Georgia Chiropractic Continuing Education

• Explain how and why documentation of a subluxation is so important for Medicare patients in chiropractic practice.
• Compare and contrast the Medicare reimbursement of chiropractic providers vs. Medical and other providers for similar services.
• Describe payments made to chiropractors, calculate the actual dollars per visit and explain what portion of payments made are considered inappropriate as medically unnecessary according to a report issued by the Department Of Health And Human Services (HHS).
• Compare and contrast non-provider services, such as drugs and durable medical devices with costs associated with chiropractic care.
• Define requirements for chiropractic services to be covered by Medicare.
• List and discuss how a subluxation may be properly documented in the medical record for Medicare patients.
• Evaluate your understanding of subluxation compared to other chiropractic providers. 
• List the various types of subluxation which may be demonstrated on xray and are acceptable to Medicare.
• List the components of the physical examination which are required by Medicare to be demonstrated in order to verify the existence of a subluxation.
• Identify the specific requirements accepted by Medicare for the initial and subsequent visits of the chiropractic patient.

• Perform a clinical assessment of pain and function
• Explain the psychophysiological profile of pain patients
• Discuss the treatment of pain
• Define spinal decompression therapy
• Demonstrate decompression table structure and use
• Describe the relevant anatomy of the lumbar spine
• Critically examine published reports of clinical outcomes of decompression therapy
• Present and discuss clinical outcomes of decompression therapy
• Determine spinal decompression table treatment protocols
• Define dizziness
• Define vertigo and other associated symptoms
• Discuss cervicogenic dysequilibrium
• Discuss diagnostic tests to determine the cause of vertigo
• Explore current understanding of pain concepts, physiology and theories behind neuropathic pain
• Discuss in detail the relevant neurological anatomy and functional neurology
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to pain receptors and neural integration
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to neural plasticity, articular neurology, and mechanisms of pain
• Explore current understanding of pain concepts, physiology and theories behind neuropathic pain and allodynia
• Discuss the importance of the neurological implications of a nerve injury
• Describe mechanisms of neural plasticity
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to neural plasticity, articular neurology, and mechanisms of pain
• Analyze current literature regarding spinal adjustments, and break down concepts, physiology and theories behind chiropractic treatment
• Appraise new and existing ideas related to mechanisms involved whereby chiropractic spinal adjustments might effect the vascular and nervous system
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to chiropractic adjustments, neural plasticity, articular neurology, and mechanisms of pain
• Explore current understanding of pain physiology and theories behind neuropathic pain, allodynia and proposed treatment using chiropractic adjustments

• Explore current role of the art and science of obtaining a relevant patient history at the bedside
• Discuss and demonstrate relevant neurological examination procedures required to examine and diagnose pathological conditions of the nervous system
• Outline considerations regarding the relationship of the upper cervical spine and headache
• Summarize characteristics of several clinical headache syndromes, emphasizing recognition and differential diagnosis of pathological conditions
• Illustrate levels of the central and peripheral nervous system and relate that to the clinical presentation resulting from disease of the various brain and cord areas
• Outline and organize various categories for headache

• Define vertigo and differentiate vertigo in the "dizzy" patient population
• Identify disorders that cause dizziness and vertigo.
• Discuss modes of presentation, providers consulted and other aspects.
• Differentiate primary and secondary dizziness.
• Understand aspects of serious and other uncommon causes of dizziness.
• Describe basic anatomy and physiologic function of components of the vestibular system.
• Demonstrate and comprehend performance of the Dix-Hallpike and Eply Maneuvers.
• Define and diagnose Benign Positional Paroxysmal Vertigo (BPPV).
• Perform a bedside examination for evaluation of the dizzy patient.

• Describe the incidence and prevalence of dizziness as a complaint.
• Define the term vertigo from a clinical perspective.
• Identify anatomical components and describe physiological function of the vestibular system.
• Perform a brief bedside examination for basic evaluation of the dizzy patient.
• Categorize varieties of conditions causing dizziness and identify which are likely to be amenable to conservative care.
• Compare and contrast the function of the utricle, saccule and semicircular canals.

• Describe the anatomical structures involved and the overall significance of the Dix-Hallpike Maneuver.
• Perform the Dix-Hallpike Maneuver.
• Describe the anatomical structures involved and the overall significance of the Epley Maneuver.
• Perform the Epley Maneuver.
• Compare and contrast the use of the Dix Hallpike and the Roll Test.
• Discuss in detail the proper use of various vestibular function tests (past pointing, veering, balance, gait, etc.), Swivel Chair Test, Swinging Stool Test, Semont Procedure and the Brandt-Daroff exercises.
• Perform vestibular function tests (past pointing, veering, balance, gait, etc.), Swivel Chair Test, Swinging Stool Test, Semont Procedure and the Brandt-Daroff exercises.

• Evaluate a case of an adult female patient who presents with facial spasms and other complaints including facial weakness, slurred speech, and drooling.
• Differentiate central causes of facial spasm from central causes of facial spasm.
• Consider the effect of chiropractic adjustments on intracranial arterial function.
• Develop improved skills in obtaining an accurate case history and performing a neurological examination of patient’s presenting with facial spasms.
• Improve interpretation of relevant clinical findings of patients presenting with facial spasms.
• List the differential diagnoses to consider in a patient presenting with facial spasms.
• Identify portions of the brainstem, origins of the cranial nerves and the relationship between arteries and cranial nerves at the brainstem.

• Identify the anatomical components of the peripheral arterial system.
• Identify the anatomical components of the peripheral venous system.
• Identify, define and discuss commonly presenting disorders of the vascular system.
• Briefly describe methods of medical and conservative treatment for select vascular illnesses.
• Compare and contrast clinical findings in arterial versus venous disease involving the lower extremity.

• Identify the anatomical components of the thyroid gland.
• Identify the anatomical components and drainage areas of the lymphatic vascular system.
• Identify, define and discuss commonly presenting disorders of the thyroid gland and lymphatic vascular system.
• Briefly describe methods of medical and conservative treatment for select thyroid and lymphatic illnesses.
• Define and discuss landmarks of the human thorax and their implication in the clinical examination.

• Identify the surface anatomy of the 5 lobes of the lungs.
• Identify anatomical landmarks related to the lung lobes.
• Identify, define and discuss normal and abnormal breath sounds.
• Briefly describe methods of stethoscope use and placement.
• Define and discuss methods used to analyze breaths during auscultation.

• Recall normal chest ratios and differentiate from abnormal chest ratios.
• Compare and contrast clinical findings associated with various breathing abnormalities.
• Recognize the location of the cardiac auscultation points and distinguish which structures are best heard at each point.
• Identify pain producing structures in the thorax.
• Describe the physics of sound transmission.
• Define and discuss physical signs in selected abnormalities of the bronchi and lungs.

• Relate relatively common but sometimes challenging patient cases
• Explain diagnostic and therapeutic considerations in thyroid disease
• Give examples of diagnostic and therapeutic considerations in drug toxicity
• Describe diagnostic and therapeutic considerations in diabetic neuropathy
• Demonstrate diagnostic and therapeutic considerations in vitamin deficiency

• Outline relatively common but sometimes challenging patient cases.
• Comprehend diagnostic and therapeutic considerations in multiple pathological conditions.
• Demonstrate knowledge of laboratory tests for alcoholic cirrhosis.
• Recite abnormal blood pressure parameters in malignant hypertension.

• Relate relatively common but sometimes challenging patient cases including vitamin B12 deficiency, metabolic conditions, drug toxicity, neuropathy, lymphoma and drug diversion.
• Explain diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.
• Give examples of diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.
• Describe diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.
• Demonstrate diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.

• Relate relatively common but sometimes challenging patient cases including myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Explain diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Give examples of diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Describe diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.

• List common signs and symptoms of Perinephric Abscess.
• List common signs and symptoms of Adenocarcinoma of the Esophagus.
• List common signs and symptoms of Methanphetimine use and Complications.
• List common signs and symptoms of Cavernous Hemangioma.
• List common signs and symptoms of Cardiomyopathy.
• Discuss use of Zoll Lifevest.
• List common signs and symptoms of Quinolone toxicity.

• Compare and contrast use of PRP injections for joints versus tendons.
• Itemize criticisms of Stem Cell injections and discuss the current state of the science.
• Contrast characterized and uncharacterized Stem Cell therapies.
• List the relative indications for hip replacement.
• List common hip injuries that may require surgical referral, and discuss the surgical procedure most likely to be employed.
• List Indications for knee replacement.
• Describe progression from normal knee to a knee with severe osteoarthritis.
• Compare and contrast the indications and procedures for a partial knee replacement and a total knee replacement.
• List the benefits of robotic joint replacement surgery.
• List the rational for surgical referral for surgical treatment and possible joint replacement.
• List common knee injuries that may require surgical referral, and discuss the surgical procedure most likely to be employed.
• Compare and contrast shoulder replacement and reverse shoulder replacement, emphasizing the relative indications for each.
• List common shoulder injuries that may require surgical referral, and discuss the surgical procedure most likely to be employed.
• List common elbow injuries that may require surgical referral, and discuss the surgical procedure most likely to be employed.
• List common hand and wrist injuries that may require surgical referral, and discuss the surgical procedure most likely to be employed.

