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NBCE Part II: Chiropractic principles 2025
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NBCE Part II: Chiropractic principles 2025
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NBCE Part II Chiropractic principles 2025What is Myopathology? - answer>>>Spasm or hypertonicity of muscles as a result of
compensation, facilitation, Hilton's law(mm and joint supplied by same nerve) or any
combination (acute=spasm, if chronic becomes atrophy)
What is Histopathology? - answer>>>Damage on the cellular level via subluxation. This
component relates to inflammation (release of histamines, prostagladins and kinins)
Can cause 5 signs of inflammation: redness (rubor), heat (calor), swelling (tumor), pain (dolor),
loss of function (functio laesa)
cellular flow of inflamm proccess
What is Pathophysiology? - answer>>>hormonal and chemical effects -imbalances- related to
inflammation-stress syndrome
end result of VSC=dis-ease
What is the Neurological reflex model? - answer>>>All reflex arcs must involve the spinal cord.
A reflex arc is where sensory meets motor. Reflexes are named by "cause then effect"
Somatic (somato) - refers to skin, bone, muscle, nerve
Visceral - autonomic - organs, blood, lymph
Psycho - thinking about something
ex. Gallstones refer pain to the right shoulder (viscerosomatic reflex)
What is the Gate Control Theory of Pain? - answer>>>Within the substantia gelatinosa (lamina
II of the gray matter), several factors are able to block or facilitate the transmission of pain-
producing impulses to the thalamus, the degree of which the "gate" is open or closed depends
on the spinal cord:
Signals travelling on fast, type A afferent fibers greatly depress pain transmission (on slow, type
C fibers)
Pain fibers terminate at the dorsal horn of the spinal cord in the substantia gelatinosa
Second order mechanoreceptor axons also terminate here causing presynaptic inhibition
,What is the Vascular Insufficiency model? - answer>>>Vertebral arteries provide a large portion
of the blood supply to the cranium and are the major blood supply to the brain stem
Vertebrobasilar arterial insufficiency (VBAI) hypothesis states that cervical intervertebral
subluxations may cause deflection or compression of the vertebral arteries, thereby altering
cerebral circulation
Signs/symptoms: Ataxia, diplopia, dizziness, diarrhea, dysphagia, falling to side, nausea,
numbness, nystagmus, visual disturbances, vomiting
Symptoms with rotation and extension of the head - never give 2nd adjustment!
What can cause VBAI? (5) Most common location? - answer>>>Injury to the cervical spine
Congenital anomalies
Spondylosis
Atherosclerosis or arteriosclerosis
Subluxation of cervical vertebrae
Most common over the posterior arch of C1, rotation and extension of C1 and C2 causes the
most compression to the vertebral artery
What are symptoms of VBAI? (11) - answer>>>Ataxia, diploplia, dizziness, diarrhea, dysphagia,
falling to the side, nausea, numbness, nystagmus, visual disturbances, vomiting
Circle of Willis. - answer>>>Posterior Inferior Cerebellar arteries --> Vertebral arteries --> Basilar
artery --> Posterior cerebral artery (connected to Middle cerebral artery via the posterior
communicating artery)
Middle cerebral arteries + Internal carotid arteries --> Anterior cerebral arteries (Connected to
each other via anterior communicating artery)
Nerve Compression theory - answer>>>DD Palmer
Intervertebral subluxations may interfere with the normal transmission of nerve energy (ex.
action potentials and other associated neural phenomena) by irritating or compressing the
spinal nerve roots
Compression decreases nerve fiber function --> decrements in the compound action potential
(numbness and paralysis)
, Degenerative changes in the bony structure (DJD) in the IVF predispose nerve roots to
compression. Bone on a nerve (nerve pressure) will cause:
ACUTE:Increased signals, irritation/excitation, hyperesthesia, spasms, increased sympathetic
CHRONIC: decreased sensation, decreased conductivity, muscle atrophy, decreased deep
tendon reflexes, pain (sharp/localized), dermatomal patterns, Wallerian degeneration
2-5% of subluxations exhibit these characteristics
What are nerve roots more predisposed to irritation or compression than peripheral nerves? -
answer>>>Nerve roots (endoneurium) do not have the strong connective tissue sheaths
epineurium and perineurium) that support peripheral nerves
Nerve roots are placed in tension by traction on peripheral nerves such as head and neck
movements. Nerve roots fail before peripheral nerves when nerveroots are tested under
increasing tension
Axonal Aberration-Trophic models - answer>>>Axoplasmic transport is the mechanism by
which the nerve is provided nutrition through the flow of proteins and other materials by way
of sliding filaments (similar to actin and myosin cross bridges). There are fast, slow and bulk
mechanisms that transmit proteins, glycoproteins and neurotransmitters in both directions
along the nerve fiber. Axonal aberration occurs secondary to neural compression.
Anterograde transport - answer>>>Foorward moving products from cell body to terminal
(proximal to distal), transports products necessary for trophic or growth functions. This is faster
and more common
Retrograde transport - answer>>>Backward moving products from distal to cell body, brings
back products/waste to cell body, slower, less common
Cord Compression (Compressive Myelopathy) - answer>>>BJ Palmer, utilized to explain HIO
technique. C1-C1 are most important areas of the spine because according to BJ misalignments
of the associated cervical (or lumbar) vertebrae would affect any and all functions of the body.
This causes any inflammation, arthritide, trauma, central disc herniation, fx, dislocation,
subluxation, stenosis, DJD, Down's. All SIDS babies had an inverted atlas. However, this type of
compression can only occur with extreme trauma, tumors or other masses
Compressive myelopathy or cord compression refers to dectruction of spinal cord tissue caused
by pressure from neoplasms, hematomas and other masses
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