STUDY THE FIELD CHIROPRACTIC TAXONOMY

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You will 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 review.

THE FORENSIC ANALYSIS OF CHIROPRACTIC-LEGAL TAXONOMY ©

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 utility is 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:

1.     ELECTROCARDIOGRAM-Electr/o/cardi/o/gram

a.      Electr would be considered the root word meaning electricity.

b.     O would be considered the combining vowel that links root to root and the root to the suffix.

c.     Cardi would be considered a root word meaning the heart.

d.     Gram means to record and is considered the suffix. 

     Thus the entire word means to record the electrical condition of the heart.

2.     GASTROENTEROLOGY-Gastro/o/enter/o/logy.

a.      Gastr would be considered the root word meaning the stomach.

b.     O would be considered the combining vowel, which links root to root, and the root to the suffix.

c.     Enter refers to the intestines and is considered a root

d.     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. 

3.     ONCOGENIC-Onc/o/gen/ic

a.      One would be considered the root word-meaning tumor.

b.     O would be considered the combining vowel, which links root to root, and the root to the suffix.

c.     Gen would be considered a root word meaning producing.

d.     Ic means pertaining to and is considered a suffix. 

     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 follow: 

1.     Always read the meaning for the term from the suffix back to the first portion of the word.

2.     Leave out the combining vowel (generally O) before a suffix beginning with a vowel.  Example; gastric instead of gastroic.

3.     Always retain the combining vowel between the two roots. 

     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 follows: 

HEMATOLOGY-Hemat/o/logy.  The 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 mispronounced words: 

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 follow:

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 vowel (O).

 The following lists will demonstrate new combining forms, suffixes and prefixes. 

COMBINING FORMS:         DEFINITIONS:

 Aden/o                                             gland

Arthr/o                                               joint

Bi/o                                                    life

Cardi/o                                              heart

Cephal/o                                           head

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.

Crin/o                                                secrete (to form and give off)

Cyt/o                                                 cell

Derm/o, drmat/o                              skin

Encephal/o                                       brain (en=in, cephal/o=head)

Enter/o                                              intestines (usually the small intestines)

Erythro/o                                           red

Gastr/o                                              stomach

Gen/o                                                producing, beginning

Gynec/o                                            women, female

Hem/o., hemat/o                              blood

Leuk/o                                               white

Nephr/o                                             kidney

Neur/o                                               nerve

Ophthalm/o                                       eye

Oste/o                                               bone

Path/o                                               disease

Physi/o                                              nature

Psych/o                                             mind

Rhin/o                                                nose 

     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:

Suffixes                         Meaning

-ac                                                     pertaining to

-al                                                      pertaining to

-algia                                                  pain

-blast                                                 embryonic, immature

-coccus                                              berry-shaped

-cyte                                                  cell

-ectomy                                              to cut out, excision, resection or surgical removal

-emia                                                  blood condition

-ia                                                      condition, process

-ic                                                      pertaining to

-it is                                                    inflammation of

-logy                                                   process of study

-lysis                                                   breakdown

-malacia                                              softening

-megaly                                              enlargement

-odynia                                               pain

-oma                                                   tumor

-opsy                                                  to view

-orrhea                                                flow, discharge

-osisq                                                 condition, generally abnormal (when used with blood cell terms, it means an increase in cell numbers)

-ostomy                                             to make a new opening

-pathy                                                disease

-penia                                                 deficiency

-partum                                              birth, labor

-stasis                                                 to stop, control

-tome                                                  instrument to cut

-tomy                                                 process of cutting, to section, make an incision

-trophy                                               nourishment, development

-y                                                       process, condition

The following are a list of prefixes and their meanings:

PREFIXES                MEANING

A, an                                                  no, not, without

Ab                                                     away from

Ad                                                     toward

Anti                                                   against

Ante                                                   before, forward

Auto                                                  self

Ana                                                    up

Brady                                                 slow

Cata                                                  down

Con                                                   with, together

Contra                                               against, opposite

Dia                                                     through, coplete

Dys                                                    bad, painful,difficult

Ec, ecto                                             out, outside

En                                                      in

Endo                                                  within

Epi                                                     above

Ex                                                      OUT

Exo                                                    outside, outer

Hemi                                                  half

Hyper                                                above, excessive

Hypo                                                 deficient, below, under, less than

Infra                                                   below, inferior

Inter                                                   between

Intra                                                   within

Macro                                                large

mal                                                    bad

meso                                                  middle

meta                                                   between, beyond, change

micro                                                 small

pan                                                    all

para                                                   near, beside, abnormal    

poly                                                   many

post                                                   after, behind

pre                                                     before, in front of

pro                                                    before

pseudo                                               false

re                                                       back

retro                                                   behind, back

syn, sym                                            together, with

tachy                                                  fast

ultra                                                   beyond, excess

 The following list of words are combining forms with their meanings:

COMBINING FORMS MEANING

Acr/o                                                 abdomen

Acu/o                                                sharp

Arteri/o                                              artery

Arth/o                                                joint

Chir/                                                  hand

Chondr/o                                           cartilage

Chondr/o                                           time

Col/o                                                 colon, large intestine

Dactyl/o                                             fingers or toes

Eosin/o                                              rosy, dawn-colored

Gon/o                                                seed

Hepat/o                                              liver

Hydr/o                                               water

Ischo/o                                              to hold back

Laryng/o                                            larynx (voice box)

Cost/o                                               rib

Gloss/o                                              tongue

Glyc/o                                               sugar

Morph/o                                            death

Pne/o                                                breathing, breath

Secti/o                                              to cut

Seps/o                                              infection

Somn/o                                             sleep

Tox/o                                                 poison

Lith/o                                                 stone, calculus

Ophthalm/o                                       eye

Myel/o                                               bone marrow, spinal cord (the context of the usage of the word indicates which meaning is intended)

