Hawaii Chiropractic Continuing Education

• Distinguish how orange juice can improve blood lipid profiles
• Discuss dietary aspects for the vegetarian athlete
• Identify the relationship between bromelain and acute inflammation
• Develop the anti-septic activity of tea tree oil
• Describe Probiotics

• Review aspects of antioxidants and free radicals
• Discuss how silymarin can improve an alcohol-damaged liver
• Describe the connection/mechanism between atherosclerosis and vitamin E
• Identify research evidence between whole grains and disease
• Delineate the relationship of magnesium and hypertension

• Identify risk factors of cardiovascular disease
• Construct a list of appropriate food and food groups associated with cardiovascular disease prevention
• Evaluate various supplements that are beneficial in prevention and treatment of cardiovascular disease
• Differentiate various diets in regard to cardiovascular disease

• Discuss various diet and lifestyle factors involving hypertension
• Recognize the relationship between various minerals and hypertension
• Distinguish the nutritional aspects of various related cardiovascular conditions
• Identify the relationship between various herbs and peripheral vascular diseases

• Discuss the basics of herbal medicine
• Identify the conditions treated with herbs
• List the effects, indications and dosages for Bilberry, Black Cohosh, and Boswellia

• Identify the conditions treated with specific herbs
• List the effects, indications and dosages for Burdock Root, Bromelain, Calendula, Cascara sagrada, Cayenne, CBD (cannabis), Chamomile, Echinacea, Feverfew, and Garlic.

• Discuss the mechanism and effects of Ginger, Ginkgo Biloba, Ginseng, Goldenseal, Gugulipid, Gymnena Sylvestre, Horse Chestnut, Lemon Balm, Licorice, Milk Thistle, Nettle, Passionflower, Psyllium, Pygeum, Senna, Shiitake, St. Johns Wort, Saw Palmetto, Tea Tree Oil, Tumeric, Valerian Root, and White Willow

• Identify changes in vitamin needs and status that occurs with aging and in the elderly
• List changes in mineral needs and status that occurs with aging and in the elderly
• Demonstrate an understanding of protein, fiber and water needs of the elderly
• Identify important antioxidants in the elderly and the interactions that exist between them
• Create a list of nutritional deficiencies and how they can lead to disease and illness in the elderly

• Demonstrate an understanding of the role of calcium and other minerals in osteoporosis
• Design a treatment protocol for the osteoporotic patient
• Create nutritional guidelines for the pregnant female
• Identify changes in vitamin and mineral requirements in pregnancy
• Review the nutritional changes that occur with lactation

• Understand proper growth rates and weight gain in early childhood
• Identify specific minerals involved in childhood nutrition
• Explain the stages of obesity development in childhood
• Review the importance and problems associated with childhood obesity
• Evaluate the role of fiber in childhood

• Identify the link between obesity and disease
• Understand body composition and assessment methods
• Design a practical weight loss diet program
• Perform obesity related calculations quick and easily in the office
• Recognize the role of exercise and other lifestyle factors that can influence obesity.

• Identify the challenges inherent in the diagnosis and management of patients with complex and chronic multi-factorial problems
• Associate a multitude of common symptomatic complaints with foundational metabolic disorders such as elevated total toxic load and "leaky gut"
• Apply a systematic approach to functional laboratory diagnostics and associate the findings with the need for specific therapeutic strategies using nutrients, botanical medicines, and nutraceutical compounds
• Demonstrate an ability to institute life-style modifications, such as dietary changes, stress management techniques, and exercise in the management of patients with complex chronic illness
• Measure your ability to assess, diagnose, and treat patients with fatigue-related disorders, vague gastrointestinal complaints, cognitive dysfunction, thyroid-adrenal problems, food intolerance, and more

• Identify the challenges inherent in the diagnosis and management of patients with complex and chronic multi-factorial problems
• Associate findings such systemic skin problems with foundational metabolic disorders
• Apply a systematic approach to functional laboratory diagnostics and associate the findings with the need for specific therapeutic strategies
• Discuss the modification of your approach to case management based on outcome-assessment
• Assess, diagnose, and treat patients with serious food allergy and sensitivity, dermatologic disorders, immune dysfunction, and persistent serious hypertension

• Identify the sources of toxic exposure in modern industrial society, the prevalence of exposure, and the health ramifications of elevated total toxic body burden
• Associate a multitude of common symptomatic complaints (ie: fatigue, cognitive dysfunction, skin problems, global pain, etc.) with foundational metabolic disorders related to issues such as elevated total toxic load and "leaky gut"
• Discover the specific biochemical methodology utilized by human metabolism to render toxins harmless and excrete them from the body
• Explain the inherent complications within the normal detoxification process related to the formation of toxic intermediates and the increase in oxidative stress
• Explore the effect of elevated oxidative stress on mitochondrial function and cellular energy production

• Identify various pathologies associated with increased toxicity and total oxidative stress
• Outline specific strategies of patient assessment to determine toxic load and individual hepatic detoxification capacity
• Discriminate between the various pathways of hepatic detoxification biochemistry and objectively assess each pathway
• Explain the use of specific nutrients, nutraceutical compounds, botanical medicines, and foods to lower oxidative stress
• Explore the benefits and complications of adjunctive therapies in the management of patients with elevated toxic load and poor detoxification capacity

• Identify common drug and nutrient interactions
• Identify herbal interactions
• Identify nutrient and nutrient interactions
• Recognize different toxicity levels for various nutrients
• To formulate treatment recommendations based a patient's medication intake.

• Identify some of the functions of Co Q10
• Use Co Q10 for as appropriate as a supplement
• List the issues of performance changes with Co Q10
• Discuss the reasons for, and application of, Co Q10 for patients with Parkinson Disease and migraines

• Identify how free radicals are formed and what parts of the body are affected.
• Determine the relationship between antioxidants and cardiovascular disease and cancer
• Discuss the role that vitamins, amino acids and herbs have in pain control.
• Examine inflammation and the pro-inflammatory state.
• Construct an anti-inflammatory diet
• Determine which vitamins, minerals and herbs are useful as natural anti-inflammatories.
• Identify the role of Proteolytic enzymes and inflammation and review sources of fatty acids.

• Frame the problem and basic epidemiology of chronic G.I. disorders
• Present evidence of linkage between chronic G.I. disorders with other common medical conditions
• Discuss the current hypothesis of associations between intestinal hyperpermeability and systemic illnesses
• Review cutting edge assessment tools and tests for G.I. disorders
• Outline and suggest rational and efficacious cutting-edge non-drug treatment interventions for functional G.I. disorders.

• Understand how muscle contraction occurs
• Review practical muscle physiology
• Determine how the body responds to exercise
• Discuss the role of hormones in regards to muscle
• Identify the components of proper assessment for physical fitness
• Review the main components of a weight training exercise program
• Identify various exercise training methods
• Discuss the practical aspects of body composition
• Review basic nutrition and how it relates to sport and exercise
• Determine the energy needs and energy balance of the athlete

• Discuss the causes and genetics of Alzheimer's Disease
• Review the diagnosis of Alzheimer's Disease, including symptoms, incidence, course, and risk factors
• Understand conventional lab tests for Alzheimer's Disease
• Review the conventional treatment options for Alzheimer's disease, including drug therapies
• Understand new drug research and innovative drug strategies for Alzheimer's disease
• Utilize nutritional strategies for Alzheimer's disease, including vitamin, mineral and herbal therapies
• Discuss and define drug-vitamin-herb interactions for nutritional supplements recommended for Alzheimer's disease

• Define the common signs and symptoms leading to the diagnosis of Amyotrophic Lateral Sclerosis
• Utilize conventional and alternative lab test for Amyotrophic Lateral Sclerosis
• Learn about the conventional treatment options for ALS, including drug therapies and new drug research
• Utilize nutritional support strategies for ALS, including diet, and nutritional supplements
• Coordinate care with the Medical Profession for innovative drug strategies for ALS

• Review Age-Associated Mental Decline, including its symptoms, causes and innovative drug therapies
• Discuss and define nutritional support strategies for Age-Associated Mental Decline, including vitamins, hormones and antioxidants
• Outline innovative drug strategies for cognitive enhancement
• Apply nutritional support strategies for cognitive enhancement

• Discuss the interactions between nutritional supplements and diuretics, statins and anticoagulant drugs
• Discuss the interactions between nutritional supplements and antidepressants, antidiabetic medications, and antibiotics
• Discuss the interactions between drugs and the B vitamins, fat soluble vitamins
• Discuss the interactions between drugs and vitamin C, folic acid, PABA, progesterone, tyrosine, phenylalanine, and therapeutic oils

• Define the criteria for diagnosing chronic fatigue syndrome
• Outline the causes of chronic fatigue syndrome
• Summarize the relationship between chronic fatigue syndrome and the endocrine system
• Discuss natural therapies that may be helpful for CFS patients
• Describe the relationship between neurotransmitters and chronic fatigue syndrome

• Define obesity, including its symptoms, epidemiology and effects on health and wellness.
• Review conventional treatments for obesity
• Discuss popular diets for obesity and weight loss, and the macronutrients: carbohydrates, protein, and fats
• Review nutritional support strategies for weight loss.

