transmission 106
Axoplasmic Flow 106
Interneuron Communication 107
Gross Neurologic Areas and Levels 108
Basic Considerations 108
Ganglions, Nuclei, and Nerve Centers 110
The Brain as a Whole 110
The Skull 111
The Fontanels and Sutures 112
The Meninges 112
Dura Mater 112
Arachnoid Mater 113
Pia Mater 114
The Ventricular System 114
The Major Cranial Blood Vessels 115
The Internal Carotid Arteries 115
The Vertebrobasilar System 116
Venous Drainage of the Brain 116
The Supratentorial Level 117
The Cerebrum 117
The Diencephalon 118
Cranial Nerves I and II 119
The Posterior Fossa Level 119
The Longitudinal Systems 119
The Sensory System 120
The Motor System 120
The Visceral System 120
The Spinal Levels 121
The Peripheral Levels 122
Microneuropathologic Reactions: General Considerations 123
Basics 123
Cerebral Edema 123
Neuronal Pathology 123
Central Chromatolysis 124
Wallerian Degeneration 124
Storage (Balloon) Cells 125
Inclusion Bodies 125
Neurofibrillary Degeneration 125
Oligodendroglia and Schwann Cell Pathology 125
Microglia Pathology 126
Astrocyte Proliferation 126
Neuronal Electroneurophysiology 126
Basic Considerations 127
Membrane Potentials 127
Local Potentials 127
Resting Potential 128
The Sodium Pump 129
Local Effects 130
Neuronal Summation 131
Neuronal Accommodation 131
Action Potentials 131
Excitability 131
Propagation 132
Facilitation 133
Reaction Time 134
Synaptic Transmission 134
Synaptic Inhibition 135
Presynaptic Inhibition 135
Postsynaptic Summation 135
Clinical Applications 136
Importance of Normal Findings 137
Applied Neuroembryology 137
Pathoanatomical Correlations 138
Topographic Localization 138
Diffuse vs Focal Lesions 139
Transient Physiologic Disorders 140
Potassium Imbalance 140
Sodium Imbalance 140
Calcium Imbalance 141
Drug Reactions 141
Nerve Fatigue 141
Neural Regeneration 142
Pressure Neuropathy 143
Traumatic Neuropathy 144
Toxic Neuropathy 144
Bibliography 144