Ot/o                                                   ear

Peritone/o                                          peritoneum

Phag/o                                               to eat, swallow

Phob/o                                               fear

Plas/o                                                development, formation

Pnwum/o                                           lungs

rect/o                                                 rectum

staphyl/o                                            clusters, grapes

strept/o                                              twisted chain

thorac/o                                             chest

thromb/o                                            clot

ven/o                                                 vein

KEY TO PHARMACY ABBREVIATIONS

5-HT          5-hydroxytryptamine (serotonin)

AC             adenylate cyclase

ACh           acetylcholine

AChR        acetylcholine receptor

ACE          angiotensin converting enzyme

ACEI         angiotensin converting exzyme inhibitor

ADH          anti-diuretic hormone

AF             atrial fibrillation

AFL           atrial flutter

AIDS         acquired immune deficiency syndrome

ALL           acute lymphocyctic leukemia

AML          acute myelogenous leukemia

ANA          antinuclear anti-body

ARB           angiotensin receptor blocker

ATI            angiotensin I

ATII           angiotensin II

ATP           adenosine triphosphate

AV             atrioventricular

BBB           blood-brain barrier

CAD          coronary artery disease

cAMP        cyclic adenosine monophosphate

cGMP        cyclic guanosine monophosphate

CCB          calcium channel blocker

CHF           congestive heart failure

CMV          cytomegalovirus

CNS           central nervous system

CO             cardiac output

COMT       catechol O-methyl transferase

COPD        chronic obstructive pulmonary disease

COX          cyclooxygenase

CFS           cerebrospinal fluid

CV             cardiovascular

CVA          cerebrovascular accident

DA             dopamine

DAG          diacyl glycerol

DCT           distal convoluted tubule

DHF           dihydrofolate

DHFR        dihydrofolate reductase

DIC           disseminated intravascular coagulation

DNA         deoxyribonucleic acid

DVT          deep vein thrombosis

EBV          Epstein-Barr virus

FAD          Flavin adenine dinucleotide

FMN         Flavin mononucleotide

FSH          follicle-stimulating hormone

G_i              inhibitory G protein

G_s              stimulatory G protein

G6PD        glucose 6-phosphate dehydrogenase

GABA       gamma-amino butryic acid

GC             guanylate cyclase

GFR           glomerular filtration rate

GnRH         gonadotropin-releasing hormone

GU             genitourinary

HBV           hepatitis B virus

HCV           hepatitis C virus

HDL           high-density lipoprotein

HIV            human immunodeficiency virus

HSV           herpes simplex virus

IDDM         insulin-dependent diabetes mellitus

IDL             intermediate-density lipoprotein

Ig                immunoglobulin

IM              intramuscular

IMP            inosine monophosphate

IP₃              inositol 1,4,5-triphosphate

IV               intravenous

JGA           juxtaglomerular apparatus

LDL           low-density lipoprotein

LFT            liver function test

LH             luteinizing hormone

LO             lipoxygenase

LTX           leukotrienes (X=A,B,C and so forth.)

MAC         Myobacterium avium-intracellulare complex

MAO         monoamine oxidase

MAOI        monoamine oxidase inhibitor

MEOS        microsomal ethanol oxidizing system

MI              myocardial infarction

MLCK       myosin light-chain kinase

NAD          nicotinamide adenine dinucleotide

NADP        nicotinamide adenine dinucleotide posphate

NE             norepinephrine

NIDDM     non-insulin-dependent diabetes mellitus

NM            neuromuscular

NSAID       nonsteroidal anti-inflammatory drug

PABA        para-aminobenzoic acid

PAC           premature atrial contraction

PCT           proximal convoluted tubule

PDE           phosphodiesterase

PFT            pulmonary function test

PGX           prostaglandins

PIP₂            phosphatidyl inositol 4,5-bisphosphate

PLA₂           phospholipase A₂

PO              per os (by mouth)

PPD            purified protein derivative

PR               per rectum

PRPP          5-phosphoribosyl-1-pyrophosphate

PSVT          paroxysmal supraventricular tachycardia

PT               prothrombin time

PTH             parathyroid hormone

RBC             red blood cell

RNA            ribonucleic acid

RR               respiratory rate

RSV             respiratory syncytial virus

SC                subcutaneous

SIADH         syndrome of inappropriate ADH (antidiuretic hormone)

SL                sublingual

SLE              systemic lupus erythematous

SVR             systemic vascular resistance

TB                tuberculosis

TCA             tricyclic antidepressant

TF                tissue factor

TFPI             tissue factor pathway inhibitor

TFT              thyroid function test

TG                triglyceride

THF              tetrahydrofolate

TIA               transient ischemic attack

TNF              tumor necrosis factor

TPR              total peripheral resistance

TXA₂            thromboxane

UTI               urinary tract infection

VLDL           very low-density lipoprotein

VT                ventricular tachycardiar

vWF             von Willebrand's factor

VZV             varicella-zoster virus

DERMATOPATHOLOGICAL TERMINOLOGY

MACROSCOPIC TERMINOLOGY

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

Bulla:      Fluid-filled raised area more than 5 mm

Blister:    Common name used for vesicle or bulla

Pustule:  Discrete, pus-filled raised area

Scale:     Dry, horny, platelike excrescence

Lichenification:  Thickened and rough skin with prominent skin markings often due to rubbing

Excoriation:  Traumatic breakage of epidermis

Oncholysis:  Loss of integrity of the nail substance

MICROSCOPIC TERMINOLOGY

Hyperkeratosis:  Hyperplasia of the stratum corneum

Parakeratosis:    Keratinization with nuclei retention in the stratum corneum, whereas a normal finding on mucous membranes

Acanthosis:  Epidermal hyperplasia stratum spinosum

Dyskeratosis:  Abnormal keratinization prematurely within individual cells or groups of cells below the stratum granulosum

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

Exocytosis:    Epidermal 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

FORENSIC MEDICAL-LEGAL TAXONOMY

Acceleration:  Acceleration is the rate of change of a linear velocity.  The unit of measure of the accelerations magnitude is meters per second per second  (feet/second/second). 

