P-DTR Advanced Series Curriculum

MODULE 1

TONGUE

• Tongue anatomy o Osteofibrous internal skeleton o Tongue muscles ▪ Extrinsic muscles ▪ Intrinsic muscles o Superficial mucous membrane • Tongue afferent innervation • Papillae and taste buds o Papillae ▪ Filiform ▪ Fungiform ▪ Vallate ▪ Foliate o Taste buds ▪ Physiology of taste • Tongue organs map • Tongue long kinematic chains • Hyoid o Rules of the hyoid o Muscles ▪ Superior ▪ Inferior • Treatment o Common pairs

ORGANS

• Organ physiology • Muscle-organ association • Organ receptors o Mechanoreceptors o Chemoreceptors o Nocioceptors • Visceral referred pain • Visceral parietal pain • Organ o Viscerovisceral reflexes o Viscerosomatic reflexes o Somatovisceral reflexes o Somatosomatic reflexes • Autonomic nervous system o Sympathetic functions o Parasympathetic functions • carrying parasympathetic information • Rules of the viscera • Differentiating organ vs. supraspinous ligament dysfunctions • Peritoneal fascia • Treatment o Common pairs • Digestive sequence dysfunctions

ILIOCECAL VALVE

• Location • Function • Anatomy • Mechanics of control over ICV • Symptoms of dysfunction • Common causes of dysfunction • Open ICV o Organ dysfunction o o Nutrition o Related muscles o Cranial fault o Spinal level o Meridian points and Chapman points • Closed ICV o Organ dysfunction o Emotions o Nutrition o Related muscles o Cranial fault o Spinal level o Meridian points and Chapman points • Treatment

ENTEROGASTRIC

• Common disorders caused by stomach dysfunction • Classical causes of underworking stomach • Factors monitored by enterogastric reflex o Physical o Chemical • Enterogastric nervous reflexes o Mediating factors • Overactive enterogastric reflex o Presentation o Treatment • Underactive enterogastric reflex o Presentation o Treatment

NEUROLOGICAL TOOTH

• Anatomy of the tooth o Crown o Root • Teeth numbers • Muscle-teeth relationships • Challenge and manipulation of teeth • Teeth VRP’s • Treatment • Nutrition

SPONDYLOGENIC REFLEXES

• Background • Use of therapy localization • Testing • Referred pain patterns o Anterior trunk referred pain o Posterior trunk referred pain o Pelvic referred pain o Scapula referred pain o Pelvic ligament referred pain • Treatment

BARORECEPTORS

• Control mechanisms of cardiac activity o Intrinsic o Extrinsic • Autonomic innervation of the heart o Sympathetic o Parasympathetic • Mechanisms of control of blood pressure o Local mechanisms o Neural mechanisms o Humoral mechanisms • Autoregulation mechanisms o Myogenic mechanism o Tissue pressure o Release of metabolites and local temperature • Metabolic mediators o Vasoconstrictors o Vasodilators • Relationship between blood pressure and baroreceptors o Baroreceptor reflex • Baroreceptor response ranges o Carotid baroreceptors o Aortic baroreceptors • Central Ischemic Response • Effect of temperature on blood pressure • Effect of emotional stress or pain on blood pressure • Renin-Angiotensin system o Physiological mechanisms o Changes in peripheral resistance o Changes in cardiac structure • Blood pressure ranges o Hypotension ▪ Adrenal function o Hypertension ▪ Nocioception ▪ Major organs • Blood pressure nutrition • Treatment

ALKALOSIS

• Background • Role of and absorption of calcium in the body • Common causes • Symptoms of dysfunction • Nutrition

LYMPHATIC SYSTEM

• Functions o Immune system o Fat transport o Fluid balance • Lymphatic ducts • Components of lymphatic system • T cells and B cells • Lymphatic organs o Lymph nodes o Spleen o Thymus gland • Lymphatic nodules o MALT o Tonsils o Peyer’s patches • Lymphatic circulation • Lymphatic drainage • Elephantitis/lymphedema • Lacteals • Symptoms of lymphatic dysfunction • Common causes of dysfunction • Testing • Nutrition

KREBS CYCLE

• ATP production o Krebs cycle o Citric acid cycle o Tricarboxylic acid cycle • Electron transport chain • Citric acid cycle factors o Main factors o Lesser factors • Common sources of CAC and ETC dysfunction • Lipoic acid o Mercury toxicity • CO2 • Treatment • CAC and cranial faults • Urea cycle • GABA • Nutrition o Coenzyme Q10

METABOLISM OF FATTY ACIDS

• Three families of natural fats and associated prostaglandins o Fats 1-PG 1 o Fats 2-PG 2 o Fats 3-PG 3 • Dietary sources of three families of fats • Steps in PG production from fat in diet • Aspirin and other NSAIDs o Physiologic effects o Testing • Leukotrines and thromboxanes • Symptoms of EFA metabolism dysfunction • Treatment

MODULE 2

NEUROANATOMY

• Major regions of the brain o Prosencephalon ▪ Telencephalon ▪ Diencephalon o Mesencephalon o Rhombencephalon ▪ Metencephalon ▪ Myelencephalon • Organization of brain tissue o Gray matter vs. white matter • Cranial meninges o Dura mater o Arachnoid mater o Pia mater • Cranial dural septa • Brain ventricles • Cerebrospinal fluid • Blood-brain barrier • Cerebral cortex o Motor areas o Sensory areas o Association areas • Basal nuclei • Diencephalon o Thalamus o Hypothalamus o Epithalamus • Brain stem o Midbrain o Pons o Medulla oblongata • Cerebellum o Cerebellar peduncles • Functional brain systems o Limbic system o Reticular formation