Part II: The Neurologic Systems

3. THE LONGITUDINAL NEUROLOGIC SYSTEMS

Overview 153
The Sensory System 155
Basic Types of Sensory Perception 155
Sensory Neuron Levels 156
Primary Neurons 156
Secondary Neurons 157
Tertiary Neurons 157
Receptors: General Considerations 157
Receptor Adaptation 158
Receptor Specificity 158
Balance Recovery 160
Labyrinthine Receptors 161
Cervical Receptors 161
Joint Receptors for Pain 162
Major Pathways 163
Conscious Proprioception and Tactile Discrimination 166
Unconscious Proprioception 167
Touch 169
Pathways of Other Sensations 170
Clinical Considerations 170
Localization: General Principles 172
Supratentorial Level Lesions 173
Posterior Fossa Level Lesions 174
Spinal Level Lesions 174
Peripheral Lesions 177
Peripheral vs Central Lesions 179
The Components of Pain 180
Basic Types of Pain 181
The Motor System 184
Basic Sensory and Motor Segmental Mechanisms 184
Functional Anatomy: An Overview 185
The Final Common Pathway 186
The Spinal Cord and Peripheral Motor Cells 187
Muscle Fibers 187
Muscle Fiber Blood Supply 188
Typical Motor Reflexes 188
The Reflex Arc and Its Components 188
Stretch Reflexes 189
Lengthening Reflexes 189
Nocifensive Reflexes 190
Reciprocal Innervation 190
The Direct Activation Pathway 190
Course 190
Clinical Significance 191
The Indirect Activation Pathway 192
Influence from the Red Nucleus 192
Postural Control: Neuronal Reciprocity 193
Influences from the Reticular Formation 193
Influences from the Vestibular Nuclei 194
Influences of the Tectospinal Tract 194
Clinical Significance 194
The Control Circuits 196
Basal Ganglia Influences 196
Cerebellar Influences 197
Clinical Considerations 197
Diagnostic Reflexes 198
Upper Motor Neuron Lesions: Summary Review 198
Lower Motor Neuron Lesions: Summary Review 200
Control of Locomotion Patterns 202
The Development of Motor Skills 202
Clinical Reflexes 202
     Evaluation of the Motor System 204
The Reticular Activating System 204
Functional Anatomy: An Overview 204
Arousal and Sleep States 205
Attention 205
Clinical Observations 206
The Visceral System 207
Functional Anatomy: An Overview 208
General Organization 208
Activation and Inhibition Mechanisms 210
Viscerosensory Pathways 213
Viscerosensory Receptors 213
Distal Viscerosensory Fibers 214
Proximal Viscerosensory Fibers 214
Central Visceral Control 215
Cortical Control 215
Role of the Limbic System and Hypothalamus 216
Reticular Formation Control Centers 217
Visceromotor Pathways 217
Tracts: Summary Review 217
Visceral Ganglia and Plexuses 218
Hormonal Mechanisms 218
Visceral Effector Organs 218
Types of Autonomic Neurotransmitters 219
Autonomic Neurotransmitter Actions 219
The Adrenal Medullae 221
Clinical Considerations 221
Imbalance Manifestations 222
Skin Reactions 222
Circulatory Reactions 223
Pupil Reactions 224
Duct Glands and Gut Reactions 224
Endocrine Reactions 224
Micturition 225
Defecation 225
Sexual Function 225
Factors Involved in Vegetative Imbalance 226
Sympathicotonia and Vagotonia: Basic Considerations 227
The Vascular System 229
Functional Anatomy: An Overview 229
Circulation of the Spinal Cord 229
Circulation of the Spine 230
Clinical Considerations 231
Extradural Hematoma 231
Subdural Hematoma 233
Apoplexy 235
Vertebrobasilar Insufficiency 236
Other Common Considerations 236
The Consciousness System 239
Central Neural Control Mechanisms 239
Memory 239
Cortical Hemispheric Dominance 240
Cerebral Asymmetry 241
Brain Waves 241
Beta Waves 242
Alpha Waves 242
Theta Waves 242
Delta Waves 243
Disorders of Consciousness 243
The Cerebrospinal Fluid System 246
Functional Anatomy: An Overview 246
Clinical Considerations 246
The Dynamic Craniosacral System 247
Bibliography 248

4. THE HORIZONTAL NEUROLOGIC LEVELS

Overview 259
Tone 260
The Supratentorial Level 261
The Diencephalon 261
The Thalamic Body 261
The Anterior Thalamus 261
The Hypothalamus 262
The Epithalamus 262
The Telencephalon 262
The Basal Ganglia 263
The Subcortical White Matter 263
The Cerebral Cortex 263
The Limbic System 264
The Olfactory Apparatus 265
Memory 265
Amnesia 266
Orientation 266
Disorders of the Limbic System 267
The Visual System 267
The Peripheral Neural System 268
The Central Neural System 269
Disorders of the Visual System 270
The Consciousness System 271
Anatomical Considerations 272
The Major Structures of the ARAS 272
Physiologic Considerations 273
    EEG Tracings
    Consciousness 274
    Unconsciousness 274
Mental Functions 274
Presentative vs Representative Powers 275
    Creativity Powers 275
Classification and Reasoning Powers 275
Attention 276
Attention and the Alpha State 278
Abstraction 278
Thought Content and Association 279
Sleep States 279
    Sleep Patterns 281
    REM Sleep 281
    NonREM Sleep 281
    Arousal from Normal Sleep 282
    Insomnia 282
    Sleep Theories 282
    The Hypnotic State 283
Dreams 283
Supratentorial Disorders: Basic Considerations 284
Agnosia 286
Alexia and Agraphia 287
Aphasia 287
Apraxia 289
The Dominant Hemisphere 290
Cranial Entrapment Syndromes 291
Some Current Subtle Energy Research 291
The Posterior Fossa Level 292
The Medulla Oblongata 293
Basic Considerations 294
Basic Functions 295
Medulla Dysfunction 297
The Pons 299
Basic Considerations 300
Pontine Dysfunction 301
The Midbrain 302
Midbrain Dysfunction 303
The Cerebellum 304
     Structure 304
     Function 306
     Dysfunction 306
     Clinical Considerations 306
The Spinal Levels 306
Functional Anatomy 306
Normal Reflex Activity 308
General Considerations 308
Basic Spinal Reflex Acts 309
Reflex Modulation 309
Stretch Reflexes 310
Lengthening Reflexes 312
Nocifensive Reflexes 314
Sustaining Mechanisms 314
Gamma Neuron Reflexes 314
Renshaw Inhibition 315
Righting and Placement Reflexes 315
Diagnostic Considerations 316
Spinal Cord Injuries 317
Reflex Phenomena in Spinal Disorders 318
The Peripheral Levels 319
The Peripheral Nerves 319
The Peripheral Plexuses 319
The Posterior Rami 320
Muscle Histology 320
The Neuromuscular Junction 321
Impulse Response 322
Muscle Spindles and Their Role in Motor Reflexes 323
The Contraction Process 324
Contraction Strength 325
Clinical Considerations 325
Focal and Diffuse Disorders 326
Specific Peripheral Nerve Disease 326
Neuronal Plasticity in the Healing Process: A Review 326
Motor Axonal Impairments 327
Neuromuscular Trophic Impairments 328
Neuromuscular Junction Disease 328
Peripheral Nerve Pinch, Stretch, & Compression Syndromes 329
Peripheral Nerve Entrapment Syndromes 330
Bibliography 332