Actinic keratosis:  This often precedes squamous cell carcinoma.

Addison's disease:  Primary adrenocortical deficiency.

Adenomyosis:  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 uterus.

Adjudicate:  The process of trying and determining judicially, a judgment or the decision of the court.

Agenesis:  A lack or failure of development.

Aggravation or 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. 

Albright's syndrome:  Polyostotic fibrous dysplasia, precoucous puberty, cafe-au-lait spots, short stature, young girls with shortened 4th & 5th metacarpals.

Albuminocytologic dissociation:  Guillain-Barre.   protein in CSF with only a modest ↑ in cell count.

Allowable 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.

Altered Interosseous Spacing:  This refers to the most common of all chiropractic subluxations or areas of altered joint dynamics in the geriatric population. 

Amenorrhea:  Absence of menstruation.  This could be primary; when the women have never menstruated, or secondary; when it stops after having menstruated for some time.

Anencephaly:  Congenital abnormality whereby the brain has failed to develop. 

Angiothlipsis:  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 manifestations. 

Angular 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 (degrees/second/second). 

Aniostropic Material:  Aniostropic 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. 

Ankylosing:  Immobility and consolidation of joints due to a disease process which can be due to a bridging o osteophytes or diseases. 

Ankylosis:  The acquired fusion due to a disease process. 

Ankylosing 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.   

Antalgic:  This generally refers to a person’s posture where there is a leaning or diversion from the norm. 

Anterolisthesis:  There will be a disruption of Georges Line of Menstration due to an anterior displacement of one vertebral segment upon another. 

Anti-basement membrane antibodies:  Goodpasture's syndrome.

Anticentromere antibodies:  Scleroderma (CREST).

Anti-double-stranded DNA antibodies (ANA antibodies):  SLE type III hypersensitivity.

Anti-epithelial cell antibodies:  Pemphigus vulgaris.  Bullae cleavage plane above basal layer of epidermis.  Nikol Sky sign = Separation of epidermis by manuel stroking.

Antigliadin antibodies:  celiac disease.

Antihistone antibodies:  Drug-induced SLE.

Anti-IgG antibodies:  Rheumatoid arthritis.

Anti-microsomal, 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.

Antimitochondrial antibodies:  Primary biliar cirrosis.

Antineutrophil antibodies:  Vasculitis.

Antiplatelet antibodies:  Idopathic thrombocytopenic purpura.

AOE/COE:  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”.   

Apophysis:  This is a secondary growth center, which serves for ligamentous and tendon attachments.  This can pertain to the shaping of bone. 

Appeal:  This is the act of formally referring to a higher authority for a reconsideration of a judgment or decision. 

Appeals Board: 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. 

Appendicular Skeleton:  This would include the pectoral and pelvic girdles along with the long bones. 

Applicant:  This is the injured party or any party affected by the occurrence of an Industrial Injury who files an action. 

Application to 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. 

Apportionment:  If, 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.   

Arachnodactyly:  Marfan's syndrome.

Arcuate 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.

Arnold-Chiarimalformation:  Cerebellar tonsillar herniation.

Aschoff bodies:  Rheumatic fever.

Assignment:  This is a written contract for the transfer of a benefit or compensation. 

Atrophy of the mammillary bodies:  Wernicke's encephalopaty.

Auer rods:  Acute myelogenous leukemia (espceially the promyelocytic type).

Avulsion 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. 

Award:  This is a judgment or decision that is given to the prevailing party by means of arbitration. 

Axial Skeleton:  This includes the skull, sternum, vertebrae and ribs. 

Autosplenectomy:  Sickle cell anemia.

Babinski's sign:  UMN lesion.

Baker's cyst in popliteal fossa:  Rheumatoid arthritis.

Bamboo Spine:  See Ankylosing Spondylitis. 

Bartter's sydrome:  Hyperreninemia.

Basophilic stippling of RBCs:  Lead poisoning.

Basilar 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.

Basilar 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 VII palsy.

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).

Bending:  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 bending. 

Bending Moment:  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). 

Benefit:  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. 

Berger's disease:  IgA nephropathy and most common cause of glomerulonephritis.

Bernard-Soulier disease.  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).

Biomechanical Adaptation:  Over time as the biped

Blastic Metastatsis:  Bone cell proliferations in a bone resulting from a form of carcinogenic disease.  It will appear as a very dense, sclerotic bone.

Block Vertebra:  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:  Subarachnoid hemorrhage.

Blue-bloater:  Chronic bronchitis.

Blue-domed cysts:  Fibrocystic change of the breast.

Blue sclera:  Osteogenesis imperfecta.

Boot-shaped heart on x-ray:  Tetralogy of Fallot; RVH.

Bouchard's nodes:  Osteoarthritis (PIP swelling secondary to osteophytes).

Boutonniere deformity:  Rheumatoid arthritis.

BR-By Report:  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:  Penicillin.

Brown tumor of bone:  Hemorrhage causes brown color of osteolytic cysts in: Hyperparathyroidism and Osteitis fibrosa cyctica (von Recklinghausen's disease).

Brusfield's spots:  Down syndrome.

Bruton's disease:  X-linked agammaglobulinemia with deficiency of B cels in Boys causing life threatening Pseudomonos.  Tx:  IVID & Antibioics.

Budd-Chiari syndrome:  Posthepatic veous thrombosis.

Buerger's disease:  Small/medium-artery vasculitis.

Burkitt's lymphoma:  8:14 translocation associated with EBV.

Burton's lines:  Lead poisoning.

