find in this section several examples of what the
average forensic Doctor of Chiropractic understands and is a good study
reference when our students are away from their books but have an
internet smart phone, or the internet in their hotels and wish to
THE FORENSIC ANALYSIS OF
Every quarter century, medicine
evolves far past that which was in evidence and taught.
Because medicine continues to evolve
into a finer understanding albeit ever more complex, physicians have little hope of fully communicating their experience with
other physicians who had specialized with disease or intellectual lay persons,
and indeed their patients, unless a universal
scientific evolving medical language taxonomy was utilized. This taxonomy
mandatory rather than permissive. Thus the purpose of this
section is to re-outline medical verbiage and taxonomy
necessary for a successful career
in the field of Medicine.
A forensic analysis of the structure of medical
terminology, abbreviations and an ever growing
forensic medical glossary follows:
Electr would be considered the root word
O would be considered the combining vowel that
links root to root and the root to the suffix.
Cardi would be considered a root word meaning
Gram means to record and is considered the
Thus the entire word
means to record the electrical condition of the heart.
Gastr would be considered the root word
meaning the stomach.
O would be considered the combining vowel,
which links root to root, and the root to the suffix.
Enter refers to the intestines and is
considered a root
Logy indicates the process of study and is
considered a suffix.
To analyze a word read
the meaning of the terms starting from the suffix back to the first
portion of the word. The entire word gastroenterology means the process
of study utilized for the stomach and intestines.
One would be considered the root word-meaning
O would be considered the combining vowel,
which links root to root, and the root to the suffix.
Gen would be considered a root word meaning
Ic means pertaining to and is considered a
The entire word oncogenic
thus pertains to a tumor producing condition. It must be noted that in
the word, oncogenic, the combining vowel (o), which is usually found
between the root and the suffix, was dropped out because the suffix (ic)
begins with a vowel. However, the combining of vowels is usually
retained between two roots in a word even if the second root begins with
a vowel. An example of these follows:
GASTROENTERIC where gastro is
the root, O is the combining vowel, and enteric is a root.
The three most basic rules
Always read the meaning for the term from the
suffix back to the first portion of the word.
Leave out the combining vowel (generally O)
before a suffix beginning with a vowel. Example; gastric instead of
Always retain the combining vowel between the
The understanding of word
elements is thus correlated with basic anatomy, physiology, and
pathological process of the human body is thus correlated. This can be
accomplished by placing emphasis on the division of the terms into
structural elements as well as the relationship of the words to the
functioning of the body, in both health and disease. An example of this
term hematology means the study of the blood. However the word will
actually mean more once you have learned the many different components
of the blood, how they function in the human body, and the various
diseases associated with the blood. Medico-legal words are structured
as such to teach the relevance of the anatomy, physiology, ad
pathological process of the body.
Learn the correct
spelling of words. Some words sound the same but are spelled
differently which can lead to the incorrect diagnosis, incorrect portion
of the body, or incorrect review. Two examples are presented:
Ileum is a part of the small
intestine where Ilium is a part of the pelvic, or hipbone.
Hepat/oma is a tumor of the
liver where hemat/oma is a blood tumor.
Always learn to pronounce
the words correctly as incorrect pronunciation may lead to misunderstood
diagnosis and malpractice. The following are some of the most commonly
Urethra (r-re’thrah) is the urinary tract
tube leading from the urinary bladder to the external surface.
Ureter (u-re’ter) is one of the two
tubes, which lead from the kidney to the urinary bladder.
A study of various suffix
and prefixes will modify words to convey vital information. Examples of
suffixes and prefixes follow:
Words beginnings are referred to as Prefixes.
Two examples are presented:
Epi is a prefix, which means
above. An example would be epi/gastri/ic. Trans is a prefix meaning
across. A example would be trans/gastr/ic.
Word endings are called suffixes. Two examples
Itis is a suffix meaning
inflammation as in gastri/it is. Iuc is a suffix meaning pertaining to
as in gastr/ic.
Sometimes a vowel
(generally O) will be found linking the root of a word the suffix or to
another root of the same word. Examples follow:
Cardi/o/gram where the cardi
is the root, the O is the combining vowel and the gram is the suffix.
Eectr/o/cari/o/gram where electr is the root, O is the combining vowel,
cardi is a root, O is again a combining vowel and gram is the suffix.
Word roots can be
combined with the utilization of a combining vowel as in cardi/o/gram
where cardi is the combining form of the word utilized with a combining
The following lists will
demonstrate new combining forms, suffixes and prefixes.
Cerebr/o brain, or cerebrum
Cis/o to cut Cis/o is used primarily in words like incisioin-to cut into- and
excision-to cut out, remove.
secrete (to form and give off)
Derm/o, drmat/o skin
Encephal/o brain (en=in, cephal/o=head)
Enter/o intestines (usually the small intestines)
Gynec/o women, female
Hem/o., hemat/o blood
The following are a list
of suffixes and their meanings. It must be remembered that suffixes may
be short and simple (al, ic, gram) or long and complex, being composed
of a root and a final suffix. Examples follow:
-algia (alg=pain, ia=condition).
–logy (log=study, y=process)
-tomy (tom=cut, y=process)
The lists of suffixes follow:
-ac pertaining to
-al pertaining to
to cut out, excision, resection or surgical removal
process of study
condition, generally abnormal (when used with blood cell terms, it means
an increase in cell numbers)
to make a new opening
-partum birth, labor
to stop, control
instrument to cut
process of cutting, to section, make an incision
following are a list of prefixes and their meanings:
an no, not, without
Ante before, forward
Con with, together
Contra against, opposite
ecto out, outside
Hyper above, excessive
Hypo deficient, below,
under, less than
Infra below, inferior
meta between, beyond,
near, beside, abnormal
post after, behind
pre before, in front
retro behind, back
sym together, with
ultra beyond, excess
following list of words are combining forms with their meanings:
COMBINING FORMS MEANING
Col/o colon, large
Dactyl/o fingers or toes
Eosin/o rosy, dawn-colored
Ischo/o to hold back
Laryng/o larynx (voice box)
Pne/o breathing, breath
Secti/o to cut
bone marrow, spinal cord (the context of the usage of the word indicates
which meaning is intended)
to eat, swallow
staphyl/o clusters, grapes
strept/o twisted chain
angiotensin converting enzyme
angiotensin converting exzyme inhibitor
acquired immune deficiency syndrome
acute lymphocyctic leukemia
acute myelogenous leukemia
angiotensin receptor blocker
coronary artery disease
calcium channel blocker
congestive heart failure
central nervous system
chronic obstructive pulmonary disease
distal convoluted tubule
disseminated intravascular coagulation
deep vein thrombosis
Flavin adenine dinucleotide
inhibitory G protein
stimulatory G protein
glucose 6-phosphate dehydrogenase
glomerular filtration rate
hepatitis B virus
hepatitis C virus
human immunodeficiency virus
herpes simplex virus
insulin-dependent diabetes mellitus
liver function test
leukotrienes (X=A,B,C and so forth.)
Myobacterium avium-intracellulare complex
monoamine oxidase inhibitor
microsomal ethanol oxidizing system
nicotinamide adenine dinucleotide
nicotinamide adenine dinucleotide posphate
nonsteroidal anti-inflammatory drug
premature atrial contraction
proximal convoluted tubule
pulmonary function test
phosphatidyl inositol 4,5-bisphosphate
per os (by mouth)
purified protein derivative
paroxysmal supraventricular tachycardia
red blood cell
respiratory syncytial virus
syndrome of inappropriate ADH (antidiuretic hormone)
SLE systemic lupus erythematous
SVR systemic vascular resistance
tissue factor pathway inhibitor
thyroid function test
transient ischemic attack
tumor necrosis factor
total peripheral resistance
urinary tract infection
very low-density lipoprotein
von Willebrand's factor
Macule: Circumscribed area of any size
characterized by its flatness and usually distinguished from surrounding
skin by its coloration.
Papule: Elevated solid area 5 mm
or less across
Nodule: Elevated solid area more
than 5 mm across
Plaque: Elevated flat-topped
area greater than 5 mm
Vesicle: Fluid-filled raised
area 5 mm or less across
Fluid-filled raised area more than 5 mm
Blister: Common name used
for vesicle or bulla
Pustule: Discrete, pus-filled raised
Scale: Dry, horny,
Lichenification: Thickened and rough
skin with prominent skin markings often due to rubbing
Excoriation: Traumatic breakage of
Oncholysis: Loss of integrity of the
Hyperkeratosis: Hyperplasia of the
Keratinization with nuclei retention in the stratum corneum, whereas a
normal finding on mucous membranes
Acanthosis: Epidermal hyperplasia
Dyskeratosis: Abnormal keratinization
prematurely within individual cells or groups of cells below the stratum
Acantholysis: Loss of intercellular
connections resulting in loss of cohesion between keratinocytes
Papillomatosis: Hyperplasia of the
papillary dermis with elongation and/or widening of the dermal papillae
Lentiginous: Linear pattern of
melanocyte proliferation within the epidermal basal cell layer occurring
as a reactive change or part of a neoplasm of melanocytes
Spongiosis: Intercellular edema of the epidermis
inflammatory or cell infiltration
Erosion: Skin discontinuity
exhibiting incomplete loss of the epidermis
Ulceration: Skin discontinuity exhibiting
complete loss of the epidermis & often dermis and subcutaneous fat
Vacuolization: Formation of vacuoles
within or adjacent to cells and often refers to the basal cell-basement
membrane zone area
Acceleration: Acceleration is the rate of change of a linear velocity. The
unit of measure of the accelerations magnitude is meters per second per
This often precedes squamous cell
Primary adrenocortical deficiency.