• Recall the location of the organs in the abdomen.
• Define various regions of the abdomen.
• Describe techniques of examination including observation, palpation, percussion and special tests and their relevant clinical findings associated with abdominal disease.
• Recognize signs and symptoms of abdominal visceral disease including differentiation of symptoms by hollow versus solid viscera.
• Identify somatic locations of pain associated with abdominal visceral disease.
• Describe changes in stool and vomitus associated with various pathological conditions.

• Recall the structural anatomy of the external eye.
• Define various functions of components of the external eye.
• List local disorders affecting the external eye.
• Differentiate local conditions of the external eye with cranial nerve II, III, IV, V, VI and VII.
• Describe techniques of examination of the internal eye such illumination, observation, and special tests and their relevant clinical findings associated with local external eye disease.
• Recognize the appearance of common eyelid conditions such as chalazion, internal and external hordeolum, blepharitis, blepharospasm, dacrocystitis, and a wide variety of others.
• Identify and perform methods for examining the external eye for conjunctivitis, episceritis and others.
• Perform the technique of removing a foreign body from the external eye.
• Identify and describe pathological changes associated with disease of the cornea.

• Recall the structural anatomy of the internal eye.
• Define various functions of components of the internal eye.
• List local disorders affecting the internal eye.
• Describe techniques of examination of the internal eye such illumination, observation, and special tests and their relevant clinical findings associated with local internal eye disease.
• Identify and perform methods for examining the internal eye for uveal tract disease, cataracts, and vitreous disease.
• Identify and describe pathological changes conditions associated with disease of the uveal tract disease, cataracts, and vitreous humor.

• Review the categorizations for the specialty of radiology and its related subspecialties
• Compare and contrast typical analog x-ray suites with Computed Radiography (CR) and Digital radiology (DR) detection systems
• Review and describe equipment, concepts and various types of CT Scanning
• Review and describe equipment, concepts and various types of magnetic resonance imaging (MRI/MRA), and angiography
• Discuss newer technologies for assessing neurological tissue function, including SPECT,  PET and fMRI scanning
• Review and describe equipment, concepts and various types of diagnostic ultrasoundography
• Identify and define other techniques of diagnostic imaging

• Define professional ethics and morals
• Sensitize the DC to issues related to common ethical dilemma in chiropractic practice
• Discuss specific ethical considerations in situations and scenarios related to patients, former patients and society

• Maintain proper records of neurological examination in the SOAP format
• Write narrative reports reflecting the neurological examination
• Apply an outline of fundamental procedures in performing a complete chiropractic neurological examination

• Correctly assess the level of the lesion in case scenario questions.
• Identify the components of the neurological examination.
• Demonstrate a basic examination flow from sitting to standing, to the supine and prone positions.
• Outline "Ferezy's MSR's" which is a pneumonic devise to help recall areas needing to be tested.
• Summarize implications of neurological findings for lesions in various parts of the central nervous system.
• Summarize implications of neurological findings for lesions in various parts of the peripheral nervous system.

• Describe areas of concern in the history taking process
• List areas of concern in the mental status examination
• Identify and perform methods for eliciting a patient history
• Identify and perform methods for examining the patient’s mental status

• Identify the areas of proper placement of the stethoscope bell in order to auscultate various arteries and other vascular structures available in the head and neck.
• Perform palpation of the thyroid gland.
• Perform an examination of the cranial nerves.
• Evaluate the head and neck for signs of nervous system trauma.
• Draw out the visual pathways from retina to striate cortex of the occipital lobe.
• Associate patterns of visual field losses with various portions of optic pathway disease.
• List retinal areas to evaluate and associated parameters during the fundoscopic examination.
• Correlate disorders of eye position and movement with peripheral cranial nerve disease, internuclear ophthalmoplegia and gaze palsy’s.
• List current vertebrobasilar risk assessment options as well as the value and limitations of each.
• Outline the position of the Association of Chiropractic Colleges (ACC) in regard to vertebrobasilar ischemia (VBI) provocative testing in the chiropractic office.
• Identify suggested effects of elevated homocystine levels above 7.2 umol/L.
• Perform procedures recommended by the author to evaluate candidates for manipulative therapy.
• Summarize implications of neurological findings for lesions involving the cranial nerves or their central connections.

• Define the terms somatoform disorder, hysteria, malingering, organic and non organic disease.
• Contrast and compare organic and non organic disease.
• Contrast and compare somatoform disorder and malingering.
• Identify the most common symptoms described by patients suffering from Somatoform disorder, and develop a strategy to what degree the symptoms may have a somatoform component. 

• Locate cortical areas responsible for language and describe the relationship between the areas and describe pathways of cortical information processing.
• Define the term “hemisphericity” in relation to hemisphere dominance and itemize various methods to determine hemisphere dominance for functions such as language, handedness, hearing, vision, etc.
• Describe results of “split brain” experiments regarding cortical processing of faces and items in regard to distribution of visual information and speech.
• Draw the relationships between the reception and expression categories in The Schema of Monrad Crone to illustrate the “inputs and outputs” of human interaction.
• Identify the cortical pathways involved from hearing and understanding to formulating speech and speaking, and discuss the relevance of pathway location to other cortical systems.
• Define common terms associated with cortical disorders including aphasia, agraphia and apraxia.

• List the major divisions and sub components of the neurological examination.
• Contrast and compare the effects of neurological lesions on the neurological examination of the central nervous system versus the peripheral nervous system.
• Recite the implications of neurological examination findings on disorders involving various components of the central and peripheral nervous system.
• Draw the anatomy of the lower motor neuron in its relation to the spinal cord, nerve root, spinal nerve, and the neuromyal junction.
• Describe components of the so called “SAID” principle of strength training and its relation to neural and muscular adaptation.
• List the five primary roles of functional skeletal muscle tissue.
• Describe and perform aspects of the neurological examination of the Motor Systems of the patient.
• Recite findings related to neurological “drift” performed during the neurological examination.
• Compare and contrast the findings of percussion myoedema with those of percussion myotonia.
• Discuss the significance of neural shock and detail expected associated neurological examination findings.
• Describe and perform aspects of the neurological examination of the Sensory Systems of the patient.
• List, contrast and compare the neurological signs associated with “release phenomenon” and “deficit phenomena”.
• Illustrate components of the muscle stretch reflex including the role of the Alpha motor neuron, Gama motor neuron, and large sensory fibers in relation to the muscle fibers and spinal cord.
• Describe and perform aspects of the neurological examination of the Reflex Systems of the patient.
• Draw the neurologic pathways associated with the eye light reflexes.  Include reference to cells of the retina, the optic nerve, the optic chiasm, the optic tract, the Pretectal nucleus, and the Edinger Westphal nucleus.
• Itemize and discuss categories of neurological involuntary movements.
• Perform and discuss three versions of the extensor plantar response (extensor toe sign, Babinski sign).
• Discuss the common shorthand used for grading muscle stretch reflex responses and discuss the results of the neurological examination associated with each grade.

• Contrast and compare the physical neurological examination with the physical examination of other body systems.
• Perform a neurological examination in a logical, physical sequence from sitting to standing, supine and prone.
• Describe and perform “Waddell’s Tests and six other special tests described in the literature to detect complaints without a physical basis.
• Itemize pitfalls and critically review special tests described in the literature to detect complaints without a physical basis.

• Recite essential features regarding the review of existing patient records.
• List methods and mechanisms regarding the patient examination.
• Compare and contrast the signs and symptoms of various conditions involving sensory changes that have presented to a doctor of chiropractic with emphasis on differential diagnosis.
• Itemize methods and techniques regarding proper patient examination performance.
• Describe the anatomical course of the lateral femoral cutaneous nerve and its involvement in a sensory disorder.
• List signs and symptoms of a patient with Meralgia Paresthetica.
• Compare and contrast the signs and symptoms of various headache conditions that have presented to a doctor of chiropractic with emphasis on differential diagnosis.
• List signs and symptoms of a patient with cluster headache syndrome.

• Recite essential features regarding the review of existing patient records.
• List methods and mechanisms regarding the patient examination.
• Compare and contrast the signs and symptoms of various conditions that have presented to a doctor of chiropractic with emphasis on differential diagnosis.
• Itemize methods and techniques regarding proper patient examination performance.
• List signs and symptoms of a patient with post traumatic neuro-musculoskeletal injuries as well as traumatic brain injury.
• List signs and symptoms of a patient with post-surgical severance of cranial nerve 11. 
• List complaints of a patient who sued a chiropractor for causing a stroke.
• Explain the neurocircuitry behind why right sided visual images are perceived in the opposite hemisphere.
• Explain the neurocircuitry behind why a crossed sensory deficit occurs with brainstem level lesions.