C-ANCA, P-ANCA:  Wegener's granulomatosis, polarteritis nodosa.

Cafe-au-lait spots on skin:  Neurofibromatosis.

Caisson disease:  Gas emboli.

Calf pseudohypertrophy:  Duchenne's muscular dystrophy.

Call-Exner bodies:  Granulosa-theca cell tumor of the ovary.

Cardiomegaly with apical atrophy:  Chagas disease.  TX:  Nifurtimox.

Center of Gravity:  This refers to the point in a body where the body mass is centered. 

Cerebriform nuclei:  Mycosis fungoides (cutaneious T-cell lymphoma).

Chagas' disease:  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.

Chancre:  Primary syphilis (not painful).

Chancroid:  Haemophilus ducreyi (painful).

Charcot's triad:  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 beading.

Charcot-Leyden crystals:  Bronchial asthma (eosinophil membranes).

Chediak-Higashi disease:  Phagocyte deficiency.

Cheyne-Stokes respirations:  Central apnea in CHF and increased intracranial pressure.

Chocolate casts:  Endometriosis (frequently involves both ovaries).

Chiropractic 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. 

Chordoma:  One of the most lethal tumors in man, which arises from the remnant of the notochord.  

Chronic atrophic gastritis:  Predisposition to gastric carcinoma.

Chvostek's sign:  Hypcalcemia (Tap fascial muscle see spasm of muscle).

Clay Shoveler's 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 glycogen.

Clinical 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 Pathomechanics. 

Clue cells:  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: Oteosarcoma

Coefficient of 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. 

Cold agglutinis:  Mycoplasma pneumoniae, infectious mononucleosis.

Cold intolerance: Hypothyroidism.

Collimation:  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. 

Compensation:  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. 

Condylomata lata:  Secondary syphilis:

Continuous machinery murmur:  Patent ductus arteriosus.

Cori's disease:  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.   

Condrification:  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. 

Continuous 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.   

Cotton-wool spots:  Chronic hypertension.

Cough, conjunctivits, coryza and fever:  Measles.

Councilman bodies:  Toxic or viral hepatitis.

Couple:  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:  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 motion. 

Cowdry type A bodies:  Herpesvirus.

CPT-Current Procedural Terminology:  This referees to identifying codes with relative descriptive terms for reporting medical services and procedures performed by physicians. 

Cranium Bifidum:  This refers to a non-unity of the cranium. 

Creep:  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 crescentic glomerulonephritis.

Crigler-Najjar syndrome:  Congenital unconjugated hyperbilirubinemia.

Curling's ulcer:  Acute gastric ulcer associated withsevere burns.

Currant-jelly sputum:  Klebsiella, gram negative rod, non-motile with capsule.

Curschmann's spirals:  Bronchial asthma (mucous plug whorles).

Curvature:  This refers to an abnormal curve of the spinal column.  For example hyperlordosis. 

Curve:  This refers to the normal shape of the spinal column. 

Cushing's ulcer:  Acute gastric ulcer assciated with CNS injury.

Damping:  This refers to a materials property that constitutes a resistance to speed.   

Declaration of 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. 

D-dimers:  DIC.  Decreased platelet county, low fibrinogen level, high fibrin degradation products.  There is a consumption of platelts and clotting factors.

Deformation:  Deformation refers to a change in length or shape.  Deformations generally occur in ligamentous stretch/strain and/or sprain incidents. 

Degenerative 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 arthrosis. 

Degrees of 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. 

Density:  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 disorder).

Deposition:  This is the act of giving testimony under oath; the attested written testimony of a witness.   

Dermatitis, dementia, diarrhea:  Pellagra (Vitamin B3 deficiency; Niacin).

Dermatome:  A dermatome is an area of skin supplied by a single spinal nerve and its dorsal root ganglion. 

Diabetes insipidus, exophthalmos and lesions of the skull:  Hand-Schuller-Christian disease.

Disability:  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:  Discogenic refers to disorders due to a derangement of an intervertebral disc. 

Discopathogenic:  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:  Pasteurella multocida.

Donovan bodies:  Granuloma inguinale.

Dressler's syndrome:  Post-MI fibrinous pericarditis.

Dubin-Johnson-syndrome:  Congenital conjugated hyperbilirubinemia (black liver).

Duchenne's muscular dystrophy:  Deleted dystrophin gene (X-linked recessive).

Dynamic Load:  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. 

Dynamics:  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. 

Dysarthrosis:  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. 

Dysphagia:  This refers to painful swallowing. 

Dyspnea:  This refers to difficulty in breathing. 

Eburnation:  Osteoarthritis appearing almost polished and ivory like appearance of bone).

Edwards' syndrome:  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 innitially.

Elasticity:  This refer  to the property of a material or a structure to return to its original form following the removal of some deforming load. 

Elastic 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 deformation”. 

Elastic Range:  This refers to the range of loading within a specimen or a structure remains elastic. 

Elastic Skin:  Ehlers-Danlos syndrome.

Elastic Stability:  This refers to the ability of a loaded structure, given an arbitrarily small elastic deformation, to return to its original position demonstrating elastic deformation. 

Energy:  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. 

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. 

End Vertebra:  That vertebra which displays maximum tilting into the concavity of the curve. 

EOB-Explanation of Benefits:  This is a written break down of what an insurance company paid, reduced and/or denied. 

Epiphysis:  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. 

Erb-Duchenne palsy.  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.

Erisa-Employee 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:  Lyme disease.

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 optimal health. 

Fanconi's syndrome:  Proximal tubular reabsorption defect, can be due to expired tetracycline.

Fat, female, forty, and fertile:  Acute cholecystits.

Fatty liver:  Alcoholism.

Ferruginous bodies:  Asbestosis.

Findings and Award:  This is a Workers Compensation settlement decision determined by the Workers Compensation Appeals Board. 

