Cayman Islands Chiropractic Continuing Education

• Understand the differences and similarities between TENs, low voltage and high voltage galvanic and be able to use this knowledge to select the most appropriate type to stimulation for use in ts-DC applications
• Apply precautions, other safety considerations and informed consent when administering high voltage galvanic stimulation for non-invasive spinal cord stimulation.
• Craft evidence-based treatment strategies using ts-DC stimulation for pain control and modulation of both ascending sensory and descending motor pathways based on recently published literature on central nervous systems effects of direct current stimulation.
• Be able to select optimal electrode placement for ts-DC based on clinical presentation of the patient
• Understand the basic technique for non-invasive Stellate Ganglion transcutaneous stimulation and its possible application for sympathetic maintained pain.

• Discuss the history of GVS and the historic use of GVS as diagnostic procedure.
• Identify the effects of GVS on the nervous system and use this information to construct an effective clinical protocol for his/her patient
• Apply GVS as an adjunct procedure to assist in balance rehabilitation.
• Understand and apply GVS as part of a comprehensive strategy for the treatment of neuropathic pain syndromes.
• Create a treatment protocol in terms of electrode placement, intensity, duration and precautions for the use of GVS in clinical practice.

• Communicate the risks, potential benefits and the investigational nature of tDC with a potential patient for the purpose of securing a written informed consent prior to treatment
• Understand the similarities and differences between low voltage direct current and high voltage pulsed galvanic and how to apply knowledge of their polarity specific effects in clinical neuromodulation
• Identify brain targets for neuromodulation and construct a therapeutic electrode montage, treatment protocol in terms of intensity, duration, frequency and dose of tDC 
• Explain the theory of tDC as it relates to pain modulation based on contemporaneous scientific literature
• Apply tDC  as an adjunct procedure to assist in intractable pain relief

• Compared and contrast galvanic vestibular stimulation and Tone Burst Vestibular Stimulation in the treatment of the balance impaired patient.
• Apply the polarity specific effects of the anode and cathode on the vestibular system for amelioration of common balance impairments.
• Identify the anatomical location of electrode placement for Galvanic Vestibular Stimulation.
• Create a treatment strategy using Tone Bursts based on physiological pairing of semicircular canals.
• Apply Specific Tone Protocols based on Saccule versus Utricle dysfunction in balance impaired patients.

• Recognize Traumatic Brain Injury (TBI) in your chiropractic patients
• Summarize the prevalence in your patient population
• Identify the type of patient that presents with TBI
• Explain why a chiropractor needs to differential diagnose TBI patients
• Compile correlations of TBI inciting factors with your patient presentations
• Demonstrate the pathology that occurs with TBI
• Classify the grades of TBI and discriminate what can be treated conservatively
• Identify the incidence of injuries that commonly cause TBI
• Evaluate the probability of TBI in your patient
• Describe the many different types of evaluations, in the field, in the office and upon referral
• Implement in-office Screening Tools and apply diagnostic criteria
• Identify the risk of post-concussive syndrome
• Detect patients with “Brain Cognitive Reserve”
• Identify Second Impact Syndrome
• Assess the value of MRI
• Identify Chronic Traumatic Encephalopathy
• Integrate the current concepts of conservative treatment
• Design Cognitive Rehab
• Provide appropriate patient advice, treatment or referral options

Hour 1 - 5

• Recognize Traumatic Brain Injury (TBI) in your chiropractic patients
• Summarize the prevalence in your patient population
• Identify the type of patient that presents with TBI
• Explain why a chiropractor needs to differential diagnose TBI patients
• Compile correlations of TBI inciting factors with your patient presentations
• Demonstrate the pathology that occurs with TBI
• Classify the grades of TBI and discriminate what can be treated conservatively
• Identify the incidence of injuries that commonly cause TBI
• Evaluate the probability of TBI in your patient
• Describe the many different types of evaluations, in the field, in the office and upon referral
• Implement in-office Screening Tools and apply diagnostic criteria
• Identify the risk of post-concussive syndrome
• Detect patients with “Brain Cognitive Reserve”
• Identify Second Impact Syndrome
• Assess the value of MRI
• Identify Chronic Traumatic Encephalopathy
• Integrate the current concepts of conservative treatment
• Design Cognitive Rehab
• Provide appropriate patient advice, treatment or referral options

Hour 6

• Define the trophic model
• Describe the pathology of trophic model to your patients
• Apply the trophic model of subluxation into clinical practice
• Detect signs & symptoms that correlate with the trophic model
• Extrapolate the model to patient care, especially maintenance manipulative therapy.

