ࡱ> ` bjbj 4w8xxxxxxx]]]8L]T]2^^(^^^^^^CEEEEEE$*hpiIxb^^bbixx^^}}}bx^x^C}bC}}b$xx^^ Ps8]uVC0-vxD^:`}`aJ^^^ii}X^^^bbbbDTXDXxxxxxx Ak 9/13/05 Applied Kinesiology Pre-and Post testing of therapeutic interventions: -Adjusting- spine, extremity -Cranial and pelvic corrections -Biomechanical balance, proprioceptive procedures -Soft tissue and reflex techniques -Nutrition & visceral protocols -Meridian therapy Dx approach for eval and physiological therapeutics Manual mm testing and functional neurology Using mm relationships and muscle-organ relationships Developed w/in Chiropractic; now used by many disciplines world wide (MD, DO, DDS, etc) Science and Art of MM testing: Know mm anatomy- direction of contraction Position of test correct and repeatable Vector precise and repeatable Pressure: gradual- listen w/ hand Dont try to overwhelm or prove anything Dont press on or stress jts (adding jt receptor input) Non-painful contacts Stabilization Watch for cheating Drs Attitude- no preconceived outcome Factors Interfering w/ MM testing: Jt damage/ROM ! Pain Medications/drugs: psych, epileptic, transplant drugs (affect NS) Allergies/toxicity: bug spray, heavy metals Cramping: stop testing that mm and determine cause Severe debility Paralysis/paresis: able to test mm they still have control over Age: start @ 4 yo (able to follow directions) Purpose of mm testing: Are the expected things happening (stim/inhibition)? If not= prob w/ NS somewhere Reflex: Muscle-Organ Relationship Goodheart: Certain mm tend to dysfx when particular organs are stressed. -(Weak/inhibited, occasionally hyper/over-facilitated) Tmts from diff systems for the same organ consistently affect the same mm -Neurolymphatics (Chapman) -Neurovasculars (Bennett) -Acupuncture -Nutrition A dysfx oragn is very likely to have an associated dysfx mm (inhibited or hyper-facilitated) Muscles can dysfx due to orthopedic problems as well Not every weak mm is a weak organ If a structural prob doesnt respond to usual structural care look for a viscero-somatic component Evidence for the MM-Organ Relationship: see Masarsky text Carpenter SA, Hoffman J, Mendel Rl. Investigation into the effect of organ irritation on mm strength and spinal mobility. -Stressed stomach by having subjects drink large amts of cold water fast = showed that PMC differentially weakened -. Thyroid testing dysf picked up by mm testing Recent Russian Studies: 80 subjects w/ shoulder pain and stomach dys: 40% hiatal hernia, PMC weak (EMGs). Other shoulder mm hypertonic Treating hiatal hernia. Piriformis Syndrome Cervicalgia: chronic bronchitis and pneumonia Chapman reflexes: Large intestine / LBP Vertebral Levels: Organs Traditional Spinal Level for organ: 1 level per organ (summary) Level of ANS innervation of organ: Meric chart Level of Innervation of Associated mm Acupuncture associated pt level Neurolymphatic Reflexes Chapman, DO (related to organs NOT muscles) Mapped areas of body-wall congestion and nodulation related to known visceral conditions Treated w/ rotary massage (reduce congestion of tissue) Treat until pain begins to diminish and associated mm is strong Neurovascular Dynamics Bennett, DC Stretching of tissues elicits pulsation not = to heart rate Thought to be intrinsic to blood vessels embryonic (fluid moves in tissue before there is a heart) Related to viscera w/ lab studies We will use the points on the body wall (not the head points) Treat w/ gentle stretching pressure 9/20/05 Chiro Manipulative Reflex Technique (CMRT) Dejarnette SOT Correlated vertebral levels to Occipital and Trapezius fibers and organs Body wall reflexes similar to NVD Treated w/ soft tissue manipulation rubbing, holding. Also visceral manipulation Often 2 contacts at once (counter pressure on traps while rubbing reflex) <>print for lab tomorrow Therapy Localization: Goodheart, DC Patient touching part of body changes outcome of mm test Test and find an intact muscle Pt touches area of suspected problem Retest. Inhibition (weakening) of mm indicates something wrong at that location Test further to determine what is wrong (inspection, palpation, challenge, etc) From a Weak Muscle: Find a weak (inhibited) mm Pt