Part III: Clinical Neurology

5. NEUROCONCEPTUAL MODELS IN CHIROPRACTIC

Introduction: Explanation of Conceptual Models 340
Classic Concepts of the Chiropractic Subluxation 340
The Stimulus Response Phenomenon 341
Variables Between Stimulus and Perception 342
Variables Between Perception and Response 343
Disease and the Stimulus Response Phenomena 344
Neuroinsult and the Origin of Disease 344
Stimuli and Pseudostimuli 346
Functional Alterations 346
Causes of Disease: Traditional and Current Concepts 347
The Irritation Resistance Concept 348
Habitual Responses 348
Reactions at the Vertebral Motion Unit 348
The Intrinsic Factor (Subluxation) 349
Definitions of Subluxation 350
Irritation-Subluxation-Disease 352
Patterns of Sensation and Selection 353
Causes of Subluxation 353
The Intrinsic Factor Has Two Major Categories 353
Muscular Responsibilities 354
Supporting-Tissue Responsibilities 360
Basic Effects of Spinal Subluxation 363
Immediate Local Effects of Subluxation 363
Mechanical Effects of Subluxation 364
Neurologic Effects of Subluxation 364
The Effects of Bipedism 364
Implied Etiology 366
Implied Diagnosis 368
The Diagnostic Recognition Hierarchy 369
Implied Therapeutics 370
Spinal Subluxation's Clinical Significance 371
Facilitation and the Subluxation: Segmental Rheostats 375
Segmental Facilitation and Subluxation 376
Skin Resistance Findings 378
Conceptual Models 378
Autonomic Imbalance 379
Reflex and Referral Models 382
The "Garden Hose" Theory 386
The Melzak/Wall Gate-Control Theory 387
Trophic Influences of Nerves 388
Interruption of the Neurotrophic Flow 389
Conditioning Influences of Nerves 390
Morphogenetic Influences 390
Role of Nerve in Regeneration 390
Regulation of Gene Expression 390
Bibliography 391

