Table of Contents

 

 

 

 

Ackowledgments

xi

 

Introduction

xiii

PART I

MUSCULOSKELETAL COMPLAINTS

 

Chapter 1

General Approach to Musculoskeletal Complaints

3

 

Context

3

 

General Strategy

4

 

History

8

 

Examination

20

 

Management

26

 

Appendix 1–1

43

 

Appendix 1–2

43

 

Appendix 1–3

45

Chapter 2

Neck and Neck/Arm Complaints

47

 

Context

47

 

General Strategy

48

 

Relevant Anatomy and Biomechanics

49

 

Evaluation

56

 

Management

64

 

Selected Causes of Cervical Spine Pain

75

 

Appendix 2–1

79

 

Neck Diagnosis Table

83

Chapter 3

Temporomandibular Complaints

87

 

Context

87

 

General Strategy

88

 

Relevant Anatomy and Biomechanics

88

 

Evaluation

90

 

Management

92

 

Selected TMJ Disorders

96

 

Appendix 3–1

98

Chapter 4

Thoracic Spine Complaints

101

 

Context

101

 

General Strategy

101

 

Relevant Anatomy

102

 

Biomechanics

103

 

Evaluation

104

 

Management

107

 

Selected Disorders of the Thoracic Spine

111

 

Appendix 4–1

114

 

Thoracic Diagnosis Table

116

Chapter 5

Scoliosis

119

 

Context

119

 

General Strategy

120

 

Idiopathic Scoliosis Etiology

120

 

Evaluation

121

 

Management

129

 

Summary

134

 

Appendix 5–1

138

Chapter 6

Lumbopelvic Complaints

143

 

Context

143

 

General Strategy

144

 

Relevant Anatomy, Physiology, and Biomechanics

145

 

Evaluation

147

 

Management

171

 

Selected Disorders of the Low Back

181

 

Appendix 6–1

191

 

Low Back Diagnosis Table

199

Chapter 7

Shoulder Girdle Complaints

203

 

Context

203

 

General Strategy

204

 

Relevant Anatomy and Biomechanics

205

 

Evaluation

207

 

Management

225

 

Selected Disorders of the Shoulder

235

 

Appendix 7–1

248

 

Shoulder Diagnosis Table

254

Chapter 8

Elbow Complaints

257

 

Context

257

 

General Strategy

257

 

Relevant Anatomy and Biomechanics

258

 

Evaluation

259

 

Management

264

 

Selected Disorders of the Elbow

271

 

Appendix 8–1

275

 

Elbow and Forearm Diagnosis Table

278

Chapter 9

Wrist and Forearm Complaints

281

 

Context

281

 

General Strategy

281

 

Relevant Anatomy and Biomechanics

283

 

Evaluation

284

 

Management

291

 

Selected Disorders of the Wrist and Forearm

294

 

Appendix 9–1

307

Chapter 10

Finger and Thumb Complaints

311

 

Context

311

 

General Strategy

311

 

Relevant Clinical Anatomy

312

 

Evaluation

313

 

Management

317

 

Selected Disorders of the Finger, Thumb, and Hand

324

 

Appendix 10–1

333

 

Wrist and Hand Diagnosis Table

335

Chapter 11

Hip, Groin, and Thigh Complaints

339

 

Context

339

 

General Strategy

339

 

Relevant Anatomy

340

 

Evaluation

342

 

Management

348

 

Selected Disorders of the Hip, Groin, and Thigh

353

 

Appendix 11–1

364

 

Hip Pain Diagnosis Table

366

Chapter 12

Knee Complaints

369

 

Context

369

 

General Strategy

370

 

Relevant Anatomy and Biomechanics

371

 

Evaluation

373

 

Management

385

 

Selected Disorders of the Knee

398

 

Appendix 12–1

417

 

Knee Diagnosis Table

422

Chapter 13

Lower Leg Complaints

427

 

Context

427

 