• Adequately frame the problem and basic epidemiology of cardiovascular disorders (CVD)
• Present evidence of the relationship between obesity, insulin resistance, inflammation, stress and CVD
• Summarize the standard medical and laboratory evaluation techniques and why they may only screen for approximately 50% of people at significant risk for CVD
• Appraise the latest laboratory evaluations, including Lp (a), Apo A1, Apo B, hs-CRP, homocysteine, fibrinogen, AA/EPA, LDL-subclass and others to determine CVD risk
• Critique the current dietary, lifestyle, nutritional supplement, nutraceutical, and herbal strategies as therapeutic management options to reduce CVD risk and for the treatment of those who already have cardiovascular issues, including: high cholesterol and dyslipidemia, genetic susceptibilities, chronic inflammation, coagulation abnormalities, and insulin resistance-related risk factors

• Generate a list of disorders associated with gluten sensitivity
• Describe to patients where gluten is likely to be found and which foods are generally safe for a gluten sensitive patient
• Interpret journal articles or general publication articles in the light of the history of gluten sensitivity diagnosis
• Critique articles and authors who claim that celiac disease is the only proven form of gluten reaction
• Detect and differentiate chronic gluten reactions in patients from other causes of inflammation and disease

• Describe the historical context of celiac understanding
• Document reasons why celiac disease is nearly always misdiagnosed
• Present valid arguments from cited literature how celiac disease is an autoimmune condition
• Defend recent scientific advances for the leaky gut syndrome
• Discuss reasons why celiac disease is a global concern, not just an American issue.

• Defend the implementation of a gluten free diet in celiac and non-celiac gluten sensitive patients based on sound evidence from current literature
• Document reasons why a first-degree relative of a known celiac should be gluten-free
• Summarize the current rate of celiac diagnosis in the US
• Contrast the expected findings of a celiac patient and non-celiac gluten intolerant patient
• Recognize that neurological signs can result from gluten intolerance

• Identify which supplements are commonly used in exercise and sport
• Determine the benefits and risks of individual ergogenic aids
• Discuss the role that individual vitamins have in exercise and sport
• Examine the role that individual minerals have in exercise and sport
• Investigate the value of sport drinks
• Ascertain when fluids are most beneficial in sport
• Apply how exercise effects the immune system
• Review the positive and negative effects of exercise
• Identify the role of antioxidants in sport and exercise

• Summarize the bowel protective mechanisms and their role in health and disease
• Outline a treatment strategy for imbalanced gut flora/leaky gut
• Identify common food allergies and determine appropriate nutritional therapy
• Examine the role of fiber in gastrointestinal health
• Create a treatment plan for common GI complaints of constipation and diarrhea
• Determine appropriate nutritional treatments for ulcers
• Theorize how diet can affect Inflammatory bowel disease
• Understand how to successfully use nutrition to treat a variety of gastrointestinal disorders
• Comprehend a rationale treatment protocol for Irritable bowel syndrome
• Determine correct doses of supplements used for various gastrointestinal disorders
• Ascertain the safety and risks associated with commonly prescribed gastrointestinal supplements

• Identify which supplements are commonly used in exercise and sport
• Ascertain the rationale of using specific individual sport supplements
• Differentiate between fact and fiction of the supplement in relation to sport and exercise
• Determine the practical use in sport for individual supplements
• Determine the benefits of individual ergogenic supplements
• Examine the risks associated with individual supplements
• Investigate the value of specific supplements via studies
• Define contraindications and interactions with the supplement
• Recommend the correct dose of the supplement for sport and exercise

• Identify various energy systems of the body and how they relate to exercise and sport
• Theorize which energy system is used for a specific sport event/activity
• Summarize the physiology of fat, protein and carbohydrate metabolism and utilization in exercise and sport
• Understand the relationship between the energy systems and various exercise parameters
• Create a diet protocol for the athlete prior to their sport or exercise activity
• Determine and understand the timing of meals in exercise and sport
• Outline a useful program for a person to maximize carbohydrate stores
• Theorize how glycemic index can affect exercise and sport activity
• Ascertain differences between food variables and how they affect exercise and sport performance

• Review nutritional supplements useful for weight loss.
• Discuss the research for conjugated linoleic acid for weight loss.
• Outline the associations between thyroid function and weight loss.
• Summarize dietary supplements that increase thermogenesis.

• Differentiate various nutrition assessment techniques.
• Determine which body fat/composition technique is most appropriate for the individual.
• Calculate essential measurements for weight loss patients.

• Appraise the reviewed research studies for salient elements of bias.
• Describe the sensitivity and specificity of common food sensitivity tests.
• Identify the effect of common natural interventions for IBS.
• Compare results of the low FODMAP diet to conventional dietary approach for IBS.
• Differentiate between clinical and statistical significance in natural medicine interventions for IBS
• Grade the magnitude of effect size for natural medicine interventions.
• Interpret the effect size of an intervention as it relates to the numbers needed to treat for benefit.
• Identify the risk of bias level for studies included in a systematic review on yoga for IBS.

• Discuss the role of diet in causing and preventing various diseases, particularly chronic diseases.
• Describe methods used to assess nutrition status.
• Explain how dietary recommendations are formulated.
• Incorporate nutritional information into clinical practice and advise patients about eating for optimum health as well as using dietary change as a therapeutic intervention
• Evaluate the benefits and risks of nutritional recommendations for specific health conditions through an analysis of the existing scientific and clinical evidence

Hour 1 - 3

• Discuss the role of diet in causing and preventing various diseases, particularly chronic diseases.
• Describe methods used to assess nutrition status.
• Explain how dietary recommendations are formulated.
• Incorporate nutritional information into clinical practice and advise patients about eating for optimum health as well as using dietary change as a therapeutic intervention
• Evaluate the benefits and risks of nutritional recommendations for specific health conditions through an analysis of the existing scientific and clinical evidence

Hour 4

• Investigate the importance of nutrient deficiencies
• Review the role of essential nutrients in human health
• Analyze the interaction between nutrients and various illnesses
• Ascertain the role herbs have in health and disease
• Understand drug and nutrient interactions

• Investigate the importance of nutrient deficiencies
• Review the role of essential nutrients in human health
• Analyze the interaction between nutrients and various illnesses
• Ascertain the role herbs have in health and disease
• Understand drug and nutrient interactions

• Review the clinical presentation of Diabetes
• Examine the role of nutrition and diet in Diabetes
• Design an appropriate supplement protocol for the diabetic patient
• Develop nutritional guidelines for hypoglycemia

• This contains all courses with the educational objectives listed from Nutrition 148 through 154

• Identify sources and functions of carbohydrates, proteins, fats, alcohol, vitamins, minerals, and water in the human body.
• Demonstrate the importance of a balanced diet and use tools that can be utilized to evaluate the nutritional adequacy of a diet (RDA, Dietary Guidelines, MyPlate, etc.).
• Identify the relationship between diet and chronic diseases/illnesses (cardiovascular disease, diabetes, obesity, cancer, hypertension, osteoporosis, etc.) and what modifications can be made in the diet to reduce the risk for these diseases/illnesses.
• Recall current nutritional recommendations for healthy eating habits (American Heart Association, American Cancer Society, etc.).
• Utilize nutrition terminology and related terminology appropriately.
• Demonstrate lifelong healthful eating habits by differentiating between beneficial and non-beneficial dietary practices.
• Develop nutritional scripts for 10 of the most common adult pathologies that can be potentially palliative or reverses through dietary changes.