6. GENERAL CAUSES AND POTENTIAL EFFECTS OF THE SUBLUXATION COMPLEX

Spinal Subluxation: Causes and Effects 393
General Causes of Spinal Subluxations 394
Precipitating Factors of Spinal Subluxations 395
Biochemical Reactions 395
Stress Factors Producing Subluxation 396
Physical Diagnosis Criteria 396
General Effects of Spinal Subluxations 396
Potential Scope of Reactions 397
Functional Alterations 398
Local Pathophysiologic Effects of Subluxation 399
Spondylosis and Related Disorders 399
The Phases of Vertebral Unit Degeneration 400
Disc Degeneration 401
Spinal Trauma 401
Prevalent Theories of Spinal Pain 401
Subluxation Terminology 404
Fundamental Considerations 404
Clinical Classes of Subluxation 405
The Subluxation Complex as a Disease Entity 406
The Apophyseal Joints 407
Structural Changes in the Subluxation Complex 408
Spinal Joint Locking 408
Articular Neurology 409
Receptor Types 409
Clinical Considerations 411
Reflex Effects 411
Pain Suppression 411
Conscious Perception 412
The Intervertebral Foramen 413
Size and Shape Considerations 413
The Cervical Area 413
The Thoracic Area 414
The Lumbar Area 414
Contents and Size Alterations 414
Factors That Change IVF Diameter 415
Consequences of IVF Diameter Alteration 415
Subluxation Effects At the Intervertebral Foramina 415
Effects of Microtrauma 417
Proprioceptive Responses and Reflexes 418
Direct Nerve Pressure 418
Ganglion Irritation/Compression 419
Intraneural Effects 419
Meningeal Irritations 420
Altered Nerve Root Level 420
Paraforaminal Adhesions 421
Circulatory Changes 421
Local Toxicity Effects 421
Cerebrospinal Fluid Flow Alterations 422
Distal Neurologic Manifestations of Subluxations 422
Somatosensory Responses 423
Visceromotor Responses 424
The Spinal Nerves 424
Sensory Manifestations 425
Segmental Sensory Supply 425
Nerve Fiber Proportions 425
Pain Distribution 426
The Autonomics 426
Nerve Root Insults 426
Motor Manifestations 427
The Posterior Rami 427
The Vertebral Canal and Related Tissues 430
Cord-Canal Relationships 431
The Meninges 431
The Dentate Ligaments 431
The Spinal Cord Proper 432
Cord Flexibility 432
Cord Folds 432
The Cervical Cord 432
The Lumbar Cord 433
Postural and Structural Effects 433
The Effects of Bipedism 433
Pelvic Posture Considerations 434
Structural-Functional Relationships 434
Balance Considerations 435
Functional Stress and Fatigue 437
Neurologic Considerations 437
Trigger Points 438
Circulatory Implications 438
Drainage Impairments 439
Respiratory Considerations 439
Digestive Disturbances 440
Gynecologic Considerations 440
Postural Analysis 441
The Posturometer 441
The Gravity Stress Analyzer 442
Photographic Imaging 442
The Four-Quadrant Weight Scale 443
Integrated Systems 443
Visceroptosis 443
Basic Considerations 444
Implications 444
Postural Effects of Pregnancy 445
Segmental Hypermobility 446
Basic Considerations 446
Implications 447
Segmental Hypomobility 447
Basic Considerations 448
Clinical Studies 449
Implications 449
Structural Adjustment Rationales 451
Terminology 451
The Uniqueness of the Chiropractic Adjustment 452
Motion Barriers During Structural Therapy 453
Specific Chiropractic Adjustments 454
The Articular Snap 455
Thrust Technics 455
    Low-Velocity Technics (LVTs) 456
    High-Velocity Technics (HVTs) 456
Indirect (Functional) Approaches 457
Bibliography 457