Pain in the pelvis worse just before and
during Menstration. Ultrasound reveals non focal thickening of
myometrium due to endometrial glands growing in myometrium of the
The process of trying and determining judicially, a judgment or the
decision of the court.
A lack or failure of development.
New Incidents: If, an injured worker has reached a level of
maximum medical improvement or a permanent and stationary status, is
gainfully employed, and has an aggravation or new incident in this same
area of previous involvement, this constitutes an aggravation and must
be reported as a new incident. Treatment is geared to return the
patient to pre-aggravation status.
Polyostotic fibrous dysplasia, precoucous puberty, cafe-au-lait spots,
short stature, young girls with shortened 4th & 5th metacarpals.
Guillain-Barre. protein in CSF with only a modest ↑ in cell
Stress: That stress value that is higher than that due to
the normal load which is lower than the yield stress of a given material
whether organic or inorganic. The unit of measure is Newton's per square
meters or pascals (psi).
Alport's syndrome: Hereditary
nephritis with nerve deafness.
Interosseous Spacing: This
refers to the most common of all chiropractic subluxations or areas of
altered joint dynamics in the geriatric population.
Absence of menstruation. This could be
primary; when the women have never menstruated, or secondary; when it
stops after having menstruated for some time.
whereby the brain has failed to develop.
Direct or indirect pressure
on an artery. For example, pressure may be generated in the
intervertebral foramen by a discopathy or discogenic lesion or pressure
generated within the foramina transversaria through osteogenic
Acceleration: The rate of
change of angular velocity. Because acceleration is a vector quantity,
various changes in magnitude or direction can occur. The unit of
measure of its magnitude is radians per second per second
material is a material whose mechanical properties vary with different
special orientations. Bone, ligaments, and cartilage are Aniostropic
materials were their mechanical properties such as strength and
elasticity vary according to relative orientation within the material.
Immobility and consolidation
of joints due to a disease process which can be due to a bridging o
osteophytes or diseases.
The acquired fusion due to a
Spondylitis: This was
originally called Marie-Strumpels Disease or Bamboo Spine. It is due to
a systemic rheumatic disorder that initially involves the sacroiliac
articulations and progresses upwards with syndesmophyte formation and
fusion (thus the bamboo spine). Calcification of the anterior and
posterior longitudinal ligaments or Interspinous ligaments may also
occur. Von Becterews (SP) begins in the neck and progresses caudally.
This generally refers to a
person’s posture where there is a leaning or diversion from the norm.
There will be a disruption of
Georges Line of Menstration due to an anterior displacement of one
vertebral segment upon another.
antibodies: Goodpasture's syndrome.
antibodies: Scleroderma (CREST).
antibodies (ANA antibodies): SLE type III hypersensitivity.
antibodies: Pemphigus vulgaris. Bullae cleavage plane
above basal layer of epidermis. Nikol Sky sign = Separation of
epidermis by manuel stroking.
Antithyroglobulin antibodies, Antithyoid perosixdase, and
Anti-TPO antibodies: Hashimotos Thyroiditis.
Autoimmune Hypothyrodism and most common cause of Hypothyrodism.
Biopsy Hurthle cells. TX: Levothyroxine (T4). Adv
Effects: ↑ lipids.
Primary biliar cirrosis.
Idopathic thrombocytopenic purpura.
AOE stands for arose out of the course of employment. For example when
the injury arises out of the course of employment but there is no
specific identifiable incident such as insidious repetitive micro
trauma. COE stands for the course of employment and is relative to
injuries sustained with a defined date such as an “I bent over, heard a
pop in my lower back and felt the pain”.
This is a secondary growth
center, which serves for ligamentous and tendon attachments. This can
pertain to the shaping of bone.
This is the act of formally referring to a higher authority for a
reconsideration of a judgment or decision.
This is the workers compensation court, which arbitrate disputes, issues
awards and subpoenas, publishes rules of practice and procedure, a well
as determination of punishment for contempt.
Skeleton: This would include
the pectoral and pelvic girdles along with the long bones.
This is the injured party or
any party affected by the occurrence of an Industrial Injury who files
Adjudicate: This is the
application form, which initiates the process of requesting a judicial
hearing for a determination of the right or payment/compensation on a
disputed issue. For example in California this is DIA WCAB Form 1.
an injured worker has more than one injury or injury is between two or
more involved parties, the economic consequence of a bodily impairment
must be allocated. This allocation of liability among successive
employers where a wok-disabling bodily impairment is the result of more
than one industrial injury or a cumulative work injury sustained over a
period of time, and between various causative factors, this process of
analysis is known as apportionment.
Foramen: A complete foramen
formed by the posterior
arch of the atlas. The complete
foramen is significantly more common in males, without any racial
predilection. The partial foramen is commonest in white females. The
rate of occurrence seems independent of age.
Argyll "Robertson pupil: Neurosyphilis.
Cerebellar tonsillar herniation.
Aschoff bodies: Rheumatic
This is a written contract
for the transfer of a benefit or compensation.
the mammillary bodies:
myelogenous leukemia (espceially the promyelocytic type).
Fracture: A fracture brought
abut by intense stress of a muscle insertion on a spinous process with
subsequent tearing away of the spinous process. This generally refers
to a specific level. An example would be the clay shovelor's fracture.
This is a judgment or decision that is given to the prevailing party by
means of arbitration.
This includes the skull,
sternum, vertebrae and ribs.
Sickle cell anemia.
Baker's cyst in popliteal
See Ankylosing Spondylitis.
Basophilic stippling of RBCs:
Invagination: This is a
flattening and upwards cupping of the floor of the posterior cranial
fossa so that the top of the odontoid rises above Chamberlain’s line of
Menstration and abnormally above McGregor’s line of Menstrations. This
may be both congenital and acquired.
Impression: The Acquired
form of Basilar Invagination, which is due to bony softening diseases
such as Paget’s and Osteomalacia.
Becker's muscular dystrophy:
Defective dystrophin; less severe than Duchenne's Muscular dystropy.
Bell's palsy: LMN CN
Bence Jones Proteins:
Multiple myeloma. Kappa light chains
in urine react with Anti-gamma/anti-lambda isotypes reacht with
lambda. CD 38 Y ctoplasmic immunoglbulins. Bence Jones
Proteins precipitate as amyloid fibrils. Rouleaux Formation due to
Hi serum globulin content. Waldenstrom's due to strep pneumonia
and scondary due to IgA loss, macroglobulineima (IgM).
If a load is applied to a long
structure, which is not directly supported at the point of application
of the load, that the structure deforms, and this deformation is called
This is a quantity at a point
in a structure equal to the product of the force applied and the
shortest distance from the point to the force direction. The unit of
measure is Newton meters (foot pound force).
This is an entitlement of restitution, which can be in the form of
medical care, rehabilitation, money and so forth, for injured person or
parties or property losses.
IgA nephropathy and most common cause of
Defect in platelet adhesion.
Bilateral hilar adenopathy,
uveitis: Sardcoidosis. A non-caseating
graunulomas-Asteroid body (Giant cells). 20-40 years old, 70%
biops liver, if lyph nodes unavalable. TX: Prednisone.
Birbeck granules on EM:
Histiocytosis X (eosinopilc granuloma).
Over time as the biped
Metastatsis: Bone cell
proliferations in a bone resulting from a form of carcinogenic disease.
It will appear as a very dense, sclerotic bone.
A congenital malformation
resulting in non-segmentation and fusion of two or more contiguous
vertebral bodies with obliteration of the disc space.
Blood tap on LP:
Fibrocystic change of the breast.
Boot-shaped heart on
x-ray: Tetralogy of Fallot; RVH.
Osteoarthritis (PIP swelling secondary to
This is an explanation in order to establish a value for complex
services, which are complex or are not routine.
Branching rods in oral
infection: Actinomyces israelii, Tx:
Brown tumor of bone:
Hemorrhage causes brown color of
osteolytic cysts in: Hyperparathyroidism and Osteitis fibrosa cyctica
(von Recklinghausen's disease).
X-linked agammaglobulinemia with
deficiency of B cels in Boys causing life threatening Pseudomonos.
Tx: IVID & Antibioics.
Posthepatic veous thrombosis.
8:14 translocation associated with EBV.
Wegener's granulomatosis, polarteritis nodosa.
Cafe-au-lait spots on
Duchenne's muscular dystrophy.
Granulosa-theca cell tumor of the ovary.
Cardiomegaly with apical
atrophy: Chagas disease. TX:
Gravity: This refers to the
point in a body where the body mass is centered.
Mycosis fungoides (cutaneious T-cell
Trypanosome infection. Infection from
Redviid Bugand become intracellular protozoan parasite, into muscle
cells. Cause Megaesophagus, Megacolon and Cardiomegaly with apical
atrophy. Tx: Nifurtimox or Benznidazole.
Primary syphilis (not painful).
Haemophilus ducreyi (painful).
Multiple sclerosis (scanning speech, nystagmus,
intention tremor), cholangitis (jaundice, RUQ pain, fever).