touches a related reflex, vertebra, acupuncture point, etc (focus NS to problem) Retest mm. If muscle strengthens (facilitation) on T.L., treating this reflex or Summary: Pt touches Area Positive T.L. produces CHANGE in mm (S( W; or W( S) Where it is, not What it is Pancreas: Anatomical location: Digestive effect: Stomach acid ( triggering of pancreatic enzymes Pancreatitis: (S/S) pt comes in curled up in a ball, holding stomach Causes: viral (mumps in child), alcoholism, gallstone blocking in Sphincter of Odie ( digestive enzymes back up and start to digest the pancreas; Acute abdo pain NOT due to pancreatitis: AAA, ectopic pregnancy, perforating ulcer, intestinal torsion (get them to ER to get more testing possibilities quickly) ANS innervations for pancreas: Symp ( T5-T9 (! digestion  enzyme secretion) Parasymp ( Vagus N s (! digestion  enzyme secretion) Dx Reflexes for Pancreas: see lab summary/chart Referred pain patterns: R thenar eminence (painful, nodulated) L above edge of ribs and R below edge of ribs NL: Rib 6/7 on ant; T7 on post NV: R subcoastal area at level of 2nd rib CMRT: Ampulla of Vater, Central gastric, R thenar pad, under subcostals, upper trap, clavicle release (vagus) MM related to pancreas: Lats dorsi (O: sacrum, crest of ilium, L/S, T/S ( I: ant humerus) Triceps (O: Symptoms of pancreas dysfx: dry skin, intestinal gas (! digestion  more for bacteria), fatty stools, undigested food in feces, GI distress soon after eating (time component to where problem is) Endocrine fx Pancreatic Hormones: Insulin (Beta cells) Glucagon (Alpha cells): stim by ! blood sugar Regulating blood sugar: pancreas, liver, adrenals (glucocorticoids = cortisol ! blood sugar; Epi/NE = glycogenolysis) Diabetes Type I (juvenile onset); can t produce insulin Symptoms: wt loss, neuropathy (over time) Type II: cells don t respond to insulin (! insulin levels also)  Low carb diets Symptoms: elevated blood sugar (may only be ! for a while then comes down slowly in early stages), frequent urination, poor wound healing, blindness, neuropathy Reactive Hypoglycemia: procurer to Type II - ! sugar, body ! insulin so body crashes (sympathetic, adrenal symptoms during extreme drop in blood sugar) Insulinoma (tumor): more CNS (i.e: coma) symptoms Symptoms: high then crash after sugar intake, fatigued, irritable, difficulty focusing on mental tasks, Can get hyperglycemia from pancreatic tumor also! Nutrition for Pancreas: Pancreas- Digestants Pancreatic enzymes 1/meal, (none w/ very light meal like salad w/ no dressing or just fruit), 2 w/ large meal B-complex May need HCl or mixed digestant (stomach acid signals pancreatic secretion) Pancreatic enzymes are also anti-inflammatory (intake btwn meals), accelerate injury repair Sugar handling: Hypoglycemia (non-pathologic) Breakfast w/ protein: makes a huge difference in how you feel during the day!! ( may manifest as a depressive condition due to poor nutrition Eliminate refined and concentrated CHOs Low glycemic index foods = how quickly food raises blood sugar Fat tends to reduce speed of glucose rise after meal (low fat diets arent always good!) Avoid stimulants: caffeine, etc (affect adrenals) Support adrenals Hypoglycemia Supplements: 4-6 raw liver or brewers yeast in AM B-Complex in afternoon Chromium stabilizes blood sugar over and under Pancreatic glandulars esp if also dig probs Zinc complexes w/ and synergistic w/ insulin May need individual Bs esp B1, niacin, pantothenic acid Magnesium used in CAC Adrenal glandulars Hyperglycemia/Diabetes: Type 1 insulin Dependent: High complex CHO, high fiber (HCF) diet may help reduce insulin need B-complex Vanadium  insulin-like effect, stimulates glucose uptake into cells Chromium  stabilizes blood sugar over and under Zinc  complexes w/ and synergistic w/ insulin Gymnema sylvestre  enhances endogenous insulin production, ! # of islets and beta cells, improved serum lipids Pancreatic glandulars esp if also digestive prob  HYPERLINK "http://www.hcf-nutrition.org/" www.hcf-nutrition.org/ Type 2- Non-insulin Dependent (Sundrome X) Low carb diet, moderate protein, moderate fat, high fiber EXERCISE!!!!! B-complex, individual Bs Liver glandulars