Flair-up vs. Exacerbation:  These can relate to the same situation save an Exacerbation is a new injury. 

Flexibility 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:  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. 

Foster-Kennedy Sydrome:  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 of cells.

Frequency:   

Intermittent:  When the symptoms or signs occur less than 25% of the time during waking hours. 

Occasional:  When the symptoms or signs occur between 25% and 50% during awake hours.

Frequent:  When the symptoms and signs occur between 50% and 75% during waking hours.

Constant:  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 through examination.   

Funiculitis:  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 radiculopathy. 

Gardner's syndrome:  Colon polyps with osteomas and soft tissue tumors.

Gaucher's disease:  Glucocerebrosidase deficiecy.

Genu Recurvatum:  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. 

Ghon focus:  Primary TB

Gilbert's syndrome:  Benign congenital unconjugated hyperbilirubinemia.

Glanzmann's thrombasthenia:  Defect in platelet aggregation.

Goodpasture's syndrome:  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.

Gower's maneuver:  Duchenne's patient uses arms on legs to help  self off the floor.

Green "California" Lien: 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.   

Guillain-Barre syndrome:  Idiopathic polyneuritis and has been associated to C. jejuni but Herpes virus as well. IVID 5 days .4 mg. 

Hahn’s 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).

Hand-Schuller-christian disease:  Chronic progressive histiocytosis.

HbF:  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.

HbS:  Sickle cell anemia

HCG elevated:  Hydatidiform mole, Choriocarcinoma.

Hearing: This is similar to a trial before a workers compensation judge absent a jury.  

Heberden's node:  Osteoarthritis of DIP swelling secondary to osteophytes.

Heinz bodies:  G6PD deficiency.

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 motion. 

Hemispondylus 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. 

Henoch-Schonlein purpura:  Hypersensitivity vasculitis associated with hemorrhagic urticaria and URIs.

Heterophil antibodies:  Infectious mononucleosis (EBV).

High output cardiac failure (dilated cardiomyopathy):  Wet beriberi (Vitamin B1 deficiency, Thiamine).

HLA-B27:  Reiter's syndrome, ankylosing spondylitis.

HLA-DR3 or DR4:  Diabetes mellitus type 1 (autoimmune destruction of Beta cells).

HMO-Health Maintenance Organization:  These are prepaid medical/hospital insurance plans with staff physicians. 

Histoplasmosis:  Mississippi Valley, Dry hack cough, erythema nodosum.  Bird or Bat dropping, intracellular macrophages.

Homer Wright rosettes:  Neuroblastoma.

Honecomb lung on x-ray:  Interstitial fibrosis:

Howell-Jolly bodies:  Splenectomy or nonfunctinal spleen.

Hunter-Vokman’s Law:  This law applies to growing bones and states, “the side of greatest stress will be interrupted to cause a deformity as in scoliosis”. 

Huntington's disease:  Caudate degeneration AD

Hyperlordosis:  An increase in the lordotic curvature in either the cervical or lumbar areas. 

Hyperphagia, hypersexuality, hyperorality and hyperdocility:  Kluver-Bucy syndrome, amygdala.

Hyperpigmentation of skin:  Primary adrenal insufficiency, Addison's disease.

Hypersegmentated neutrophils:  Macrocytic anemia.

Hypertension and 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.

Hypertrichosis:  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. 

Hypolordosis:  This refers to a decrease in the lordotic curve in either the cervical or lumbar areas. 

Hypomenorrhea:  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.

Hystereis:  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. 

Impairment 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 loss residual.

Impulse:  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:  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. 

Instantaneous 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. 

Instantaneous Velocity:  Instantaneous 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. 

Insulin resitance:  Due to autoimmune antibodies to insulin receptors which block receptors ability to bind Insulin.

Intensity of Pain:   

Minimal:  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 elicits  the symptoms or signs.

          Moderate:  When 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. 

Inter-menstrual bleeding:  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.

Intussusception:  Adenovirus causes hyperplasia of Peyer's patches.

Ischemic Necrosis:  This refers to a necrosis of a tissue due to the loss or severe diminution of the blood supply. 

Isotropic 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. 

Janeway lesions:  Endocarditis.

Jarisch-Herxheimer reaction:  Syphilis due to overaggressive treatment of an asymptomatic patient that causes symptoms due to rapid lysis.

Job's syndrome:  Neutrophil chemotaxis abnormality.

Joint Reaction 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. 

Judgment:  This is a decision or determination of liability by a judicial court. 

Juvenile 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 disease. 

Insured:  This refers to the policyholder. 

Insurer:  This refers to the Insurance Company. 

Kaposi"s sarcoma:  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 lymphoma-Ebstein Barr.

Kartagener's syndrome:  Dynein defect.

Kayser-Fleischer rings:  Wilson's disease.

Keratin pearls:  Squamous cell carcinoma.

Kimmelstiel-Wilson nodules:  diabetic nephropathy.

Kinematics:  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. 

Kinetic Energy:  This refers to the energy that a body possesses due to its velocity. 

Kinetics:  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. 

Klippel-Feil 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 asymptomatic:

1.     Atlanto-occipital fusion (occipitalizaiton).

2.     Cleft vertebra

3.     Cervical rib

4.     Dyspnea

5.     Dysphagia

6.     Facial asymmetry

7.     hemivertebra

8.     Low hair line

9.     Pterygium coli

10. Sprengel’s deformity

11.  Spina bifida

12. Scoliosis and Kyphosis

13. Several vertebral bodies blocked into a single mass with the neural arches fused to the spinous processes an so forth.

14. Torticollis

15. Short neck

16. Restricted range of motion 

Kluver-Bucy syndrome:  Bilateral amygdala lesions.

Knife Clasp 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. 