Cholangitis is an alternating constriction ad dilation of infrahepatic
bile duct. US reveals large bile duct obstruction, or ERCP notes
Bronchial asthma (eosinophil membranes).
Central apnea in CHF and increased
Endometriosis (frequently involves both
Adjustment: A medical
procedure which is a specific form of Articular manipulation, utilizing
the vertebral processes as levers, characterized by a dynamic,
instantaneous, high velocity, controlled low amplitude thrust. Patented
by the Chiropractic profession to include the correction of any joint
mechanic alteration which is reversible.
One of the most lethal
tumors in man, which arises from the remnant of the notochord.
Chronic atrophic gastritis:
Predisposition to gastric carcinoma.
Hypcalcemia (Tap fascial muscle see spasm of
Syndrome: Results from the
avulsion fracture of the spinous process of C7.
Clear cell adenocarcinoma
of the vagina: DES exposure in utero;
Diethylstilbestrol, 15-20 year old with clear cell which equals abundant
Stability: This refers to
the ability of the human spine to limit patterns of displacement under
physiological loads so as not to damage or irritate the spinal cord or
nerve roots and, in addition, to prevent incapacitation deformity or
pain due to structural changes. For example any disruption of the
ligaments, discs, facets and so forth that hold the spine in a
functional series of units, will decrease the clinical stability of that
spine and predispose spinal joints to further microtrauma and possible
Gardnerella vaginitis, Tx: Metronidazole which
is reduced to a substrate which inhibits cellualar DNA synthesis.
Adv: GI distress and disulfiram like reaction.
Codman's triange on x-ray:
Friction: The coefficient of
friction is defined as that ratio of tangential force to the normal
inter body compressive force, required to initiate a gliding motion
between two bodies.
Mycoplasma pneumoniae, infectious mononucleosis.
Collimation is utilized to
control scattered radiation producing better radiographic contrast and
protecting the patient from high radiation exposure. It will show the
exact body area to be exposed prior to the exposure being made.
This refers to balance and
equilibrium. The center of the head is directly over the center of the
pelvis in the standing position. The spine may have alterations in
vertebral dynamics with compensating biomechanical dynamics to return
the mechanically linked spine to the center of balance.
murmur: Patent ductus arteriosus.
Debranching enzyme deficiency.
C & R-Compromise
and Release: This
is an agreement made between disputing parties to a decision or award.
Generally the Claimant compromises doctor’s billings for a settlement.
This is a cartilaginous
formation of the developing embryonic vertebral column. It will consist
of four centers; two for the bodies and one in each arm of the neural
arch. It begins at approximately four to seven weeks in the cervical
spine and proceeds caudally.
Trauma: This is
a situation where disability was brought on by repetitive body motions
required in particular job, and where the individual may or may not have
had specific incidents of injury.
coryza and fever: Measles.
Toxic or viral hepatitis.
Couple is defined as a pair of equal
and opposite parallel forces acting on a body and separated by a
distance. The torque of a couple or coupling moment is defined s that
quantity equal to the product of one of the forces and the perpendicular
distance between the forces. The unit of measure of the torque is
Newton meters (foot pound force).
Coupling is a relationship of
consistent association of one motion (translation, excursion, rotation)
about an axis, with another motion about a second axis. One motion
cannot be produced without the other. For example spinal vertebrae may
demonstrate lateral flexion with rotation in a mechanical coupling
Cowdry type A bodies:
Procedural Terminology: This
referees to identifying codes with relative descriptive terms for
reporting medical services and procedures performed by physicians.
This refers to a non-unity of
Creep is defined as a deformation of
a visoelastic material with time when the material is subjected to a
constant, suddenly applied load. The deformation-time curve approaches
a steady state value asymptotically. An example would be when a
ligament is suddenly stretched and sprained the material being
visoelastic may deform and lengthen allowing he vertebral body to
translate out of position known as an excursion due to the ligaments
deforming and stretching. Creep can also occur with a deformation and
improper repair of the tissues allowing a shortening of the ligaments.
Crescents in Bowman's
capsule: Rapidly progressive
Acute gastric ulcer associated withsevere
Klebsiella, gram negative rod,
non-motile with capsule.
Bronchial asthma (mucous plug whorles).
This refers to an abnormal
curve of the spinal column. For example hyperlordosis.
This refers to the normal shape of
the spinal column.
Acute gastric ulcer assciated with CNS injury.
This refers to a materials property
that constitutes a resistance to speed.
Readiness: This is a request
for a hearing or conference to allow the Industrial Medical Boards to
make a determination on disputed or appeal issues.
Decompensation: In the standing position, the
center of the head is not directly over the center of the pelvis. The
amount of decompensation is measured as the distance from the Gluteal
clift to the plumb line (see gravitation analysis) dropped from the
occipital protuberance (or from C7). It can be noted upon visual
inspection as an antalgic list of the body.
Decreased platelet county, low fibrinogen
level, high fibrin degradation products. There is a consumption of
platelts and clotting factors.
Deformation refers to a
change in length or shape. Deformations generally occur in ligamentous
stretch/strain and/or sprain incidents.
Osteoarthrosis: This refers
to a degenerative bony disease resulting from chronic trauma and
microtraumas. It may lead to bony proliferation changes such as spur
formations with loss of articular surfaces, subchondral sclerosis and
cysts. In fact in the spine it may lead to spondylosis or facet
Freedom: The degrees of
freedom refer to a number of independent coordinates in a coordinate
system required to completely specify the position of an object in
space. In relation to the spine, when there are no alterations in
normal spinal dynamics, than the motion units are defined as
demonstrating joint freedom or normal motion degrees of freedom. When
the joint loses a degree of freedom it is noted or coded relative to its
position and direction of limitation with a pain response and the
degree of said response.
This refers to the degree of opacity
of a translucent medium.
Depigmentation of neurons
in substantia nigra: Parkins's
disease with rigidity, resting tremor and bradykinesia (basal ganglia
This is the act of giving
testimony under oath; the attested written testimony of a witness.
diarrhea: Pellagra (Vitamin B3
A dermatome is an area of
skin supplied by a single spinal nerve and its dorsal root ganglion.
exophthalmos and lesions of the skull:
This is the inability to
perform the job duties of current employment and/or the inability to
compete in their chosen labor market, both present and future, after the
point of maximum medical improvement, due to functional restriction or
pain and limits gainful employment activity and work capacity.
Discogenic refers to
disorders due to a derangement of an intervertebral disc.
This refers to conditions or
disease which are directly due to discal degeneration or abnormal action
or function of a disc.
Dog or cat bite:
Post-MI fibrinous pericarditis.
Congenital conjugated hyperbilirubinemia
dystrophy: Deleted dystrophin gene
This refers to a load, which
is applied to a specimen as the load varies with time. The dynamic load
is the opposite of a static load. A dynamic load with a repetitive
pattern of variation is called a cyclic load. An example would be a
continuous repetitive micro trauma.
That branch of science that
deals with the actions of forces in producing motion or equilibrium. It
is that phase of biomechanics, which deals with the motion of tissues
resultant upon different specific applied loads and forces especially
upon interacting intervertebral joint and bodies. In psychology it
refers to the balance between the various psychological processes.
This refers to a joint
splint, which demonstrates restriction upon motion examination but has
no radicular or neurological manifestations. It refers to kinetics.
Dyskinesia: This refers to an impairment
of the power of voluntary movement, resulting in aberrant motion
demonstrated by fragmentary or incomplete movements. In the spine the
motion unit, which demonstrates this alteration in joint dynamics, is
called a Chiropractic Subluxation.
This refers to painful
This refers to difficulty in
Osteoarthritis appearing almost polished and ivory like
appearance of bone).
Trisomy 18 associated with rocker-bottom
feet, low set ears, heart disease, promient occiput and micrognothia
with retardation. Life expectancy 2-3 months average.
Eisenmenger's complex: Late
cyanosis shunt R to left which was an uncorrected L to right shunt
This refer to the property
of a material or a structure to return to its original form following
the removal of some deforming load.
Deformation: When a specimen
or structure is subjected to a load, it deforms. If the deformation is
such that upon release of the load from the specimen it returns to its
pre-load shape, it is called elastic reformation or an “elastic
This refers to the range of
loading within a specimen or a structure remains elastic.
Elastic Skin: Ehlers-Danlos
Stability: This refers to
the ability of a loaded structure, given an arbitrarily small elastic
deformation, to return to its original position demonstrating elastic
The amount of work done by a load on
a body. The unit of energy is newton meters (foot pound force). If a
load deforms various ligaments and discs associated with a particular
vertebral motion unit, the energy is called the strain or the potential
energy, respectively. If the load imparts motion to the body as in
becoming hypermobile than it is called kinetic energy.
Absorption Capacity: This
refers to the mechanical energy absorbed by a structure load to
failure. The unit of measure is newton meters. For example discs will
deform if the load applied to them is in access of 200 lbs per inch
squared. Thus violating their energy absorption capacity.
That vertebra which displays
maximum tilting into the concavity of the curve.
This is a written break down of what an insurance company paid, reduced
This is a primary growth
center, which contributes to growth of the length of bone.
Epistropheus: This is a term utilized to
designate the axis (C2)
Equilibrium: If a given set of forces or
moments is applied to a body, it is said to be in equilibrium if it is
at rest or in a uniform motion.
