Abduction: Lateral movement of the limbs away from the midline of the body. Opposite of Adduction..
Acceleration-Deceleration Injury: Injury syndromes commonly associated with hyperextension-hyperflexion of the neck. Most often caused by a rear-end auto accident.
ACQUIRED BRAIN INJURY (ABI): Harm to the brain that occurs after birth. Usually it means harm caused by pressure on the brain from inside the body. Examples are harm to the brain as a result of heart attacks, strokes, illness, and near drowning.
Acromion: The triangular projection of the scapula that forms the point of the shoulder and articulates with the clavicle.
Active Range of Motion: Range of motion in the cervical, thoracic, lumber spine, or any other joint of the body which patient does under his or her own power.
Activities of Daily Living: The normal daily activities and functions a person must perform or fulfill to maintain cleanliness, self-grooming, home maintenance, eating, working and recreation.
ACUITY: Sharpness or quality of a sensation.
Acupressure: The application of manual pressure to specific points along acupuncture meridian pathways for the purpose of decreasing pain. Pain relief is believed to be accomplished by stimulating or sedating the selected acupuncture points.
Acupuncture: An oriental medicine treatment modality where needles are inserted in particular points on the “meridians” of Qi (channels of energy in the body). This is believed to have neurophysiologic effects which decrease pain and promote healing by balancing Qi.
Acute: A recent onset of an injury or problem. The precise time line of an acute condition can range from hours after onset to 16 weeks depending upon thestandard of the particular physician or treatment provider.
Acute Exacerbation: A sudden aggravation of symptoms or increase in severity of an already existing condition without re-injury or trauma.
ADAPTIVE/ASSISTIVE EQUIPMENT: A special device which assists in the performance of self care, work or play/leisure activities or physical exercise.
Adaptive Changes: Changes in a spinal segment which occur secondarily to another biomechanical problem in the spine. This usually involves loss of range of motion in a specific direction to compensate for the trauma at another area.
Adaptive Scoliosis: A lateral curvature of the spine, which is secondary to soft tissue biomechanical imbalance and not to bony changes (structural).
Adduction: Movement of a limb toward the middle of the body. Opposite of Abduction.
Adhesions: Fibrosis tissue and scar tissue that bind together tissues which are usually not attached.
Adjustment: A chiropractic term which describes the skilled application of force to a joint or motion segment to improve intersegmental motion, decrease localized muscle tension, and restore normal motion and position.
ADJUSTMENT DISORDER: This diagnosis involves the development of emotional or behavioral symptoms in response to an identifiable stress. It is not as severe a reaction as is found in post-traumatic stress disorder or acute stress disorder.
ADL: Activities of daily living. Routine activities carried out for personal hygiene and health (including bathing, dressing, eating) and for operating a household.
Adson's Test: A physical exam test used in evaluation of thoracic outlet syndrome at the junction of thebrachial plexus and the scalene muscles of the neck. The patient is placed in the sitting position with one arm straight out to the side and extended slightly backwards. The patient then takes a deep breath and turns the head toward the side being tested. A positive test is loss or diminishment of the wrist pulse on the side being tested.
Allograft: A graft taken from another person (living or dead).
AMBULATE: To walk.
AMNESIA: Lack of memory about events occurring during a particular period of time.
ANEURYSM: A balloon-like deformity in the wall of a blood vessel. The wall weakens as the balloon grows larger, and may eventually burst, causing a hemorrhage.
Ankylosing Spondylitis: A chronic inflammatory disease wherein the spinal motion segments and thesacroiliac joints progressively fuse, resulting in painful restriction of spinal movement.
Ankylosis: A joint condition of decreased or full loss of range of motion, often due to advanceddegenerative changes. A spinal segment which is fused can be said to be “ankylosed”. Also, the fusion of a joint either by advanced degeneration or by artificial means (surgery).
Annular Bulge: A bulging out of the annulus fibrosis, the tough fibrosis outer ring that provides support to the disc, which is diffuse and, usually due to degenerative changes or trauma, leading to degenerative changes. This condition may include partial rents or tears in the annulus fibrosis.