• Describe in detail the anatomy of the carpal tunnel and anatomical course of the median nerve.
• List muscles in the hand innervated by the median nerve.
• Draw the sensory distribution of the median nerve in the hand and discuss points which differentiate median nerve compression at the wrist, from other points of median nerve compression and nerve root compression.
• List important aspects of the clinical examination for carpal tunnel syndrome, as well as multiple methods of conservative treatment.
•  Demonstrate the sensory exam and Tinel’s Sign portions of the clinical evaluation for carpal tunnel syndrome.

• Recite essential features regarding the review of existing patient records.
• List methods and mechanisms regarding the patient examination.
• Compare and contrast the signs and symptoms of various conditions that have presented to a doctor of chiropractic with emphasis on differential diagnosis.
• Itemize methods and techniques regarding proper patient examination performance.
• Describe the anatomy of the cervical spinal cord and course of the exiting cervical nerves.
• List signs and symptoms of a patient with myelopathy.
• Describe the anatomy of the exiting lumbar nerve roots and femoral nerve.
• List signs and symptoms of a patient with an L4 radiculopathy.

• Identify the correlation of resistance exercise and lipoprotein Patterns
• Discuss the effect of Boswellia on arthritis
• Review the effect of green tea on weight loss
• Establish the relationship of exercise and water replacement
• Identify the relationship of red wine and the cardiovascular system

• Distinguish how orange juice can improve blood lipid profiles
• Discuss dietary aspects for the vegetarian athlete
• Identify the relationship between bromelain and acute inflammation
• Develop the anti-septic activity of tea tree oil
• Describe Probiotics

• Review aspects of antioxidants and free radicals
• Discuss how silymarin can improve an alcohol-damaged liver
• Describe the connection/mechanism between atherosclerosis and vitamin E
• Identify research evidence between whole grains and disease
• Delineate the relationship of magnesium and hypertension

• Identify risk factors of cardiovascular disease
• Construct a list of appropriate food and food groups associated with cardiovascular disease prevention
• Evaluate various supplements that are beneficial in prevention and treatment of cardiovascular disease
• Differentiate various diets in regard to cardiovascular disease

• Discuss various diet and lifestyle factors involving hypertension
• Recognize the relationship between various minerals and hypertension
• Distinguish the nutritional aspects of various related cardiovascular conditions
• Identify the relationship between various herbs and peripheral vascular diseases

• Discuss the basics of herbal medicine
• Identify the conditions treated with herbs
• List the effects, indications and dosages for T Bilberry and Black Cohosh

• Identify the conditions treated with specific herbs
• List the effects, indications and dosages for Boswellia, Burdock Root, Bromelain, Calendula, Cascara sagrada, Cayenne, CBD (cannabis), Chamomile, Echinacea

• Discuss the mechanism and effects of Feverfew, Garlic, Ginger, Ginkgo Biloba, Ginseng, Goldenseal, Gugulipid, Gymnena Sylvestre, Horse Chestnut, Lemon Balm, Licorice, Milk Thistle, Nettle, Passionflower, Psyllium, Pygeum, Senna, Shiitake, St. Johns Wort, Saw Palmetto, Tea Tree Oil, Tumeric, Valerian Root, and White Willow

• Identify changes in vitamin needs and status that occurs with aging and in the elderly
• List changes in mineral needs and status that occurs with aging and in the elderly
• Demonstrate an understanding of protein, fiber and water needs of the elderly
• Identify important antioxidants in the elderly and the interactions that exist between them
• Create a list of nutritional deficiencies and how they can lead to disease and illness in the elderly

• Demonstrate an understanding of the role of calcium and other minerals in osteoporosis
• Design a treatment protocol for the osteoporotic patient
• Create nutritional guidelines for the pregnant female
• Identify changes in vitamin and mineral requirements in pregnancy
• Review the nutritional changes that occur with lactation

• Understand proper growth rates and weight gain in early childhood
• Identify specific minerals involved in childhood nutrition
• Explain the stages of obesity development in childhood
• Review the importance and problems associated with childhood obesity
• Evaluate the role of fiber in childhood

• Identify the link between obesity and disease
• Understand body composition and assessment methods
• Design a practical weight loss diet program
• Perform obesity related calculations quick and easily in the office
• Recognize the role of exercise and other lifestyle factors that can influence obesity.

• Identify the challenges inherent in the diagnosis and management of patients with complex and chronic multi-factorial problems
• Associate a multitude of common symptomatic complaints with foundational metabolic disorders such as elevated total toxic load and "leaky gut"
• Apply a systematic approach to functional laboratory diagnostics and associate the findings with the need for specific therapeutic strategies using nutrients, botanical medicines, and nutraceutical compounds
• Demonstrate an ability to institute life-style modifications, such as dietary changes, stress management techniques, and exercise in the management of patients with complex chronic illness
• Measure your ability to assess, diagnose, and treat patients with fatigue-related disorders, vague gastrointestinal complaints, cognitive dysfunction, thyroid-adrenal problems, food intolerance, and more

• Identify the challenges inherent in the diagnosis and management of patients with complex and chronic multi-factorial problems
• Associate findings such systemic skin problems with foundational metabolic disorders
• Apply a systematic approach to functional laboratory diagnostics and associate the findings with the need for specific therapeutic strategies
• Discuss the modification of your approach to case management based on outcome-assessment
• Assess, diagnose, and treat patients with serious food allergy and sensitivity, dermatologic disorders, immune dysfunction, and persistent serious hypertension

• Identify the sources of toxic exposure in modern industrial society, the prevalence of exposure, and the health ramifications of elevated total toxic body burden
• Associate a multitude of common symptomatic complaints (ie: fatigue, cognitive dysfunction, skin problems, global pain, etc.) with foundational metabolic disorders related to issues such as elevated total toxic load and "leaky gut"
• Discover the specific biochemical methodology utilized by human metabolism to render toxins harmless and excrete them from the body
• Explain the inherent complications within the normal detoxification process related to the formation of toxic intermediates and the increase in oxidative stress
• Explore the effect of elevated oxidative stress on mitochondrial function and cellular energy production

• Identify various pathologies associated with increased toxicity and total oxidative stress
• Outline specific strategies of patient assessment to determine toxic load and individual hepatic detoxification capacity
• Discriminate between the various pathways of hepatic detoxification biochemistry and objectively assess each pathway
• Explain the use of specific nutrients, nutraceutical compounds, botanical medicines, and foods to lower oxidative stress
• Explore the benefits and complications of adjunctive therapies in the management of patients with elevated toxic load and poor detoxification capacity

• Identify common drug and nutrient interactions
• Identify herbal interactions
• Identify nutrient and nutrient interactions
• Recognize different toxicity levels for various nutrients
• To formulate treatment recommendations based a patient's medication intake.

• Identify some of the functions of Co Q10
• Use Co Q10 for as appropriate as a supplement
• List the issues of performance changes with Co Q10
• Discuss the reasons for, and application of, Co Q10 for patients with Parkinson Disease and migraines

• Identify how free radicals are formed and what parts of the body are affected.
• Determine the relationship between antioxidants and cardiovascular disease and cancer
• Discuss the role that vitamins, amino acids and herbs have in pain control.
• Examine inflammation and the pro-inflammatory state.
• Construct an anti-inflammatory diet
• Determine which vitamins, minerals and herbs are useful as natural anti-inflammatories.
• Identify the role of Proteolytic enzymes and inflammation and review sources of fatty acids.

• Frame the problem and basic epidemiology of chronic G.I. disorders
• Present evidence of linkage between chronic G.I. disorders with other common medical conditions
• Discuss the current hypothesis of associations between intestinal hyperpermeability and systemic illnesses
• Review cutting edge assessment tools and tests for G.I. disorders
• Outline and suggest rational and efficacious cutting-edge non-drug treatment interventions for functional G.I. disorders.