Koiloctes:  HPV.  Koilocyte abundant condylomata.  Tx:  Imiquimod, induce pro inflammatory cytokines.

Koplik spots:  Perivenous microglia Measles, encephalitis with demyelization.

Krukenberg tumor: Gastric adenocarcinoma with ovarian metastases, bilateral ovarian metastasis.

Kussmaul hyperpnea:  Diabetic ketoacidosis.

Lens dislocation, aortic dissection and joint hyperflexibiltiy:  Marfan's sndrome due to fibrillin deficit.

Lesch-Nyhan syndrome:  HGPRT deficiency.  Self mutilation by bitting fingers and lips.  Tx:  Allopurinol.

Level of Service:  This is the time, effort and the expertise of the physician in the evaluation, examination and treatment of the patient. 

Lewy bodies:  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.

Liability:  This term refers to responsibility. 

Libman-Sacs disease:  Endocarditis associated with SLE.

Lines of Zahn:  Arterial thrombus.

Lisch nodules:  Neurofibromatosis (von Recklinghausen's disease).

Ligamentous Sprain Grading: 

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 arthritis. 

Limbus Bone:  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. 

Litigation:  This is the action before a court of law for a decision of determination. 

Load:  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:  Wilson's disease.

Lucid interval:  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, mental changes.

Lumbarization:  Lumbarization occurs when the first sacral segment takes on the characteristics of the lumbar vertebrae. 

Lumpy-bumpy appearance of glomeruli on immunoflurescense:  Posstreptococcal glomerulonephritis.

Lytic bone lesions on x-ray:  Multiple myeloma.

Lytic 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. 

Mallory bodies:  Alcoholicl iver disease.

Mallory-Weiss syndrome:  Esophagogastric lacerations.

Manipulation:  Manipulation has been defined as the active, ;passive, and resistive movement of the body without the use of a thrust. 

Mass:  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 squared. 

MCO-Managed Care 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. 

McArdle's disease:  Muscle phosphorylasedeficiency.

McBurney's sign:  Appendicits.

Menometrorrhagia:  Irregular and heavy uterine bleeding.  Menometrorhhgia and metrorrhagia are very suggestive of some pathology in the genital tract.

Menorrhagia:  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.

Metropathia-hemorrhagica:  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 action.

Metrorrhagia:  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 the bleeding.

Meyerding Classification:  This 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:  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 mitoxantrone.

MMI-Maximum Medical Improvement:  This is when a patient condition has reached a plateau of recovery and further progress is not expected. 

Modality:  This term refers to unattended therapy.  

Modulus of 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. 

Moment of 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:  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. 

Motion-Segment:  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. 

Motor 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. 

Muscular Strain from Trauma:

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. 

Myotome:  Myotomes are derived from the embryonic somites, which form the muscular system.

Myxedema:  Hypothyroidism.

Necrosis of the tissues:

Caseous 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 proteins.

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.

Enzymatic 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).

Gangrenous 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.

Necotizing vasculitis (lungs) and necrotizing glomerulonepritis.  Wegener's and Goodpasure's.

Needle-shaped, negatively birefringent crystals:  Gout.

Negri bodies:  Rabies.

Nephritis, cataracts and hearing loss:  Alport's syndrome.

Nerve Injuries

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:  Axonotmesis 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:  With neurotmesis, the nerve cannot regenerate spontaneously due to its either being severed completely or disrupted by obstructing scar tissue. 

Neurergic:  This refers to something being pertaining to or dependent on nerve action. 

Neurexeresis:  This refers to operation of tearing out (avulsion) of a nerve. 

Neurilemma or 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. 

Neurodystrophic:  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 term Neuropathy. 

Neurofibrillary tangles:  Alzheimer's disease.

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. 

Neuroma:  This term refers to a tumor or new growth largely made up of nerve cells and nerve fibers; a tumor growing from a nerve. 

Neuropathogenicity:  This refers to the quality of producing or the ability to produce pathologic changes in nerve tissue. 

Neurophthisis:  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. 

Neurosis:  Recurrent 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.  

Neurthlipsis:  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. 

Neurotigenic:  This is defined as producing a neurosis. 

Neurotization:  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. 

Neurovascular 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. 

Niemann-Pick disease:  Sphingomyelinase deficiency.  Progressive neurodegeneration, hepatosplenomegaly, Cherry Red Spot, Sphingomelin accumulates, AR.

No lactation postpartum:  Sheehan's syndrome (pituitary infarction). 

Notochord or 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 nucleus pulposus. 

Nuclear 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. 

Nutmeg liver:  CHF

Occipitalization:  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.

Oligomenorrhoea:  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.).

Oliguria:  This is scanty production of urine pathognomonic of kidney disease.

Omo-Vertebral 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 mesothelioma).

Osler's nodes:  Endocarditis.

Os-Odontoidium:  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. 

Osiculum Terminali:  This is a non-union of the tip of the odontoid process.  It is considered a normal variant. 

Ossification:  This refers to the formation of bony tissues. 

Osteomalacia:  This is a disease process resulting in the softening of bone(s). 

Osteophyte:  These are laterally projecting bony epicules, which are laid down by osteoblastic activity during microtrauma as a defense mechanism. 

Osteophytosis: This is a decrease in bone density usually due to a loss of calcium form bone. 

Out-Of-Plane-Motion:  This 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.

Owl's eye:  CMV.

Painless jaundice:  Pancreatic cancer (head).

Palpable purpura on legs and buttocks:  Henoch-Schonlein purpura.

Pancoast's Tumor:  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.

Pannus:  Rheumatoid arthritis.

Parkinson's disease:  Nigrostriatal dopamine depletion disease.

Pathomechanical 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 Spondylolisthesis. 

Penumbra:  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. 

Permanent disability:  This applies to any permanent damage or to loss of utility of a body part. 

Petition:  A formal, written request or application. 