Superior trunk of brachial plexus injury
called waiters' tip. Affects roots C5-C6 with biceps paralysis.
During pregnancy the arm med rotates and forearm pronates.
Retirement Income Security Act of 1974:
This refers to Insurance for Retirement,
which is exempt form, the application of state insurance law. This is
Public Law 93-406.
Erythema chronicum nigrans:
Evaluation/Management-E/M: This refers to examination and evaluation of a patient by a physician,
which encompasses the wide variations in skill, effort, time
responsibilities and medical knowledge required for the prevention or
diagnosis and treatment of an illness or injury and for the promotion of
Proximal tubular reabsorption defect, can
be due to expired tetracycline.
Fat, female, forty, and
fertile: Acute cholecystits.
Award: This is a Workers
Compensation settlement decision determined by the Workers Compensation
These can relate to the same situation save an Exacerbation is a new
Coefficient: The flexibility
coefficient of a structure or tissue is defined as the ratio of the
amount of displacement produced by an applied load.
Force is defined as any action that
tends to change the state of rest or of motion of a body to which it is
applied. The unit of force is measured for magnitude in newtons.
Anosmia & optic atrophy one eye which can
be due to lesion optic nerve & papilledema other eye. Classic.
Menigniomas in olfactory groove. Light in papilledema eye yield
papillary constriction in both eyes. Loss of smell due to pressure
on olfactory tracts. Personality changes due to pressure on
frontal lobes. Path lab: Basophilic psammona bodies & whorls
When the symptoms or signs occur less
than 25% of the time during waking hours.
When the symptoms or signs occur between
25% and 50% during awake hours.
When the symptoms and signs occur
between 50% and 75% during waking hours.
When the symptoms and signs occur
between 75% and 100% of the waking hours.
Functional: Functional is defined as
pertaining to the function of an organ or structure. In the forensic
analysis of biomechanics there may be a disturbance with the function of
the structure or tissue without affecting the actual structure of the
substance. Thus a vertebra may be splinted limiting its motion dynamics
with no subluxation or misalignment noted until the spine is placed
Funiculitis is an irritation
to the spinal nerve within the intervertebral foramen yielding radicular
symptoms. For example a lateral disc protrusion within the
intervertebral foramen produces a Funiculitis or osteophyte spurs may
cause a chronic funiculitis leading to a local neuropathy with possible
Colon polyps with osteomas and soft tissue
This refers to a
hyperextended knee joint.
George’s Line of
Menstration: Georges’s line
is the line joining the posterior margins of the vertebral bodies
throughout the entire spinal column. To be considered normal this line
is represented on the radiograph as a smooth unbroken cure. Breakage of
the line with a demonstrated stair stepping defect locates ligaments,
which have undergone deformation, creep with subsequent vertebral
translation or excursion.
Benign congenital unconjugated
Defect in platelet aggregation.
Autoantibodies against alveolar and
glomerular basement membrane proteins. MC 20-40 years, Type II
Hypersensitivity Disease, crescent formations Bowman's capsule, biopsy
glomerulonephritis, hemoptysis and dyspnea, secondary bleeding alveolar
bed as collagen alpha-3 chains. Tx: Methylprednisolone and
cyclopasphamide. Then plasmapheresis, decrease circulating
antibodies, replace with washed out and naturalized.
Duchenne's patient uses arms on legs to
help self off the floor.
This is a form submitted by
any party to secure payment of unpaid medical and med legal charges in
California only. This is form DIA WCAB Form 6.
Idiopathic polyneuritis and has been associated to C. jejuni but Herpes
virus as well. IVID 5 days .4 mg.
Fissures: This refers to
horizontal lines seen on x-ray imaging running through the vertebral
bodies, which are remnants of the intersegmental arteries.
Hair on end appearance on
x-ray: Beta thalassemia, sickle cell
anmia (extramedullary hematopoiesis).
disease: Chronic progressive
Thalasemia major: Marrow expansion, wide
marrow, x-ray thin cortices, space skull, jaundiced, Jaundice due to
hemolytic anemia. Defective hemoglobin syn, defective beta globin
gene. TX: Life long transfusions, after age three nightly
subcutaneous infusions Des ferrioxamine as chelating to treat Iron
overload. Extends life 30-40 years.
Sickle cell anemia
Hydatidiform mole, Choriocarcinoma.
This is similar to a trial before a workers compensation judge absent a
Osteoarthritis of DIP swelling secondary
Helical Axis of
Motion: The helical axis of
motion is defined as a unique axis in space that completely defines a
three-dimensional motion between two rigid structures or bodies. It is
considered analogous to the instantaneous axis or rotation for plane
Posterior: This is
synonymous with a dorsal hemivertebra. Vertebral ossification is
preceded by vascularization of a segment. Ventral and dorsal
ossification centers may appear instead of a single center. If the
anterior segment fails to ossify, the posterior half will assume a
cuneiform shape resulting in Kyphosis.
Hypersensitivity vasculitis associated
with hemorrhagic urticaria and URIs.
Infectious mononucleosis (EBV).
High output cardiac
failure (dilated cardiomyopathy):
Wet beriberi (Vitamin B1 deficiency, Thiamine).
Reiter's syndrome, ankylosing spondylitis.
HLA-DR3 or DR4:
Diabetes mellitus type 1 (autoimmune
destruction of Beta cells).
Maintenance Organization: These are prepaid medical/hospital insurance plans with staff physicians.
Mississippi Valley, Dry hack cough, erythema
nodosum. Bird or Bat dropping, intracellular macrophages.
Homer Wright rosettes:
Honecomb lung on x-ray:
Splenectomy or nonfunctinal spleen.
Law: This law applies to
growing bones and states, “the side of greatest stress will be
interrupted to cause a deformity as in scoliosis”.
Caudate degeneration AD
An increase in the lordotic
curvature in either the cervical or lumbar areas.
hypersexuality, hyperorality and hyperdocility:
Kluver-Bucy syndrome, amygdala.
Hyperpigmentation of skin:
Primary adrenal insufficiency, Addison's
neutrophils: Macrocytic anemia.
hypokalemia: Conn's syndrome.
Adrenal Adenoma 30-60 percent cause priarmy hyperaldosteronism due to
secretory naturo of tumor. Secondary Hi plasma Rennin, low
volume,increased angeiotensin renin system.
This refers to an increase in
the amount of hair on a region of the skin. It is often associated with
a spina bifida occulta.
This refers to a decrease in
the lordotic curve in either the cervical or lumbar areas.
It is reverse of menorrhaia. The cycle
remains normal but the blood loss becomes less or scanty in amount and
or duration. With normal cycle the number of bleeding days
decrease with less flow on each day.
This refers to a phenomenon
associated with energy loss exhibited by visoelastic material when they
are subjected to loading and unloading cycles.
ICD.9-International Classification of Disease:
This is a coding system used for a
numerical classification of a disease or condition (diagnosis).
Impairment: This is a loss of the use of
or the loss of, or derangement of any bodily part, system or function.
Permanent: A Permanent
Impairment is always a consideration in the evaluation of permanent
disability. A Permanent Impairment is noted when after medical
rehabilitation when there is an anatomic or functional abnormality or
Impulse refers to a linear force,
which is the product of the force and the time interval of force
application. The unit of measure is newton seconds or pound force
seconds. An angular impulse of a moment is defined as the product of
the moment and the time interval of moment application. Here the unit
of measure is in newton meter seconds or foot-pound force seconds.
Increased uric acid
levels: Gout, Lesch-Nyhan syndrome,
myeloproliferative disorders, loop and thiazide diuretics.
Inertia is that property of all
material bodies to resist change in the state of rest or of motion under
the action of applied loads.
Axis of Rotation: It is
believed that when a rigid body moves in a plane, at every instant
there is some point in the body or some hypothetical extension of the
body that does not move. Thus an axis perpendicular to the plane of
motion and passing through that point is the instantaneous axis (center)
of rotation for that motion at that instant.
velocity is the average velocity when the time interval approaches
zero. The unit of measurement is meter/second or feet per second. The
velocity is considered to be linear when the motion is translation and
angular when in rotation. Because it is a vector quantity it has
magnitude (speed) and direction.
Due to autoimmune antibodies to insulin
receptors which block receptors ability to bind Insulin.
When the symptoms
or signs constitute an annoyance but cause no impairment in the
performance of the activities, which elicit the pain. This is a
non-ratable level of pain.
Slight: When the symptoms or
signs can be tolerated by would cause
some impairment in the performance of the activity that
symptoms or signs.
the symptoms and signs would cause a marked impairment in the performance of the
activity which elicits the
symptoms or signs.
Severe: When the symptoms or
signs preclude any activity that causes the
symptoms or signs.
The bleeding occurs at any time during th
cyclafter the menstrual period is over. The bleeding is irregular and
unpredictabgle, however, still it's possilbe to separate out the normal
period from this bleeding. When these episodes become too frequent
then the cycle pattern is lost and it is not possible to make out the
normal period from the irregular episodes of the bleeding.
Adenovirus causes hyperplasia of Peyer's
Necrosis: This refers to a
necrosis of a tissue due to the loss or severe diminution of the blood
Material: An Isotropic
Material is one whose mechanical properties are the same in all
directions. In other words if the material is tested its values of
strength and modulus of elasticity will be the same regardless of the
orientations the test sample was in.
reaction: Syphilis due to
overaggressive treatment of an asymptomatic patient that causes symptoms
due to rapid lysis.