• Understand how muscle contraction occurs
• Review practical muscle physiology
• Determine how the body responds to exercise
• Discuss the role of hormones in regards to muscle
• Identify the components of proper assessment for physical fitness
• Review the main components of a weight training exercise program
• Identify various exercise training methods
• Discuss the practical aspects of body composition
• Review basic nutrition and how it relates to sport and exercise
• Determine the energy needs and energy balance of the athlete

• Discuss the causes and genetics of Alzheimer's Disease
• Review the diagnosis of Alzheimer's Disease, including symptoms, incidence, course, and risk factors
• Understand conventional lab tests for Alzheimer's Disease
• Review the conventional treatment options for Alzheimer's disease, including drug therapies
• Understand new drug research and innovative drug strategies for Alzheimer's disease
• Utilize nutritional strategies for Alzheimer's disease, including vitamin, mineral and herbal therapies
• Discuss and define drug-vitamin-herb interactions for nutritional supplements recommended for Alzheimer's disease

• Define the common signs and symptoms leading to the diagnosis of Amyotrophic Lateral Sclerosis
• Utilize conventional and alternative lab test for Amyotrophic Lateral Sclerosis
• Learn about the conventional treatment options for ALS, including drug therapies and new drug research
• Utilize nutritional support strategies for ALS, including diet, and nutritional supplements
• Coordinate care with the Medical Profession for innovative drug strategies for ALS

• Review Age-Associated Mental Decline, including its symptoms, causes and innovative drug therapies
• Discuss and define nutritional support strategies for Age-Associated Mental Decline, including vitamins, hormones and antioxidants
• Outline innovative drug strategies for cognitive enhancement
• Apply nutritional support strategies for cognitive enhancement

• Discuss the interactions between nutritional supplements and diuretics, statins and anticoagulant drugs
• Discuss the interactions between nutritional supplements and antidepressants, antidiabetic medications, and antibiotics
• Discuss the interactions between drugs and the B vitamins, fat soluble vitamins
• Discuss the interactions between drugs and vitamin C, folic acid, PABA, progesterone, tyrosine, phenylalanine, and therapeutic oils

• Define the criteria for diagnosing chronic fatigue syndrome
• Outline the causes of chronic fatigue syndrome
• Summarize the relationship between chronic fatigue syndrome and the endocrine system
• Discuss natural therapies that may be helpful for CFS patients
• Describe the relationship between neurotransmitters and chronic fatigue syndrome

• Define obesity, including its symptoms, epidemiology and effects on health and wellness.
• Review conventional treatments for obesity
• Discuss popular diets for obesity and weight loss, and the macronutrients: carbohydrates, protein, and fats
• Review nutritional support strategies for weight loss.

• Adequately frame the problem and basic epidemiology of cardiovascular disorders (CVD)
• Present evidence of the relationship between obesity, insulin resistance, inflammation, stress and CVD
• Summarize the standard medical and laboratory evaluation techniques and why they may only screen for approximately 50% of people at significant risk for CVD
• Appraise the latest laboratory evaluations, including Lp (a), Apo A1, Apo B, hs-CRP, homocysteine, fibrinogen, AA/EPA, LDL-subclass and others to determine CVD risk
• Critique the current dietary, lifestyle, nutritional supplement, nutraceutical, and herbal strategies as therapeutic management options to reduce CVD risk and for the treatment of those who already have cardiovascular issues, including: high cholesterol and dyslipidemia, genetic susceptibilities, chronic inflammation, coagulation abnormalities, and insulin resistance-related risk factors

• Generate a list of disorders associated with gluten sensitivity
• Describe to patients where gluten is likely to be found and which foods are generally safe for a gluten sensitive patient
• Interpret journal articles or general publication articles in the light of the history of gluten sensitivity diagnosis
• Critique articles and authors who claim that celiac disease is the only proven form of gluten reaction
• Detect and differentiate chronic gluten reactions in patients from other causes of inflammation and disease

• Describe the historical context of celiac understanding
• Document reasons why celiac disease is nearly always misdiagnosed
• Present valid arguments from cited literature how celiac disease is an autoimmune condition
• Defend recent scientific advances for the leaky gut syndrome
• Discuss reasons why celiac disease is a global concern, not just an American issue.

• Defend the implementation of a gluten free diet in celiac and non-celiac gluten sensitive patients based on sound evidence from current literature
• Document reasons why a first-degree relative of a known celiac should be gluten-free
• Summarize the current rate of celiac diagnosis in the US
• Contrast the expected findings of a celiac patient and non-celiac gluten intolerant patient
• Recognize that neurological signs can result from gluten intolerance

• Identify which supplements are commonly used in exercise and sport
• Determine the benefits and risks of individual ergogenic aids
• Discuss the role that individual vitamins have in exercise and sport
• Examine the role that individual minerals have in exercise and sport
• Investigate the value of sport drinks
• Ascertain when fluids are most beneficial in sport
• Apply how exercise effects the immune system
• Review the positive and negative effects of exercise
• Identify the role of antioxidants in sport and exercise

• Summarize the bowel protective mechanisms and their role in health and disease
• Outline a treatment strategy for imbalanced gut flora/leaky gut
• Identify common food allergies and determine appropriate nutritional therapy
• Examine the role of fiber in gastrointestinal health
• Create a treatment plan for common GI complaints of constipation and diarrhea
• Determine appropriate nutritional treatments for ulcers
• Theorize how diet can affect Inflammatory bowel disease
• Understand how to successfully use nutrition to treat a variety of gastrointestinal disorders
• Comprehend a rationale treatment protocol for Irritable bowel syndrome
• Determine correct doses of supplements used for various gastrointestinal disorders
• Ascertain the safety and risks associated with commonly prescribed gastrointestinal supplements

• Identify which supplements are commonly used in exercise and sport
• Ascertain the rationale of using specific individual sport supplements
• Differentiate between fact and fiction of the supplement in relation to sport and exercise
• Determine the practical use in sport for individual supplements
• Determine the benefits of individual ergogenic supplements
• Examine the risks associated with individual supplements
• Investigate the value of specific supplements via studies
• Define contraindications and interactions with the supplement
• Recommend the correct dose of the supplement for sport and exercise

• Identify various energy systems of the body and how they relate to exercise and sport
• Theorize which energy system is used for a specific sport event/activity
• Summarize the physiology of fat, protein and carbohydrate metabolism and utilization in exercise and sport
• Understand the relationship between the energy systems and various exercise parameters
• Create a diet protocol for the athlete prior to their sport or exercise activity
• Determine and understand the timing of meals in exercise and sport
• Outline a useful program for a person to maximize carbohydrate stores
• Theorize how glycemic index can affect exercise and sport activity
• Ascertain differences between food variables and how they affect exercise and sport performance

• Review nutritional supplements useful for weight loss.
• Discuss the research for conjugated linoleic acid for weight loss.
• Outline the associations between thyroid function and weight loss.
• Summarize dietary supplements that increase thermogenesis.

• Differentiate various nutrition assessment techniques.
• Determine which body fat/composition technique is most appropriate for the individual.
• Calculate essential measurements for weight loss patients.

• Appraise the reviewed research studies for salient elements of bias.
• Describe the sensitivity and specificity of common food sensitivity tests.
• Identify the effect of common natural interventions for IBS.
• Compare results of the low FODMAP diet to conventional dietary approach for IBS.
• Differentiate between clinical and statistical significance in natural medicine interventions for IBS
• Grade the magnitude of effect size for natural medicine interventions.
• Interpret the effect size of an intervention as it relates to the numbers needed to treat for benefit.
• Identify the risk of bias level for studies included in a systematic review on yoga for IBS.

• Discuss the role of diet in causing and preventing various diseases, particularly chronic diseases.
• Describe methods used to assess nutrition status.
• Explain how dietary recommendations are formulated.
• Incorporate nutritional information into clinical practice and advise patients about eating for optimum health as well as using dietary change as a therapeutic intervention
• Evaluate the benefits and risks of nutritional recommendations for specific health conditions through an analysis of the existing scientific and clinical evidence

Hour 1 - 3

• Discuss the role of diet in causing and preventing various diseases, particularly chronic diseases.
• Describe methods used to assess nutrition status.
• Explain how dietary recommendations are formulated.
• Incorporate nutritional information into clinical practice and advise patients about eating for optimum health as well as using dietary change as a therapeutic intervention
• Evaluate the benefits and risks of nutritional recommendations for specific health conditions through an analysis of the existing scientific and clinical evidence

Hour 4

• Investigate the importance of nutrient deficiencies
• Review the role of essential nutrients in human health
• Analyze the interaction between nutrients and various illnesses
• Ascertain the role herbs have in health and disease
• Understand drug and nutrient interactions

• Investigate the importance of nutrient deficiencies
• Review the role of essential nutrients in human health
• Analyze the interaction between nutrients and various illnesses
• Ascertain the role herbs have in health and disease
• Understand drug and nutrient interactions

• Review the clinical presentation of Diabetes
• Examine the role of nutrition and diet in Diabetes
• Design an appropriate supplement protocol for the diabetic patient
• Develop nutritional guidelines for hypoglycemia

• This contains all courses with the educational objectives listed from Nutrition 148 through 154

• Identify sources and functions of carbohydrates, proteins, fats, alcohol, vitamins, minerals, and water in the human body.
• Demonstrate the importance of a balanced diet and use tools that can be utilized to evaluate the nutritional adequacy of a diet (RDA, Dietary Guidelines, MyPlate, etc.).
• Identify the relationship between diet and chronic diseases/illnesses (cardiovascular disease, diabetes, obesity, cancer, hypertension, osteoporosis, etc.) and what modifications can be made in the diet to reduce the risk for these diseases/illnesses.
• Recall current nutritional recommendations for healthy eating habits (American Heart Association, American Cancer Society, etc.).
• Utilize nutrition terminology and related terminology appropriately.
• Demonstrate lifelong healthful eating habits by differentiating between beneficial and non-beneficial dietary practices.
• Develop nutritional scripts for 10 of the most common adult pathologies that can be potentially palliative or reverses through dietary changes.