7. SPECIFIC POTENTIALITIES OF THE SUBLUXATION COMPLEX

General Considerations 473
Innervation of the Spinal Dura 473
Cervical Dura Attachments 474
Painful Irritations 474
Nerve Root Compression/Irritation 475
Foraminal Encroachment 475
Subarticular Entrapment 476
Pedicular Kinking 476
Axial Compression 476
Spinal Canal Stenosis 477
Major Effects of Spinal-Level Nerve Compression 477
Axoplasmic Flow Disturbances 477
The Neuronal Transport System 477
Current Research Findings 478
Cerebrospinal Fluid Flow Alterations 478
Spinal Nerve Flow 478
Occipital Subluxation Effects 479
Lower Spinal Subluxation Effects 479
Cord Compression 479
Primary Types 480
Nontraumatic Types 480
Selected Cervical Considerations 480
General Symptomatology 481
Structural Considerations 481
The Cervical Cord Suspension System 482
Nerve Root Attachments 482
Cervical Spinal Receptors 484
Cervical Righting Mechanisms 484
Dynamics of the Cervical Cord 486
Selected Clinical Implications 486
Cervical Nerve Root Insults 488
Upper Cervical Trauma 489
Lower Cervical Trauma 490
Effects of Pathologic Changes on the Cord 490
Cervical Curve Alterations 491
Cervical Scoliosis 491
Cervical Curve Reversal 492
Cervical Subluxation/Fixation Syndromes 493
Occipitoatlantal Subluxation/Fixation Syndromes 493
Atlas Subluxations 493
Axis Subluxations 494
Neurovascular Effects of Upper Cervical Subluxations 495
Sympathetic Disturbances 496
Lower Cervical Subluxations 497
Subluxation-Induced Reflex Syndromes 497
Neurologic Effects of Whiplash and Similar Syndromes 498
Disturbances of Hearing and Vision of Cervical Origin 499
Disturbances of Equilibrium of Cervical Origin 499
Headaches of Cervical Origin 499
Neck and Arm Pain of Cervical Origin 501
Intervertebral Disc Syndromes 501
Spondylosis 503
Torticollis 504
Nuchal Rigidity 505
Traumatic Brachial Plexus Traction 506
Cervical Rib and Related Syndromes 508
Thoracic Outlet Syndromes 508
Craniovertebral Malformations 509
Cervical Ankylosing Spondylitis 510
Cervical Pott's Disease 510
Pyogenic Infection 511
Cervical Rheumatic Disease 511
Neoplasms 512
Vertebral Artery Syndromes 512
Vertebral Artery Deflection 512
Vertebrobasilar System Patency 513
Effects from Cervical Manipulation 514
Selected Thoracic Considerations 514
Structural Considerations 515
Thoracic Subluxation/Fixation Syndromes 515
Vertebral Subluxations 516
Costovertebral and Costotransverse Fixations 516
Thoracic Disc Lesions 516
Spinal Tumors 518
Thoracic Scoliosis 519
Effect of Sensory Input Deficit 519
Involvement of the Righting Reflexes 519
Pulmonary Impairment 519
Selected Lumbar Considerations 520
The Lumbar Nociceptive Receptor System 522
Mechanical and Chemical Factors of Low Back Pain 522
Features of Mechanical Pain 522
Features of Chemical Pain 523
Considerations in Adjustive Therapy 523
Lumbar Subluxation/Fixation Syndromes 524
Neurogenic Low-Back Pain Syndromes 524
Acute Lumbosacral Angle Syndromes 525
Intervertebral Disc Syndromes 525
Facet Syndromes 527
Sciatica 528
Lumbar Stenosis and Claudication 528
Lumbar Nerve Root Entrapment 529
Lumbar Dorsal Ramus Syndrome 531
Meralgia Paresthetica 531
Reiter's Syndrome 532
Selected Pelvic Considerations 532
Sacroiliac Subluxation/Fixation Syndromes 533
Coccyx Syndromes 534
Pubic Syndromes 534
Neurologic Aspects of Scoliosis 534
The Node Theory 535
Spinal Cord Maladaptation 535
Equilibrium Sway Effects in Scoliosis 535
Scoliosis Presenting with Severe Low-Back Pain 536
Bibliography 537

