NBCE Part II key terms

The process of listing and comparing possible conditions that could explain a patient's symptoms, then using history, examination, and testing to rule in or rule out each one.

A structured set of questions that screens each body system for symptoms the patient may not have mentioned, helping reveal conditions outside the chief complaint.

Listening with a stethoscope to sounds made by the heart, lungs, and blood vessels to detect murmurs, wheezes, crackles, or abnormal flow.

A drop in blood pressure on standing, commonly defined as at least 20 mmHg systolic or 10 mmHg diastolic within three minutes, causing dizziness or falls.

Enlargement or abnormal texture of lymph nodes, which may reflect infection, inflammation, or malignancy and warrants evaluation of size, tenderness, and consistency.

Swelling in which finger pressure leaves a temporary indentation, graded by depth and duration, often reflecting fluid overload, venous insufficiency, or local inflammation.

The band of skin supplied by sensory fibers from a single spinal nerve root, used to map numbness or pain to a specific level.

The group of muscles innervated by motor fibers from a single spinal nerve root, tested by resisted contraction to localize a nerve-root lesion.

A rapid muscle contraction elicited by tapping a tendon with a reflex hammer; graded 0 to 4+ and used to assess the integrity of a specific nerve root and its reflex arc.

A test in which the supine patient's straightened leg is raised; reproduction of leg pain below about 60 degrees suggests nerve-root irritation, often from a disc herniation.

A cervical compression test in which the head is extended and rotated toward the symptomatic side while axial pressure is applied; it reproduces arm pain in cervical radiculopathy.

Nerve-root dysfunction producing pain, numbness, tingling, or weakness in a dermatomal or myotomal pattern, typically from disc herniation or foraminal narrowing.

Damage to the spinal cord itself, causing upper motor neuron signs such as hyperreflexia, spasticity, and clumsiness, often with bowel or bladder changes; it is a serious finding requiring prompt referral.

A 0-to-5 scale describing a muscle's strength, from no visible contraction (0) to normal strength against full resistance (5), used to document weakness.

Describing a material or tissue that lets x-rays pass through easily, appearing dark on a radiograph; air and fat are examples.

Describing a material or tissue that blocks x-rays, appearing white or light gray on a radiograph; bone and metal are examples.

Paired lateral x-rays taken while the patient bends forward and backward, used to assess segmental motion or instability by comparing alignment between views.

An imaging method using a strong magnetic field and radio waves to show soft tissues such as discs, nerves, and ligaments; T1 and T2 sequences highlight different tissues.

A four-grade system (I-IV) describing the degree of forward slippage of one vertebra over the one below in spondylolisthesis, based on the percentage of slip.

An acronym for 'as low as reasonably achievable,' the principle that radiation exposure should be minimized while still obtaining the diagnostic information needed.

A specific, controlled thrust applied to a vertebral segment to restore motion and alignment; it is the defining manual procedure of chiropractic practice.

A slower, gentler manual technique that moves a joint through its available range without a high-velocity thrust, often used when a patient cannot tolerate manipulation.

A widely used chiropractic method that combines a specific contact, a controlled high-velocity low-amplitude thrust, and a table that assists positioning.

A technique performed on a table that slowly flexes and distracts the lumbar spine while the doctor applies manual contact, often used for disc-related low back and leg pain.

The direction of force applied through a contact during an adjustment, chosen to move the segment in the plane of its restriction.

The audible pop or click heard during a joint manipulation, caused by a rapid change in pressure within the joint capsule; it does not by itself prove that the adjustment was correct.

A chiropractic model describing a spinal joint that is misaligned or restricted in motion, with associated nerve, muscle, and soft-tissue changes affecting function.

The process of explaining a proposed procedure's purpose, benefits, risks, and alternatives so the patient can make a voluntary decision to accept or decline it.

A symptom or history finding that suggests serious underlying disease, such as cancer, infection, or fracture, and calls for prompt further evaluation or referral rather than routine care.

Periodic supportive treatment given after a patient's symptoms have resolved, aimed at preserving function and preventing relapse, and usually reviewed on a scheduled basis.

Sensitivity is the proportion of people with a condition who test positive; specificity is the proportion without it who test negative. Both describe how well a test classifies patients.

A disease of reduced bone mass and weakened bone architecture that raises fracture risk, often silent until a fragility fracture occurs; DXA is used to measure bone density.

A chronic autoimmune disease that inflames the synovium of joints, typically affecting small joints symmetrically and causing morning stiffness, swelling, and eventual joint damage.

The study of what the body does to a drug over time, including absorption, distribution, metabolism, and elimination, which determine dosing intervals and duration of effect.

The spread of cancer cells from a primary tumor to distant organs through blood, lymph, or direct extension, producing secondary tumors and often changing prognosis and treatment.