• Understand the relationship between BPH and nutrition/supplements
• Develop a nutrition treatment program for UTI's
• Design a nutrition therapy program for kidney stones and gallstones
• Explore the relationship between diet and hyperestrogenism and its related diseases such as PMS and FBD
• Outline a nutrition treatment program for menopause

• Analyze the relationship between tendonitis/bursitis and nutrition
• Identify the nutritional treatment of muscle cramps/leg cramps and soreness
• Discuss nutrition treatment for Muscular dystrophy
• Determine an appropriate nutrition treatment for Fibromyalgia

• Identify the etiology and pathology of arthritis.
• Outline a diet that is helpful in the treatment of arthritis.
• Apply specific supplements to an arthritic condition.

• Review the risk factors and mechanisms of heart disease.
• Identify the parts of a proper diet to prevent heart disease.
• Evaluate various supplements that are beneficial in prevention and treatment of heart disease.

• Recall various foods with high amounts of Flavonoids and briefly relate their impact health
• Indicate the basic chemical structural similarities and differences of Flavonoids
• Relate potential benefits of combining Flavonoids, and ways of improving their bioavailability and efficacy
• Explain why some Flavonoids may be effective according to their chemical structure, specifically in a study for neuroprotection
• Discuss Flavonoid use and neuromuscular treatment considerations
• Integrate knowledge of Flavonoids and biochemical pathways to prescribe individualized nutrition treatments to your patients and appreciate the potential for overprescribing too many competing herbs
• Examine and demonstrate how and why Green Tea extract may play an inclusive role in health

• This contains all courses with the educational objectives listed in Nutrition 157 and 158

• Quantify the prevalence rates of patients using opioids and herbal products
• Demonstrate the significance to the chiropractor of interactions between different herbs and common prescription drugs
• Discuss the at risk populations for interactions including the pregnant, and elderly populations
• Record and list the most common interactions of common food and herbal products
• Record and list the effects of the common interactions of common heart medication and herbal products
• Demonstrate evidence that supports the use of health care providers assessing patients for these interactions.
• Discuss the role of the chiropractor in the role of identifying these interactions.
• Illustrate several books, and smart phone based electronic applications to make the process of identification easier for a chiropractor and patient.
• Evaluate common case scenarios

Hour 1: Evolutionary Biology Influence on Clinical Physiology

• Discuss infection, evolution, immunity, inflammation, and fibrosis.
• Compare short-term survival v. long-term chronicity.

 Hour 2: Summarize Inflammation in both Pain and Disease

• Utilize Laboratory diagnosis of inflammation.
• Provide Nutritional management for inflammation.

Hour 3: Justification of Sleep Hygiene

• Explain the role for sleep and sleep’s influence on immunity, cognition, psychiatric conditions, hunger, fertility, blood sugar control, vascular health, and more.
• Summarize the influence of sleep on brain neurochemistry.

Hour 4: Define the Recently Discovered Glymphatic System

• Discuss the glymphatic system and how to optimize its influence on health.
• Emphasize the importance of the glymphatic system in relation to neurodegenerative diseases.

Hour 5: Point out the Role of Vitamins for Chronic Disease Prevention

• Emphasize the importance of B vitamins to lower homocysteine.
• Point out the relationship between elevated homocysteine and vascular injury risks.
• Justify why people need between 5-8 different supplements and explain why.

Hour 6: Analyze the Science of a Healthy Diet

• Justify high vegetable, low lectin, low glycemic dietary habits, and their influence on physiology.
• Summarize problems with refined carbohydrates, monosodium glutamate, aspartame, and chemical toxins.
• Explain the drivers and consequences of a leaky gut.
• Demonstrate glycation and its consequences.
• Explore the benefits of Intermittent Fasting

Hour 7: Appraise Chiropractic Clinical Practice and Pain Management

• Integrate the Gate Theory of Pain and the Chiropractic Adjustment
• Quantify the Opioids Epidemic and the Positive Influence of Chiropractic
• Diagram the importance of the omega-6 / omega-3 ratio
• Caution Against the Ingestion of Excitotoxins

Hour 8: Detail the Benefits of Exercise

• Emphasize the Benefits of High Intensity Interval Training.
• Introduce the Harmful Effects of Fructose on Energy Production

• Discuss the Nutritional Aspect of effect size of red meat reduction
• Discuss the importance of the GRADE evidence evaluation method.
• Explain the Nutritional importance of the choice of the red meat reduction target
• Summarize the multiple lines of evidence supporting the guideline recommendation.

• Define very low carb (ketogenic), low carb, and moderate carbohydrate diets
• Describe the proposed mechanism of how low carbohydrate diets may improve outcomes
• Summarize the evidence supporting low and very low carbohydrate diets in diabetes management
• Critique the arguments for the long-term use of ketogenic diets

• Understand the importance of normal bowl defense mechanisms
• Develop a nutritional treatment for candidiasis and gut flora imbalances
• Examine the importance of fiber on human health
• Design a nutritional treatment program for constipation and diarrhea

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.
• Examine the concept of health and aging
• Determine an appropriate lifestyle to increase the chances of living longer
• Analyze various diets and dietary patterns that play a role in aging
• Ascertain which foods are of greater benefit in regards to aging and longevity
• Develop an appropriate anti-aging diet
• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Analyze the role between diet and the immune system.
• Design a nutrition supplement program to stimulate the immune system.
• Develop a nutrition program for colds, flu, sore throat and infections.
• Understand basic detoxification techniques.
• Examine the role of nutrition and diet in regards to chronic fatigue syndrome.

• Analyze the role between diet and the immune system.
• Design a nutrition supplement program to stimulate the immune system.
• Develop a nutrition program for colds, flu, sore throat and infections.
• Understand basic detoxification techniques.
• Examine the role of nutrition and diet in regards to chronic fatigue syndrome.

Hour 1

• Define and explain the chronic illnesses so prevalent in today’s society.
• Recognize and calculate life expectancy statistics
• Describe the difference between traditional and modern (commercial diets)
• Distinguish the differences between raw and pasteurized milk
• Recognize the difference between healthy and commercial butter and eggs
• Discuss the difference between hydrogenated and non-hydrogenated fats/oils

 Hour 2 

• Contrast the differences between lacto fermented and non-fermented soy (tofu, edamame)
• Compare breast milk to soy formula
• Identify the difference between sea salt and industrialized salt
• Summarize the benefits of cholesterol
• Explain the dangers of cholesterol lowering drugs
• List the benefits of sunlight

• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.

• Develop an appropriate nutrition program for an ulcer
• Identify the importance of diet in Celiac’s disease (non-tropical sprue)
• Outline a nutrition program for a patient with lactose intolerance
• Design a nutrition treatment program for GERD
• Examine the role of nutrition and supplements in irritable bowel syndrome

Hour 1

• Recognize normal cognitive and memory lapses and signs of declining cognition.
• Differentiate the assessment tools and the pros & cons of each
• Review evidence-based dietary patterns and specific foods that impact cognition
• Review additional evidence-based lifestyle factors that contribute to cognition
• Summarize dietary supplements which may impact cognition

Hour 2

• Recognize 5 categories of early aging
• Identify nutrient deficiencies associated with aging
• Examine epigenetics in aging, specifically COMT and MTHFR
• Review stress physiology and its contribution to aging
• Review contributions of microbiome to healthy physiology and aging

• Design an effective nutrition treatment program for carpal tunnel syndrome
• Develop a nutritional treatment program for Multiple Sclerosis
• Investigate the role of nutrition and supplements in regards to the treatment of headaches
• Understand how nutrition and nutrition supplements can influence dementia
• Identify appropriate diet and supplement agents in the treatment of dementia

• Identify behaviors associated with artificial sweeteners
• Examine the main artificial sweeteners used in the United States
• Determine why artificial sweeteners are used in the food industry
• Summarize the general risks associated with artificial sweeteners
• Evaluate the benefits and risks of Neotame and Advantame

• Identify the benefits and risks of Saccharin
• Discover the benefits and risks of Acesulfame potassium
• Summarize the benefits and risks of Sucralose
• Differentiate Aspartame benefits and risks
• Critique the current research on artificial sweeteners and cancer risk
• Explain the effect of artificial sweeteners on the gastrointestinal environment
• Interpret the research on artificial sweeteners and blood sugar