8. CLINICAL DISORDERS AND THE SENSORY SYSTEM

The Analysis of Pain in the Clinical Setting 558
Common Causes of Pain and Paresthesia 588
Pain of Mechanical Origin 560
Pain Induced by Change of Position 561
Pain Induced by Chemical Irritation 561
Tissue Ischemia 561
Naturally Occurring Pain-Producing Substances 562
Pain of Psychic Origin 562
Etiologic Factors in Psychogenic Pain 563
Reaction Component of Pain and Central Dampening 564
Assessing the Origin of Pain 564
Posterior Lemniscal vs Anterolateral Spinothalamic Sys. 565
The Qualities of Pain 566
The Intensity of Pain 567
Pain Threshold 568
Distribution and Timing 570
Measuring Sensitivity 570
Subjective Methods 570
Objective Methods 571
Common Patterns of Pain 572
Dermatomes, Myotomes, and Sclerotomes 572
Referred Pain 573
Projected Pain 574
Prolonged Pain 575
Recurrent Pain 576
Nocturnal Pain 577
Effects of Spinal Manipulation in Pain Control 577
Myofascial Trigger Points 577
Common Locations 578
Predisposing Factors 579
Precipitating Factors 579
Etiologic Hypotheses 580
The Neurophysiologic Theories 581
The Neurochemical Theory 582
Correlation with Acupoints 583
Visceral Pain 584
Splanchnic Pain 584
Parietal Reflexes 584
Visceral Pain Mimicking Musculoskeletal Disorders 585
Musculoskeletal Disorders Mimicking Visceral Disease 586
Headaches 587
Vertigo 587
Chest Pain 587
Chest Pains Associated with Cough 587
Respiratory Symptoms 588
Upper Extremity Symptoms 588
Paresthesia 588
Common Types 589
Numbness 589
Itching 589
Precordial Constriction 589
Girdle Sensation 589
Bearing Down 589
Fullness 590
Coldness 590
Faintness 590
Vertigo 590
Weakness 590
Meralgia Paresthetica 591
Notalgia Paresthetica 591
Diagnostic Considerations 592
The Clinical Differentiation of Pain 592
Significance of Localization 592
Superficial vs Deep Pain 593
Painful Muscles 593
Tendon Pain 594
Lymph Stasis 594
Painful Joints 595
Ligament Pain 595
Painful Adhesions 595
Cartilage Pain 596
Evaluating the Sensory System 596
Mechanoreceptive Sensations 596
The Tactile Senses 597
Superficial Pain Perception 597
Hypalgesia and Analgesia 597
Hyperesthesia 598
Deep Pain Perception 598
Thermal Perception 598
Local Temperature Changes 599
Effects of Chirop. Adjustments on Peripheral Temp. 599
Vibration Perception 600
Position and Motion Senses 600
Stereognotic Perception 601
Two-Point Discrimination 601
Tenderness 601
    Localized Tenderness 601
Paravertebral Tenderness 601
Nerve Tracing 602
Clinical Reflexes 604
Skin Resistance 605
General Bilateral Differences 605
Correlation with Pain 606
Correlation with Manipulative Therapy 606
Evaluating Cranial Nerve Sensory Fibers 606
The Olfactory Nerve (Cranial I) 606
The Optic Nerve (Cranial II) 607
The Trigeminal Nerve (Sensory Fibers of Cranial V) 609
The Facial Nerve (Sensory Fibers of Cranial VII) 610
The Cochlear Division of Auditory Nerve (Cranial VIII) 610
The Vestibular Division of Auditory Nerve (Cranial VIII) 611
Glossopharyngeal Nerve (Sensory Fibers of Cranial IX) 613
The Vagus Nerve (Sensory Fibers of Cranial X) 613
Carotid Sinus Syndrome 614
The Salivary-Taste Phenomenon 614
Bibliography 614

