aaCM 13 in design

Neurology
Shimizu Reflex
Orthopaedic
Thomas’ Test
A muscle stretch reflex, innervated by the high cervical
spinal cord.
The reflex is performed by caudally tapping the tip of the
spine of the scapula with a reflex hammer.
Elevation of the scapula or abduction of the humerus is
noted as a positive test
Presence of a hyperactive reflex is considered diagnostic
for craniovertebral or high cervical lesions. The major
muscles participating in the reflex are considered to be the
upper portion of the trapezius, the levator scapulae, and
the deltoid.
This is a test for fixed flexion deformities of the hip. It can also
be used to assess muscle length of the rectus femoris, iliacus,
tensor fascia lata and the iliotibial band.
With the patient supine, the patient flexes the unaffected hip
and knee towards the chest. grasping the knee with both hands.
In a positive test ‘the affected hip will be drawn into a degree of
flexion bringing the thigh away from the couch’ (1) If the hip
goes into abduction more than flexion (known as the ‘J sign’ it
can specifically indicate shortening of the ITB (2) Fixed flexion
deformities may be due to soft tissue (such as muscle) shortening,
postural imbalances, fixed lumbar lordosis, significant
posterior pelvic tilt, or may be secondary to pathologies such as
osteoarthritis or fracture (1)
Source:
Shimizu T, Shimada H, Shirakura K (1993)
Scapulohumeral reflex (Shimizu). Its clinical
significance and testing maneuver. Spine,
18(15): 2182-90
GCC Code
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References:
1) Hattam P, Smeatham A (2010) Special Tests in
Musculoskeletal Examination; An evidence-based
guide for clinicians, Churchill Livingstone Elsevier,
Pages 166-169
2) Magee DJ (2008), Orthopaedic Physical
Assessment, 5 edn., Saunders, Philadelphia.
Hodgkin's
Lymphoma
Source:
http://www.gcc-uk.org/UserFiles/Docs/
G20.006%20CofP_stage%203%20hyperlinks%202708.pdf
(Effective from June 30 2016)
Source:
Souza (2009) Differential Diagnosis and Management
for the Chiropractor, 4 edn,Jones & Bartlett
Publishers, USA, Page 976
C4: Develop, apply and document a plan of care in full
agreement with the patient. You must check the
effectiveness of the care and keep the plan of care under
review. A more formal reassessment of the effectiveness of
the plan of care must be undertaken at intervals
that suit the patient and their needs. All subsequent
modifications to the plan of care must be discussed and
agreed with the patient and properly documented.
F1: Explore care options, likely outcomes, risks and benefits
with patients, encouraging them to ask questions. You
must answer fully and honestly, bearing in mind patients
are unlikely to possess clinical knowledge.
Professional
Malignancy of the lymphatic system. 60% occur in children
10-16 years old.
Signs and symptoms include fatigue, fever, chronic cough,
night sweats, weight loss, painless cervical or
supraclavicular lymphadenopathy, pruritis and pain worse
with alcohol ingestion.' 50% have mediastinal mass on xray.
CT scans, lymphangiography, bone marrow aspirate and
biopsies determine spread of the disease. Presence of
malignant Reed-Sternberg cells is diagnostic.
Condition