Technic and Practice of ChiropracticLoban, Joy Maxwell
Science
Technic and Practice of Chiropractic
Loban, Joy Maxwell
Chiropractic
When palpation has been made, remember that the impinged nerve is
usually found on the side opposite to the direction of the spinous
process in its departure from the median line. With a left subluxation
the tenderness is usually, though not always, on the right side. If in
the Lumbar, and the subluxation a rotation, the impinged nerve will be
found _below_ the transverse process of the subluxated vertebra. In the
Cervical and Dorsal regions the tender nerve is usually below, but may
be either above or below, the transverse of the subluxated one.
Examine the nerves having exit from the foramina of each subluxated
vertebra in turn from above downward. When a tender point is found
about an inch from the mid-spinal line, attempt to follow the nerve and
palpate until it has been traced as completely as possible.
Where to Expect Tenderness
The region immediately surrounding the spinous process of the
subluxated vertebra may be tender because of impingement of the axons
of the posterior primary division of that spinal nerve which emerges
below the vertebra. Such tenderness is more common with anterior
subluxations than with others. It is not to be confused with the
_soreness_ which often appears after adjustment and is due to bruising
or straining of the tissues.
Nerve tenderness may be discovered at a little distance from the
mid-spinal line and at a level slightly lower than the emergence of
the nerve. If a nerve is irritated, the finger inserted between the
ribs near their articulation with the transverse processes will elicit
tenderness. The discovery of tender points along the spine is the most
important part of nerve-tracing.
Nerve-Paths
Detailed description of the paths of all the spinal nerves may be
studied from any standard work on anatomy and will not be included
here, but it may be well to remind the reader of certain general
tendencies.
The spinal nerves do not cross the median line in front except perhaps
fine interlacing fibres.
In the Dorsal region the nerves are usually found following the
interspaces until the lower ones debauch upon the abdominal wall
anteriorly. There are, however, some Dorsal and lower Cervical nerve
bundles which pass obliquely downward and outward to innervate back
muscles.
Reference to the section on Spino-Organic Connection will make clear
the tissues supplied by each nerve.
_Slight_ deviations from the usual course of nerves are common;
_marked_ deviations very infrequent.
Use of Fingers
Use second finger of either hand for the palpating finger, choosing the
hand which can be most conveniently used as determined by the position
of patient and the part of the body to be examined. There is no set
rule. Reinforce this second finger by the pressure upon it of the first
and third and, if desired, by pressing thumb against it. (See Fig. 5.)
Public-domain text, read in full here on John Shaqi.
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