• Understand the relationship between BPH and nutrition/supplements
• Develop a nutrition treatment program for UTI's
• Design a nutrition therapy program for kidney stones and gallstones
• Explore the relationship between diet and hyperestrogenism and its related diseases such as PMS and FBD
• Outline a nutrition treatment program for menopause

• Analyze the relationship between tendonitis/bursitis and nutrition
• Identify the nutritional treatment of muscle cramps/leg cramps and soreness
• Discuss nutrition treatment for Muscular dystrophy
• Determine an appropriate nutrition treatment for Fibromyalgia

• Identify the etiology and pathology of arthritis.
• Outline a diet that is helpful in the treatment of arthritis.
• Apply specific supplements to an arthritic condition.

• Review the risk factors and mechanisms of heart disease.
• Identify the parts of a proper diet to prevent heart disease.
• Evaluate various supplements that are beneficial in prevention and treatment of heart disease.

• Recall various foods with high amounts of Flavonoids and briefly relate their impact health
• Indicate the basic chemical structural similarities and differences of Flavonoids
• Relate potential benefits of combining Flavonoids, and ways of improving their bioavailability and efficacy
• Explain why some Flavonoids may be effective according to their chemical structure, specifically in a study for neuroprotection
• Discuss Flavonoid use and neuromuscular treatment considerations
• Integrate knowledge of Flavonoids and biochemical pathways to prescribe individualized nutrition treatments to your patients and appreciate the potential for overprescribing too many competing herbs
• Examine and demonstrate how and why Green Tea extract may play an inclusive role in health

• This contains all courses with the educational objectives listed in Nutrition 157 and 158

• Quantify the prevalence rates of patients using opioids and herbal products
• Demonstrate the significance to the chiropractor of interactions between different herbs and common prescription drugs
• Discuss the at risk populations for interactions including the pregnant, and elderly populations
• Record and list the most common interactions of common food and herbal products
• Record and list the effects of the common interactions of common heart medication and herbal products
• Demonstrate evidence that supports the use of health care providers assessing patients for these interactions.
• Discuss the role of the chiropractor in the role of identifying these interactions.
• Illustrate several books, and smart phone based electronic applications to make the process of identification easier for a chiropractor and patient.
• Evaluate common case scenarios

• Define very low carb (ketogenic), low carb, and moderate carbohydrate diets
• Describe the proposed mechanism of how low carbohydrate diets may improve outcomes
• Summarize the evidence supporting low and very low carbohydrate diets in diabetes management
• Critique the arguments for the long-term use of ketogenic diets

• Understand the importance of normal bowl defense mechanisms
• Develop a nutritional treatment for candidiasis and gut flora imbalances
• Examine the importance of fiber on human health
• Design a nutritional treatment program for constipation and diarrhea

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.
• Examine the concept of health and aging
• Determine an appropriate lifestyle to increase the chances of living longer
• Analyze various diets and dietary patterns that play a role in aging
• Ascertain which foods are of greater benefit in regards to aging and longevity
• Develop an appropriate anti-aging diet
• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Analyze the role between diet and the immune system.
• Design a nutrition supplement program to stimulate the immune system.
• Develop a nutrition program for colds, flu, sore throat and infections.
• Understand basic detoxification techniques.
• Examine the role of nutrition and diet in regards to chronic fatigue syndrome.

• Identify the risk factors associated with osteoporosis
• Outline a beneficial diet for osteoporosis
• Determine an appropriate supplement protocol
• Examine the role of exercise in the treatment of osteoporosis

• Identify different types of natural anti-inflammatories.
• Determine which anti-inflammatory is best for a particular patient.
• Develop an anti-inflammatory diet.

• Develop an appropriate nutrition program for an ulcer
• Identify the importance of diet in Celiac’s disease (non-tropical sprue)
• Outline a nutrition program for a patient with lactose intolerance
• Design a nutrition treatment program for GERD
• Examine the role of nutrition and supplements in irritable bowel syndrome

Hour 1

• Recognize normal cognitive and memory lapses and signs of declining cognition.
• Differentiate the assessment tools and the pros & cons of each
• Review evidence-based dietary patterns and specific foods that impact cognition
• Review additional evidence-based lifestyle factors that contribute to cognition
• Summarize dietary supplements which may impact cognition

Hour 2

• Recognize 5 categories of early aging
• Identify nutrient deficiencies associated with aging
• Examine epigenetics in aging, specifically COMT and MTHFR
• Review stress physiology and its contribution to aging
• Review contributions of microbiome to healthy physiology and aging

• Design an effective nutrition treatment program for carpal tunnel syndrome
• Develop a nutritional treatment program for Multiple Sclerosis
• Investigate the role of nutrition and supplements in regards to the treatment of headaches
• Understand how nutrition and nutrition supplements can influence dementia
• Identify appropriate diet and supplement agents in the treatment of dementia

• Identify behaviors associated with artificial sweeteners
• Examine the main artificial sweeteners used in the United States
• Determine why artificial sweeteners are used in the food industry
• Summarize the general risks associated with artificial sweeteners
• Evaluate the benefits and risks of Neotame and Advantame

• Identify the benefits and risks of Saccharin
• Discover the benefits and risks of Acesulfame potassium
• Summarize the benefits and risks of Sucralose
• Differentiate Aspartame benefits and risks
• Critique the current research on artificial sweeteners and cancer risk
• Explain the effect of artificial sweeteners on the gastrointestinal environment
• Interpret the research on artificial sweeteners and blood sugar

• Distinguish between the negative and positive effects on obesity, weight control and artificial sweeteners
• Identify the natural sweeteners that are generally recognized as safe
• Evaluate the effectiveness and safety of Stevia
• Determine the effectiveness and safety of Luo han guo (Swingle fruit or monk fruit extract)
• Analyze the effectiveness and safety of Thaumatin

• Identify behaviors associated with artificial sweeteners
• Examine the main artificial sweeteners used in the United States
• Determine why artificial sweeteners are used in the food industry
• Summarize the general risks associated with artificial sweeteners
• Evaluate the benefits and risks of Neotame and Advantame

• Identify the benefits and risks of Saccharin
• Discover the benefits and risks of Acesulfame potassium
• Summarize the benefits and risks of Sucralose
• Differentiate Aspartame benefits and risks
• Critique the current research on artificial sweeteners and cancer risk
• Explain the effect of artificial sweeteners on the gastrointestinal environment
• Interpret the research on artificial sweeteners and blood sugar

• Distinguish between the negative and positive effects on obesity, weight control and artificial sweeteners
• Identify the natural sweeteners that are generally recognized as safe
• Evaluate the effectiveness and safety of Stevia
• Determine the effectiveness and safety of Luo han guo (Swingle fruit or monk fruit extract)
• Analyze the effectiveness and safety of Thaumatin

• Review exercise physiology principles and techniques
• Analyze various exercise prescription principles
• Identify appropriate carbohydrate – fat – and protein recommendations
• Develop meal timing and fluid guidelines for the athlete

• Review exercise physiology principles and techniques
• Analyze various exercise prescription principles
• Identify appropriate carbohydrate – fat – and protein recommendations
• Develop meal timing and fluid guidelines for the athlete

• Review the signs and symptoms of neuroinflammation and the processes that drive neurodegeneration.
• Identify the neurological signs and symptoms of long COVID and apply research-based protocols.
• Utilize dietary improvements and selected supplements to reduce neuroinflammation.
• Treatment protocols on testing to identify gut barrier and gut-brain axis imbalances.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Understand the effect of bacterial toxins originating in the gut on the gut-brain axis as a key to neurological disorders pathogenesis.
• Assess intestinal and blood-brain barrier dysfunction for better managing chronic neurological disorders.
• Understand new functional nutritional strategies for longevity.
• Incorporate leading-edge protocols for extending healthspan and longevity.
• Clarify the effects of intermittent fasting on immunity and longevity.
• Recognize that neuroplasticity plays a fluctuating but essential role in health and trauma.
• Integrate optimal lifestyle adaptations in diet, exercise, and supplement protocols to enhance neuroplasticity and improve quality of life.

• Understand basic concepts of health
• Identify the health spectrum
• Investigate the various facts associated with aging
• Investigate the various theories of aging

• Understand basic concepts of health
• Identify the health spectrum
• Investigate the various facts associated with aging
• Investigate the various theories of aging

• Explain the basic principles of nutrigenomics, focusing on the interaction between nutrition, genetics, and health outcomes, with an emphasis on conditions like headaches.
• Analyze how single nucleotide polymorphisms (SNPs) and other genetic variations impact nutrient metabolism and their potential role in triggering headaches, such as those linked to impaired methylation.
• Examine the mechanisms by which a lack of essential nutrients (e.g., magnesium, B vitamins) contributes to headaches, and how nutrigenomics can inform targeted nutritional interventions.
• Design tailored dietary strategies based on genetic testing results, addressing deficiencies or imbalances that may exacerbate headache conditions.
• Assess the benefits and limitations of using nutrigenomic testing to guide clinical decision-making for headache management and prevention, highlighting the importance of personalized nutrition in improving patient outcomes.