• Distinguish between the negative and positive effects on obesity, weight control and artificial sweeteners
• Identify the natural sweeteners that are generally recognized as safe
• Evaluate the effectiveness and safety of Stevia
• Determine the effectiveness and safety of Luo han guo (Swingle fruit or monk fruit extract)
• Analyze the effectiveness and safety of Thaumatin

• Identify behaviors associated with artificial sweeteners
• Examine the main artificial sweeteners used in the United States
• Determine why artificial sweeteners are used in the food industry
• Summarize the general risks associated with artificial sweeteners
• Evaluate the benefits and risks of Neotame and Advantame

• Identify the benefits and risks of Saccharin
• Discover the benefits and risks of Acesulfame potassium
• Summarize the benefits and risks of Sucralose
• Differentiate Aspartame benefits and risks
• Critique the current research on artificial sweeteners and cancer risk
• Explain the effect of artificial sweeteners on the gastrointestinal environment
• Interpret the research on artificial sweeteners and blood sugar

• Distinguish between the negative and positive effects on obesity, weight control and artificial sweeteners
• Identify the natural sweeteners that are generally recognized as safe
• Evaluate the effectiveness and safety of Stevia
• Determine the effectiveness and safety of Luo han guo (Swingle fruit or monk fruit extract)
• Analyze the effectiveness and safety of Thaumatin

• Review exercise physiology principles and techniques
• Analyze various exercise prescription principles
• Identify appropriate carbohydrate – fat – and protein recommendations
• Develop meal timing and fluid guidelines for the athlete

• Review exercise physiology principles and techniques
• Analyze various exercise prescription principles
• Identify appropriate carbohydrate – fat – and protein recommendations
• Develop meal timing and fluid guidelines for the athlete

• Review the signs and symptoms of neuroinflammation and the processes that drive neurodegeneration.
• Identify the neurological signs and symptoms of long COVID and apply research-based protocols.
• Utilize dietary improvements and selected supplements to reduce neuroinflammation.
• Treatment protocols on testing to identify gut barrier and gut-brain axis imbalances.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Understand the effect of bacterial toxins originating in the gut on the gut-brain axis as a key to neurological disorders pathogenesis.
• Assess intestinal and blood-brain barrier dysfunction for better managing chronic neurological disorders.
• Understand new functional nutritional strategies for longevity.
• Incorporate leading-edge protocols for extending healthspan and longevity.
• Clarify the effects of intermittent fasting on immunity and longevity.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Integrate optimal lifestyle adaptations in diet, exercise, and supplement protocols to enhance neuroplasticity and improve quality of life.

• Understand basic concepts of health
• Identify the health spectrum
• Investigate the various facts associated with aging
• Investigate the various theories of aging

• Explain the basic principles of nutrigenomics, focusing on the interaction between nutrition, genetics, and health outcomes, with an emphasis on conditions like headaches.
• Analyze how single nucleotide polymorphisms (SNPs) and other genetic variations impact nutrient metabolism and their potential role in triggering headaches, such as those linked to impaired methylation.
• Examine the mechanisms by which a lack of essential nutrients (e.g., magnesium, B vitamins) contributes to headaches, and how nutrigenomics can inform targeted nutritional interventions.
• Design tailored dietary strategies based on genetic testing results, addressing deficiencies or imbalances that may exacerbate headache conditions.
• Assess the benefits and limitations of using nutrigenomic testing to guide clinical decision-making for headache management and prevention, highlighting the importance of personalized nutrition in improving patient outcomes.

Hour 1

• Compare the differences between acute and chronic inflammation.
• Associate background inflammation with chiropractic treatment outcomes.
• Discuss the aging trends in the U.S. population.
• Summarize the role of aging on background inflammation.
• Explain the differing outcomes of disc disease and radiculitis driven by inflammation.

Hour 2

• Identify the mechanisms by which macrophages activate inflammation.
• Discuss the historical trends in long chain fatty acid intake in relation to inflammation.
• Explain the dependency on the COX 2 enzyme both in inflammatory up-regulation and in resolution.
• Recognized dietary induced “meta-inflammation” and the dietary patterns that induce it.
• Summarize the role of phytonutrients in limiting dietary induced inflammation.

Hour 3

• Define immunosenescence and “inflammaging”.
• Summarize the role of autophagy in limiting inflammaging.
• Summarize the role of apoptosis in eliminating senescent immune cells.
• Examine the phytonutrients with senomorphic/pro-autophagy properties.
• Examine the phytonutrients with senolytic/pro-apoptotic properties.

Hour 4

• Describe the role of vagal nerve activation in regulating the transition to inflammatory resolution.
• Examine the splenic cholinergic anti-inflammatory pathway.
• Outline the mechanisms by which vagal activation increases specialized pro-resolving mediator (SPMs) production from omega-3 fatty acids.
• Summarize the role of transcutaneous vagal nerve stimulation (tVNS) in the inflammatory to pro-resolving transition.
• Contrast the inflammatory suppressing and pro-resolving treatment strategies.

• Explain basic concepts of health
• Identify the health spectrum
• Investigate the various facts associated with aging
• Determine the difference between sickly aging and normal aging
• Investigate the various theories of aging

• This contains all courses with the educational objectives listed from Nutrition 201 to Nutrition 212

• Recognize the most common theory of aging
• Determine the risks associated with being sedentary
• Identify the effect of exercise on the cardiovascular system
• Describe how exercise affects cholesterol and cancer
• Examine the various components of an exercise program

• Identify which exercises are best for health and longevity
• Investigate the relationship between exercise and antioxidants
• Recognize basic concepts of stress
• Explain how stress and other emotions can cause disease and ill health
• Determine the relationship between nutrition and stress

• Differentiate the relationship between various stress reducing techniques
• Identify how social relationships, religion and prayer can affect health and aging
• Investigate the negative and positive factors from consuming alcohol
• Recognize how alcohol affects nutrition
• Identify how smoking affects health

• Identify the relationship between nutrition and smoking
• Investigate the relationship between second hand smoke and nutrition
• Identify various smoking cessation techniques
• Identify the role of antioxidants and free radicals
• Examine the relationship between antioxidants and heart disease

• Determine the relationship between diet, cancer, and the environment
• Identify various antioxidants that can affect cancer
• Describe how caloric restriction affects longevity
• Explore basic concepts of weight control and obesity
• Recognize how obesity affects overall health and promotes disease

• Identify various dietary patterns and habits
• Determine how diet patterns affect health and promote disease
• Explore the typical American diet pattern
• Review the vegetarian diet pattern
• Analyze the Mediterranean diet pattern and its components

• Identify why fruits and vegetables are anti-aging foods
• Determine how fruits and vegetables offer health benefits
• Select what components of fish have positive effects on health
• Investigate how fish affects cardiovascular disease and cancer
• Identify how garlic affects health and inhibits disease

• Demonstrate the role grains have in health and longevity
• Explain the basics of fiber and how it can affect health and disease
• Identify how nuts can positively affect health and decrease disease
• Investigate how legumes and soy can affect heart disease
• Relate how legumes and soy can affect cancer

• Recognize the beneficial components of yogurt
• Identify how yogurt can affect the immune system
• Define what prebiotics are and how they affect health
• Describe how chocolate can promote health and longevity
• Explore how tea can positively affect health and decrease disease risk

• Identify what the beneficial components of wine are
• Determine the how and when of wine consumption
• Explain basic concepts of water and signs of dehydration
• List how water affects disease and promotes health
• Identify who is susceptible to nutrient deficiencies

• Determine the relationship between a daily multiple vitamin and health
• Analyze how growth hormone can promote health and possibly slow aging
• Explain the risk versus benefit of using testosterone and melatonin
• Recognize the role of DHEA and DHEA-S on health and longevity
• Identify the main concepts of an anti-aging strategy

• Discuss the epidemiology and current state of the opioid crisis
• Discuss the use of opioids for pain relief
• Discuss the use of manual therapies for chronic pain management of patients during opioid the crisis
• Outline the evidence for manual therapies for chronic pain
• Discuss the use of lifestyle measures in aiding chronic pain sufferers

• Define addiction, and identify the two main categories of addiction.
• List the main addictions of concern in the current addiction crisis.
• Summarize the neurophysiological and pharmacological dynamics of addiction, and appraise the possible solutions of recovery by using this information and delegating it to various medications and herbs (such as CBD oil).
• Outline some of the solutions indicated for addressing the addiction crisis and critique these treatment plans.
• Assess using herbal medicine (CBD oil) for the treatment of opioid and other addictions.