Vanadium, Chromium, Zinc, Gymnema sylvestre, pancreatic glandulars same. Diaphragm: Hiatal Hernia Charting: dont call it a hiatal hernia unless you have imaging to support claim (diaphragm release) Psoas mm interdigitate w/ back fibers of diaphragm Ipsilateral weakness of psoas and diaphragm Testing: w/ hands, check chest expansion ( see restricted motion on inspiration - Restricted toe-in on restricted psoas side (supine, push feet medial) Balance diaphragm: Strip psoas (treat NL, NV, etc) T/L junct fixation adjustment Check C3 (phrenic n. origin) Visceral challenges see if changes a mm function If think stomach as gone sup ( push sup on stomach (if S( W) then go opp direction of weakness Stomach: Nutritional Support: Stomach Digestants Trial doses  see if HCl helps or ! pain (too much HCl gives diarrhea) Vegetable-based Enzymes  sometimes good to start w/, as they are less sensitive to pH. Very well tolerated generally Mixed digestive enzymes  HCl, pepsin, pancreatic enzymes, etc. More powerful, more pH sensitive. Nutrition Stomach Hypoacid HCl relieves, mild alkalizer worsens pain HCl, Betaine HCl, Pepsin, etc Zinc necessary for carbonic anhydrase and HCl production Hyper acid/Ulcers nutrition Mild alkalizer relieves pain, acid worsens Raw duodenum (soothing, healing supplement) Chlorophyll (also used for morning sickness) Bismuth/deglycyrrhizinated licorice (H. pylori) makes feces dk green!! Gastritis nutrition Acidophilus esp. in infective gastritis Raw Duodenum Chlorophyll also for morning sickness Upper Digestion other nutrition - Parotid chewing and early digestion: if food moves through gut really rapidly, parotid glandulars helpful - B-complex general help for stomach Diet and lifestyles Avoid stomach irritants caffeine, alcohol, spicy, sometimes acid fruits, veggies, colas, carbonated beverages, tobacco If tolerated, hyper acid may benefit from milk. Shouldnt do milk plus heavy alkalis or can get stones from calcium precipitation. Milk-alkalai syndrome Avoid known food sensitivities Regular schedule (sleep, meals). Let the sympathetics calm down Gallbladder: Location: Under trans-pyloric plane (T9 rib) in the RU Quadrant, tucked under the liver Dont suggest doing gallbladder flush fasting then take large amt of olive oil!!! Sympathetics: Celiac Ganglion, T4 (traditional levels T5-9) ! digestion = ! gallbladder contents Parasympathetics :Vagus (contract gallbladder) Popliteus: breaks screw-hall motion so you can bend the knee (hold tibia in internal rotation) Test: supine w/ knee flexed and foot internally rotated (stabilize the calcaneous & pull toward external rotation) NL points: Mid clav line at 5th rib, T5-6 on R posterior NV: Medial to rib 7-9 (do the duodenal and Ampulla of Vater first) CMRT: Ampulla of Vater (1 up and out from umbilicus) CO2 Technique (acute attacks) DeJarnette Thought to normalize distribution of CO2 in tissues Useful for several organ systems, GB, Lung, Heart, etc Firm pressure on TP of T5 on R, the T10 R and L, then L2 R & L Repeat sequence 4-5 times. Gallbladder pump: one hand on lower ribcage and compress while other hand massages sup and medial Symptoms: intolerance of fatty foods, bloating after meals, belching, acute biliary pain Can have symptoms even after gallbladder removed (nerves, scarring still there) Nutrition: some benefits to using concentrated bile salts to dissolve stones (! side effects/toxicity) ! veggies/fruit & water soluable fibers, supplemental fiber may be useful like flax seed, oat bran, guar gum, pectin, et ! Water (thins bile) Reduce fat, fried No coffee, CHOH, spices Avoid food allergens Eat slowly, relax after meals, lie down after lunch and dinner for 20 min Lecithin  thins bile, ! solubility of cholesterol, won t dissolve stones on own Beet leaf  as in AF Betafood Liver glandulars Pancreatic glandulars or combined panc and bile salts  help fat digestion. Bile salts can give sfx in lg doses and over time may be hepatotoxic Vit C & E Lipotropics: Substances that hasten the removal of fat from the liver or reduce fat deposition in liver: Choline, methionine, Betaine, Folic acid, B12 Cholagogues (stim GB to contract) vs. Choloretics (stim bile