Hour 1

• Compare the differences between acute and chronic inflammation.
• Associate background inflammation with chiropractic treatment outcomes.
• Discuss the aging trends in the U.S. population.
• Summarize the role of aging on background inflammation.
• Explain the differing outcomes of disc disease and radiculitis driven by inflammation.

Hour 2

• Identify the mechanisms by which macrophages activate inflammation.
• Discuss the historical trends in long chain fatty acid intake in relation to inflammation.
• Explain the dependency on the COX 2 enzyme both in inflammatory up-regulation and in resolution.
• Recognized dietary induced “meta-inflammation” and the dietary patterns that induce it.
• Summarize the role of phytonutrients in limiting dietary induced inflammation.

Hour 3

• Define immunosenescence and “inflammaging”.
• Summarize the role of autophagy in limiting inflammaging.
• Summarize the role of apoptosis in eliminating senescent immune cells.
• Examine the phytonutrients with senomorphic/pro-autophagy properties.
• Examine the phytonutrients with senolytic/pro-apoptotic properties.

Hour 4

• Describe the role of vagal nerve activation in regulating the transition to inflammatory resolution.
• Examine the splenic cholinergic anti-inflammatory pathway.
• Outline the mechanisms by which vagal activation increases specialized pro-resolving mediator (SPMs) production from omega-3 fatty acids.
• Summarize the role of transcutaneous vagal nerve stimulation (tVNS) in the inflammatory to pro-resolving transition.
• Contrast the inflammatory suppressing and pro-resolving treatment strategies.

• Discuss healthy habits vs. genetics in healthy aging.
• Review the importance of evolutionary biology in determining healthy habits.
• Name and Define the “legs” of the Epidemiological Triad.
• Emphasize the “Host Health Leg” in the practice of chiropractic.
• Explain the history of the mitochondria as a synergistic organelle with its own genetic material.
• Outline the basics of mitochondrial physiology and the clinical interventions to affect mitochondrial function.
• Explain why modern humans should take 5 supplements.
• Give an overview of what these supplements do physiologically and the risks associated with their deficiency.
• Explain the greatest impact of magnesium on neurophysiology and energy production.
• Identify the forms and discuss the protocols for magnesium supplementation.
• Outline the evolutionary biology of omega-6/omega-3 ratios in inflammation and infection.
• Summarize the importance of omega-3 derived molecules call resolvins for health and disease prevention.

• Distinguish the health implication from consumption of grained meat v. wild meat.
• Look at the implications of excessive linolenic consumption as related to aggression.
• Detail the sources of microplastics and nanoplastics exposures for humans.
• Discuss the health risks associated with microplastics and nanoplastics exposures.
• Recite the basic pathophysiological cascade for traumatic brain injury.
• Discuss therapeutic interventions for brain injury patients, including Omega-3s, vitamin D, Magnesium, Low-level laser therapy, etc.
• Apply the 8 lifestyle factors that have the potential to increase healthy longevity by 24 years.
• Recommend supplements that are recommended for longevity.
• Appraise the 2025 US Surgeon General’s Report on alcohol as a carcinogen, and learn the appropriate biochemistry.
• Summarize modern factors that are suspected as being related to the escalation of cancer in young American adults.
• Emphasize the importance of minimizing exposure to environmental toxins, including glyphosate and ultraprocessed foods.
• Distinguish the importance of vascular integrity as related to homocysteine and B vitamins.

• Explain the complex multidimensional and individual specific nature of pain
• Present the theories and science for understanding pain
• Define the terminology for describing pain and associated conditions
• Describe the impact of pain on society
• Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain  
• Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess outcomes as appropriate for the clinical context and population.
• Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management
• Assess patient preferences and values to determine pain-related goals and priorities
• Demonstrate empathetic and compassionate communication during pain assessment

• Explain the complex multidimensional and individual specific nature of pain
• Present the theories and science for understanding pain
• Define the terminology for describing pain and associated conditions
• Describe the impact of pain on society
• Explain how cultural, institutional, societal and regulatory influences affect assessment and management of pain  
• Use valid and reliable tools for measuring pain and associated symptoms to assess and reassess outcomes as appropriate for the clinical context and population.
• Describe patient, provider, and system factors that can facilitate or interfere with effective pain assessment and management
• Assess patient preferences and values to determine pain-related goals and priorities
• Demonstrate empathetic and compassionate communication during pain assessment
• Demonstrate the inclusion of patient and others, in the education and shared decision-making process for pain care
• Identify treatment options that can be assessed in a comprehensive pain management plan
• Explain how health promotion and self-management strategies are important to the management of pain
• Develop a pain treatment plan based on benefits and risks of available treatments
• Monitor the effects of pain management approaches to adjust the plan of care as needed
• Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence
• Develop a treatment plan that accounts for the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at end of life
• Describe the unique pain assessment and management needs of special populations
• Explain how to assess and manage pain across settings and transitions of care
• Describe the role, scope of practice, and contribution of the different professions within a pain management care team
• Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources
• Describe the role of the clinician as an advocate in assisting patients to meet treatment goals

• Demonstrate the inclusion of patient and others, in the education and shared decision-making process for pain care
• Identify treatment options that can be assessed in a comprehensive pain management plan
• Explain how health promotion and self-management strategies are important to the management of pain
• Develop a pain treatment plan based on benefits and risks of available treatments
• Monitor the effects of pain management approaches to adjust the plan of care as needed
• Differentiate physical dependence, substance use disorder, misuse, tolerance, addiction, and nonadherence
• Develop a treatment plan that accounts for the differences between acute pain, acute-on-chronic pain, chronic/persistent pain, and pain at end of life
• Describe the unique pain assessment and management needs of special populations
• Explain how to assess and manage pain across settings and transitions of care
• Describe the role, scope of practice, and contribution of the different professions within a pain management care team
• Implement an individualized pain management plan that integrates the perspectives of patients, their social support systems, and health care providers in the context of available resources
• Describe the role of the clinician as an advocate in assisting patients to meet treatment goals

• Construct examination/radiographic criteria for Osteochondritis Dissecans
• Dissect the elbow as it relates to lateral epicondylitis
• Develop a diagnostic and treatment approach for adhesive capsulitis
• Review possible causes of Intervertebral Disc Degeneration
• Create a list of differential diagnoses of foot pain

• Develop an understanding of shoulder anatomy and motion as they pertain to diagnosis and treatment of the injured shoulder
• Review examination techniques relative to diagnosis of injury in the overhead athlete
• Review the characteristics and diagnosis of shoulder injuries common to overhead athletes
• Understand the functional anatomy of joint and the classification of traumatic injuries of the acromioclavicular joint
• Develop understanding of the mechanisms, examination, diagnosis, radiography and treatment of common acromioclavicular joint injuries

• Identify common causes of patellofemoral syndrome
• Understand knee mechanics relative to patellofemoral syndrome
• Differentially diagnose patellofemoral syndrome from other knee conditions
• Define an appropriate treatment program for patellofemoral syndrome

• Identify common causes of shoulder syndrome
• Understand functional mechanics of the shoulder relative to impingement syndrome
• Differentially diagnose shoulder impingement from other shoulder conditions
• Define an appropriate treatment program for impingement syndrome.