• Assess the association between opioid use and chiropractic treatment for LBP
• Demonstrate the potential for chiropractic care to reduce the use of prescription opioids in patients with spinal pain
• Summarize two papers exploring the effects of utilization and availability of chiropractic services on opioid usage and medical services
• Evaluate the impact of chiropractic utilization on the use of prescription opioid use in Medicare beneficiaries aged 65 and over with spinal pain
• Describe the comparative risk of treatment escalation in patients with neck pain between recipients of spinal manipulation and nonrecipients of spinal manipulation

• Identify differences between strength and balance training
• Discuss the dynamic aspects of posture
• Learn aspects of Postural control in chronic LBP patients
• Understand relationship of posture and sports injuries
• Review some concepts of posture, mobility and pain in children

• This contains all courses with the educational objectives listed from Ortho 102 through Ortho 117.

• Review normal cervical biomechanics and apply to examination
• Discuss some effects of manipulation on EMG/ROM
• Recognize lumbar movements during mobilization
• Discuss how whiplash invisibility is not evidence of absence of injury
• Understand muscle adaptation through stretching

• Distinguish Chiropractic influences on muscular strength
• Develop the use of hand-held dynamometry in chiropractic practice
• Identify basic strength training principles for chiropractors
• Construct basics of strength training guidelines for all ages

• Review an Introduction to the Clinical Biomechanics of Stability
• Identify causes of select musculoskeletal injuries
• Describe how LBP in golfers alters motor control
• Describe spinal stability changes with posture
• Distinguish how stability improves with resistance training

• Describe neck anticipatory control with pain
• Describe lateralized fatigue with unilateral neck pain
• Assess head and trunk motion during neck manipulation
• Identify neuromuscular dysfunction in neck pain patients
• Outline exercises for the rehabilitation of neck neuromuscular dysfunction

• Discuss the biomechanical, physiological and psychological evidence for the use of back belts
• Identify and describe recent recommendations and findings for the use of back belts.
• Discuss the principle of affordances and how they relate to environmental constraints (such as a back belt) and posture.

• Summarize the affects of low back health status on low back disorder risk
• Discuss the relation between lumbar curvature and LBP risk factors during postural loading
• Assess the relation between asymmetric lifting and spine loading
• Describe the differences in spine kinematics between LBP patients and normal controls
• Analyze the functional deficits that occur following low back disorders

• Summarize recommendations for backpack use
• Appraise recent research on backpacks and human health
• Discuss the effects of backpacks on musculoskeletal and non-musculoskeletal variables
• Describe current studies on backpack use in children: perceptions, load, biomechanics, physiology

• Learn current perspectives on which structures are strongly but variably linked to back pain
• Review the state-of-the art in low back disorders research applied to ergonomics
• Describe workplace design guidelines for asymptomatic and low back pain workers
• Determine the influence of exercise on lumbar spine disorders

• Identify common underlying causes of non-organic pain
• Recognize the eight Waddell signs of non-organic back pain
• Develop a level of knowledge, comprehension, and understanding of the medicolegal system as it relates to Waddell signs
• Encourage development and nurturing of skill sets in utilizing Waddell signs

• Determine the epidemiology of low back pain in children and adolescents
• Assess the risk factors associated with back pain in school children
• Outline the effect of an intervention to improve sitting habits in schoolchildren
• Assess the effects of reading a book or using a computer on neck and upper back muscle activity in children
• Review the diagnostic criteria of tension-type headaches in children

• Describe the basic principles of postural control
• Clinically assess postural control
• Outline a protocol of postural rehabilitation

• Examine the association between chiropractic spinal manipulation for newly diagnosed lumbar disc herniation and/or lumbosacral radiculopathy and the odds of lumbar discectomy over 1-year and 2-year follow-up periods 
• Evaluate the clinical outcomes and MRI changes in a cohort of patients who had surgery compared to conservative treatment for sequestered lumbar disc herniations 
• Summarize existing evidence relating to the reliability of the straight leg raise (SLR) and crossed SLR test in patients with suspected lumbar radicular pain 
• Establish the validity of the extended straight leg raise (ESLR) compared to findings on MRI 
• Recognize the effectiveness of neural mobilization interventions in improving pain, disability, and function in adults with low back and radicular pain

Hour 1

• Describe four purposes for performing orthopedic tests
• Describe three approaches to performing orthopedic tests
• Discuss the clinical importance of pertinent negative findings when performing orthopedic tests
• Discuss the concept of “Evidence Based Medicine”
• Define “Orthopedic Test Item Cluster”
• Describe several metrics used in the validation of orthopedic tests for inclusion in orthopedic test item clusters

 Hour 2

• Describe three Orthopedic Test Item Clusters (OSTs) relevant to the evaluation of the sacroiliac region
• Describe the five procedures included in the Laslett Cluster #2 for the assessment of sacroiliac pain
• Describe the two primary types of Thoracic Outlet Syndrome
• Discuss the clinical utility of the Bakody Test and the Reverse Bakody Test

 Hour 3

• Describe four testing procedures included in Wainner’s Cluster for the assessment of cervical radiculopathy
• Describe Cook’s Cervical Myelopathy Cluster
• Discuss potential problems that may arise in the application of OST clusters
• Discuss ways to minimize inappropriate application of OST clusters

• Outline the nature of and hallmarks of cancer
• Summarize the relationship between physical activity and cancer
• Summarize the relationship between nutrition and cancer
• Summarize the relationship between massage therapy and cancer
• Summarize the relationship between acupuncture and cancer
• Summarize the relationship between manual therapy and cancer

• Summarize the assessment and diagnosis of pain
• List and describe 5 common causes of back pain and how to prevent injury
• Outline the causes of fibromyalgia
• Illustrate the mechanisms of inflammation and pain
• Discuss the pain of peripheral neuropathy

• Evaluate the test-retest, intra- and inter-examiner reliability of the body pain diagram for determining pain distribution and location for musculoskeletal conditions
• Summarize the current state of knowledge on neuropathic pain, with focus on how it differs from nociception
• Review of the current literature regarding the epidemiology, diagnosis and management of Complex Regional Pain Syndrome
• Explore central nervous system neuroplastic adaptations that may contribute to the pathophysiology of chronic conditions
• Differentiate symptoms and signs of central sensitization, peripheral neuropathic pain and nociceptive pain in patients with low back pain (with or without leg pain)

• Gain insight into the different types of pain
• Differentiate different sources of spinal pain
• Summarize the societal and clinical challenges of the pain patient
• Describe the difference between acute and chronic pain
• Provide an initial appreciation of alternative treatment options
• Understand the importance of chiropractic principles with the pain patient

• Evaluate the relationships among thoracic spinal stiffness, pain and muscle activity in healthy subjects and those with chronic thoracic pain
• Summarize updated chronic pain classification updates from the ICD-11
• Compare and contrast the clinical presentation and pathophysiology of Fibromyalgia (FM) and Myofascial Pain Syndrome (MPS)
• Summarize a clinical framework to sub-categorize pain patients based on an individual’s dominant pain etiology 
• Examine the effect of neural tissue management on pain and disability in patients with chronic musculoskeletal pain

• Expand your application of the biopsychosocial model of chronic pain by exploring an enactive approach to pain
• Recognize the clinical complexities involved in identifying malingering in chronic pain patients
• Outline relevant factors pertaining to clinical presentation, pathophysiology and treatment of chronic neuropathic pain
• Investigate the hypoalgesic effect of thoracic spinal manipulation on pain induced by temporal summation
• Explore the potential brain mechanisms involved in pain relief achieved via Transcutaneous Electrical Nerve Stimulation (TENS) application

• Outline a recent clinical guideline on the chiropractic management of chronic musculoskeletal pain 
• Identify a common set of recommendations from high-quality clinical guidelines that can be applied to a wide range of musculoskeletal pain conditions 
• Explore which target concepts are important to patients who improved following a pain science education intervention for persistent pain 
• Investigate whether untrained trait mindfulness is associated with differential responses to pain stimuli and whether these intrinsic differences reflect differential patterns of resting-state functional connectivity in the brain 
• Characterize the pain-based mechanisms of thoracic spinal manipulation and advance the preliminary validation of brain-based models as potential clinical biomarkers of pain

Hour 1

• Define interventional pain management and how it can be applied to help solve acute and chronic pain.
• Outline and critique different pain theories.
• Outline the Biopsychosocial model of chronic pain and explain why this model is the most comprehensive for acute and chronic pain management.
• Summarize how to integrate interventional pain management with conservative care for acute and chronic pain.

Hour 2:

• Describe common interventional pain management procedures and how to integrate them into a comprehensive plan of care.
• List the most utilized injections and when they are considered.
• Identify when a spinal cord stimulator may be considered and how it can aid conservative management.
• Explain the use of endoscopic procedures and when they may be utilized to treat acute and chronic pain.

• Explore chiropractic patients’ perceptions of discomfort, pain, and stiffness to determine if and how they differentiate among the concepts 
• Describe the relationship between the presence of an audible pop during spinal manipulative therapy and pain outcomes
• Evaluate the effect of spinal manipulation on pressure pain thresholds in a real-world clinical setting 
• Assess whether a 10-second one legged stance test can independently predict survival in middle and older aged men and women 
• Illustrate the relationship between physical activity levels and pain

• Relate the different neurophysiologic mechanisms to the development of chronic pain states. 
• Draw the pathways specific to Lamina I versus Lamina V sensory pathways.
• Discuss basic science research that supports the main theories of chronic/central pain syndromes.  
• Apply basic neurorehabilitation techniques to modulate chronic pain circuits.
• Develop treatment plans for chronic pin patients consistent with current pain models.