Neutrophil chemotaxis abnormality.
Force: This refers to the
situation when a joint in the body has been subjected to external forces
in the form of external loads and/or muscle forces, the internal
reaction forces which act at the contact surfaces are called the joint
reaction forces. The unit of measure is newtons or pound force.
This is a decision or
determination of liability by a judicial court.
Rheumatoid Arthritis: Rheumatoid arthritis of children is characterized by swelling,
tenderness and pain involving one or more joints leading to impaired
growth and development, limitation of movement and ankylosis and flexion
contractures of the joints. This condition is also known as Still’s
This refers to the policyholder.
This refers to the Insurance Company.
Aids cancer. HIV retrovirus, CD4T
lymphocytes & Monocytes, reverse transcriptase to make DNA copy from
RNA. TX: Nevirapine reverse transcriptase inhibitor HIV,
Trimetoprim/Sulfa for PCP, Cervical cancers HPV, Kaposi HHV8, CNS
Squamous cell carcinoma.
nodules: diabetic nephropathy.
Kinematics refers to that
division of mechanics (dynamics) that deals with the geometry of the
motion of bodies including displacement, velocity, and acceleration,
without taking into account the forces that produce the motion. For
example when you utilize Cobb’s method of analysis of scoliotic
deformities and compared your findings at different times, a kinematic
study of the disease was performed.
This refers to the energy
that a body possesses due to its velocity.
Kinetics is a branch of
mechanics (dynamics) that studies the relations between the force system
acting on a body and the changes it produces in the body motion.
Syndrome: A congenital
malformation associated with non-segmentation of the vertebral column.
It is characterized by any or all of the following and have been
Atlanto-occipital fusion (occipitalizaiton).
Low hair line
Scoliosis and Kyphosis
Several vertebral bodies blocked into a single mass with the
neural arches fused to the spinous processes an so forth.
Restricted range of motion
Bilateral amygdala lesions.
Deformity: This is a
deformity resulting in the elongation of one or more spinous processes
in order to cover an opened portion of the posterior arch structures
below as in a spina bifida occulta.
HPV. Koilocyte abundant condylomata.
Tx: Imiquimod, induce pro inflammatory cytokines.
Perivenous microglia Measles, encephalitis with
Gastric adenocarcinoma with ovarian
metastases, bilateral ovarian metastasis.
Lens dislocation, aortic
dissection and joint hyperflexibiltiy:
Marfan's sndrome due to fibrillin deficit.
HGPRT deficiency. Self mutilation by
bitting fingers and lips. Tx: Allopurinol.
Service: This is the time,
effort and the expertise of the physician in the evaluation, examination
and treatment of the patient.
Parkinson's disease: Tyrosine Hydroxylase
in degenerating Neuron. Substantia Nigra midbrain mesencephalon. MPIP
illicit drug induced as well. Tx: Carbidopa/levodopa,
tolcapone COMT inhibitor Contr: Chlorpromazine D2 dopamine
receptor antagonist used in schizophrenia.
This term refers to
Endocarditis associated with SLE.
Lines of Zahn: Arterial
Neurofibromatosis (von Recklinghausen's disease).
Mild, Grade 1.
Stretching or separation of a few
ligamentous fibers and exhibits mild inflammation, edema, tenderness but
absent any functional loss.
Moderate, Grade 2. The
tearing or disruption is or greater significance characterized by pain,
edema, inflammation, and partial loss of function and possible permanent
instability due to scar tissue formation with possible development of
traumatic degenerative arthritis.
Severe Grade 3.
Complete tearing or disruption of the
ligament with edema, inflammation, hemorrhage, complete loss of function
and usually requires surgical intervention and may result in persistent
instability and possible development of traumatic degenerative
A limbus bone is a non-union
of the secondary epiphysis of the superior and inferior end plate of a
vertebral body. It must be differentially diagnosed from a fracture.
This is the action before a
court of law for a decision of determination.
Load is a term, which is utilized to
describe the application of a force and/or moment (torque) to a
structure. The unit of measure for the force are in newtons or pound
force. The unit of measure for the moment are in newton meters or
foot-pound force. Generally a load must be thought of as a
six-component vector as the force and moment are three-dimensional
vectors each having three components.
Low serum ceruloplasmin:
Asymptomatic period 1-48hours relative to
Epidural hematoma. Could be blow to lateral skull, temporary
unconsiousness but 12 hour later, no symptoms, then vomiting headache,
Lumbarization: Lumbarization occurs when the
first sacral segment takes on the characteristics of the lumbar
Lumpy-bumpy appearance of
glomeruli on immunoflurescense:
Lytic bone lesions on
x-ray: Multiple myeloma.
Metastases: This refers to
the breaking down or eating away of bone as a result of some form of
cancer such as a carcinoma. This can often be found as a missing
pedicle on the X-ray.
Alcoholicl iver disease.
Manipulation: Manipulation has been defined
as the active, ;passive, and resistive movement of the body without the
use of a thrust.
Mass is the quantitative measure of
inertia for linear motion. The unit of measure is kilograms.
Mass Moment of
Inertia: This can be defined
as the quantitative measure of inertia for the change in angular
velocity. The unit of measure is kilogram-meter squared or pound foot
Organization: This is a
facility or organization (PPO, HMO etc.), which has contracted with an
employer or insurer to provide appropriate medial and hospital care for
injured workers at a reduced or discounted rate of pay.
Irregular and heavy uterine bleeding.
Menometrorhhgia and metrorrhagia are very suggestive of some pathology
in the genital tract.
Excessive menstrual bleeding, in duration and
or amount with normal menstrual cycle. The normal cyclical pattern
is preserved but the bleeding increases i.e., there is increased flow on
each day, or she bleeds for more number of days with it or increased
flow as well.
This refers to a specific type of
abnormality where the cycles become prolonged and the blood loss is
excessive in both duration and amount. here the cycles may come
after long intervals e.g., 2-3 months, however, when the period starts,
the bleeding is heavy and may last for a number of days. This kind of
pattern is typical of anovular cycles and suggests unopposed estrogen
The cycle pattern is completely lost and there
is irregular bleeding. The bleeding is unpredictable in duration,
amount or its occurrence. The cycle pattern is lost and it is not
possible to make out the normal period from the irregular episodes of
classification divides the sacral base into four quarters and is used to
determine the degrees of Anterolisthesis of L5. It is divided into the
first, second, third or fourth degrees.
Microtrauma is defined as a
minute trauma of a vertebral segment(s) resulting in the laying down of
bone (osteophytes) due to muscle tension, especially in the cervical
region. Often it results in the loss of the shape of the IVF.
Microtrauma often occur due to repetitive minute traumas, which over a
period of time produce the affects of a trauma.
MLF syndrome (INO):
Multiple Sclerosis. Demyelinated
plaques and perivascular DR2 hist antigen, CNS-Oligodendracytes, PNS
Schwann cells. Tx: IFN beta glatiramer acetate and
This is when a patient condition has reached a plateau of recovery and
further progress is not expected.
This term refers to unattended therapy.
Elasticity: The modulus of
elasticity is a ratio of normal stress to normal strain in a material
such as a ligament. This unit of measure for the modulus of elasticity
(E) is newtons per square meter or pound force per square foot.
Inertial of an area: The
moment of inertial of a given area is a measure of the distribution of a
material in a certain manner about its centroid. Thus its distribution
determines the strength in bending and torsion. The unit of measure is
meters to the fourth power.
Momentum: Momentum is defined as a
linear momentum of a particle or rigid body, which is the product of its
mass and its velocity. The unit measure is kilogram-meters per second.
It must be noted that angular momentum of a particle or rigid body is
defined as the product of its mass moment of inertia and its angular
velocity. The unit of measurement is kilogram-meter squared per second.
Monoclonal antibody spike:
Multiple myeloma called the M protein,
usually IgG or IgA, MGUS ( monoclonal gammopathy of undetermined
significance), Waldnsrom's (M protein is IgM) macroglobulinemia.
Motion is defined as the relative
displacement with time of a body in space, with respect to other bodies
or some reference point in space.
The motion segment is defined
as a unit of the spine representing inherent biomechanical
characteristics of the ligamentous spine. The motion unit consists of
two adjacent vertebrae and the interconnecting soft tissue, devoid of
musculature. When considering the thoracic spine the two articulating
heads of ribs with their connecting ligaments are also included.
Motion-segment is also know as the spinal unit.
A motor unit is a structural
unit of the vertebral joint complete, which consists of two vertebral
bodies, the interposed disc, all ligaments and soft tissues in which
neurological elements are found.
Simple, Grade 1: Mild muscle pull caused by a forceful
and traumatic stretch which exhibits a low-grade inflammation with
limited disruption of musculotendinous fibers.
Moderate, Grade 2:
A moderate muscle pull caused by a
forceful overstretch or traumatic contraction which results in torn
muscle fibers without complete disruption and characterized by edema,
inflammation, muscle spasm, and a moderate degree of function loss.
Severe, Grade 3:
This is a severe
muscle pull resulting in a ruptured muscle(s) or torn tendon(s) and
characterized by pain, edema, muscle spasm, inflammation, and
significant loss of muscle function.
Myotomes are derived from the
embryonic somites, which form the muscular system.