• Identify common risk factors and causes for CTS
• Define tests and examination procedures to diagnose CTS
• List the common conditions important in the differential diagnosis of CTS
• Develop a chiropractic treatment plan for CTS

• Understand the use of plain film and advanced imaging for patients with Rheumatoid Arthritis
• Identify conservative treatments for Rheumatoid Arthritis
• Discuss supplements relative to alleviating Rheumatoid Arthritis symptoms as well as other treatment additions to the patient's drug regimen
• Provide an overview of the rheumatoid arthritis diagnosis and traditional treatments

• Understand the general features of congestive heart failure, a condition which currently affects 4.9 million Americans
• Determine physical examination and diagnostic imaging findings in patients with congestive heart failure
• Discuss treatment, including conservative management, for congestive heart failure patients
• Discuss conditions commonly associated with congestive heart failure

• Define the classifications of Breast cancer and compare the stage
• List some of the major risk factors for Breast Cancer
• List some of the screening techniques for the detection of Breast Cancer
• Discuss some main options in evaluating breast cancer
• List some of the treatment options that are available for women with a genetic predisposition for Breast Cancer

• List some of the risk factors for low back injuries in the work place
• List the classes of low back etiologies and describe some of the spinal diseases that may cause low back syndrome exacerbation
• List some of the protocols for documenting and managing repetitive stress type injuries and low back pain and describe some of the factors to consider when documenting
• List some of the clinical manifestations of pain
• Describe some of the orthopedic tests that may be utilized in the examination for low back pain
• List some treatment options for Low back injuries

• Relate relatively common but sometimes challenging patient cases
• Explain diagnostic and therapeutic considerations in thyroid disease
• Give examples of diagnostic and therapeutic considerations in drug toxicity
• Describe diagnostic and therapeutic considerations in diabetic neuropathy
• Demonstrate diagnostic and therapeutic considerations in vitamin deficiency

• Summarize premenstrual syndrome, its diagnosis, causes and natural therapies
• Understand premenstrual dysphoric disorder, its diagnosis, causes and natural therapies
• Outline polycystic ovarian syndrome, its diagnosis, causes and natural therapies
• Illustrate menopause, its diagnosis, causes and natural therapies
• Discuss nutritional support for womens health

• Differentiate between premenstrual disorder, menopause and perimenopause
• Identify the causes of Estrogen Dominance in the typical patient for patient education
• Assess hormone levels and diagnosis with saliva and blood spot testing with reputable labs listed
• Observe recorded changes in actual patient histories with treatments and results
• Apply products listed by Brand Names to use for treatments, with suggested dosages

• Diagnose Fibromyalgia and Discuss the modern research that contradicts older ideas about the syndrome, separating myth from fact
• Obtain an accurate diagnosis and differentiate from other syndromes
• Recognize prescription medication side effects
• Apply appropriate movement and exercise therapy
• Select the best alternative and holistic treatments and design a treatment plan
• Treat using integrated care, including physical, emotional and spiritual support as needed

• Detect Intracellular inflammation and its effects on the entire body
• Define Oxidation and illustrate the importance of quality anti-oxidants
• Discover affordable tests you can easily run in your office to determine levels of oxidative stress
• Recall what causes free radicals and discover what resolves the problem
• Summarize environmental toxins and their realistic effects on the health of your patients, your family and you
• Show that Insulin resistance is yesterday’s news, now it’s Hormonal resistance Analyze weight loss resistance and how to correct it
• Analyze lifestyle choices that "pull the trigger" for epigenetics and how to reverse it
• Describe the new catch-all term: Mitochondrial diseases. Formerly known as “no known cause, no known cure”
• Summarize Methylation, Methyl donors, and its depletion
• Examine cell membrane impermeability and its effect on your paradigm of health
• Determine the role of antioxidants, fatty acids, and vitamin D: what you should use in your clinic now to get people well

• Utilize Salivary pH readings to determine the need for Fatty Acid Supplementation and dietary modification
• Discuss Candidiasis with your patient and interpret the results of their home self-test
• Determine if your patient is best served with a vegetarian lifestyle, and if not, measures you can take to improve their health
• Interpret the Zinc Tally test for your patient and prescribe a treatment plan that can greatly improve the overall health and longevity of your patient
• Measure specific blood pressure readings to demonstrate adrenal hypofunction
• Formulate your treatment plan based upon your results Discover an affordable and simple test for Sick Building Syndrome, Toxic Mold and other toxic loads
• Rate a patient’s need for calcium and mineral supplementation with the easily-performed Tissue Calcium Test
• Identify important underlying factors in weight loss or gain with Barne’s Thyroid Test
• Diagnosis an underlying deficiency that contributes to immune dysfunction, metabolic dysfunction, weight gain, skin rashes and more
• Quickly determine a definitive need for hydrochloric acid supplementation in every patient with gastric upset

• Define Genetic Testing and name some of the components in the gene that are being examined.
• List some laboratory techniques used in genetic testing.
• Name some types of genetic tests and explain the purpose of the tests. 
• Describe some of the methods of obtaining gene samples for laboratory analysis
• List some of the limitations and risks for genetic testing
• Discuss some of the ethical issues in genetic testing

• Define Fibromyalgia from an allopathic perspective
• Review historical treatment by traditional medical community
• Examine current allopathic theories and treatments
• Review signs and symptoms, demographics and presentation of the fibromyalgia patient
• Obtain an accurate diagnosis through labwork and history as it pertains to the fibromyalgia patient.
• Differentially Diagnosis adrenal fatigue, perimenopause, myofascial pain syndrome, chronic fatigue
• Determine the Labwork needed to evaluate a fibromyalgia patient
• Discuss the fibromyalgia patient’s point of view of symptoms and treatments
• Contrast the varying possible diagnoses from the alternative healer viewpoint
• Explain the Fibromyalgia “personality type”
• Create a team approach with other practitioners in the treatment of the fibromyalgia patient
• Determine the appropriate organic treatments that may be needed to treat the fibromyalgia patient including Gluten intolerance, Food allergies, and Supplementation
• Discuss Musculoskeletal treatments for fibromyalgia patients including Adjustments, Massage, and Prolo therapy
• Integrate appropriate exercise and home remedies for the fibromyalgia patient including 5 Tibetan Rites, Yoga, Walking, and swimming

• Discuss the effects of spinal manipulation on headache
• Refer for alternative remedies for headaches
• Evaluate the emotional and mind-body connections as it relates to headaches
• List 14 different categories of foods that can trigger a Migraine
• Discover the eastern diagnosis of underlying conditions for headaches, including emotional and spiritual blockages
• Create a treatment plan for addressing the headache and potential underlying conditions
• Differentially diagnose underlying conditions related to headache
• Educate your patients on home remedies for their headaches
• Examine the economic impact of headaches
• Discriminate between headache pains and locations
• Recognize migraine headaches, even when head pain is not present
• Specify musculoskeletal treatments to reduce or eliminate headache symptoms

• Recognize the signs and symptoms of a low back disorder
• List the differential diagnosis of low back disorders
• Outline the different elements of a low back examination
• Identify “red flags” in the examination and evaluation of low back patients
• Summarize additional low back tests that can be performed and the reasons why to use them

• Compare knee joint biomechanics during running and cutting tasks performed with and without ankle taping
• Review common and unusual causes of lateral ankle pain
• Examine the effects of foot orthotics on overpronation and gait
• Relate the current state of knowledge about the pathogenesis of hallux valgus
• Apply contemporary knowledge to the assessment, management and prevention of ankle sprains
• Appraise the relationship between posterior lower limb muscle tightness and plantar fasciitis

• This contains all courses with the educational objectives listed from Physical Diagnosis 146 through Physical Diagnosis 159

• Recognize the signs and symptoms of an elbow disorder
• List appropriate exam procedures for differential diagnosis of elbow disorders
• Outline the different elements of a elbow exam
• Discuss the importance of “red flags” in the exam and evaluation of elbow complaints
• Summarize additional elbow tests that can be performed and under what conditions to use them

• Identify and describe the signs and symptoms hip disorders
• Synthesize differential diagnosis of hip disorders
• Outline and analyze the different elements of a hip exam
• Comprehend the nature of spinal cord and cauda equina injuries and determine their importance in hip disorders
• Apply knowledge of available hip assessments and evaluate how each can best be utilized

Hour 1

• Identify and describe the signs and symptoms hip disorders
• Synthesize differential diagnosis of hip disorders
• Outline and analyze the different elements of a hip exam
• Comprehend the nature of spinal cord and cauda equina injuries and determine their importance in hip disorders
• Apply knowledge of available hip assessments and evaluate how each can best be utilized

Hour 2

• Recognize the signs and symptoms of a neck disorder
• Differentially diagnose neck disorders
• Perform the different elements of a neck exam
• Comprehend the importance of "red flags" in the exam and evaluation of neck complainants
• Summarize additional neck tests that can be performed and under what conditions to use them

Hour 3

• Recognize the signs and symptoms of a shoulder disorder
• Be able to list differential diagnosis of shoulder disorders
• Outline the different elements of a shoulder exam
• Understand the importance of “red flags” in the exam and evaluation of shoulder complainants
• Be able to summarize additional shoulder tests that can be performed and under what conditions to use them

Hour 4

• Identify important chest and thorax landmarks in order to perform a lung examination.
• Summarize the various musculature associated with adult breathing mechanics.
• Demonstrate the differences between consolidation and effusion lung pathologies.
• Diagnose common adult lung pathologies with use of a medical history and full physical examination.