Annular Rent: Another way to describe a tear in the annulus, usually seen during discography, less commonly on MRI, or during surgery. These tears can be traumatic in origin. Also known as an annular fissure.
Annulus: See Annulus Fibrosis.
Annulus Fibrosis: The outer covering of the softer, gel-like nucleus pulposus of the intervertebral disc. The intervertebral discs are located between each of the vertebrae of the spine.
ANOMIA: Inability to recall names of objects. Persons with this problem can often speak fluently but have to use other words to describe familiar objects.
ANOSMIA: Loss of the sense of smell.
ANOXIA: A lack of oxygen. Cells of the brain need oxygen to stay alive. When blood flow to the brain is reduced or when oxygen in the blood is too low, brain cells are damaged.
Anterior: Front side, the opposite of posterior. Synonymous with ventral.
Anterior Disc Herniation: An extrusion of the nucleus pulposus through the front side of the annulus of the disc.
Anterior Discectomy and Fusion: The surgical removal of an abnormal intervertebraldisc and replacement with bone graft and/or surgical hardware for fusion, using an anterior approach to the spine.
Anterior Scalene Syndrome: Compression of the bundle of nerves, veins and arteries as it passes between the anterior and middle scalene muscles. This is a cause of thoracic outlet syndrome orcervicobrachial syndrome, as this is one of the more common areas of entrapment.
ANTEROGRADE AMNESIA: Inability to consolidate information about ongoing events. Difficulty with new learning.
Anterolisthesis: A vertebral segment which is moved forward relative to the segment below.
ANTICONVULSANT: Medication used to decrease the possibility of a seizure (e.g., Dilantin, Phenobarbital, Mysoline, Tegretol).
AO Joint: Atlanto-occipital joint is the vertebral joint formed by the occiput (a portion of the skull) at the base of the skull resting upon the atlas or first cervicalvertebra (C1).
AP: Anterior to Posterior or front to back. This refers to the orientation of the patient to the x-ray beam. With AP films the patient faces away from the x-ray film and faces the x-ray machine. The x-ray photons pass from anterior to posterior through the patient. The image produced is a “front to back” view of the patient.
APATHY: A lack of interest or concern.
APHASIA: Loss of the ability to express oneself and/or to understand language. Caused by damage to brain cells..
APRAXIA: Inability to carry out a complex or skilled movement, not due to paralysis, sensory changes or deficiencies in understanding.
ARBITRATION: Alternative to trial where parties agree to appoint an individual or panel to make a binding award or decision based on the evidence and testimony presented.
AROM Exercise: An exercise designed to increase Active Range of Motion.
AROUSAL: Being awake. Primitive state of alertness managed by the reticular activating system (extending from medulla to the thalamus in the core of the brainstem) activating the cortex. Cognition is not possible without some degree of arousal.
ARTERIAL LINE: A very thin tube (catheter) inserted into an artery to allow direct measurement of the blood pressure, the oxygen and carbon dioxide concentrations in arterial blood.
Arthralgia: Joint pain.
Arthrochondritis:Inflammation of the cartilage portion of a joint.
Arthrogram: The injection of radiographic dye into a joint that is then x-rayed. The contrast dye allows for better visualization of the joint and possible irregularities. Arthrograms are being progressively replaced by MRI.
Arthrosis: A disorder of a joint.
Articulation: 1. The joint between bones. The movement of bones as a result of the joint. 2. Movement of the lips, tongue, teeth and palate into specific patterns for purposes of speech. Also, a movable joint.
Articular Dysfunction: A chiropractic term, which refers to an abnormality of spinal biomechanics involving a loss of normal movement of vertebral motion segment.
Articular Fixation: A loss of one or more joint motions. One of the components of the chiropracticdiagnosis of subluxation. See Subluxation. See Hypomobility.
Articular Spondylolisthesis: A forward or anterior “slipping” of one vertebra in relation to another, due to trauma and/or degenerativechanges within the facet joints and/or the discs.
Articular Surface: The surface of a joint, lined with cartilage and synovial fluid to lubricate joint movement.