General Strategy

427

 

Relevant Anatomy

428

 

Evaluation

428

 

Management

430

 

Selected Disorders of the Lower Leg and Posterior Heel

433

 

Appendix 13–1

438

Chapter 14

Foot and Ankle Complaints

441

 

Context

441

 

General Strategy

441

 

Relevant Anatomy and Biomechanics

442

 

Evaluation

445

 

Management

452

 

Selected Foot Disorders

464

 

Appendix 14–1

474

 

Foot/Ankle/Lower Leg Diagnosis Table

476

PART II

NEUROLOGIC COMPLAINTS

 

Chapter 15

Weakness

483

 

Context

483

 

General Strategy

483

 

Relevant Anatomy and Physiology

485

 

Evaluation

485

 

Management

491

 

Selected Neurologic and Muscular Diseases

495

 

Appendix 15–1

500

Chapter 16

Numbness, Tingling, and Pain

501

 

Context

501

 

General Strategy

501

 

Relevant Anatomy

503

 

Evaluation

506

 

Management

508

 

Appendix 16–1

512

 

Appendix 16–2

512

Chapter 17

Headache

513

 

Context

513

 

General Strategy

514

 

Theories of Causation of Primary Headaches

516

 

Management

523

 

Selected Headache Disorders

531

 

Appendix 17–1

536

 

Appendix 17–2

536

 

Headache Diagnosis Matrix

541

Chapter 18

Dizziness

545

 

Context

545

 

General Strategy

545

 

Relevant Anatomy and Physiology

547

 

Evaluation

548

 

Management

554

 

Selected Causes of Vertigo

563

 

Appendix 18–1

566

Chapter 19

Seizures

569

 

Context

569

 

General Strategy

570

 

Definitions and Classifications

570

 

Relevant Anatomy and Physiology

574

 

Evaluation

574

 

Management

576

 

Appendix 19–1

581

 

Appendix 19–2

581

PART III

GENERAL CONCERNS

 

Chapter 20

Depression

585

 

Context

585

 

General Strategy

585

 

Terminology and Classification

586

 

Evaluation

588

 

Management

589

 

Appendix 20–1

592

 

Appendix 20–2

592

Chapter 21

Fatigue

595

 

Context

595

 

General Strategy

595

 

General Discussion

596

 

Evaluation

597

 

Management

599

 

Selected Disorders Presenting as Fatigue

602

 

Appendix 21–1

608

Chapter 22

Fever

611

 

Context

611

 

General Strategy

612

 

Relevant Physiology

612

 

Hyperthermia

612

 

Evaluation

613

 

Management

615

 

Appendix 22–1

616

Chapter 23

Sleep and Related Complaints

617

 

Context

617

 

General Strategy

617

 

Relevant Anatomy and Physiology

618

 

Classification System

619

 

Evaluation

620

 

Management

621

 

Appendix 23–1

625

 

Appendix 23–2

625

Chapter 24

Hypertension

627

 

Context

627

 

Relevant Physiology

627

 

General Strategy

628

 

Evaluation

628

 

Management

631

 

Appendix 24–1

636

 

Appendix 24–2

636

Chapter 25

Lower Leg Swelling

639

 

Context

639

 

General Strategy

639

 

Relevant Physiology and Anatomy

639

 

Evaluation

641

 

Management

642

 

Selected Causes of Lower Leg Swelling

644

 

Appendix 25–1

647

Chapter 26

Lymphadenopathy

649

 

Context

649

 

General Strategy

649

 

Relevant Anatomy and Physiology

650

 

Evaluation

650

 

Management

651

 

Selected Causes of Lymphadenopathy

653

 

Appendix 26–1

655

Chapter 27

Skin Problems

657

 

Context

657

 

General Strategy

660

 

Evaluation

661

 

Management

665

 

Appendix 27–1

665

Chapter 28

Vaccination: A Brief Overview

667

 

Context

667

 