• Define the trophic model
• Describe the pathology of trophic model to your patients
• Apply the trophic model of subluxation into clinical practice
• Detect signs & symptoms that correlate with the trophic model
• Extrapolate the model to patient care, especially maintenance manipulative therapy.

Hour 1

• Identify and recite all components of the neurological examination 
• Outline basic peripheral and central nervous system pathways that are clinically relevant to the bedside (ambulatory) neurological examination.
• Perform an examination of the cranial nerve and somatic motor system, including aspects of strength, tone and volume.

Hour 2

• Perform an examination of the cranial nerve and somatic sensory system, including sensory testing of deep and superficial CNS pathways.
• Perform an examination of the reflex system, including testing of deep, superficial, visceral and pathological reflexes.

Hour 3

• Perform an examination of the movement, balance and coordination systems, including tests of cerebellar function.
• Demonstrate an examination flow and performing tests taking the patient from sitting to standing, to the supine and prone positions.
• 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.

• Identify the domains of and concepts within motor control
• Outline some research on chiropractic's influence on motor control
• Discuss principles of motor control and rehabilitation applied to practice

• Discuss briefly the relevant brain anatomy and functional neurology with focus on the frontal lobe and motor cortex.
• Describe the anatomy and physiology of the human brain cortex as it relates to the basic tenants of chiropractic and to spinal subluxation.
• Identify key anatomical components of the frontal lobe and motor cortex.
• Discuss some of the pioneers in neuroscience underscoring their individual contributions.
• Draw basic neurological pathways associated with the frontal lobe and motor cortex.
• Relate function of the frontal lobe and motor cortex to various associated disease conditions.

• This allows you to purchase all 12 hours of 201 level courses. Please see the educational objectives listed for each individual 201 module

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss briefly the relevant neurological anatomy and functional neurology
• Describe in detail the anatomy and function of the components of the human skull with attention to aspects which may be important to the chiropractic physician
• Explore the current role of clinical neurology for the practicing chiropractor
• Describe in detail the anatomy and function of the components of the human spine with attention to aspects which may be important to the chiropractic physician

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss relevant neurological anatomy of the central nervous system, exclusive of the cortex
• Summarize relevant functional neurology of the central nervous system exclusive of the cortex
• Illustrate the clinical presentation resulting from disease of the various brain and cord areas
• Outline various categories for spinal cord lesions
• Organize findings of central nervous system disease by anatomical location and clinical presentation

• Observe a doctor patient encounter where the patient is a paraplegic
• Explore the relevant issues and action protocols involved in acute spinal cord disease
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Summarize relevant functional neurology of the spinal cord

• Explore current role of the art and science of clinical neurology for the chiropractor
• Discuss relevant neurological anatomy of the spinal cord
• Summarize relevant functional neurology of the spinal cord
• Illustrate the clinical presentation resulting from disease of the various cord areas
• Outline various categories for spinal cord lesions
• Organize findings of spinal cord disease by anatomical location and clinical presentation

• Discuss relevant neurological anatomy and function of the meninges
• Discuss relevant neurological anatomy and function of the arterial and venous CNS circulation
• Discuss relevant neurological anatomy and function of the cerebrospinal fluid (CSF) circulation
• Illustrate the clinical presentation resulting from disease of the various areas
• Outline various categories for vascular CNS lesions
• Utilize a Grand Rounds type case presentation

• Properly record a chief complaint
• Demonstrate skills to properly perform a patient interview
• Perform a neurological examination of the head and neck
• Perform a mental status examination
• Cite anatomy and function of the cranial nerves
• Examine the twelve cranial nerves during a clinical examination
• Discuss disorders of cranial nerves
• Discuss, in detail, aspects of neural ischemia and Cervical Spinal Manipulation
• Overview cerebrovascular anatomy and hemodynamics
• Describe pathophyiological mechanisms in vascular injuries
• Clinically test a patient to evaluate predisposition
• Recognize postadjustment vertebrobasilar insufficiency and review case studies

• This allows you to purchase all 26 hours of 202 level courses. Please see the educational objectives listed for each individual 202 module

• Observe a doctor patient encounter where the patient is a young female with a primary complaint of a balance problem
• Improve the history taking process in an actual clinical setting
• Develop improved patient examination techniques
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Observe a doctor patient encounter where the patient is a middle aged female with a primary complaint of upper extremity paralysis.
• Improve the history taking process in an actual clinical setting
• Develop improved patient examination techniques
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint.