Necrosis of the tissues:
necrosis is generally an indication of infection by Mycobacterium
tuberculosis. The term caseous refers to the appearance of the
tissues (i.e., soft, white necrotic areas that have a cheese-like
appearance.). Microscopically the necrotic areas are lightly
eosinophilic (stain light pink), with little or no discernible cellular
detail. The eosinophilia reflects staining of residual cellular
Coagulative necrosis is a more common type of necrosis,
characteristic of anoxic injury and most infarcts. Cellular
outlines are preserved, but proteins are denatured, and the cells stain
in an eosinophilic manner.
fat necrosis is seen primarily with pancreatic injury when
pancreatic lipases are released and digest fat to form free fatty acids.
These fatty acids complex with calcium, resulting in the production of
calcium soaps (saponification) in the pancreatic tissue or in
extrapancreatic fatty tissues (e.g., omentum).
necrosis or gangrene, bacterial infection is superimposed on
a background of massive necrosis and putrefaction.
Liquefactive Necrosis occurs in brain or other neural tissues and in
pancreatic tissue. The tissue appears liquefied under the microscope,
without preservation of cell outlines. Liquefactive necrosis can also be
seen in some bacterial infections, especially those caused by pyogenic
Staphylococci, Streptococci, or certain coliform bacteria.
(lungs) and necrotizing glomerulonepritis.
Wegener's and Goodpasure's.
birefringent crystals: Gout.
Nephritis, cataracts and
hearing loss: Alport's syndrome.
Neurapraxia, Class 1: Neuropraxis
however is found when conduction is locally blocked (for example focal
demyelination), and recovery is relatively rapid. With neuropraxia
think of some local, focal blockage to nerve conduction, such as a
carpal tunnel syndrome.
Axonotmesis, Class 2:
may, in rare cases, indicate that the nerve was severed; however, it
generally indicates that regeneration can occur because the endoneurial
coverings maintain their proper alignment, indicating that this patient
will recover with conservative care.
Neurotmesis, Class 3:
neurotmesis, the nerve cannot regenerate spontaneously due to its either
being severed completely or disrupted by obstructing scar tissue.
This refers to something
being pertaining to or dependent on nerve action.
This refers to operation of
tearing out (avulsion) of a nerve.
Neurolemma: This refers to
the thin membrane spirally enwrapping the myelin layers of a myelinated
nerve fiber or the axon of an unmyelinated nerve fiber.
This refers to a disease
process within a nerve resulting form trauma, circulatory disorders and
metabolic diseases. The term has been used interchangeably with the
Neurogenic: This term refers to a
substance, which is capable of forcing nerve regeneration or
development. Examples of such substance are GABA, phospholipids,
thiamine, thyrosine and so forth. The term neurogenic has also been
utilized to mean that a disorder originated from nervous tissues. The
cause of this disease has a neurogenic basis.
This term refers to a tumor or new
growth largely made up of nerve cells and nerve fibers; a tumor growing
from a nerve.
refers to the quality of producing or the ability to produce pathologic
changes in nerve tissue.
This term means the wasting
of nerve tissue.
Neurophysiological effects: This is a common term referring to the functional or aberrant
disturbances of the autonomic and’/or peripheral nervous systems and
their respective innervations.
or Chronic nonpsychotic disorder characterized
mainly by anxiety, which is experienced or expressed directly or is
altered through defense mechanism; it appears as a symptom, such as an
obsession, a compulsion, a phobia, or a sexual dysfunction.
This term refers to pressure
on a nerve, direct or indirect. The pressure can occur in the
intervertebral foramen through congestion of the perineural tissues. It
can also occur in the carpal tunnel through direct ligament pressures
and so forth.
This is defined as producing
The process of regeneration
of a nerve after its division. It also can refer to the operation of
implanting a nerve into a paralyzed muscle.
compression syndrome: This
syndrome results in a radiating neuritis of the arm due to compression
of the brachial plexus. The etiology may be a cervical rib.
Progressive neurodegeneration, hepatosplenomegaly, Cherry Red Spot,
Sphingomelin accumulates, AR.
No lactation postpartum:
Sheehan's syndrome (pituitary infarction).
Chordae Dorsalis: The
notochord is the primitive axial supportive structure, which is found
during embryonic development. It is derived from mesoderm and extends
from the sphenoid bone to the coccyx. After birth it is present as the
Impression: This is an
Invagination of the superior aspect of a disc into the inferior end
plate. It generally will occur in the posterior third of the vertebral
body. It is often shallower than a Schmorl’s node ad is also known as
the notochordal persistency or persistent notochord.
This refers to a
non-segmentation or a syostosis of the atlas with the occipital bone.
Occupational exposure to
asbestos: malignant mesothelioma with psammoma bodies.
It is reverse of polymenorrhea. The cycles
become less frequent and the flow is less. The cycle may
come after many months and when the period starts in only lasts for a
few days with scanty flow (Cf metropathia- hemorrhagica; here also cycle
is prolonged but he flow is heavy.).
This is scanty production of urine pathognomonic of
Bone: This is an osseous
structure attaching the spine of the scapula to the vertebral column as
a result of Sprengel’s deformity.
Orphan Annie nuclei:
Papillary carcinoma of the thyroid. Orphan
Annie nuclei and psammoma bodies (found in ovary, thyroid, mal
This is a non-union of the
odontoid process to the axis, which should fuse by the eighteenth year.
It must be differentially diagnosed form a fracture.
Terminali: This is a
non-union of the tip of the odontoid process. It is considered a normal
This refers to the formation
of bony tissues.
This is a disease process
resulting in the softening of bone(s).
These are laterally
projecting bony epicules, which are laid down by osteoblastic activity
during microtrauma as a defense mechanism.
This is a decrease in bone
density usually due to a loss of calcium form bone.
refers to the motion of a rigid body in which the body does not move in
a single plane such as vertebral bodies. Generally out-of-plane motion
is considered to be a combination of excursion or translation and
rotation. It will have three degrees of freedom; rotation abut two
mutually perpendicular axis, forming a plane, and translation
perpendicular to that plane. For example for a vertebra to undergo
lateral flexion the vertebra rotates (see coupling) about a horizontal
axis (z-axis) and translates out of the sagital plane into the
horizontal pane. Axial rotation will also occur due to the
biomechanical coupling of the spinal column. An understanding of this
out-of-plane-motion is essential for those who profess to be experts in
Biomechanical Trauma or Chiropractic
Orthopedics or Orthopedic Medicine.
Pancreatic cancer (head).
Palpable purpura on legs
and buttocks: Henoch-Schonlein
This is a primary
Bronchogenic carcinoma involving the apex of the lung(s). It is also
known as a superior Sulcus tumor
associated with Horner's syndrome.
Nigrostriatal dopamine depletion disease.
Status: This refers to joint
Pathomechanics with actual structural changes such s the scars of
imbalanced motion and weight bearing, trauma and biochemical changes
associated with aging and deficiency states. Examples of a vertebra
with a pathomechanical status are arthrosis, disc degeneration, and
This term refers to the
magnification and distortion of x-rays due to the distance of the object
from the film.
Periosteal elevation on
x-ray: Pyogenic ostomyelitis.
P & S-Permanent
and Stationary: This
is the condition of the patient when they have reached the point of
maximum medical improvement and there is no further expected improvement
or decline in the patient’s condition. A patient who is Permanent
and Stationary can be graphed demonstrating the final status. A
patient can be permanent and Stationary relative to care. In this
instance the patient is no longer responsive to that form of care.
A patient is not permanent and stationary to care until all recognized
forms have been tried. For example for a backache. The
patient may be permanent and stationary to Acupuncture, Medicine and
Chiropractic and thus no further care would be recommended unless there
are flair-ups or exacerbations.
disability: This applies to
any permanent damage or to loss of utility of a body part.
A formal, written request or
Pick's disease is a presenile onset < 65
progressive dementia similar to Alzheimer's with personality change,
language dysfunction, hyperorality, due to frontal and temporal lobes
circumscribed knife like lobar atrophy which is its Hallmark.
Chrom 17 abnormality of tau protein. Biopsy find ballooned cells &
Post fosse, cerebellar and hypothalamus.
Rosenthal fibers (cork-screw shape), intensely eosinophilic, elongated
astrocytes with bipolar process. Usually Children.
Emphysema (centroacinar-smoking, panacinar-alpha
This motion refers to a
motion in which all points of rigid body move parallel to a fixed
plane. The motion is biomechanical and considered to have a combination
of translation and rotation. Its three degrees of freedom are
translations along two mutually perpendicular to the other two axis.
For example when the spinal column undergoes flexion then extension
vertebra translate into the horizontal and vertical direction. At the
same moment it rotates the vertebra about an axis perpendicular to the
sagital plane, from extension to the neutral an then to flexion. This
motion takes place in a single plane.
Plasticity: This refers to the property
of a material to permanently deform when it is loaded beyond its elastic
When a material is loaded
beyond its elastic range, it enters the plastic range.
This is an acquired deformity
of the occipital bone and upper end of the cervical spine in which the
latter appears to have pushed the floor of the occipital one upwards due
to bone necrosis and softening.
Esophageal webs with iron deficiency
anemia which can become Squamous cell carcinoma.
Gout (MP joint of hallux)
The cycles are shortened. the cycles come more
frequently and thus the women have more total blood loss.
The cycles come more frequently and are also
excessive in amount and or duration. the frequent cycles now have
heavier bleeding as well.
pathology, and edema: Dry beriberi
(Vitamin B1 deficiency, thiamine).
