Technic and Practice of ChiropracticLoban, Joy Maxwell
Science
Technic and Practice of Chiropractic
Loban, Joy Maxwell
Chiropractic
The regional location of vertebrae by means of certain landmarks (so
called) in or near the spine, is a much discussed question in the
profession. Without discussing the various arguments in favor of this
method, chief of which is the _inability of the untrained to count
vertebrae_, let us set forth the principal landmarks used and the facts
in regard to them.
The seventh Cervical, called Vertebra Prominens, is usually considered
a guide to the count. In over three hundred cases examined for that
purpose the seventh Cervical was found to be Vertebra Prominens in
about 65%, the other 35% showing the sixth Cervical or first Dorsal to
be the prominent one. This method is two-thirds as accurate as counting.
The tubercle (Chassaignac’s) of the sixth Cervical transverse is said
to be directly opposite the lower border of the cricoid cartilage and
this is a better guide than the above.
The third Dorsal spinous process is said to be on a level with the root
of the spine of the scapula, and with arms hanging at sides, the upper
angle of the scapula to be on a line between first and second Dorsal
spinous process. This is not at all constant.
The inferior angle of the scapula is said by some writers to be
on a line with the tip of the seventh Dorsal spine. Others locate
it opposite the interspace between seventh and eighth Dorsals.
Still others give it as opposite the eighth Dorsal spine. All are
correct--_sometimes_. In truth, the inferior angle may be opposite any
part of the spine between the sixth and ninth Dorsals. There is nothing
constant about it.
The twelfth rib may be followed to its articulation with the twelfth
Dorsal vertebra. This is a good guide, providing that the rib can be
palpated. The lower margin of the last rib is usually even with the
spinous process of D 12 about one inch and a half from the mid-spinal
line. The humor lies in the fact that the patient upon whom the count
is so difficult as to require this verification is usually obese and
obesity renders the rib impalpable.
The line drawn between the iliac crests falls between the third and
fourth Lumbar spinous processes in about 98% of all cases. _This is our
most reliable landmark._ It is used as described under the Count.
All landmarks except the last two show such variance in different
individuals as to be quite unreliable. The correct method of numbering
spinous processes is the obvious and logical method--_count them_.
The skill and accuracy of touch required for successful counting is
invaluable in determining direction of subluxations.
MENTAL ATTITUDE
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