secretion, may ! solubility of bile) Dandelion root (both) Choloretics: Artichoke leaves, Berberine  in goldenseal, Oregon Grape); Turmeric (Curcumin  can be used as spice); Methionine/SAM (protects against estrogen- induced cholestasis) NO SINUS NOTES 10/4/05 Clearing the Eustachian Tube (ear infections): pump on TMJ Gallwreath Technique: TMJ fossa is just lateral to the Eustachian tube, therefore pumping the TMJ stretches soft tissue around the Eustachian tube and open it up for drainage Method: drag TMJ down and medial while supporting the head above the TMJ Can also do a pharyngeal sweep, gargle w/ salt-water to ! swelling of tissues Lungs: Location of lobes Conditions: allergic rxn (asthma), infections (pneumonia, histoplasmosis), tissue destruction (emphysema, bronchiectasis), CA How can we help? Autonomics: Symp = T1-T5, inferior cervical ganglion (stellate ganglion) Bronchodilation Parasym = Vagus Bronchoconstriction Monitor Lungs: Middle Delt: abduct and elbow bent 90% - push to floor Serratus Anterior: (stabilizer of shoulder)  pt shoulder flexed w/ thumb pointing up, dr thumb pushing back on inf aspect of scapulae then push down on arm Long thoracic nerve palsy (cant raise arm, but indicator is the flaring of the scapula) Symptoms: cough, mucous production, wheezing, etc Pain indicators: cap of the shoulder, in between the upper ribs, T3 tenderness, occipital pain not responding to manipulation (use of accessory mm) Reflexes NL: between ribs 3-4 anterior (along sternum), Thoracic Lymphatic pump: compress chest following pt breathing thru mouth ( then compress and hold while pt breathes in and let off suddenly (create pressure gradient in chest) NV: bronchial cough reflex (below episternal notch) CMRT: Lymphatic pumps Psoas Release Free up shoulder restrictions: lay on sternal roll (under T-spine), then roll shoulder back while stabilize opp ribs Free up clavicles: simulate vagus Relax intercostals mms Cough control: squeeze C5 B/L until get warmth (pulsation in tissues) Asthma: CO2 technique: press on T5 then T10 then L2 Press: by sternum between 3-4 rib (30-60 sec) Press T3-4 TP for 30-60 sec Adrenal NL Hold upper traps and release on ipsilateral intercostals margin (release diaphragm) Bronchitis CO2 technique Press ant ribs 2-3 Post, press T2-3 Nutrition/Lifestyle: Avoid known food & inhalant allergens (esp. milk for kids w/ ear infection) Supplements: Lung Glandulars Vit C, or C-A-E-Zinc combo Trace minerals Thymus, spleen glandulars (infection) Adrenal glandulars asthma, bronchoconstriction Echinacea based herbal supplements Liver support allergy, toxicity Thin mucus bile salts Thick mucus - I2 (Iodine), N-Acetyl Cysteine N-Acetyl cysteine: mucolytic, antioxidant. May help COPD Magnesium EFAs anti-inflammatory (Get enough Omega 6 but not enough Omega 3 flaxseed oil, fish oils) Avoid Trans fats (Crisco, margarine) Acidophilus break up antibiotic merry-go-round SPLEEN, THYMUS, LYMPH: Physiology: fx to filter blood (old RBCs lyse and contents recycled) and immune function Lymphatic drainage: R head/chest/arm ( drain thru R subclavian vein Lymphatic drainage: rest of body ( drain thru L subclavian vein Lymph vessels: valves but no contractibility (resp, mm move lymph), protein & fat retrieval Holds 100mL of blood ( can contract capsule under sympathetic stim ( extra blood/RBCs in times of crisis Thymus: active site for T-cell origin (larger in kids - ! size in adults) Location: under ribs and behind stomach Thymus: behind sternum (different autonomic innervation than spleen!!) Innervation: Spleen: Sym T6-T7 (splenic plexus) Parasym = vagus Thymus: Sym T1-T4; Parasym = vagus Cond s w/ Spleen: fatigue, irritability, memory probs, (toxic effect) worse in morning; blood handling probs Reflexes: Cysterna Chyli = inf to umbilicus anatomically is actually sup to umbilicus NL spleen: 2nd ICS, lat (back is T7) or 5th ICS near sternum, or R lat chest at 6/7th ICS Pec Minor: at xyphoid process Acupressure pts: aling L lat thumb (lymph vessel), sup to medial malleoli, R dorsal big toe and foot Muscles: Mid (Horizontal fibers) Traps & Lower (T6-T12 SP and spine of scapula hold scapula to spine) Traps Infraspinatus (ext rotator): abduct to 90% and try to int rotate Pec Minor (lymphatic fx?)  corocoid process and ribs = pull scapulae forward Dysfx can interfere w/ Subclavian vein  lymphatic drainage HEART: (need rest of notes for heart) Nutrition: Vit E, C (w/ minerals) Lecithin Wheat germ oil EFAs Mineral balance: Mg, Ca, Na, K Taurine B-complex CoQ 10 (esp if on stain drugs) Lipid handling niacin, lipotropics, fiber, lecithin, carnitine (transport fat across mitochondria membrane) Adrenal support Antioxidants: protect endothelial lining from oxidative damage (1st step to atherosclerosis) Heart Glandulars Review Approach to a Patient: Hx, Clinical Presentation Pain patterns any specific organ suggested? Purely orthopedic? Labs, Imaging, Physical diagnosis Test mm related to suspected organ or, if purely orthopedic all mm around the joint TL to possible tmt reflexes change related mm? if so, treat Adjust the spine &/or extremities as needed Recheck pain patterns, posture, physical dx findings Give recommendations on diet, nutrition, lifestyle changes, exercise Tmt options: use any or all until assoc weak mm strengthen NL (Chapman) massage congested areas until pain begins to ! NV (Bennett)  light stretching contact. Hold for tissue relaxation and pulsation. Assoc weak mm CMRT (Dejarnette)  hold or massage indicated reflexes, often 2 at once, until tissue relaxation, warmth is felt. Often upper traps is held w/ a 2nd reflex point. Adjust a spinal level of autonomic innervation, traditional associated level Basic Techn w/ abdominal contacts as indicated Cranial adjusting if previously studied (finals material) Especially helps vagal-innervated organs and endocrine problems Pineal Sartorius weakens in the dark Treat w/ maxilla and mandible spread Retrograde Lymphatic Technique MM weaken when the pt is placed on a slant, head down or when the feet are elevated Tmt by balancing shoulder girdle mm, especially pec minor. NL at xiphoid Improves lymphatic returen to subclavian vein R head/arm/torso ( drain into R subclavian V Rest of body ( drain into L subclavian V Reviewed Nutrition for organs (see notes above) Begin Final notes: Principles of nutritional eval Pt Hx Diet Diary Physical Exam Lab studies Address most primary areas of dysfunction 1st Nutrient Testing MM testing to help decide among otherwise-indicated nutrients Nutrients are always tasted during testing Test several mms and reflexes related to the pts complaint Optimum nutrients will: Strengthen related mms May reduce palpatory pain immediately Normalized leg length and evenness of toe-in Should not weaken other mms Common Sense Nutrition: Be logical and avoid redundancy Use the fewest possible supplements which each strengthens the most mms and reflexes Dose per clinical judgment & pt response 4-10 times the RDA usual therapeutic dose Childrens dose in proportion to body wt. Moderate to low dose nutrition in pregnancy ADRENALS Physiology: Adrenal Medulla: produces catecholamines (epi, NE, dopamine)  the Fight or Flight Rxn (Symp NS) Epi (adrenalin) Main adult adrenal catecholamine ! amino acid uptake into cells ! glycogenolysis Stim adrenal cortex Dilates pupils Norepi Only NE prenatally = & . Adrenal Hormone Synthesis Catecholamines Tyrosine ( Dopa ( Dopamine ( NE ( Epi Precursors and cofactors: Phenylalanine ( tyrosine; Cu, B12, B6, Folic acid Vit C, Fe, Mn Release controlled by hypothalamus, sympathetic nerve (splanchnic) cholinergic Medullary response ! by hypoglycemia, hypoxia, hypercapnia, nicotine, caffeine, histamine, glucagons Adrenal Cortex Synthesis  cortical steroids (Glucocorticoids, mineralocorticoids, sex steroids) Cholesterol ( pregnenolone ( progesterone ( all other steroids Precursor steal: in chronic stress, precursors diverted to make cortisol instead of DHEA. Ratio is altered. Aldosterone may go down (Na loss) Cofactors and Precursors: Niacin, Vit E,A,C, B6, Pantothenic acid, Folic acid, Biotin, Ca GAS (General Adaptation Syndrome): Hans Selye The Stress of Life Defined physiology of general effects of any stress as distinct from specific effects of specific stressors Three stages in all infections and stressful conditions ALARM, RESISTANCE