Polyneuropathy preceded by
GI or respiratory infection:
Lyosomal glucosidase deficiency alpha 1,4
glucosidase where glycogen accumulates within cells causing cardiomegaly
with damage to liver and skeletal muscles.
Positive anterior drawer
sign: Anterior cruciate ligament
Probable would be more than 50% inference, causation, or future need,
whereas possible would be considered less than 50% chance.
Ponticle: This is a
calcification of the posterior Atlanto-occipital membrane fro the
superior articular facet t the posterior arch of the atlas. It is best
seen on a lateral view. Complete (arcuate) or incomplete foramen is
Energy: Potential energy may
be stored within a material as a result of deformation or displacement
of that material or structure. The unit of measurement is newton meters
This is tuberculosis of the
spine representing another form of ankylosis.
Provider Organization: A
prepaid medical plan with contracted physicians.
Pathology vs. Pre-Existing Disability:
This is the differentiation between pre-existing asymptomatic pathology
from pre-existing disability as it applies to the area of injury under
Stresses: These stresses are
normal to the principal planes. The unit of measure is newtons per
square meter or Pascals.
This term refers to the
attempt by a specialist in occupational medicine to reduce or eradicate
disease by removing or altering the responsible etiologic factors.
Examples follow: Prophylaxis is utilized to prevent faulty body
biomechanics. The term may also refer to the prevention of recurrence
with follow-up car, limitations of amounts to be lifted by the employee
for a given period of time, lumbar supports to be worn for a period of
time, exercise and so forth.
Evidence: When the evidence
is weighed against that which is opposed to it, and has a more
convincing force and greater probability or truth.
Charge: These are charges,
which are most frequently charged in a specific geographical area by
specialized groups of doctors.
This is a therapy in which the physician or therapist rendering it is in
Codes: This is a listing of
descriptive terminology and identifying codes for reporting medical
services and procedures. (CPT, RV, HCPCS).
This is the one who is
licensed by the state to perform a health care service.
Pseudopalisade tumor cell
arrangement (astrocytes with necrois):
Beside surgery, Dexamethasone, hi pot
steroid to lower intra cranial pressure. Untreated right
hemiparesisas frontoparietal lesion at motor strip with possible right
side sensory loss as well.
Ewing sarcoma t 11,22 chromosom
mutation. Onion skin effect x-ray. Hist: Small, round, blue
This refers to a false
Increased epidermal cell proliferation and
inflammation. HLA B13 & B17 - pink patch plus silvery scale.
Impairment of mental function emphasized loss
of reality testing manifested by delusion, hallucinations, confusion,
and impaired memory.
Pterygium Coli: This term refers to a webbing
of the neck, often seen in the Klippel-Feil Syndrome patients.
Ptosis, miosis, anhidrosis:
Horner's syndrome associated with
This refers to matter, which
is easily penetrated by x-ray, resulting in blackness of the film.
This refers to matter, which
absorbs ionizing radiation from x-rays, resulting in whiteness on the
Motion: The range of motion
for the human species is measured at the extremes of the physi9lotgical
range of translation and rotation of a joint or region of the spinal
column (hips, knees, elbows, wrists, ankles etc.) for each of its six
(six degrees of motion in the spinal column) degrees of joint freedom.
The units of measure are meters and degrees.
Rash on palms and soles:
Secondary syphilis and Rock Mountain
Recurrent vasospasm in extremities.
RBC casts in urine:
Pseudomonas and S. aureus infections:
Red urine in the morning:
Paroxysmal noctrnal hemoglobinuria/PNH.
Reid index (increased):
Chronic bronchitis (Green/yellow sputum).
Leydig cell tumor of rod shaped crystals.
Large uniform cells. Golden Brown testicular tumor, interstitial,
may elaborate androgens, estrogens causing precocious puberty and
gynecomastia, 20-60 y/o, 10% mel,
Urethritis, conjunctivitis, arthritis.
This refers to the decrease
in stress in a deformed structure with time when the deformation is held
constant. This definition is applied to somatic tissues (Bones,
Ligaments, Muscles, Tendons). Relaxation can also be considered a
“state” o psychological dynamics, which controls conscious and
unconscious innervation of the body tissues and structures.
cell carcinoma, cavernous hemangiomas, adenomas:
von Hippel-Lindau disease. Young child with
headache, papilledema, hemangioblastoma of retina, retinal vascular
tumor, hemangioblastoma cerebellum.
Renal epithelial casts
in urine: Acute toxic/viral nephrosis.
This is the remaining effect
of disabilities of an injury or condition.
This is an ongoing monitoring of services as they are being provided to a patient.
Review: This is a review
performed by a provider of the same profession with similar training and
practice to that of the provider under review, and with similar
experience in providing the treatment rendered.
Prospective Review: This is
a review of the appropriateness of a specifically proposed procedure or
course of treatment, such as pre-authorized care.
Retrospective Review: This
is a review performed after the services have been provided.
positively birefringent: Pseudogout.
Coarctation of the aorta. Infantile Aortic
Coarctation may present with newborn lower 1/2 body cyanotic.
Infantile CoArc associated with PDA. BP decrease distal to PDA
blood shunt pulmonary artery thru PDA to Aorta.
Not Established: This is a
newly established or infrequently used procedure.
Roth's spots in retina:
Congenital conjugated hyperbilirubinemia.
Rouleaux formation (RBCs):
Yolk sac tumor.
Value study: This is a coded
listing of physicians services in which a value/fee has been affixed to
said service or procedure.
Left to right shunt VSD, PDA, ASD, mitral
regurgitation, LV failure (CHF).
Aortic stenosis, hypertrophic subaortic stenosis.
This refers to a fusion of
the transverse process of L5 to the sacrum; since the transverse process
is elongated it is also referred to as a spatulated transverse process.
Yolk sac tumor.
Nodules: Discal Invagination,
which occurs as a result of an area of weakness in the hyaline cartilage
Sclerotomes: Sclerotomes are derived form
the somites during embryonic development and form the vertebral bodies
and neural arches, which fuse. Thus they surround the neural tube or
developing spinal cord.
The Scotty dog is noted on a
lumbar oblique x-ray study. The nose is seen as the transverse
processes. The eyes are the pedicles, the ears are the superior
articular facets, the front legs are the inferior articular facets, the
hind legs are the Contralateral inferior articular process, the body is
the ipsilateral lamina, the tail is the lamina and the Contralateral
superior articular facet and finally ad most importantly the neck of the
Scotty dog is actually the pars-interarticularis. When looking for
spondylogenic disorders a break in the pars will be noted.
Classification: (Obtained by the Cobb Method)
Group 1: 0-20 degrees
2: 21-30 degrees
3: 31 to 50 degrees
4: 51 to 75 degrees
5: 76 to 100 degrees
6: 101 to 125 degrees
7: 126 degrees or greater
This is an employer who
qualifies to act as the insurer for those in their employ.
A senile Kyphosis is the loss
of the anterior height of the thoracic vertebral bodies yielding an
accentuation of the Kyphotic curvature. This is differentially
diagnosed from another osteoporosis manifestation known as Pottinger's
Saucer or an elongation of the Spinous Process of the cervicothoracic
vertebra noted as a hump on the back of some geriatric women.
This is a payment or
acceptable compensation for a loss.
Cutaneous T-cell lymphoma.
The shear modulus is a ratio
of shearing stress to the shear strain in a material. The unit of
measure is newtons per square meter or Pascals.
Shearing stress refers to the
intensity of force parallel to the surface on which it acts. The unit
of measure is newtons per square meter or Pascals.
Postpartum pituitary necrosis.
Men type IIa
Dry eyes, dry mouth, arthritis.
Erythema infectiosum (fifth disease).
Parvovirus B19. Adults get arthralgia & arthritis but not usually
Soap bubble on x-ray:
Giant cell tumor of bone.
Somites are formed during eh
embryonic development as block-like paired structures, which appear at
about the fourth week on either side of the median line close to the
notochord. Somites are derived from the mesoderm and give rise to the
Spike and dome on EM:
Occulta: Spina Bifida
Occulta is a congenital a abnormality resulting in an apparent cleft
(non-union) of the posterior arch structure of a vertebra. It is most
often found in the lumbosacral region. However it has also been noted
in the Atlanto-axial areas.
with Meningomyelocele: This
refers to a herniated protrusion of a part of the spinal cord and its
meninges through a cleft in the neural arch.
Rachischisis: This is
considered the most severe form of spina bifida. In this condition a
large section or al of the vertebral column may be split with a
protrusion of the entire spinal cord.
Splinter hemorrhages in
refers to a spondylosis plus a degenerative bone disease at the same
Spondylolisthesis: This is
an anterior translation and excursion of one vertebral body on another
due to many etiologies. Three follow:
A defect in the pars interarticularis most commonly at L5/S1.
Degenerative slippage with facet over-riding.
Elongation of the pedicles.
This refers to a defective
ossification (non-union) of the pars-interarticularis. It is noted as a
small black line on the x-rays and if bilateral may give rise to a
This refers to a degenerative
intervertebral disc with Osteophytosis on the anterior vertebra body
margin at the same level of the degenerative intervertebral disc.
deformity is a congenital malformation resulting in an un-descended
scapula or one demonstrating altered scapular dynamics. Generally a Omo-vertebral
bone is associated with this variant.