ASSISTIVE TECHNOLOGY DEVICE (AT): Equipment used by people with disabilities to help them function better. Examples include crutches, wheelchairs, hearing aids, flashing doorbells, computers, and memory aids, such as, post-it notes, alarm clocks, or tape recorders.
Atlanto-Occipital: Referring to the articulation of the joint between the occiput of the skull and the C1vertebra (atlas). See AO Joint.
Atlas: The first cervicalvertebra which moves with the occipital bone of the skull, and the second cervicalvertebra in the neck. Also known as C1.
ATAXIA: A problem of muscle coordination not due to apraxia, weakness, rigidity, spasticity, or sensory loss. Caused by lesion of the cerebellum or basal ganglia. Can interfere with a person's ability to walk, talk, eat and perform other self-care tasks.
Atrophy: A wasting or decrease in size, often in reference to muscle tissue.
ATTENTION/CONCENTRATION: The ability to focus on a given task or set of stimuli for an appropriate period of time.
Autonomic Nervous System: The part of the nervous system controlling involuntary bodily functions, including regulation of glands, organs, and smooth muscle tissue. The autonomic nervous system acts upon these tissues to slow or initiate their function.
Autograft: A graft taken from the patient.
Avulsion: The pulling away of one tissue from another, either by trauma or surgery.
AWARENESS: Conscious of stimulation, arising from within or from outside the person.
Axilla: The armpit.
Balance: The ability to use appropriate righting and equilibrium reactions to maintain an upright position. It is usually tested in sitting and standing positions.
Bench Trial : A case heard and decided by a judge without a jury.
Bone: The hard, osseous material consisting of bone cells (osteocytes) embedded in a matrix of calcified intercellular material.
Bone Spur: See Osteophyte.
Brachial: Pertaining to the arm.
Brachial Plexus: A complex network of nerve tissues in the neck and armpit, which stem from the C5-T1nerve roots. The brachial plexus contains the nerves going to the arms.
Capsulitis: Inflammation of tissues enclosing a joint.
Carpal Tunnel Syndrome: Soreness, tenderness, and weakness of the muscles of the thumb, index and middle fingers caused by pressure on the median nerve at the point at which it goes through the carpal tunnel of the wrist.
Cartilage: The dense connective tissue between the bodies of the vertebrae (the intervertebral discs) and between the articular surfaces of the join
Concussion: Any alteration in cerebral function caused by direct or indirect (rotation) force transmitted to the head resulting in one or more of the following: a brief loss of consciousness, lightheadedness, vertigo, cognitive and memory dysfunction, tinnitus, difficulty concentrating, amnesia, headache, balance disorder, nausea or vomiting.
Confabulation: Verbalizations about people, places and events with no basis in reality. The person appears to “fill in” gaps in memory with plausible facts.
Confusion: A state in which a person is bewildered, perplexed or unable to self-orient.
Connective Tissue: Tissue connecting and supporting muscles, tendons, and ligaments.
Consciousness: The state of awareness of the self and the environment.
Continent: The ability to control urination and bowel movements.
Contracture: Loss of range of motion in a joint due to abnormal shortening of soft tissues.
Contusion, Brain: A bruise. The result of a blow to the head which bruises the brain.
Cortical Blindness: Loss of vision resulting from a lesion of the primary visual areas of the occipital lobe. Light reflex is preserved.
Corticosteroid: A potent anti-inflammatory drug
Decompression: In spine surgery, the term refers to the lessening of pressure on a nerve root, spinal nerve or the spinal chord. This is also a manual therapy term referring to the lessening of pressure on a nerve or joint through manual traction.
De-conditioned: The loss of strength, flexibility and endurance due to long-term illness, injury, or lack of proper motion or exercise.
Decorticate Posture (Decorticate Rigidity): Exaggerated posture of upper extremity flexion and lower extremity extension as a result of a lesion to the mesencephalon or above. In reporting, it is preferable to describe the posture seen.
Decree: A judgment or order issued by a court.
Decubitus: Pressure area, bed sore, skin opening, skin breakdown. A discolored or open area of skin damage caused by pressure. Common areas most prone to breakdown are buttocks or backside, hips, shoulder blades, heels, ankles and elbows.
