NBCE SPEC flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Dermatome C6

Sensation over the thumb and lateral forearm; associated with biceps reflex and wrist extension strength testing.

Straight leg raise

Passive hip flexion with knee extended; pain between 30 and 70 degrees suggests L4-S1 nerve root irritation or disc herniation.

Babinski sign

Dorsiflexion of the great toe with fanning of other toes after plantar stimulation; indicates upper motor neuron pathology in adults.

Cauda equina syndrome

Saddle anesthesia, urinary retention, and bilateral leg weakness from compression of the lumbosacral nerve roots; a surgical emergency requiring immediate referral.

TART findings

Tissue texture change, Asymmetry, Restriction of motion, and Tenderness; the four criteria used to identify somatic dysfunction.

Fryette's Law I

In a neutral spine, sidebending and rotation occur to opposite sides; describes coupled motion in neutral posture.

Nucleus pulposus migration

With spinal flexion, the nucleus pulposus migrates posteriorly; with extension, it migrates anteriorly, influencing disc herniation risk.

Corticospinal decussation

The corticospinal tract crosses at the medullary pyramids; lesions above produce contralateral weakness, below produce ipsilateral findings.

Informed consent elements

Diagnosis, proposed treatment, material risks and benefits, alternatives, and the patient's right to refuse care.

HIPAA treatment exception

Disclosure of protected health information for treatment, payment, and operations does not require written patient authorization.

Patient abandonment

Terminating care without notice, without providing records, or without reasonable opportunity to arrange alternate care.

Spurling's test

Cervical extension, sidebending, and axial compression reproducing arm pain; suggests cervical nerve root compression.

FABER test

Flexion, abduction, external rotation of the hip; groin pain suggests hip pathology, posterior pain suggests sacroiliac involvement.

Trendelenburg sign

Pelvic drop on the swing side during single-leg stance; indicates gluteus medius weakness on the stance side.

Cobb angle

Angle measured between the superior endplate of the upper and inferior endplate of the lower vertebral bodies in scoliosis.

Predental space

Distance between the anterior arch of C1 and the dens; greater than 3 mm in adults suggests atlantoaxial instability.

MRI indication

Preferred for disc herniation, cord compression, and soft tissue pathology; superior contrast resolution compared with plain radiography.

Cervical myelopathy signs

Hyperreflexia, clonus, positive Hoffmann sign, gait disturbance, and clumsy hands; contraindicate cervical manipulation and require referral.

Ankylosing spondylitis

Inflammatory back pain in patients under 40 with morning stiffness over 30 minutes, improvement with exercise, and sacroiliitis on imaging.

Temporal arteritis

Headache, jaw claudication, and elevated ESR in patients over 50; urgent corticosteroid referral prevents blindness.

Cavitation

Audible release of gas, mainly nitrogen, from synovial fluid during joint manipulation; not required for clinical benefit.

Viscoelastic creep

Progressive deformation of soft tissue under sustained load over time; relevant to prolonged stretching and postural adaptation.

Line of drive

Direction of manipulative force aligned with the plane of the target facet joint to maximize gapping and minimize adjacent stress.

Sensitivity and specificity

Sensitivity detects disease when present; specificity confirms absence; predictive value depends on disease prevalence.

Number needed to treat

One divided by the absolute risk reduction; the number of patients treated to prevent one additional adverse outcome.

NBCE Part IV

Practical clinical skills examination assessing case management, technique, and clinical competency for chiropractic licensure.

Malpractice elements

Duty, breach of duty, causation, and damages; all four must be proven by the plaintiff in a negligence claim.

Rotator cuff muscles

Supraspinatus, infraspinatus, teres minor, and subscapularis; supraspinatus initiates shoulder abduction.

Carpal tunnel syndrome

Median nerve compression causing numbness in the thumb, index, and middle fingers with nocturnal worsening.

Osteoporosis

Reduced bone mineral density with T-score at or below -2.5; increases fragility fracture risk and cautions high-velocity thrust.

SOAP note

Subjective, Objective, Assessment, and Plan; structured documentation format required for each patient encounter.

Yellow flags

Psychosocial factors such as fear avoidance and catastrophizing that predict chronicity and guide education and graded activity.