• Recognize the signs and symptoms of a neck disorder
• Differentially diagnose neck disorders
• Perform the different elements of a neck exam
• Comprehend the importance of "red flags" in the exam and evaluation of neck complainants
• Summarize additional neck tests that can be performed and under what conditions to use them

• Recognize the signs and symptoms of a shoulder disorder
• Be able to list differential diagnosis of shoulder disorders
• Outline the different elements of a shoulder exam
• Understand the importance of “red flags” in the exam and evaluation of shoulder complainants
• Be able to summarize additional shoulder tests that can be performed and under what conditions to use them

• Identify important chest and thorax landmarks in order to perform a lung examination.
• Summarize the various musculature associated with adult breathing mechanics.
• Demonstrate the differences between consolidation and effusion lung pathologies.
• Diagnose common adult lung pathologies with use of a medical history and full physical examination.

• Define the differences between visual fields and pathways.
• Recognize the three most common eye conditions and diseases affecting the cranial nerves seen within the chiropractic practice.
• Diagnose common eye diseases and conditions from a funduscopic examination.
• Propose management and co-management options for specific common eye conditions.

• Explain jurisdictional authority over school enrollment and pre-participation physical examinations
• List the common items required on a school enrollment and pre-participation physical examinations
• Outline the key components of the health history
• Identify normal values for vision and hearing acuity
• Calculate BMI and determine age appropriate percentile ranking
• Classify physical maturity using the Tanner Scale
• Assess immunization records for statutory compliance
• Indicate the difference in the level of detail required in the pre-participation exam versus the school enrollment physical
• Recognize the classifications of sports based on exertion required and level of contact
• Describe the process of clearing an athlete to resume training and competition
• Recognize the risk factors to sudden cardiac death syndrome
• Determine the association between risk factors and specific sports

• Recognize the elements and significance of the jugular venous pulse
• Know the physiology and sound of S1 and S2
• Know the physiology and sound of S3 and S4
• Identify systole and diastole by palpation and listening
• Describe heart murmurs
•  Hear and understand the mechanism of two common systolic murmurs

• Justify the addition of manipulative therapy to rehabilitation in the management of recurrent ankle sprain with functional instability
• Compare the effectiveness of plantar fascia-specific stretching to high-load strength training in patients with plantar fasciitis
• Examine the biomechanical mechanisms that may be involved in the foot-to-low back relationship, and how foot orthoses might be used to manage low back pain
• Outline the state of current clinical evidence regarding the use of manual therapies in the treatment of lateral ankle sprains
• Summarize relevant concepts for the diagnosis and management of ankle syndesmosis injuries

• Differentially diagnose prostate pathologies in individuals who present to your office with musculoskeletal pain,
• Differentiate various types of common prostate pathologies
• Expand understanding of prostate pathophysiology, including hormonal and biochemical implications
• Identify prostate pathology risk factors
• Identify the common pre-disposing factors for prostate pathologies that can ultimately mimic musculoskeletal complaints
• Interpret conventional prostate diagnostic procedures and identify protocols to evaluate and monitor prostate health and/or pathology
• Hone diagnostic skills by reviewing and analyzing patient case studies, inclusive of history, exam findings, lab test results for patients presenting with musculoskeletal complaints that may have underlying prostate pathologies

• Recognize the signs and symptoms of a wrist and hand disorder
• Be able to list appropriate exam procedures for a differential diagnosis of wrist and hand disorders
• Outline the different elements of a wrist and hand exam
• Discuss the importance of “red flags” in the exam and evaluation of wrist and hand complaints
• Be able to summarize additional wrist and hand tests that can be performed and under what conditions to use them

• Outline the current state of the literature on the etiology, diagnosis and management of frozen shoulder
• Clarify the influence of the spine on shoulder range of motion in middle-aged and elderly patients
• Assess the utility of three clinical tests evaluating subscapularis muscle function
• Utilize and integrate a simple clinical test to assist in distinguishing neck from shoulder pain
• Summarize the recent Clinical Practice Guideline (APTA) regarding the treatment of adhesive capsulitis

• Recognize the signs and symptoms of a mid-back disorder
• Be able to list differential diagnosis of mid-back disorders
• Outline the different elements of a mid-back exam
• Understand the importance of “red flags” in the exam and evaluation of mid-back complainants
• Be able to summarize additional mid-back tests that can be performed and the reasons why to use them

• Understand basic genetic and how this new field of medicine may impact your practice
• Learn and key common genomic medicine study type.
• Critically evaluate genomic medicine studies by identifying bias, evaluating effect size, and applying it to your patient.
• Understand the cardiovascular disease association between the SNPs ApoE, Kif6, and MTHFR.
• Consider how polymorphisms may impact the placebo effect.

• List five statistical references that relate to evidence based practice.
• List four Red flags that are pertinent in the evaluation component of treatment.
• Identify the five categories that pertain to possible spinal pain and referred pain.
• Describe two metabolic diseases that can affect the spine.

• This contains all courses with the educational objectives listed from Physical Diagnosis 166 through Physical Diagnosis 169

• Recognize and list four red flags for the cervical and shoulder girdle.
• Identify three medical conditions that may refer to the cervical spine but are non-musculoskeletal in origin and require a physician's intervention.
• Name and describe two CPR for the Cervical Spine.
• List two dural tests that are done for the nervous system in the Cervical region.

• Identify and describe two musculoskeletal issues of the thoracic region.
• List one dural test that is used to evaluate the thoracic region which will assist in determining normal neuromeningeal pathway mobility.
• List two CPR of the spine in the thoracic region that have good reliability and are effective in use.
• List and describe two vascular diagnoses which may relate to Thoracic Spine referred pain

• Identify two serious pathologies that appear to be related to the lumbar spine but are not.
• Describe three categories of pelvic fractures than may occur.
• Describe the objective differences between vascular claudication and neurogenic claudication.
• List the five screening tests for the pelvis and SI joint.

Hour 1:

• Knowledge of human gait analysis and its application to clinical scenarios.
• Explain the common gait terminology, such as stride length, step width, and cadence.
• Identify the stance and swing cycles of gait.
• Summarize the gait cycle and how it relates to normal human ambulation.
• Explain how movements at the pelvis, lower extremity, hip, knee, ankle, and subtalar joints interact during stance to conserve energy, and to protect one from injuries that might otherwise result from the repetitive stresses that occur during gait.

• Describe how patients with over-pronation and over-supination present in a clinical setting.
• Comprehend the functional biomechanics of the lunge, and squat and its relationships to faulty movement patterns.
• Compare Janda’s lower extremity functional screens.
• Demonstrate that clinical gait analysis alters treatment decisions to improve functional outcomes.

Hour 3:

• Illustrate the LEFS (lower extremity functional scale), and report its clinical value.
• Demonstrate evidence-based exercises to help improve over-pronation in patients.
• Apply the scientific foundations of modifications for custom orthotics with clinical case scenarios.
• Illustrate, through the use of case scenarios the typical examination findings and documentation of gait analysis in the “O” (objective) section of notes.

• Identify musculoskeletal anatomy pertinent to the abdominal exam.
• Identify the location of intra-abdominal contents relative to the abdominal wall and what is normally palpable.
• Recognize examination techniques used for inspection, auscultation, percussion and palpation of the abdomen.
• Name advanced techniques used to evaluate the acute abdomen.

• Describe thyroid anatomy and physiology. 
• Outline the pathophysiology of hypothyroidism, including possible causes and associated conditions.
• Identify signs and symptoms of hypothyroidism and hyperthyroidism.
• Demonstrate the typical thyroid exam performed in the chiropractor’s office.
• Review the usual and customary conservative and non-conservation management for common thyroid conditions.
• Discuss the role of the chiropractic spinal manipulation in care for patients with thyroid conditions.

• Identify vascular anatomy pertinent to the cardiovascular exam
• Interpret cardiovascular physiology as it relates to physical examination.
• Discuss characteristics of, and techniques used to evaluate, the pulse and blood pressure.
• Name advanced techniques used to evaluate peripheral artery disorders and conditions.