Deductible: An amount of money a person must pay for their health care costs before their health insurance company will begin to pay for any other health care costs. Generally, a person must pay a deductible every year.
Deep Tendon Reflex Test: A physical exam technique used to determine the existence and functioning of the nerves connected to the tested muscle. With proper technique, in normal patients, striking the tendon of the muscle will elicit a standard contraction of the muscle, thus assuring the reflex “arc” is intact. Disruption of either the sensory or motor pathways will affect the reflex.
Defamation: Injury to a person's character, fame, or reputation by false and malicious statements.
Default Judgment: When a defendant fails to formally answer a plaintiff's complaint in a timely manner, the plaintiff may ask the court to enter a judgment against the defendant. Most often in personal injury cases, these judgments are set aside once the defendant begins to comply with the rules and initiates a formal defense by filing an answer.
Defendant: The party the plaintiff claims is responsible for his/her damages and from whom the plaintiff seeks some form of relief.
Deficit: A deficiency in amount or quality of functioning.
Degenerative Changes: Degeneration of any joint due to wear and tear, trauma, or unusual postures. The degenerative changes include discspace narrowing, osteophytes or bony spurring. These type of changes can be seen both on x-ray and MRI imaging.
Degenerative Disc Disease: An intervertebral disc, which has suffered the effects of the aging process or the effects of trauma. A disc becomes degenerated over time, often spanning years. Often there are small circumferential tears in the annulus fibrosis, the tough outer covering of the disc. A degenerated disc is also characterized by a loss of its height due to a drying-out of the nucleus pulposus, the gelatinous material inside the disc. It is often caused by a loss of motion between the vertebrae above and below, thus decreasing the mechanical flow of nutrients to the disc.
Degenerative Facet Joints: Facet joints, which, as a result of age and time or trauma, have signs of arthritic changes. The degenerative arthritic changes may include thinning of joint spaces, changes in the joint and cartilage surfaces, and inflammation of the joint and connecting tissues of the joint. Degenerativefacet joints may or may not be symptomatic.
Degenerative Joint Disease: (DJD) In the spine, DJD refers to the inflammatory changes in the facet joint, also known as the zygapophyseal joints of the vertebral bodies. These changes often lead to bone changes and reduced range of motion at the joint. Degenerative joint disease is not limited to the spine.
Degenerative Symptoms: Pain and physical restrictions are a result of degenerative changes usually in the weight-bearing joints of the body.
Demand Letter: A letter expressly stating a legal right and an amount due as reasonable compensation for injuries to person and/or property.
Denervation: The blocking of a nerve supply by trauma, degeneration or surgery.
Deposition: A form of discovery whereby the attorney calling for the deposition has the right to ask questions and obtain answers from a party, witness, or expert while that individual is under oath. Notice of the deposition must be served on the party or witness five (5) days in advance of the date of the deposition unless the parties agree otherwise. A court reporter makes a word-for-word record of all that is said at the deposition.
Dermatomal Somatosensory Evoked Potential: An electrical conductivity test specific to nerve (dermatome) patterns. See Somatosensory Evoked Potential, SSEP.
Dermatome: A specific sensory nerve distribution pattern, which can be outlined or traced on the skin.
Dessication: Dehydration of an intervertebral disc.
Diffuse Axonal Injury (DAI): A shearing injury of large nerve fibers (axons covered with myelin) in many areas of the brain. It appears to be one of the two primary lesions of brain injury, the other being stretching or shearing of blood vessels from the same forces, producing hemorrhage.
Diffuse Brain Injury: Injury to cells in many areas of the brain rather than in one specific location.
Diplopia: Seeing two images of a single object; double vision
Disc: See Intervertebral Disc.
Disc Bulge: A broad-based enlargement
Edema: Collection of fluid in the tissue causing swelling.
EMG: Electromyogram or Electromyelogram. A test to evaluate the motor function of the peripheral nerves and the related spinal nerves. The test involves use of a needle to test nerve conduction speed. The method of the EMG is to insert small needles in muscle groups and observe for electrical indications of denervation or loss of nerve function.
Emotional Lability: Exhibiting rapid and drastic changes in emotional state (laughing, crying, anger) inappropriately without apparent reason.
