Orthopedics
5/7/99

Clinical Indication
•	Triage—if a person has experienced a trauma where they are still in danger
•	In an emergent situation you may go directly to x-ray or referral depending upon the situation

Jendrassik maneuver—interlock the fingers and pull out—distraction while doing the lower extremity DTR
Re-enforcement—grit the teeth, scrunch the forehead for the upper extremity 

VBI—vertebral basilar injury
•	P19 of book
•	Major signs and symptoms
1.	Dizziness/vertigo/giddiness/light headedness
2.	Drop attacks/loss of consciousness
3.	Diplopia (or other visual problems/amaurosis fugax (partial blindness) (double vision)
4.	Dysarthria (speech diffculites)
5.	Dysphagia
6.	Ataxia of gait (walking difficulties/incoordination of the extremities, ataxia/falling to one side)
7.	Nausea (w/possible vomiting)
8.	Numbness on one side of the face and/or body
9.	Nystagmus--rapid lateral twitch of the eye

•	Extremely rare event w/cervical adjusting
•	1/10million manipulations
•	100/100million adjustments
•	proximate cause--