이번 module은 chiropractic neurology의 전반적인 개념이나 접근방식을 토대로 해서 근본적인 기능적인 문제가 어디에 있는지를 찾아내는 diagnostic evaluation입니다. 진단하는 clinician이 진단도구가 되어서 단순히 질병을 찾아내는데 그치지 않고 인체의 각 system의 기능적인 평가를 신경학적인 측면에서 합니다. 강의 순서나 내용에 대해서 간단히 알려드립니다. 관심이 있으신 선생님들의 참석바랍니다.

강의 순서는
1. functional neuroanatomy and neurophysiology for for comprehensive physical examination especially concentrating on the global and interrelated aspect of every system of the human being.

2. History taking for the presumtive localization of the lesion; receptionist or nurse activities in the waiting room who are they what are they why are they here? etc specific questions regarding patient's neurological problems or neuraxis such as the review of the system in conjuction with neurological and functional interpretation from the history taking.

3. Physical examination practicum will be divided into several sections such as sitting standing supine and prone. In each section previous practicum in every module will be reviewed and practice every method of the examination for dissecting the human nervous system from rostral and caudal.

Sitting
head position hair distribution pin wheel of the face upper extremity vibratory sense Weber Rinne tympanic memb. pupillary response accomodation extrocular movement with cover uncover test ophthalmoscopic exam visual field test corneal reflex eyelid lid lag ptosis blepharospasm facial __EXPRESSION__ bite down jaw deviation tongue fasciculation atrophy crease palate deviation in Ah canal of parotid gland smell taste stretch reflex of jaw triceps trapezius pectoralis biceps brachioradialis knee ankle percussion myotonia of thenar taping for tinnel sign JPS muscle strength test of upper extremity according to the level of nerve root observation of respiration for the rate and accessory respiratory muscle auscultation of respiration percussion with ausculation palpation of thyroid neck and palpation of carotid pulse palpation of the spine and rib and associated joint and musculature in regards to coupling movement and biomechanical aspect door bell sign finger to target optokinetic response

Standing
observation of gait and posture; inrotation of the shoulder curvature of the spine in standing posture in lateral view winging of the scapula with its movement forward bending of lumbar or leg elevation in standing to observe the breakdown movement feet together with eye closed parietal drift finger to nose piano playing rapid pronation-supination of forearm

Supine
stethoscope; bell-- vascular trees; temporal carotid subclavian axillary abdominal aorta iliac femoral a with palpation
Heart; S1 2 split S1 2; physiological splitting fixed splitting paradoxical splitting bowel sound percussion; typmpanic due to hepatic or splenic flexture liver border etc abdominal reflex cremasteric reflex hair distribution FRA stretch reflex again ankle clonus observation of the nail heel to shin external or internal rotation of leg muscle test for toe extensor abduction adduction ext and internal rotator caloric irrigation.

Prone
percussion of spine and rib with hammer stretch reflex in medial hamstring

The attendees should be aware of not only how to do these examinations but also the meaning of the findings in concert with the global aspect of central neuraxis during the drill of this workshop.

Additional information
Rib biomechanic in regards to oxygenation; back musculature for rib movement spine curvature for diaphragmatic movement posture regarding brain activity brachial plexus lumbosacral plexus and upper lower extremity entrapment syndrome tone of mucle muscle physiology review of blind spot mapping review of extrocular movement and vestibulocerebellum optokinetic response with localization of the lesion; forebrain hindbrain cerebellum etc.

Every attendees will practice physical examination with some information about the history of patients. The cases using this workshop are mainly from Dr. Carrick’s grand round.
The attendees will be asked to follow up with this sequence for the practicum.
Practicum
1. history
2. exam
3. clinical assessment
4. treatment plan
5. methodologies for the application.
6. further investigation
7. prognosis with or without referral