Encephalography: Non-invasive use of ultrasound waves to record echoes from brain tissue. Used to detect hematoma, tumor or ventricle problems.
End Feel: The quality of the resistance to movement that the health care provider feels when testing therange of motion end point of a particular joint.
Epidural: Outside the brain and its fibrous covering, but under the skull.
Epidural Block: The injection of anesthetic into the epidural space in order to block or desensitize a specific nerve at particular points of a nerve pathway.
Epidural Space: The space outside the dura of the brain and spinal cord. The dura is the outer membrane covering the spinal cord and the brain.
Epidural Steroid Injection: The injection of a potent anti-inflammation drug into the epidural spacearound the nerve or joint for therapeutic purposes. It is used to decrease inflammation in the spinal space and spinal nerves and reduce pai
Facet Arthrosis: Degenerative changes of the facetjoints.
Facet Block: The injection of anesthetic and/or steroid into a facet joint using video x-ray or CT scan to assist the practitioner in guiding a needle through the skin. This can be done for both diagnostic and therapeutic purposes.
Facet Hypertrophy: Enlargement of the facet joints as a result of degenerative changes.
Facet Injection: See Facet Block.
Facet Joint Dysfunction: A vertebral motion segment whose joint does not move freely in all directions or moves excessively. Commonly used by treatment providers to refer to a syndrome producing facet joint pain.
Facet Joints: A set of paired joints representing the articulation (joining) of the back portions of two adjoining vertebrae at the back of each vertebra articulating with the vertebra above and vertebra below. An injured or degenerative facet joint may be the source of spinal pain and stiffness. Also referred to aszygapophyseal joint.
Gait: The manner in which a patient walks.
Gait Evaluation: Observation and analysis of a patient walking. The type of gait is noted.
General Damages: Money damages for pain and suffering, disability, or reduction in quality of life.
George's Line: An x-ray study technique to detect abnormal vertebral alignment as seen on a side view x-ray of the neck. The back-side edges of the vertebral bodies are connected with a continuous line. In a normal study, there is a smooth curving line. In an abnormal study there is an abrupt jog or offset in the line to an anterolisthesis or retrolisthesis position. If there is a sharp break in the line, or a stepping effect, this could be a sign of fracture, dislocation or gross ligamentous instability.
GI Tube: A tube inserted through a surgical opening into the stomach. It is used to introduce liquids, food or medication into the stomach when the person is unable to take these substances by mouth
Giveway Weakness: An abnormal muscle weakness noted upon examination. It is weakness that is inconsistent; usually involving full motor strength against initial resistance, followed by the strength “giving way”.
Glascow Coma Scale: A standardized system used to assess the degree of brain impairment and to identify the seriousness of injury in relation to outcome. The system involves three determinants: eye opening, verbal responses and motor response – all of which are evaluated independently according to a numerical value that indicates the level of consciousness and degree of dysfunction. Scores run from a high of 15 to a low of 3. Persons are considered to have experienced a “mild” brain injury when their score is 13 to 15. A score of 9 to 12 is considered to reflect a “moderate” brain injury and a score of 8 or less reflects a “severe” brain injury.
Goniometer: A protector device used for measuring joint angle and range of motion.
Gonstead Technique: A chiropractic technique that uses the practitioner's hands to make corrections of the spine. This is a high-velocity (high-acceleration), low-amplitude adjusting technique. It is taught at most chiropractic colleges. It was developed over several decades by Clarence Gonstead, D.C. It also utilizes specific x-ray analysis and spinal heat readings.
GP: Abbreviation for a medical doctor who is a General Practitioner.
Grip Strength Testing: Determination of the amount of strength in the hand and forearms while gripping a dynamometer. It can be used to assess changes over time of the motor function of nerves exiting the lower cervical spine.
Gross Instability: An orthopedic spine term which refers to excessive motion between two joints or twovertebral segments. In spinal evaluation, gross instability usually indicates ligamentous injury.
Hematoma: The collection of blood in tissues or a space following rupture of a blood vessel.
Hemianopsia: Visual field cut. Blindness for one half of the field of vision. This is not the right or left eye, but the right or left half of vision in each eye.