9. CLINICAL DISORDERS AND THE MOTOR SYSTEM

Overview 628
Basic Neuromuscular Activities 629
Muscle and Joint Correlations 629
Muscle Mass and Atrophy 630
The Determination of Atrophy 630
Local Atrophy 630
Types of Atrophy and Their Differentiation 631
     Disuse Atrophy 631
     Denervation Atrophy 631
Muscle Tone 631
Evaluation of Muscle Tone 632
Postural Tone and Balance 632
Muscle Tone and the Stretch Reflex 632
Dystonia 633
Cerebral Palsy Hypotonicity 634
Hypertonicity 635
Muscle Weakness 636
Psychomotor Responses 637
Pathologic Weakness 637
Weakness Evaluated by Its Site 638
Weakness Evaluated by Its Anatomical Origin 638
Weakness or Paralysis Evaluated by Progression Rate 639
Muscle Fatigue 639
Types of Paralysis 640
Flaccid Paralysis 640
Spastic Paralysis 640
Muscle Soreness and Stiffness 642
Muscle Cramps and Spasms 642
Neuromechanisms 643
Etiology 644
Abdominal Cramps 645
General Spasms 645
Painful Splinting 645
Fatigue Spasm 646
Muscle Trauma 646
Local Movement Disturbances 647
Fibrillation 647
Fasciculation 647
Tics and Habit Spasms 648
Myokymia 648
Tremors 649
     Basic Classes 649
     Parkinson's Disease 650
Myoclonus 650
Chorea and Coreiform Movements 651
Ballismus and Hemiballismus 651
Athetosis 652
Dystonic Movements 652
Ataxic Movements 652
Convulsions and Seizures 653
     Tonic vs Clonic Spasms 653
     Epileptic Seizures 653
Miscellaneous Types of Movement Disturbances 654
Gait Disturbances 654
Muscle Analysis During Gait 654
Stance Actions 654
Swing Actions 655
Neurologic Gaits 655
Unilateral Flexor Spasticity 655
Unilateral Extensor Spasticity 656
Adductor Spasticity 656
Mowing (Hemiplegic) Gait 656
Proprioception Impairment: Ataxic and Tabetic Gaits 656
Basal Ganglia Dysfunction 656
Cerebellar Dysfunction 658
Paralytic Gaits 658
General Considerations 658
Hip Weakness 659
Knee Weakness 660
Ankle Weakness 660
Psychomotor Disorders 661
Hysteria 661
Astasia-Abasia 661
Gait Apraxia 661
Effects of Spinal Adjustments on Gait 661
Reflexes 662
General Types of Reflexes 662
Somatosomatic Reflexes 663
Somatovisceral Reflexes 663
Psychosomatic Syndromes 664
Spinal-Related Psychiatric Syndromes 664
Psychophysiologic Neuromuscular Reactions 664
Screening Procedures 664
Evaluating the Motor System 665
Examination Protocol 666
Tendon and Periosteal Reflexes 666
General Considerations 667
Deep Reflex Techniques 668
Muscle Strength Testing 670
Physical Procedures 671
Mechanical Procedures 672
Electrodiagnosis 673
Nerve Conduction Analyses 673
Degeneration Reactions 675
Miscellaneous Electrical Muscle Testing Procedures 676
Electromyography 677
Rationale 677
     Procedure 678
Electromyography in Scoliosis 679
Electromyographic Studies After Adjustive Therapy 680
Evaluating the Cerebellar System 680
Symptomatology 681
Testing Procedures 682
Upper Extremity Coordination Tests 682
Trunk and Lower Extremity Coordination Tests 684
Evaluating Cranial Nerve Motor Fibers 685
The Oculomotor System (Cranial III, IV, VI) 685
Extraocular Movements 687
Trigeminal Nerve (Cranial V Motor Fibers) 688
Facial Nerve (Cranial VII Motor Fibers) 689
Glossopharyngeal & Vagus Nerves (IX and X Motor) 690
Spinal Accessory Nerve (Cranial XI) 691
Hypoglossal Nerve (Cranial XII) 692
Bibliography 692

10. CLINICAL DISORDERS & THE AUTONOMIC NERVOUS SYSTEM

Overview 702
Sympathetic Distribution 703
Parasympathetic Distribution 703
Stress and the Neurodystrophies 703
Autoadaptation and Immunity 704
Tissue Repair 705
Cellular Alterations 705
Diseases Showing Marked Trophic Changes 706
Evaluation of Vegetative Function 706
Factors Involved in Autonomic Imbalance 707
Clinical Signs and Tests 708
General Screening: The Saliva Test 708
Tests for Sympathicotonia 708
Tests for Vagotonia 710
Clinical Considerations 711
Patient Classifications 711
Behavioral Characteristics 711
Characteristics and Assessment of Autonomic Pain 712
Spinal Therapy in Visceral Dysfunction 713
Background 713
Autonomic Function and Control Is Still a Mystery 714
Spinal-Related Reflex Changes in Internal Dysfunction 716
Autonomic Symptoms Assoc. with Back Pain Syn. 716
Spinal Adjustments on Autonomic Function 717
Spinal Adjustments in Neurodystrophy 718
Reflexology 718
Somatosomatic and Somatovisceral Reflexes 719
Somatosomatic Reflexes 719
Somatovisceral Reflexes 720
Cutaneovisceral Reflexes 720
Cutaneocardiac Reflexes 721
Pain Inhibition 721
Somatovisceral and Viscerosomatic Reflexes 722
Somatovisceral Reflexes 722
Viscerosomatic Reflexes 723
Viscerovisceral Reflexes 724
Psychovisceral and Somatopsychic Reflexes 725
Psychovisceral Reflexes 725
Somatopsychic and Visceropsychic Reflexes 726
Diagnostic and Therapeutic Procedures Investigated 727
Applied Kinesiology 728
Basic Technique 728
Craniotherapy 729
Meridian Therapy 729
Neurolymphatic Reflexes 731
Neurovascular Reflexes 731
Bibliography 732

11. EPILOGUE 746

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