OPV (Polio)

671

 

MMR (Focus on Measles)

671

 

DPT (Focus on Pertussis)

671

 

Summary

672

 

Some Childhood Diseases

673

 

Appendix 28–1

675

 

Appendix 28–2

672

Chapter 29

Weight Loss

677

 

Context

677

 

General Strategy

677

 

Relevant Physiology

678

 

Evaluation

678

 

Management

680

 

Appendix 29–1

683

Chapter 30

Weight Gain/Obesity

685

 

Context

685

 

General Strategy

686

 

Evaluation

687

 

Management

687

 

Appendix 30–1

690

 

Appendix 30–2

690

Chapter 31

Osteoporosis

691

 

Context

691

 

General Strategy

692

 

Relevant Anatomy and Physiology

692

 

Evaluation

693

 

Management

695

 

Appendix 31–1

698

PART IV

GASTROINTESTINAL COMPLAINTS

 

Chapter 32

Abdominal Pain

703

 

Context

703

 

General Strategy

703

 

Relevant Anatomy and Physiology

704

 

Evaluation

706

 

Examination

712

 

Management

714

 

Selected Causes of Acute Abdominal Pain

717

 

Selected Causes of Recurrent Abdominal Pain

722

 

Appendix 32–1

729

 

Appendix 32–2

729

Chapter 33

Constipation

733

 

Context

733

 

General Strategy

733

 

Relevant Anatomy and Physiology

734

 

Evaluation

735

 

Management

737

 

Appendix 33–1

741

Chapter 34

Diarrhea

743

 

Context

743

 

General Strategy

743

 

Relevant Anatomy and Physiology

746

 

Evaluation

746

 

Management

748

 

Appendix 34–1

751

PART V

GENITOURINARY COMPLAINTS

 

Chapter 35

Urinary Incontinence and Voiding Dysfunction

755

 

Context

755

 

General Strategy

755

 

Relevant Anatomy and Physiology

757

 

Evaluation

758

 

Management

759

 

Selected Causes of Voiding Dysfunction or Pain

764

 

Appendix 35–1

767

 

Appendix 35–2

768

Chapter 36

Enuresis

769

 

Context

769

 

General Strategy

769

 

Relevant Anatomy and Physiology

770

 

Evaluation

770

 

Management

771

 

Appendix 36–1

773

Chapter 37

Vaginal Bleeding

775

 

Context

775

 

General Strategy

775

 

Relevant Anatomy and Physiology

775

 

Evaluation

776

 

Management

776

 

Appendix 37–1

779

PART VI

CARDIOPULMONARY COMPLAINTS

 

Chapter 38

Syncope/Presyncope

783

 

Context

783

 

General Strategy

783

 

Relevant Physiology

784

 

Evaluation

784

 

Management

786

 

Appendix 38–1

787

Chapter 39

Chest Pain

789

 

Context

789

 

General Strategy

789

 

Relevant Anatomy and Physiology

789

 

Evaluation

794

 

Management

796

 

Selected Causes of Chest Pain

799

 

Appendix 39–1

806

 

Appendix 39–2

806

Chapter 40

Palpitations

809

 

Context

809

 

General Strategy

809

 

Relevant Anatomy and Physiology

810

 

Evaluation

810

 

Management

814

 

Possible Causes of Palpitations

817

 

Appendix 40–1

819

Chapter 41

Dyspnea (Difficulty Breathing)

821

 

Context

821

 

General Strategy

821

 

Relevant Anatomy and Physiology

824

 

Evaluation

825

 

Management

827

 

Selected Causes of Dyspnea

830

 

Appendix 41–1

835

 

Appendix 41–2

835

Chapter 42

Cough

837

 

Context

837

 

General Strategy

837

 

Relevant Anatomy and Physiology

838

 

Evaluation

838

 

Management

840

 

Selected Causes of Cough

844

 

Appendix 42–1

846

PART VII

HEAD AND FACE COMPLAINTS

 