• This contains all courses with the educational objectives listed in Physical Diagnosis 173 thru 175

Hour 1

• Define Nonspecific Low Back/Neck Pain            
• Outline the subcategories of Nonspecific Spinal Pain
• Provide an overview of different techniques
• Analyze the anatomical source of the injury
• Examine Differentiate the functional or anatomical diagnosis

 Hour 2

• Produce a specific conservative treatment plan
• Measure the patient’s response to care.
• Neurological differential diagnosis via pain patterns
• Choosing the most appropriate type of manual therapy
• Provide Appropriate Documentation

• Compare the difference between angular and linear motion.
• List the limiting factors necessary for stability in respect to linear motion.
• List and describe the function of the limiting structures of the atlantooccipital joint and the atlantoaxial joint.
• Describe the path of the vertebral artery from the subclavian artery to the basilar artery
• List the three types of Atlantooccipital fractures.
• Describe five diseases that may compromise the stability of the cervical region and how.
• List and elaborate on the immune specific diseases that can affect the atlantoaxial joint.
• Summarize the normal growth of the cervical spine and craniovertebral region in children.
• Outline the details of IFOMPT Framework for Red Flags.
• Demonstrate three stability tests of the cervical region and interpret the results.
• Demonstrate a neurological scan to clear spinal cord and neurological dysfunction in the cervical spine.
• Apply a vigorous mandatory scan for all patients to rule out serious pathology of the cervical spine and the neurological system and be able to interpret the results.

• Recognize the importance of knowing and diagnosing a tremor.
• Define what is a tremor List some of the general symptoms of a tremor.
• Discuss the triggers that may exacerbate a tremor.
• Name the main categories of a tremor.
• Recall the subclasses of action tremor List the most common diseases and syndromes demonstrating each type of tremor.
• Differentiate the symptoms of Essential tremors (ET) and debate the current gold standard treatment plan of action.

• Recognize the signs and symptoms of a knee disorder.
• List differential diagnosis of knee disorders.
• Outline the different elements of a knee exam.
• Identify “red flags” during the evaluation of knee complaints.
• Summarize additional knee tests that can be performed and the reasons why to use them.

• Identify the 4 muscles that are associated with the Rotator Cuff.  
• Recall the major epidemiological variables associated with Rotator Cuff Tears.
• Differentiate the 2 major etiological factors associated with Rotator Cuff Tears.
• Recognize the symptoms and signs associated with Rotator Cuff Tears.
• Determine conservative treatment approaches in the acute and/or sub-acute phase of Rotator Cuff Tears.
• Select appropriate ancillary studies that may be necessitated upon failed conservative treatment of presented upper extremity conditions.

• Recognize and apply the diagnostic criteria for hypermobility spectrum disorders (HSD) including hypermobile Ehlers-Danlos Syndrome (hEDS).
• Outline the importance of blood pressure screening and review evidence-based recommendations for clinical practice.
• Appraise the evidence regarding nonpharmacological approaches used in the management of restless legs syndrome (RLS).
• Summarize a contemporary clinical framework for identifying red flags for four serious spinal pathologies that may present in chiropractic practice.
• Describe our contemporary understanding of the appropriate diagnosis and management of cervical spondylotic myelopathy (CSM).

• Investigate the effect of patient expectations on short-term, subjective improvement in recurrent or persistent low back pain patients.
• Determine whether the ritual of the history and physical examination results in meaningful change in pain and function for low back pain patients before any treatment is provided.
• Assess the potential negative effect of routine MRI reports on the perception of the patient and treatment outcomes and explore a method for improvement.
• Explore the level of association between kinesiophobia and pain, disability, and quality of life as well as its role as a prognostic factor in people with chronic musculoskeletal pain.
• Quantify the role of contextual effects in the nonpharmacologic treatment of knee osteoarthritis.

• Outline the congruence of the manual interventions used in clinical practice with the scientific evidence regarding the biomechanical aspects of degenerative disc disease (DDD) leading to pain.
• Compare the efficacy and cost-effectiveness of a stratified care model versus usual care for patients with sciatica.
• Assess the value of intervertebral disc degeneration detected in early adulthood as a predictor for progression of degenerative changes as well as low back pain symptoms and disability in middle age.
• Define deep gluteal syndrome and the deep gluteal space, as well as propose a general diagnostic pathway for this condition.
• Breakdown the utilization of conservative treatments used in lumbar disc herniation patients successfully treated nonoperatively versus unsuccessfully treated nonoperatively.

• Defend a contemporary view of the implications of the biology of pain and injury for sensorimotor function
• Outline neuroplastic structural and functional changes as they relate to non-specific (mechanical) low back pain and sensorimotor function
• Appraise the current state of the literature regarding the changes in motor control in those with low back pain
• Assess whether low back pain patients display signs of muscular guarding or splinting
• Summarize existing observational evidence regarding the association between primary or chronic headache and persistent low back pain

Hour 1 

• Document the patients history to include an accurate list of all herbal/dietary supplements and other medicinals they are taking and refer to their MD if there are any concerns that it will affect Chiropractic Care being considered
• Explain the concept of the use of simultaneous interventions to treat a single condition as it is relative to the patient history.

 Hour 2

• Discuss potential side effects of herbal/dietary supplement as components of history taking & physical exam procedures.
• Refer to Medical Doctor if you feel any signs or symptoms are related to any side effects of anything the patient is taking
• Give examples of how herbal/dietary supplement use may impact the history taking, physical exam procedures, and treatment plan.

Hour 3

• Describe pertinent patient medical history and physical examination procedures included in a comprehensive evaluation for conditions that may have been previously treated with surgical interventions
• Connect patient medical history and physical examination with evidence-based intervention/treatment plan of care to achieve best patient outcomes

Hour 4

• Identify evidence-based rehabilitation principles for patients whose history may include prior surgical intervention.
• Explain specific rehabilitation programs for each case based on documented evaluation findings

Hour 1

• Describe behavioral model for insomnia
• Explain why sleep quality is important
• Discuss sleep interventions as prevention for chronic musculoskeletal pain
• Discuss sleep interventions for chronic musculoskeletal pain

 Hour 2

• Ask the correct questions to assess sleep and sleep behaviors
• Identify factors to maladaptive sleep habits
• Discuss sleep efficiency and tracking progress
• Explain why rest in bed is not optimal
• Refer patients to appropriate healthcare providers for sleep dysfunction

• Increase awareness and recognition of statin intolerance in musculoskeletal patients.
• Learn the risk factors associated with Statin Associated Muscle Symptoms (SAMS).
• Identify the signs and symptoms of myositis/myopathy.
• Discuss the physiological process involved with SAMS and tests to confirm.

• Investigate the diagnostic accuracy of information from the patient history associated with hip-related pain 
• Characterize the association between manual therapy dosing and treatment outcomes for patients with hip osteoarthritis
• Summarize the literature regarding the diagnosis and non-operative treatment of femoroacetabular impingement (FAI) syndrome 
• Determine whether the addition of hip treatment and rehabilitation improves outcomes in patients with low back pain
• Quantify the prevalence of hip girdle weakness and tenderness in people with chronic non-specific low back pain

• List the major divisions and subcomponents of the neurological examination. 
• List, contrast and compare the neurological signs associated with “release phenomenon” and “deficit phenomena”.
• Contrast and compare the effects of neurological lesions on the neurological examination of the central nervous system versus the peripheral nervous system.
• Recite the implications of neurological examination findings on disorders involving various components of the central and peripheral nervous system.
• Draw the anatomy of the lower motor neuron in its relation to the spinal cord, nerve root, spinal nerve, and the neuro-myal junction.
• Describe the physical positioning of the patient during aspects of the neurological examination.
• List the subjects to question when in taking a good patient history.
• Describe and perform aspects of the neurological examination of the Cranial Nerves of the patient.
• Draw the neurologic pathways associated with the eye light reflexes.  Include reference to cells of the retina, the optic nerve, the optic chiasm, the optic tract, the Pretectal nucleus, and the Edinger Westphal nucleus.
• Describe and perform aspects of the neurological examination of the Motor Systems of the patient.
• Describe and perform aspects of the neurological examination of the Sensory Systems of the patient.
• Recite findings related to neurological “drift” performed during the neurological examination.
• Describe and perform aspects of the neurological examination of the Reflex Systems of the patient.
• Illustrate components of the muscle stretch reflex including the role of the Alpha motor neuron, Gama motor neuron, and large sensory fibers in relation to the muscle fibers and spinal cord.
• Discuss the common shorthand used for grading muscle stretch reflex responses and discuss the results of the neurological examination associated with each grade.
• Perform and discuss three versions of the extensor plantar response (extensor toe sign, Babinski sign).
• Describe and perform aspects of the neurological examination of movement of the patient.