• This contains all courses with the educational objectives listed from Pain 116 through Pain 121

• Relate the effects of interoceptive dysfunction to the development of chronic pain.
• Draw the pathways specific to Lamina I versus Lamina V sensory pathways.
• Discuss how the interoceptive nervous system may relate to Functional Neurologic Symptom Disorder.
• Apply knowledge of how interoceptive dysfunction may negatively affect higher cortical functions.
• Design and utilize strategies that normalize interoception to improve intractable patient symptoms.

• Relate the effects of cold sensory deficit to chronic central pain states.
• Map the pathways specific to Lamina I versus Lamina V sensory afferents.
• Discuss basic science research that links C-Fiber subpopulations with hyper-excitability of sensory neurons.
• Apply techniques to gate pain processing through the Dorsal Insula/Anterior Cingulate pain switch.
• Utilize relationship between cold pathways and pain pathways to gate chronic pain.

• Identify the relationship between the ANS and chronic pain.
• Explore the cause of sympathetic maintained pain.
• Discuss the emerging role of the brain and spinal cord in CRPS.
• Apply non-invasive neuromodulation techniques for pain control.
• Formulate an effective treatment plan based on current knowledge.

• Relate the effects of failure within the DNIC to the development of chronic pain.
• Draw the pathways specific to ascending sensory and descending pain modulatory circuits.
• Apply knowledge of the DNIC, as it relates to chronic lower back pain.
• Discuss basic science research that links the PAG with the phenomena of offset analgesia and conditioned pain modulation.
• Formulate and apply treatment plans based on stimulation of the DNIC utilizing spinal cord stimulation, motor cortex activation and heterotopic noxious conditioning stimulation.

• Relate the effects of cingulate cortex activation on chronic pain suppression.
• Draw and identify regions of the cingulate cortex pertinent to pain and suppression.
• Discuss basic science research that links area’s 32, 24 and 25 with pain and its relief.
• Apply specific techniques to modulate cortical areas 32, 24, and 25 for pain suppression.
• Formulate and implement a treatment plan based on the M1-ACC pain model.

• Explain the complex multidimensional and individual specific nature of pain
• Present the theories and science for understanding pain
• Define the terminology for describing pain and associated conditions
• Describe the impact of pain on society
• Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain  
• Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess outcomes as appropriate for the clinical context and population.
• Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management
• Assess patient preferences and values to determine pain-related goals and priorities
• Demonstrate empathetic and compassionate communication during pain assessment

• Explain the complex multidimensional and individual specific nature of pain
• Present the theories and science for understanding pain
• Define the terminology for describing pain and associated conditions
• Describe the impact of pain on society
• Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain  
• Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess outcomes as appropriate for the clinical context and population.
• Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management
• Assess patient preferences and values to determine pain-related goals and priorities
• Demonstrate empathetic and compassionate communication during pain assessment
• Demonstrate the inclusion of patient and others, in the education and shared decision-making process for pain care
• Identify treatment options that can be assessed in a comprehensive pain management plan
• Explain how health promotion and self-management strategies are important to the management of pain
• Develop a pain treatment plan based on benefits and risks of available treatments
• Monitor the effects of pain management approaches to adjust the plan of care as needed
• Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence
• Develop a treatment plan that accounts for the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at end of life
• Describe the unique pain assessment and management needs of special populations
• Explain how to assess and manage pain across settings and transitions of care
• Describe the role, scope of practice, and contribution of the different professions within a pain management care team
• Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources
• Describe the role of the clinician as an advocate in assisting patients to meet treatment goals

• Demonstrate the inclusion of patient and others, in the education and shared decision-making process for pain care
• Identify treatment options that can be assessed in a comprehensive pain management plan
• Explain how health promotion and self-management strategies are important to the management of pain
• Develop a pain treatment plan based on benefits and risks of available treatments
• Monitor the effects of pain management approaches to adjust the plan of care as needed
• Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence
• Develop a treatment plan that accounts for the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at end of life
• Describe the unique pain assessment and management needs of special populations
• Explain how to assess and manage pain across settings and transitions of care
• Describe the role, scope of practice, and contribution of the different professions within a pain management care team
• Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources
• Describe the role of the clinician as an advocate in assisting patients to meet treatment goals

• Determine why communication is imperative in clinical encounters
• Classify rights and responsibilities of the patient -provider partnership
• Recognize barriers and benefits regarding improved communication
• Apply numerous strategies to improve and solidify patient interactions
• Summarize how to fix the system so providers will provide better quality visits

• Identify the ways your conscious or unconscious bias toward patient characteristics may enter the clinical relationship
• Outline ways to improve your clinical communication with patients who are elderly, poor or ethnic minorities.
• Distinguish male and female patient communication styles and plan what to do when your patient wants a different gender provider
• Compare the way Jewish, Irish, Italian, and other cultures present differently as patients and prepare your communication style appropriately
• Internalize the seven ideal interpersonal traits patients want in their health care providers

• Recognize deceptive behaviors from other people and integrate these skills
• Use tips garnered from former CIA officers to separate truth from lies
• Determine motivations for patients to lie to health care providers
• Strategize ways to avoid being lied to by your patients and staff
• Assess the consequences of lying and how it compromises clinical relationships

• Explain the Four Habits of Highly Effective Clinicians
• Show the payoffs for each of the habits and provide examples
• Demonstrate how to avoid “Door Knob Concerns” and uncover hidden problems
• Specify barriers to patient communication and how to overcome them
• Describe action steps to incorporate better communication habits into practice immediately

• Modify explanations about risks, harms and benefits to avoid miscommunication to patients
• Apply research concepts such as sensitivity and specificity to outcomes communications
• Identify weak spots in clinical trials with regard to benefits and harms
• Implement the best practitioner action to build trust in patients
• Discover strategies for better communicating with low functional health literacy patients

• Describe and utilize an effective but non-invasive treatment for warts
• Understand the risk versus benefit of diagnostic imaging radiation in children
• Recognize patterns of pain in children that might actually indicate malignancies
• Develop an understanding of pediatric atlantooccipital dislocation
• Be able to perform 5 minute infant physical examination to detect congenital anomalies of the musculoskeletal system

• Determine the epidemiology of low back pain in children and adolescents
• Assess the risk factors associated with back pain in school children
• Outline the effect of an intervention to improve sitting habits in schoolchildren
• Assess the effects of reading a book or using a computer on neck and upper back muscle activity in children

Hour 1

• Discover what primitive reflexes are and why we have them
• Understand the various possible causes of retained primitive reflexes in a child
• Outline common questions that would suggest retention of primitive reflexes
• Identify and assess eight primitive reflexes that can be easily evaluated by a doctor of chiropractic, specifically the Moro, Grasp, Spinal Galant, Rooting, Asymmetrical Tonic Neck, Symmetrical Tonic Neck, Tonic Labyrinthine, and the Landau reflexes.

Hour 2

• Further identify and assess the remaining of the eight primitive reflexes not covered in the first hour
• Detect the presence or absence of specific primitive reflexes
• Recognize the need for intervention when a retained primitive reflex is demonstrated by a patient
• Prescribe a specific course of treatment for each of the eight primitive reflexes if they are determined to be retained

• This contains all courses with the educational objectives listed from Pediatrics 116 through Pediatrics 119

Hour 1:

• Learn age-appropriate general health screening and health education for babies.
• Analyze through evidence the use of chiropractic manipulation for pregnant women.
• Identify normal growth, development and behavior and their assessment, as well as approaches to abnormalities for neonatals.
• Describe a typical pediatric examination on a neonatal.

Hour 2:

• Learn age-appropriate general health screening and health education for toddlers.
• Analyze through evidence the use of chiropractic manipulation for toddlers through young children.
• Identify normal growth, development and behavior and their assessment, as well as approaches to abnormalities from infancy through toddlers.
• Describe a typical pediatric examination on an infant 1-5 years old.

Hour 3:

• Learn age-appropriate general health screening and health education for adolescents.
• Identify the signs and symptoms of mild traumatic brain injury (through accident and sport) in children.
• Discuss and describe typical examination forms and outcome assessment tools used for the pediatric population.
• Evaluate through clinical cases and it’s management.

Hour 1

• Explain the necessity of evidence for infant healthcare
• Describe what mothers want from healthcare for their newborn?
• Outline the need for and development of the United Kingdom Infant Questionnaire
• Cite the outcomes of infant care in chiropractic practice and the adaptability of a parent-reported outcome measure to the infant population