Chapter 43

Eye Complaints

851

 

Context

851

 

Review of General Terminology

851

 

General Strategy

852

 

Evaluation

853

 

Management

856

 

Selected Causes of Vision Loss

860

 

Appendix 43–1

864

 

Appendix 43–2

864

Chapter 44

Facial Pain

867

 

Context

867

 

General Strategy

867

 

Relevant Neurology

868

 

Evaluation

868

 

Management

869

 

Facial Pain Caused by Neuralgias

872

 

Appendix 44–1

873

Chapter 45

Ear Pain

875

 

Context

875

 

General Strategy

875

 

Relevant Anatomy and Physiology

875

 

Evaluation

876

 

Management

877

 

Selected Causes of Ear Pain

881

 

Appendix 45–1

884

 

Appendix 45–2

884

Chapter 46

Hearing Loss

885

 

Context

885

 

General Strategy

885

 

Relevant Anatomy and Physiology

886

 

Evaluation

886

 

Management

889

 

Selected Causes of Hearing Loss

892

 

Appendix 46–1

893

 

Appendix 46–2

893

Chapter 47

Tinnitus

895

 

Context

895

 

General Strategy

895

 

Relevant Anatomy and Physiology

895

 

Evaluation

896

 

Management

896

 

Appendix 47–1

899

Chapter 48

Epistaxis (Nosebleed)

901

 

Contest

901

 

General Strategy

901

 

Relevant Anatomy

901

 

Evaluation

902

 

Management

902

 

Appendix 48–1

902

Chapter 49

Sore Throat

903

 

Context

903

 

General Strategy

903

 

Evaluation

904

 

Management

905

 

Appendix 49–1

906

PART VIII

SPECIAL CONDITIONS

 

Chapter 50

Diabetes Mellitus

909

 

Context

909

 

General Strategy

910

 

Relevant Physiology

910

 

Evaluation

912

 

Management

914

 

Appendix 50–1

919

 

Appendix 50–2

919

Chapter 51

Thyroid Dysfunction

921

 

Context

921

 

General Strategy

921

 

Relevant Physiology

922

 

Evaluation

922

 

Laboratory Testing and Management

923

 

Selected Thyroid Disorders

925

 

Appendix 51–1

928

Chapter 52

Hyperlipidemia

929

 

Context

929

 

General Strategy

929

 

Relevant Physiology

930

 

Evaluation

930

 

Management

933

 

Appendix 52–1

942

 

Appendix 52–2

942

Chapter 53

Anemia

945

 

Context

945

 

General Strategy

945

 

Relevant Physiology

947

 

Management

949

 

Selected Anemias

953

 

Appendix 53–1

956

PART IX

SPECIAL PATIENT GROUPS

 

Chapter 54

The Pediatric/Adolescent Patient

961

 

Context

961

 

General Strategy

961

 

Sports-Related Issues in the Young Patient

975

 

A Region-based Approach to Complaints and Concerns of Patient/Parent

996

 

Appendix 54–1

1008

 

Appendix 54–2

1009

Chapter 55

The Geriatric Patient

1011

 

Context

1011

 

General Strategy

1013

 

Relevant Anatomy and Physiology

1015

 

Evaluation

1017

 

Focused Concerns

1022

 

Specific Management Issues

1034

 

Appendix 55–1

1037

 

Appendix 55–2

1037

Chapter 56

The Female Patient

1041

 

Context

1041

 

General Strategy

1042

 

Female Hormonal and Reproductive Physiology

1043

 

Focused Issues

1045

 

Appendix 56–1

1071

 

Appendix 56–2

1071

 

Appendix

 

 

Pharmacology for the Chiropractor: How Medications may Affect Patient Presentation and Management-Outcomes

1075

 

Concensus Document for the Operationally Defined Use of LCD Codes: Palmer Chiropractic College West Clinics

1111

 

Index

1113