AND EXHAUSTION Alarm: general call to arms in acute stress Medulla and Cortex resp;ond (Epi, Cortisol and DHEA !) & & . Altered DHEA ratio?? Resistance: Exhaustion: Both cortisol and DHEA ! Can t resist any longer  goes into chronic ds stage Degenerative conditions develop Adrenal Stress Disorder (salivary tests) Addisons Ds: life threatening adrenal deficiency (requires replacement of hormones and salt Adrenal Stress Disorder: not recognized by most endocrinologists (not demonstrable in lab by altered cortisol:DHEA ratios Tired all the time, Just dont feel good Symptoms: Just Sick, fatigue CHO intolerance Light sensitive Immune probs, allergies Recurrent SI subluxsations and knee instability (sartorius, gracilus, gastrocnemius) Hormonal imbalances, male or female Lig weak multiple joint pain Orthostatic Hypotension (Raglands s Sign Systolic BP drops upon standing (should ! 4-10 mm Hg): 5-10 mm Hg drop to be medically diagnosed (ANY drosp in Diastolic = orthostatic HTN) Normally, vasoconstriction occurs due to symp stim, with NE/EPI release. Depends on adeqauate cortisol to sensitize arterioles (can be adrenal stress sign) Orthostatic HTN aslko caused by anything which reduces sypm or central autonomic control: Hypotensive and sympatholytic drugs CNS ds affecting autonomics, including genetic Diabetic autonomic neuropathy Wernickes ds (chronic alcoholism) Paradoxical Pupillary Dilation: pupil dilates during sustained light stim (just wobbling doesnt count) Elevated intracellular potassium due to Na:K imbalance thought to interfere w/ cholinergic nerve fx responsible for activating pupillo-constrictor mm 11/1/05 Allergies (over-response of the immune system that causes damage to tissues) Allergy Type I IgE Immediate hypersensitivity Small amts of food can trigger (rxn w/in 2 hrs) Usually 1 or 2 foods or inhalants Asthma, rhinitis, eczema, hives, diarrhea Considered permanent Type II IgG mediated Delayed sensitivity Rxn 2-24 hrs 3-10 foods, often favorites (i.e; wheat, etc) Larger quantity to trigger rxn Addictive cravings Symptoms in any body tissue GI, CNS, musculoskeletal Other adverse Rxns (not immune/allergy) Not immune-mediated (not allergy) Toxicity Lactose intolerance or other disaccharidase deficiencies (cant drink milk but may be able to eat cheese or yogurt) Lack of nutrients needed to metabolize substances (Ex: sugar requires adequate B-complex to handle) Adverse Rxn Symptoms: Itchy eyes, red cheeks or nose Behavioral changes foggy, cranky, confused (turn on and off) Musculoskeletal pains, && in tenderness HAs GI disturbances Skin rashes Screening for Adverse Rxns NS reacts to tasting or smelling the substance w/ neuro-musculo-skeletal imbalance: Changes in leg length Toe-in becomes uneven MM become dysfunctional weak or non-responsive/non-sedatable (See specialized technique class) Therapy Localization become positive Elimination/Provocation Diet: Best way to confirm adverse rxns Single food elimination Pick foods to test by: Foods which pts already suspects Foods which are common allergens wheat, milk, corn, yeast, eggs  x  STp Fg  Bb [\|9J\]ef,վվպ jh[h[ jh!FhP*hAth!F5>*h!F jhdUh{h6C3h6C36hnhdUh6C3hghFv5hFvhg h-\hd0hd0h=Rh" Q<  !Tq  L w  $ N v  . < Q x  & Fgd" Q hh^h`hgd" Q & Fgd" Qgd" QKx   P p &=5)^ hh^h`hgdFv & FgdFv & FgdFv & Fgdd0gdd0!C[)Qj7c4KW & F gd6C3 & F gd6C3 & Fgd6C3gd6C3 & FgddU & Fgd6C3gdFvWX| +~*cG[v & F gddU & F gddUgddU & F gdngdn & F gd6C3%6j,`U; & FgdP* & FgdP* & Fgd!F & Fgd[ & FgdP* & FgdP* & FgdP*gd!F & F gd!F & F gddU "rtST  !2!4!!!""##$$%%%%?'((+++++--J.K.v.w.x.ֱֵֵֵֵֵּjhnQUjhnQU hl'h2}hnQh=? jh2}h2} hl'hub h-\hub h-\h[hP*h!Fh!FH*hub hl'h!F h-\h!F jh!Fh!Fh[h[h[55;T!4!^!!!""D##<$%X&&&''?'T'' & Fgd2} & Fgd2} & Fgd2}h^hgdub & Fgdub & Fgdub & Fgd[ & FgdP* & Fgd!F''(u((1)Y)))$*5*O*t****+T+m+++++, & Fgd=?gd2}gd=? & Fgd2} & Fgd2} & Fgd2} & Fgd2},,,N-.J.....///x/y////*0V0001%1C1`1 & Fgd=?