Peutz-Jeghers syndrome:  benign polyposis.

Peyronie's disease:  Penile fibrosis.

Philadelphia chromosome:  CML, bcr-abl.

Pick bodies:  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 & argyrophilic bodies.

Piloctic astroctoma:  Post fosse, cerebellar and hypothalamus.  Rosenthal fibers (cork-screw shape), intensely eosinophilic, elongated astrocytes with bipolar process.  Usually Children.

Pink puffer:  Emphysema (centroacinar-smoking, panacinar-alpha antitrpsin deficiency.

Plane Motion:  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 range. 

Plastic Range:  When a material is loaded beyond its elastic range, it enters the plastic range. 

Platybasia:  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. 

Plummer-Vinson syndrome:  Esophageal webs with iron deficiency anemia which can become Squamous cell carcinoma.

Podagra:  Gout (MP joint of hallux)

Polymenorrhea: The cycles are shortened.  the cycles come more frequently and thus the women have more total blood loss.

Polymenorrhagia:  The cycles come more frequently and are also excessive in amount and or duration.  the frequent cycles now have heavier bleeding as well.

Polyneuropathy, cardiac pathology, and edema:  Dry beriberi (Vitamin B1 deficiency, thiamine).

Polyneuropathy preceded by GI or respiratory infection:  Guillain-Barre syndrome. 

Pompe's disease:  Lyosomal glucosidase deficiency alpha 1,4 glucosidase where glycogen accumulates within cells causing cardiomegaly with damage to liver and skeletal muscles.

Port-wine stain:  Hemangioma.

Positive anterior drawer sign:  Anterior cruciate ligament injury.

Possible vs. Probable:  Probable would be more than 50% inference, causation, or future need, whereas possible would be considered less than 50% chance.      

Posterior 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 formed. 

Potential 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 or joules. 

Pott’s Disease:  This is tuberculosis of the spine representing another form of ankylosis. 

PPO-Preferred Provider Organization:  A prepaid medical plan with contracted physicians. 

Pre-Existing 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 investigation. 

Principal Stresses:  These stresses are normal to the principal planes.  The unit of measure is newtons per square meter or Pascals. 

Prophylaxis:  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. 

Preponderance of Evidence:  When the evidence is weighed against that which is opposed to it, and has a more convincing force and greater probability or truth. 

Prevailing Charge:  These are charges, which are most frequently charged in a specific geographical area by specialized groups of doctors. 

Procedure:  This is a therapy in which the physician or therapist rendering it is in constant attendance. 

Procedure Codes:  This is a listing of descriptive terminology and identifying codes for reporting medical services and procedures.  (CPT, RV, HCPCS). 

Provider:  This is the one who is licensed by the state to perform a health care service.  

Pseudopalisade tumor cell arrangement (astrocytes with necrois):  Glioblastoma multiforme.  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.

Pseudorosettes:  Ewing sarcoma t 11,22 chromosom mutation. Onion skin effect x-ray.  Hist:  Small, round, blue cell tumor.

Pseudostosis:  This refers to a false synostosis joint. 

Psoriasis:  Increased epidermal cell proliferation and inflammation.  HLA B13 & B17 - pink patch plus silvery scale.

Psychosis:  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 Pancoast's tumor.

Radiolucent:  This refers to matter, which is easily penetrated by x-ray, resulting in blackness of the film. 

Radiopaque:  This refers to matter, which absorbs ionizing radiation from x-rays, resulting in whiteness on the film. 

Range of 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 spotted fever.

Ranaud's syndrome:  Recurrent vasospasm in extremities.

RBC casts in urine:  Acute glomerulonephritis.

Recurrent pulmonary Pseudomonas and S. aureus infections:  Cystic fibrosis.

Red urine in the morning:  Paroxysmal noctrnal hemoglobinuria/PNH.

Reed-Sternberg cells:  Hodgkin's lymphoma.

Reid index (increased):  Chronic bronchitis (Green/yellow sputum).

Reinke crystals:  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,

Reiter's syndrome:  Urethritis, conjunctivitis, arthritis.

Relaxation:  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. 

Renal 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.

Residual:  This is the remaining effect of disabilities of an injury or condition. 

Review: 

          Concurrent Review:  This is an ongoing monitoring of services as they are being provided to a patient.

          Peer 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. 

Rhomboid crystals, positively birefringent:  Pseudogout.

Rib notching: 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.

RNE-Relatively Not Established:  This is a newly established or infrequently used procedure. 

Roth's spots in retina:  Endocarditis.

Rotor's syndrome:  Congenital conjugated hyperbilirubinemia.

Rouleaux formation (RBCs):  Multiple myeloma.

Russel bodies:  Yolk sac tumor.

RVS-Relative Value study:  This is a coded listing of physicians services in which a value/fee has been affixed to said service or procedure. 

S3:  Left to right shunt VSD, PDA, ASD, mitral regurgitation, LV failure (CHF).

S4:  Aortic stenosis, hypertrophic subaortic stenosis.

Sacralization:  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. 

Schiller-Duval bodies:  Yolk sac tumor.

Schmorl’s Nodules:  Discal Invagination, which occurs as a result of an area of weakness in the hyaline cartilage and plate. 

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. 

Scotty Dog:  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. 

Scoliotic Curve Classification: (Obtained by the Cobb Method) 

       Group 1:  0-20 degrees

          Group 2:  21-30 degrees

          Group 3:  31 to 50 degrees

          Group 4:  51 to 75 degrees

          Group 5:  76 to 100 degrees

          Group 6:  101 to 125 degrees

          Group 7:  126 degrees or greater 

Self-Insured:  This is an employer who qualifies to act as the insurer for those in their employ. 

Senile Kyphosis:  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. 

Senile plaques:  Alzeimer's disease.

Settlement:  This is a payment or acceptable compensation for a loss. 