Statics refer to that branch of
mechanics that deals directly with the equilibrium of bodies at rest or
in motion with zero acceleration.
Static load refers to a load,
which is applied to a specimen if it remains constant with respect to
Stiffness is a measure of the
resistance offered to external loads by a material or specimen as it
coefficient refers to the property of a structure defined by the ratio
of force applied to the deformation produced. It is utilized to
quantify the resistance that a structure offers to deformation.
This is a condition for an
Strain refers to the change in unit
length or angle in a material subjected to a load. When discussing the
change in length strain is referred to as a normal strain. When
discussing the change in angle of a material due to stain it is referred
to as a shearing strain.
Sprains: These two terms
refer to clinical characteristics of injury to capsular, ligamentous, or
musculoligamentous and musculotendinous structures. With strain and
sprains, the structures have been loaded and deformed to a point at
which pain is produced and joint instability may occur. Sprains will
contain microscopic tears to partial or gross tears. Many refer to
strains of the muscle and its structures and sprains to ligaments, discs
and any tear of Somatic Structures.
Stress is the force per unit area of
a structure and a measurement of and intensity of the forces.
Biomechanically, normal stress refers to stress, which is perpendicular
to the plane of a cross section. Shear stress is parallel to the
cross-section. The unit of measure is newtons/square meter or Pascals.
Stress can also be a state of the psychological dynamics, or a state of
diminished health of the body and certain organs.
String sign on x-ray:
Subepitelial humps on EM:
Swollen gums, poor wound
healing, anemia, bruising: Scurvy.
Vitamin C deficiency, ascorbic acid is necessary for hydroxylation of
proline and lysine in collagen synthesis.
This is a paravertebral
ossification of the longitudinal spinal ligaments and the outer portion
of the annals, which extend vertically bridging adjacent vertebrae.
Systolic ejection murmur
crescendo-decrescendo: Aortic valve
stenosis. Dyspnea, Angina, syncope, Pulmonary congestion.
ECG-LV hypertrophy. Gallavardin phenomena. Heydes
syndrome-As with angrodysplasia of colon. As increased left vent
pressure so vent hypertrophy, stiff = S4. Avoid Nitroglycerin in
AS as sudden drop of B P. Delayed carotid upstroke, AV 2nd MC
valvle RF, Bicuspid Aortic Valves, MC type Aortic disorder, N American
Calcific MCC degenerative Monckenberg senile calcific AS.
Medical correlation with Chiropractic:
The term subluxation was actually a
popular medical term prior to the discovery of chiropractic. When D.D.
Palmer discovered chiropractic he utilize the known science of his times
and believed the altered vertebral joint he found and corrected must be
a subluxation. A subluxation in chiropractic is thought to be any
alteration in the normal relationship between two adjae3nt articulating
joints. It can also be a joint, which appears within normal
relationships when viewed statically but then demonstrates aberrant
motion upon a motion examination due to soft tissue restrictions,
laxity, edema, congestion and so forth. The various alterations in
joint dynamics, which can viewed radiographically, have been
subluxation is relatively a new concept. Here the subluxation is
defined as a partial dislocation (thus far this is exactly what DD had
said over 100 years ago. He said luxation is a complete dislocation and
a subluxation was thus less than a dislocation or a partial
dislocation). Medical physician believe that a medical subluxation is
any pathological situation in which there is not a normal physiological
juxtaposition of the articular surfaces of a joint. What they are
actually saying here is that first some pathological process such as
rheumatoid arthritis causes damage to the motor unit thus allowing a
can occur to the holding elements of the spinal column by injury causing
joint instability, than an alteration in joint dynamics will occur
Subpoena: This is a process commanding
the attendance of any person included indirectly in a claim.
Fertilization of two ova within the same
menstrual cycle but not at the same coitus, nor necessarily by sperm
from the same sex partner. John
Archer MD, the first doctor to receive a
medical degree in the United States cared for
a white woman who had sex with a black man and
a white man within a short time and
subsequently gave birth to twins--one white with
blood type O, one black with blood type A.
Other cases have been reported since.
Partial Disability: This is
that period of time in which the injured worker may perform part of
their work or lighter duty, but cannot yet return to hi regular work.
Temporary Total Disability:
This is that
period of time in which the injured employee is totally unable to
perform their regular work.
Tension is defined as a normal force
that tends to elongate the fibers of a material. The unit of measure is
This refers to a type of load that
is applied by a couple of forces, which are parallel and directed
opposite to each other about the long axis of a structure. The load in
this example would be called torque. Torque will produce relative
rotation of different axial sections of a material with respect to each
other. If a structure is straight all sections of it will receive the
same torque. However if the structure is curved and the load is applied
at the ends of it, each cross-sectional area is subjected not only to
torque, but also to bending. Particular bending magnitudes depend
directly upon the orientations of the particular cross-section with
respect to the torque axis.
Rigidity: Torsional rigidity
refers to the torque per unit of angular deformation. The unit of
measure is newton meters per radian.
Translation: Translation refers to the
motion of a rigid body in which a straight line in the body always
remains parallel to itself. The nit of measure s millimeters of
meters. Translation usually begins the alteration in a given joint due
to injury. However if he vertebra translates out of position as in a
Anterolisthesis because of the soft tissue structures (discs, muscles,
ligaments and so forth) and the vertebra may take position, which is not
straight and parallel. Thus the vertebra translates into an ercursional
position and remains there unless affected by some external force.
Multiple Myeloma, Small Cell Lymphoma.
Burkitt's lymphoma (c-myc activation).
Philadelphia chromosome, CML (bcr-abl/hybrid),
increased neutrophil count.
Follicular lymphomas (bcl-2 activation).
Tendon xanthomas (classically
Thumb sign on lateral
x-ray: Epiglottitis (Haemophilus
Thyroidization of kidney:
Chronic bacterial pyelonephritis.
Tram-track appearance on
Migratory thrombophlebitis of pancratic
adenocarcinoma, hypocalcemia and carpal spasm.
Tyrosine, L-dopa, Dopamine, Norepinephrine
Customary and Reasonable:
This is the fee, which the individual doctor most frequently charges to their patients for specific
This is the average range of fees charged by doctors of similar training and experience in a
given geographic area.
Reasonable: This is a fee,
which differs form the usual or customary charges because of unusual circumstance,
which requires additional time, skill and effort.
The ultimate load
is the final load reached by a structure subjected to failure. The unit
of measure is newtons if the load is a force and newton meters if the
load is a torque or moment.
This refers to a vector with
unit magnitude. It is a mathematical quantity and is used to define a
Vaginal discharge of
whitish cottage cheese, branching pseudohypae and buds:
Candidiasis, Candida Albicans. Tx:
Miconazole which inhibit ergonsterol synthesis.
This refers to a quantity that
possesses both a magnitude and a direction.
Correction: The vector of
correction denotes the direction in which a joint must be adjusted for
correction of its state of altered joint dynamics. The vector of
correction will always be along the plane lines of the facets or across
the path of least resistance to cause no jamming of articular
Velocity refers to the rate
of change of position of a point with respect to a coordinate system.
It is a vector quantity where its magnitude is called speed. The
velocity may be angular or linear, depending upon the type of motion.
The unit of measure is meter per second or radians per second.
Visoelasticity is the
property of a structure to show sensitivity to the rate of loading or
deformation. The two component of Visoelasticity are of course
viscosity and elasticity. Two phenomenological characteristics of
visoelastic materials are Creep and relaxation, which quantify their
behavior. Two other phenomenological characteristics are a
load-deformation curve, which is dependent upon the rate of loading. In
other words the higher the rate of loading the steeper the resultant
curve. This is a direct relationship. The other phenomenological
characteristic involved the loading and unloading cycles of the
material. Here the material shows Hystereis or the loss of energy in the
form of heat during each cycle.
Virchow's node: Left supraclavicular
node enlargement from metastatc carcinom of the stomach.
Virchow's triad: Pulmonary embolism
triad of blood stasis, endothelial damage and hpercoagulation.
Neurofibromatosis with cafe-au-lait spots.
Recklingausen's disease of bone:
Osteitis fibrosa cystica (brown tumor).
Wallenberg's sydrome: Pica
syndrome: Adrenal hemorrhage
associated with meningococcemia.
Chronic end-stage renal disease.
casts in urine: Acute pyelonephritis.
urine: Acute cystitis.
Wermer's syndrome: Men type 1
Whipple's disease: Malabsorption
syndrome caused by tropherma whippelii. PAS stain granules in
macropages with diarrhea, flatulence, freq Iron deficincy anemia.
Wilson's disease: Hepatolenticlar
degneration. Ceruloplasmin, Tx: Zinc Acetate to prevent
Wire loop appearance on
LM: Lupus nephropathy.
headache of my life: Berry aneurys
associated with adult polcystic kidney disease.
Xanthochromia (CSF): Subarachnoid
Upper GI diverticulum.
Zollinger-Ellison syndrome: Gastrin-secreting
tumor associated with ulcers.
by Scott D.
Neff, DC DABCO CFE
FFAAJTS as a dedication to the students of America and the
"Fountain Heads" of learning and advancement of hope for our world, the
medical schools of our mother earth.
"Why does this magnificent applied
science which saves work and makes life
easier, bring us little happiness? The simple answer runs, because we
have not yet learned to make sensible use of it." Albert Einstein 1931