CRANIAL NERVES

• Rules of brain nuclei • Abnormal breathing patterns o Cheyne-Stokes o Central neurogenic hyperventilation/Kussmaul’s hyperventilation o Apneusis o Cluster breathing o Ataxic breathing • Cranial nerves o Olfactory nerve o Optic nerve ▪ o Occulomotor nerve ▪ Five systems of eye movement • Gaze shifting o Saccades o Vergence o Smooth pursuit • Gaze holding o Vestibular ocular reflex o Optokinetic reflex o Trochlear nerve ▪ Bielschowsky’s head tilt test o Trigeminal nerve ▪ Opthalmic division ▪ Maxillary division ▪ Mandibular division o Abducens nerve o Facial nerve ▪ Differentiating UMN vs. LMN lesions o Vestibulocochlear nerve ▪ Vestibular nerve • Semicircular canals ▪ Cochlear nerve o Glossopharyngeal nerve o Vagus nerve o Accessory nerve o Hypoglossal nerve • Stimulation of cranial nerves • Treatment

BASAL GANGLIA

• Classification o Structures • Neurotransmitters • Function • Pathways o Direct pathway o Indirect pathway o Hyperdirect pathway • Dopaminergenic and cholinergic modulation • Basal ganglia disorders o Hypokinetic disorders ▪ Parkinson’s disease o Hyperkinetic disorders ▪ Huntington’s disease • Basal ganglia connections throughout the brain • Limbic system o Structures • Testing • Treatment • Receptor pools o Testing o Treatment

PRIMITIVE REFLEXES

• Developmental background • Integration of • Primitive vs. lifespan reflexes • Role of reflexes in survival and developing future movement • Reflexes as diagnostic tools • Signs of neuro-developmental delay • Primitive reflexes o ▪ ▪ Inhibition pattern o ▪ Stimulus ▪ Inhibition pattern o Startle reflex ▪ Stimulus ▪ Inhibition pattern o Palmar mandibular/Babkin reflex ▪ Stimulus ▪ Inhibition pattern o Palmar mental ▪ Stimulus ▪ Inhibition pattern o Palmar grasp ▪ Stimulus ▪ Inhibition pattern o Plantar grasp ▪ Stimulus ▪ Inhibition pattern o Symmetrical tonic neck reflex ▪ Stimulus ▪ Inhibition pattern o Asymmetrical tonic neck reflex ▪ Stimulus ▪ Inhibition pattern o Sucking ▪ Stimulus ▪ Inhibition pattern o Rooting/Search ▪ Stimulus ▪ Inhibition pattern o Babinski ▪ Stimulus ▪ Inhibition pattern • Postural reflexes o Crawling ▪ Stimulus ▪ Inhibition pattern o Swimming ▪ Stimulus ▪ Inhibition pattern o Head and body righting ▪ Stimulus ▪ Inhibition pattern o Parachuting ▪ Stimulus ▪ Inhibition pattern o Tonic labrynthine ▪ Stimulus ▪ Inhibition pattern o Pull up ▪ Stimulus ▪ Inhibition pattern o Landau ▪ Stimulus ▪ Inhibition pattern o Spinal galant ▪ Stimulus ▪ Inhibition pattern

PERIPHERAL NERVES

• Embryonologic development • Anatomy of nerves o Structures o Blood supply to nerves • Effect of endoneurial ischemia • Classification of nerve injuries o Physiologic conduction nerve block o Neurapraxia o Axonotmesis o Neurotmesis • Wallerian degeneration • Localization of lesion in PNS o Radiculopathy o Plexopathy o Mononeuropathy o Polyneuropathy

*Spinal level, innervation, and clinical significance of each of the peripheral nerves below

• Upper extremities o Cervical plexus ▪ Motor nerves • Ansa cervicalis • Phrenic n. ▪ Cutaneous nerves • Lesser occipital n. • Greater auricular n. • Transverse cervical n. • Supraclavicular n. o Brachial plexus ▪ Branches from roots • Dorsal scapular n. • Long thoracic n. ▪ Branches from trunks • Suprascapular n. • Subclavian n. ▪ Branches from cords • Lateral cord o Lateral pectoral n. • Posterior cord o Upper subscapular n. o Thoracodorsal n. o Lower subscapular n. • Medial cord o Medial pectoral n. o Medial cutaneous n. of arm o Medial cutaneous n. of forearm ▪ Terminal branches • Ulnar n. • Radial n. • Musculocutaneous n. • Axillary n. • Median n. • Lower extremities o Lumbar plexus ▪ Iliohypogastric n. ▪ Ilioinguinal n. ▪ Genitofemoral n. ▪ Lateral femoral cutaneous n. ▪ Femoral n. • Saphenous n. ▪ Obturator n. o Sacral and coccygeal plexuses ▪ Superior gluteal n. ▪ Inferior gluteal n. ▪ Sciatic n. • Tibial n. • Common peroneal n. ▪ Posterior femoral cutaneous n. ▪ Pudendal n. • Other nerves o Intercostal n. o Superior cluneal n.