`gdI & Fgd=? & Fgd=?gd2} & Fgd=?x...x/y//00000011111122A4B4_4b4555d6f6667888=8>8~888888 9 9 97989::::'<D<ĽĹĹıĹ h-\hvhdB"hvhAth=?5>*h=?hhf\hf\6h`U8 hl'hf\hf\hAthf\5>*hI jh=?hAth=?5>*h=?hnQjhnQUhhnQ0J5`1111F223B4_44445+5W5555 66B6 & Fgd`U8 & Fgd`U8 & Fgd`U8 & Fgd`U8 & Fgd`U8 & Fgdf\ & Fgdf\gdf\ & Fgd=? & Fgd=?B6d666 778>8~88889t9L::h;'<`< & FgddB" & Fgdv^gdv & Fgdv & Fgdv & Fgd=?gd=? & Fgd & Fgd`U8 & F%gd`gd^gdgdD<F<<<<<+=,===>@@2@4@$A&ABBKDVDDDEEFFTFVFGGGGGGJJ.J* h-\hqhqhmhq5hmhm5hmhvhgph7h75 hl'h7h7hAthdB"5hdB"hdB"H*hdB"hdB"56H*hdB"hdB"56hdB"hdB"hdB"H*/`<<<=8=o===+>>>2@$ANArAAA`BC>C`CADKDXDD,F & Fgd7 & Fgd7 & FgddB" & FgddB" & FgddB",FXFGGGGGG6HH.I,J.J*hAtha5>*hahAthAthC!5hC!hAthAt5hAth|5H*hAth|5h|h!Jhhgp5RRRRSS.S=ScSSSSS TYTcTTTU0U1UUU & Fgda & Fgdagda & FgdAt & Fgd| & Fgd| & Fgd & FgdUVlVV$XtXYYYYSZ]ZZ[#[[[[p\ ]]]]gdAt & FgdA+ & FgdX & FgdA+ & FgdA+ & Fgda & Fgda & Fgda@\B\]]]8_:_e_f_:a;aaabb.bRbccdd dddeeIfJfrfsfffffffffGgIg{ggggggh#h5h;hFhJhWhlhhhʸʱʱʩʝʝhdwfhdwf5hdwfhdwfH*hdwfhuQhWq5huQhdwf5 jhWqhWqhWq56hAthWq5hWqh`3h`3H* h-\h`3h`3hAthAtH*huQhAt5hAthA+ hIKhA+7]] ^^#^)^H^P^Z^y^^^T_e_f____`W````;ava & F&gd`3gd`3h^hgd`3 & F(gdAt & F(gdAtvabbdSdddeNemee f8fefffffffggg & F&gddwf & F&gdWqgddwf & F&gdAt & F&gdWq & F&gdWq & F&gdWq & F&gd`3gJg[ggghh1hWhhhhh/iXiiiiiiijj & F&gdh & F&gdhgdh & F&gd & F&gdWq & F&gddwf & F&gddwf & F&gddwfhhhhhhiiiiikkDkFk)l*l0l1l;lEFOPklĽĽȶįĶīȗh[h[H*h[huQhnV15huQh[5h $g hl'hnV1 h-\hnV1 jhnV1hnV1h#%he=huQh]5huQh#%5h_Uh] h?66hsh?6huQh?657p|y||Q}g}}}}}~~)~}~~~ /nEs & F&gd_ & F&gd_ & F&gd] & F&gd] & F&gdWq & F&gd?6, soy, tomato/potato family, nuts, dyes and colors, tuna, strawberry Foods which create alterations in mm testing Procedure: Pt eliminates suspect foods entirely for at least one week ON convenient day, have a lot of the suspected food. Watch for rxns. Few hrs to next day: Recurrence of symptoms Respiratory or GI S/.S Rashes HA Behavior or mood changes Great patient education vehicle If severe rxn, try Alka-Seltzer Gold NA, K Bicarbonate often will break up rxn. Or Vit C, Mg, Pantoth. Acid, Adrenal glandulars Allergy Tmt: Basic Principles Avoid allergen until tolerated again, if ever Normalize immune system reflexes, lifestyle, adjusting and supplements Glandulars adrenal, liver, thymus, spleen Vit C Zinc Panto. Acid Trace minerals and Ca, Mg Allergies nutrition Normalized digestion esp for food allergies Stomach digestants, HCL, pancreatic enzymes Leaky gut/dysfloria pan allergic absorbs too lg fragments of protein Acidophilus Glutamine, gut permeability formulas Antioxidantrs/anti-inflammatory nutrition A,C,E, Selenium EFAs Better quality fats in diet Herbal antioxidants ensure no sensitivity SMALL INTESTINES Iliocecal valve: below umbilical line, lat to umbilicus Innervation: T10-T12 (use L1 as representative level) Parasympathetics = vagus MM: TFL Tmt of valve: If dir goes wsk, makes it weak ( go towards to direction of strength (closed valve) Strength goes up to L shoulder = closing an open valve Spastic valve: (constipation/diarrhea) drag down to open (to the right) ( strengthen mm Home care: open  foot on chair, fist below RLQ and bend over fist Diet: Ileocecal valve ! raw fruits and veggies, scratchy roughage like popcorn, p-nuts, coarse cereals  1-2 wks, reintroduce gradually ! water ! caffeine, alcohol, spicy foods while healing Nutrition B complex, Low dose vit E, choline (parasympathetic Ach) Closed my need Ca, Vit D, HCl for Ca absorption Digestive enzymes too alkaline may lead to poor anal control (fecal leakage) Chlorophyll oil soluble Raw duodenum Comfrey-pepsin (short-term, as long-term comfrey can cause liver probs) Acidophilus COLON: L4 Transit Time/Retention Time Pt takes dye capsule, usually Blue #1 (can use charcoal tablets blk) Transit time = time until dye is 1st seen iin stool. 20-30 hrs is normal: 2-3 hr in stomach, 6-8 in sm intestine, rest in colon. (1 studey: 1-5 days, mean 2.3, 1.6 w/ ! fiber) Retention time = time until color is last seen I stool. Normal is <72 hrs., 50-55 hrs usual GI tract is not a straight tube. A tube + a vat (colon)  major mixing component Retention time msr colonic mixing Very short colon spastic or rigid, acts like tube Very long- colon is flaccid, con. Transit time Msr motility.. Nutrition Colon Acidophilus, Mixed probiotics Low potency iron, eg. Raw liver, may help if TFL weak B/L. Test B complex Digestive enzymes for failures of digestion higher up Bentonite clay binds endotoxins, cleansing (absorbent) Parasites (found on stool analysis Depending. Hemorrhoids: Nutrition for vascular tone- C w/ bioflavonoids, Herbal formulas Topicals.. Inflamm Bowel, Diverticulitis Immune support such as thymus, vit C Support adrenals Psyllium Probiotics, acidophilus Avoid food sensitivities Avoid seeds and small hard food fragments (diverticulitis) Endocrine (L3) Female: PMS, infertility, menopause, amennorhea, preg Males: infertility, impotency, ! testosterone, poor conversion of hormones  test/estrogen imbalance Innervation: Symp: T11-L4 (male up to T10) Parasym: S2-S4 (male Associated MM: Glut max (atrophy when hormones !)  