• Observe a doctor patient encounter where the patient is a young female with a generalized headache without any specific area of pain
• Improve the history taking process in an actual clinical setting
• Develop improved patient examination techniques
• Evaluate relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Observe a doctor patient encounter where the patient is a young female with a primary complaint of tremor
• Explore the history taking process in an actual clinical setting
• Observe patient examination techniques
• Summarize relevant clinical findings
• Illustrate the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Observe a doctor sort through a difficult history in a patient encounter where the patient is a female with multiple and unusual complaints
• Explore the history taking process in an actual clinical setting
• Observe patient examination techniques
• Summarize relevant clinical findings
• Illustrate the clinical presentations of various complaints and the approach to diagnosis
• Organize findings during the examination and explore for relevancy as applied to diagnosis of the presenting complaint

• Explore basic principles of the patient interview
• Discuss briefly the relevance of maintaining good history taking procedures
• Describe in detail the benefits of history questionnaires
• Explore different types of patient historians and as strategy for dealing with each type
• Describe specific area constituting a complete patient interview

• Explore basic principles of the mental status examination
• Discuss briefly the relevance of maintaining good history taking procedures
• Describe in detail the need for a mental status assessment
• Explore different techniques and a strategy for dealing with mental status problems
• Demonstrate specific methods of implementing the Mini-Mental State Examination.

• Explore basic principles of the physical examination of the face, head and neck
• Discuss briefly the relevance the physical examination prior to the neurologic examination
• Describe in detail rational and procedure for observation, auscultation, palpation and percussion
• Visualize patient problems and deformities that might go un-noticed by a casual observer
• Demonstrate specific methods of implementing a brief orthopedic examination of the cervical spine.

• Define specific terminology including organic disease, non-organic disease, functional disease, somatoform disease, malingering and others
• Discuss the distinction between somatoform disorders (hysteria) and malingering
• Describe patient presentations and examination techniques which are useful in somatoform disorders of the special senses
• Elaborate on the somatic manifestations of somatoform disease in motor and sensory presentations
• Explore caveats of diagnosing somatoform disorders
• Discuss completely the performance and usefulness of in office "credibility" tests used to unveil non-organic disorders
• Define and describe aspects of the malingering patient

• Describe the reasons for using an ophthalmoscope in the clinical bedside examination
• Define and contrast the Pan-Optic ophthalmoscope from the common ophthalmoscopes
• Discuss common settings and features of the ophthalmoscope
• Define methods of describing findings in the fundus of the eye\
• Identify and define common systemic and local pathologic processes that may be encountered in the course of the ophthalmoscopic examination.

• Outline methods used and estimations as to the incidence of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia
• Review and describe cerebrovascular anatomy and hemodynamics
• Discuss proposed patho-physiological mechanisms believed responsible for subsequent vertebrobasilar ischemia
• Review and discuss past and present scientific literature to explore the evolution of what we think we know about the process of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia
• Explore issues and examination procedures related to patient assessment as well as vertebrobasilar ischemia recognition and proper diagnosis
• Define and contrast currently suggested procedures  and develop a vertebrobasilar ischemia plan of action
• Explore various perspectives and reveal bias in both public media and biomedical journals
• Identify and define new theoretical concepts and prophylactic therapies

• Perform and chart a neurological examination of the voluntary motor system and the somatic sensory system
• Apply results of the examination findings in the differential diagnosis of patients
• Describe the three neuron pathway involved with sensorineural innervation
• Discuss multimodal sensations
• Perform an appropriate examination of the reflexes, including deep tendon, superficial, visceral and pathological reflexes
• Describe the anatomy associated with reflexes
• Properly grade and record reflexes
• Interpret the Results of Reflex Testing