Hemiplegia: Paralysis of one side of the body as a result of injury to neurons carrying signals to muscles from the motor areas of the brain.
Hemiparesis: Weakness of one side of the body.
Herniated Disc: A rupture of the annulus fibrosis, through which the inner disc material (nucleus pulposus) extrudes. This may put pressure on the exiting spinal nerve and/or cause an inflammatory reaction leading to radiculopathy or weakness, numbness, and/or tingling in the arms or legs.
ICP: See Intracranial Pressure.
Idiopathic: A condition or disease of unknown cause or etiology.
ILA: An osteopathic or manual physical therapy term referring to the Inferior Lateral Angle of the sacrum. Often designated as a reference point in the diagnosis of sacroiliac joint dysfunction.
Iliac: Referring to the Ilium.
Iliac Crest: The uppermost part of the iliac “wings.” This is the superior border of the ilium easily palpated above the lateral hip. This point is commonly used as a reference point for many physical exam techniques. This is often the site from which bone grafts are harvested.
Iliosacral Dysfunction: An osteopathic or manual physical therapy term referring to a dysfunction of theilium on the sacrum. See Sacroiliac Joint Dysfunction.
Iliotibial Band Syndrome: An inflammatory condition of the thick band of tissue (iliotibial band) extending from the hip to the knee down the side of the leg. Patients report a snapping or pain at the lateral hip or knee or both.
Ilium: One of the bones of each half of the pelvis, forms a joint with the sacrum
Peripheral Neuropathy: A generalized “slowing” of the peripheral nervous system which is often characterized by decreased sensation in a stocking and glove distribution in the feet and hands. This condition can sometimes be diagnosed with a nerve conduction study
Referred Pain: Pain that originates in one part of the body, but is felt in another part of the body.
Reflex Dystrophy: See Reflex Sympathetic Dystrophy.
Reflexology: A therapy which connects various regions in the sole of the foot with different body parts. The theory is that life energy, or chi, is channeled through these zones.
Reflex Sympathetic Dystrophy: A clinically determined syndrome characterized by burning, atrophy, hypersensitivity, temperature changes in the affected area, and decreased range of motion. The cause is usually trauma. This has recently been renamed Complex Regional Pain Syndrome
Temporomandibular Dysfunction (TMD): Dysfunction of the temporomandibular joint.May result in headaches, jaw pain and contribute to neck pain.
Temporomandibular Joint (TMJ): The jaw joint between the mandible and the articular surface of thetemporal bone. This joint allows opening and closing of the jaw, as well as numerous other movements. The joint contains a disc.
Tender Point: A specific area of tenderness within a muscle which does not refer pain to other body parts. It is commonly seen in fibromyalgia. Sometimes considered a latent trigger point.
Tendinitis: Inflammation of a tendon.
Tendon: Primarily the fibrosis non-contractile connective tissue attaching muscles to bones.
Vascular Headache: A headache caused by excessive dilation of the arteries in the brain and its dural coverings. See Migraine Headaches.
Vegetative State: A condition in which the person utters no words and does not follow commands or make any response that is psychologically meaningful. The transition of a person who remains unconscious from a state of “coma” to one of “vegetative behaviors” reflects subtle changes over a period of several months from a condition of no response to the internal or external environment (except reflexively) to a state of wakefulness but with no indication of awareness (cortical function). A person in this state may have a range of biological responses at the subcortical level such as eye opening (with sleep and wake rhythms) and sometimes the ability to follow with their eyes. Normal levels of blood pressure and respiration (vegetative functions) are maintained automatically. Also called Coma Vigil.
Ventral: Pertaining to the front part of the human anatomy.
Ventricles, Brain: Four natural cavities in the brain which are filled with cerebrospinal fluid (CSF). The outline of one or more of these cavities may change when a space-occupying lesion (hemorrhage, tumor) has developed in a lobe of the brain.
Verdict: The definitive answer given by the jury concerning the issues the judge asked them to resolve.
Vertebra: One of the twenty-four (24) bones that make up the spine. There are three types: cervical(seven in number), thoracic (twelve), and lumbar (five), with each section possessing unique characteristics