pelvic stabilizer Glut med  abductor test (supine)  easier on pt w/ back prob Hip adductors (climacteric menopause) adduct past midline and try to pull legs apart Piriformis - Pain patterns: Mid lower abdo (ovaries); Supra-pubic (testes) Med knees, L3/5 area, burning soles of feet, breast pain, upper traps Lab testing: List of clinical labs (on school center) Diagnos-Techs, Inc Salivary tests, serum THYROID: Innervation: Symp: T1-T2 Parasymp: middle cervical ganglion, C1, upper T/S Symptoms: ! metabolism (fatigue, memory loss, lat 1/3 eyebrows disappear, wt gain, low temp) Lab tests: T3/4 anti-thyroid antibodies and TSH: T3 active form of hormone ! TSH  hypothyroid indicator (push to keep T4 levels up) ! TSH  hyperthyroid or on thyroid meds Hormonal patterns for women (! when ! estrogen and vice versa for progesterone) Salivary TSH (new stage)  free hormones tested Assoc MM: teres minor (axillary border of scapulae to gr tuberosity of humerus) External rotator of shoulder  arm against side and pt ext rotate while dr push internally on forearm Nutrition  thyroid Soy can interfere w/ absorption of thyroid meds Soy can alter thyroid levels, usually not significantly, but instances of both ! and ! thyroid hormone levels in literature Iodine is+BILe 'U?k &B & F&gd_ & F&gdWq & F&gd_ & F&gd_BnrK{ & F&gdnV1 & F&gdnV1 & F&gdnV1 & F&gde= & F&gde= & F&gdWqh^hgd#% & F&gd_9EFPl~2f V & F&gdXX & F&gd& & F&gd[ & F&gd[ & F&gdWqgd[ & F&gdnV156&'jlU]^jk|>@<>JLnƻƴƻƻƴư尩hX jh.IU h-\h.I hl'h.Ih.I hl'hF. h-\hF.hUhF.huQh.5huQhF.5hc  h-\h.h.hXXh#%h&h[ hl'h[: 6[lu' * cq & F&gd#%gd. & F&gd. & F&gd. & F&gd. & F&gdXX & F&gdXXq,?U^kw>n & F&gd.I & F&gdF. & F&gdF.gdF. & F&gdc  & F&gdc  & F&gd. needed, but excess can suppress thyroid Iodine indicators: cant reach decision, costo-cartilages tender, cries easily Hyperthyroid Vit E may help Hypo thyroid glandulars, some, iodine, w/in RDAs Hyper cortisol interferes w/ T4 ( T3 conversion (reverse T3) low thyroid symptoms when labs are normal. Treat HPA asi, reduce stress, Phosphatidyl Serine Facilitate conversion of T4 to T3 & utilization in tissues: Zinc, Selenium, Gugulipid (commiphora mukul), anti-oxidants Uterus & Prostate (L5) Uterus Innervation: hypogastric plexus T11-L4, S@-S4 Symp NS- contraction of fallopian tubes Assoc MM: glut meds, glut max (prostate, broad lig) Vaginitis Acidophilus orally If candida anti fungal nutrition Immune support nutrition Reduce excess sugar consumption Vinegar/acidophilus douche alternate nights for 4 nights then stop for 3 nights I TB. Vinegar/quart of water. Nutrition for Uterus/Prostate general: Soy can lower testosterone levels, may help balance estrogen levels in moderation Low dose vit E Male and female glandulars Wheat germ oil Male and Female herbal combinations Lecithin Adrenal support Essential FAs Zinc Prostate Benign Prostate Hypertrophy Prostate lift: inter-rectal w/ pelvic piece elevated ( lift up on isthmus Prostatic cancer (Mets) Nutrition Saw Palmetto may be preventive and possible tmt Modified Citru Pectin may slow growth and reduce Nutrition Male herbals, glandulars BPH Cernilton/Bee Pollen extract Saw palmetto (Serenoa Repens) Pumpkin seed Zinc Prostate glandulars & herbals Pygeum Africanum Prostitis handle as an infection Pygeum Africanum     AK  PAGE 10 of  NUMPAGES 15 Fall 05 )xf+STt & F&gdp\gd & F&gd & F&gd & F&gd & F&gdX & F&gd. & F&gd.gdX & F&gd.IS6@STwwxGJKLNOQRTUWZ[abdeijtuwxɿɪh1huQ0JmHnHu hy0Jjhy0JUhyhW%jhW%Uh6C3h=?h jh=;3hp\h=;3hhXh.7&JScrw:nx & F&gd & F&gd & F&gd & F&gd=;3 & F&gd=;3 & F&gd. & 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