Sezary syndrome:  Cutaneous T-cell lymphoma.

Shear Modulus:  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. 

Shear Stress:  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. 

Sheenhan's syndrome:  Postpartum pituitary necrosis.

Shwartzman reaction:  Neisseria meningitidis.

Signet-ring cells:  Gastric carcinoma.

Simian crease:  Down syndrome.

Sipple's syndrome:  Men type IIa

Sjogren's syndrome:  Dry eyes, dry mouth, arthritis.

Skip lesions:  Crohn's.

Slapped cheeks:  Erythema infectiosum (fifth disease).  Parvovirus B19.  Adults get arthralgia & arthritis but not usually fascial rash.

Smith antige:  SLE.

Smudge cell:  CLL.

Soap bubble on x-ray:  Giant cell tumor of bone.

Somites:  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 vertebral column.

Spike and dome on EM:  Membranous glomerulonephritis.

Spina Bifida 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.

Spina Bifida 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. 

Spina Bifida 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 fingernails:  Endocarditis.

Spondyloarthrosis:  This refers to a spondylosis plus a degenerative bone disease at the same segmental level. 

Spondylolisthesis:  This is an anterior translation and excursion of one vertebral body on another due to many etiologies.  Three follow:

1.     A defect in the pars interarticularis most commonly at L5/S1.

2.     Degenerative slippage with facet over-riding.

3.     Elongation of the pedicles. 

Spondylolysis:  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 Spondylolisthesis. 

Spondylosis:  This refers to a degenerative intervertebral disc with Osteophytosis on the anterior  vertebra body margin at the same level of the degenerative intervertebral disc.

Sprengel’s Deformity:  Sprengel’s 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. 

Starry-sky pattern:  Burkitt's lymphoma.

Statics:  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:  Static load refers to a load, which is applied to a specimen if it remains constant with respect to time. 

Stiffness:  Stiffness is a measure of the resistance offered to external loads by a material or specimen as it deforms. 

Stiffness Coefficient:  This 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. 

Stipulation:  This is a condition for an agreement. 

Strain:  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. 

Strains and 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. 

Strawberry tongue:  Scarlet fever.

Streaky ovaries:  Turner's syndrome.

Stress:  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:  Crohn's disease.

Subepitelial humps on EM:  Poststreptococcal glomerulonephritis.

Suboccipital lymphadenopathy:  Rubella.

Sulfur granules:  Actinomyces israelii.

Swollen gums, poor wound healing, anemia, bruising:  Scurvy.  Vitamin C deficiency, ascorbic acid is necessary for hydroxylation of proline and lysine in collagen synthesis.

Syndesmophyte:  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.

Subluxation 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 established.

The medical 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 subluxation. 

Truthfully, damage can occur to the holding elements of the spinal column by injury causing joint instability, than an alteration in joint dynamics will occur (Chiropractic Subluxation).  

Subpoena:  This is a process commanding the attendance of any person included indirectly in a claim. 

Superfecundation:  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.

Temporary 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:  Tension is defined as a normal force that tends to elongate the fibers of a material.  The unit of measure is newtons. 

Torsion:  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. 

Torsional 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.                             

t (11:22):  Ewings Sarcoma.

t (11:14): Multiple Myeloma, Small Cell Lymphoma.

t (8:14):  Burkitt's lymphoma (c-myc activation).

t (9:22):  Philadelphia chromosome, CML (bcr-abl/hybrid), increased neutrophil count.

t (14:18): Follicular lymphomas (bcl-2 activation).

Tabes dorsalis:  Tertiary syphilis.

Tendon xanthomas (classically Achilles):  Familial hypercholesterolemia.

Thumb sign on lateral x-ray:  Epiglottitis (Haemophilus influenzae).

Thyroidization of kidney:  Chronic bacterial pyelonephritis.

Tophi:  Gout.

Tram-track appearance on LM:  Membranoproliferative glomerulonephritis.

Trousseau's sign:  Migratory thrombophlebitis of pancratic adenocarcinoma, hypocalcemia and carpal spasm.

Tyrosine progression:  Tyrosine, L-dopa, Dopamine, Norepinephrine becomes Epinephrine.

UCR-Usual, Customary and Reasonable:  

           Usual:  This is the fee, which the individual doctor most frequently charges to their patients for specific procedures performed.

Customary:  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.   

Ultimate Load:  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. 

Unit Vector:  This refers to a vector with unit magnitude.  It is a mathematical quantity and is used to define a direction. 

Vaginal discharge of whitish cottage cheese, branching pseudohypae and buds:  Candidiasis, Candida Albicans.  Tx:  Miconazole which inhibit ergonsterol synthesis.

Vector:  This refers to a quantity that possesses both a magnitude and a direction. 

Vector of 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 structures. 

Velocity:  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:  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.

von Recklinghausen's disease:  Neurofibromatosis with cafe-au-lait spots.

von Recklingausen's disease of bone:  Osteitis fibrosa cystica (brown tumor).

Wallenberg's sydrome:  Pica thrombosis.

Waterhouse-Friderichsen syndrome:  Adrenal hemorrhage associated with meningococcemia.

Waxy casts:  Chronic end-stage renal disease.

WBC casts in urine:  Acute pyelonephritis.

WBCs in 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 absorption.

Wire loop appearance on LM:  Lupus nephropathy.

Worst headache of my life:  Berry aneurys associated with adult polcystic kidney disease.

Xanthochromia (CSF):  Subarachnoid hemorrhage.

Xerostomia, arthritis, keratoconjunctivitis sicca:  Sjogren's syndrome.

Zenker's diverticulum:  Upper GI diverticulum.

Zollinger-Ellison syndrome:  Gastrin-secreting tumor associated with ulcers.

by Scott D. Neff, DC DABCO CFE DABFE FFABS 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