Hour 1

• Compare the similarities and differences between EDS and HSD in both diagnosis and clinical presentation
• Summarize the history of the diagnosis and classifications of EDS and HSD
• Discuss the scales/outcome measures commonly used with EDS and HSD patients
• Identify common comorbidities and complications of EDS and other HSD
• Name potential differential diagnoses for these conditions
• Recognize common patient presentations of individuals with EDS and HSD

 Hour 2

• Develop a history taking protocol (including subjective complaints) for this patient population
• Identify possible precautions and referral protocols 
• Recognize and address common postural faults seen in EDS and HSD patients
• Determine treatment methods and other self/home-care recommendations for this population
• Develop exercise modifications and exercise progression strategies in the context of EDS/HSD
• Formulate appropriate activity recommendations and management strategies

• Explain the principles of linear and angular motion as they relate to spinal movement.
• Demonstrate the ability to locate and palpate multifidus.
• Identify and summarize common spinal instability pathologies.
• Describe the anatomy of the lumbar spine, emphasizing key limiting structures and the role of the multifidus in dynamic muscular control.
• Explain the chronic adaptations of the multifidus muscle in response to dysfunction.
• Demonstrate targeted, non-weight-bearing segmental stabilization techniques for the cervical, thoracic, and lumbar regions of the spine.

• Differentiate ossification from calcification
• Identify the categories of ossification
• Differentiate myositis ossificans progressiva from myositis ossificans traumatica
• Discuss imaging utilization with regards to ossification
• Review common and uncommon entities predisposed to ossification or calcification

• Recognize and identify important key factors for interpreting plain film x-rays of the spine and pelvis
• Recognize important medical/legal issues regarding interpreting plain films of the spine and pelvis and be able to apply appropriate radiographic documentation requirements when charting x-ray findings in the medical record
• Identify, analyze and interpret normal and abnormal anatomical osseous structures, common congenital and acquired pathologies, common normal radiographic variants and soft tissue calcifications/structures of the cervical, thoracic, lumbar, lumbosacral spine and pelvis

• Alert your clinical consciousness to prevent complacency
• Explain ways to identify the most common aneurysms clinically and on x-ray in the abdominal aorta, thoracic aorta, and splenic artery
• Differentiate aneurysm from dissection and pseudoaneurysm

• Identify the source of metastatic lesions
• Determine an advanced imaging protocol once a metastatic lesion is found
• Discuss how to identify on radiographs the two most common primary malignancies of bone - multiple myeloma and osteosarcoma

• Discuss the fundamental role of trauma in musculoskeletal disease and the various diagnostic imaging techniques used to evaluate it
• Identify, describe, and classify fractures by both direct & indirect radiographic signs
• Review fractures of specific etiologies based upon imaging findings
• Evaluate fracture alignment issues, complications, and healing
• Identify non-accidental injury of childhood, as well as normal structures that mimic fractures

• Understand Osteoporosis - (risk factors, incidence, prevalence, morbidity, etc.)
• Understand the fundamentals of DEXA (dual-energy x-ray absorptiometry), the gold standard in bone density testing
• Explain how to interpret the results
• Investigate the advantages and limitations of DEXA
• Investigate the indications and contraindications for utilization of DEXA

• This contains all courses with the educational objectives listed in Xray 119, and, Xray 123 through 127

• Use plain film to identify imaging findings of common diabetic foot fractures
• Discuss foot ulcers and using diagnostic imaging to rule out secondary osteomyelitis
• Identify diagnostic imaging findings of neuropathic osteoarthropathy (Charcot foot)

• Explain the clinical presentation, physical examination findings, orthopedic tests, laboratory findings, and radiographic findings associated with ankylosing spondylitis
• Discuss the extraskeletal manifestations of ankylosing spondylitis
• Explain the similarities and differences between the spondyloarthropathies
• Discuss the surgical and pharmacological management
• Discuss treatment that promotes spine mobility including the chiropractic adjustment

• This contains all courses with the educational objectives listed from Xray 124 through 146

• Explain the origin and pathophysiology of gout
• Understand how to prevent and monitor gout
• Examine gout on plain film
• Determine the clinical presentation of gout
• Describe the differences between the crystal arthritides on plain film

• Describe the patients that are at risk for developing osteoarthritis
• Summarize the pathophysiology behind the disease
• Discuss what osteoarthritis looks like on plain film and which joints are most likely affected
• Discuss the use of advanced imaging in osteoarthritis
• Present the research on many conservative treatment options including: physiotherapy, physical therapy/exercise, diet, and acupuncture

• Describe the anatomy of the disc and what causes the disc herniation
• Discuss the clinical presentation and who is at risk for a disc herniation
• Explain the diagnostic imaging findings for the disc herniation patient
• Evaluate the treatment options for disc herniation patients

• Assess the clinical presentation and diagnostic imaging procedure for vertebral compression fractures
• Discuss the use of plain film, CT, MRI, and DEXA
• Discuss treatments for vertebral compression fractures
• Identify other causes of vertebral fractures
• Identify other fractures besides vertebral fractures

• This contains all courses with the educational objectives listed from Xray 129 to Xray 134

• Summarize the current literature on fracture prevention
• Discuss diagnostic imaging and treatment of hip fractures
• Evaluate common lower extremity fractures, including stress fractures
• Discuss common upper extremity fractures, including the Colle's fracture and stress fractures
• Demonstrate knowledge of fractures in special populations, including adolescents and the developmentally disabled

• Evaluate the plain film images of upper and lower extremity dislocations
• Determine the mechanism of action and clinical presentation for upper and lower extremity dislocations
• Summarize the treatment options for the different upper and lower extremity dislocation
• Use assessment tools to determine treatment outcomes for extremity dislocations

• Determine the risk of MRI procedures and gadolinium contrast agents with respect to children
• Discuss the consequences of ionizing radiation in plain film, computed tomography, nuclear medicine, and fluoroscopy
• Demonstrate procedures to lessen the consequences of diagnostic imaging and discuss alternatives to the riskier modalities

• Determine the risks of ionizing radiation on the fetus
• Demonstrate the usefulness and limitations of ultrasound with regards to the pregnant woman
• Analyze the appropriate usage of magnetic resonance imaging in fetal diagnoses

• This contains all courses with the educational objectives listed from Xray 133 through Xray 144

• Demonstrating the differences between pediatric fractures and adult fractures
• Looking at the red flags for reporting non-accidental trauma (child abuse)
• Identifying fractures in children with osteopenia
• Discussing common upper extremity and lower extremity fractures
• Assessing proper protocol in imaging pediatric fractures, namely the use of plain film, ultrasound, MRI and CT

• Identifying bone and joint uses for PET
• Discussing neurological uses of PET, focusing on Parkinson’s disease and Alzheimer’s disease diagnosis
• Demonstrating the oncology use of PET
• Comparing PET with other diagnostic imaging modalities

• Determine the skeletal manifestations of neurofibromatosis and Paget’s disease
• Assess the diagnostic features of someone with neurofibromatosis or Paget’s disease
• Identify benign and malignant tumors commonly associated with neurofibromatosis and Paget’s disease
• Discuss the pathophysiology of neurofibromatosis and Paget’s disease

• Order proper diagnostic imaging for the lumbar spine
• Determine appropriate imaging for various pediatric musculoskeletal complaints
• Use plain film imaging for extremity complaints
• Determine what advanced imaging is appropriate for different extremity pathology

• Recognize normal bony and soft tissue anatomy of the upper cervical spine.
• Describe the direct and indirect signs of cervical trauma.
• Identify the more common mimics to cervical spine trauma.
• Summarize specific traumatic conditions affecting the upper cervical spine and their imaging findings.
• Assess which traumatic conditions of the upper cervical spine are stable, which are unstable, and how to manage each.

• Determine the diagnostic imaging findings consistent with a diagnosis of emphysema
• Discuss the plain film findings of congestive heart failure and conservative treatment options for these patients
• Determine the stage of sarcoidosis on plain film
• Identify the most common mediastinal masses of the chest
• Analyze different diagnostic imaging manifestations of pneumonia

• Analyze the debate between ALARA and AHARS with respect to the allowable amount of artificial radiation
• Express the cost vs. benefit of using CT, the imaging modality with the highest radiation risk
• Understand the added risk of radiation consequences in children
• Identify the different types of ionizing radiation

• Assess cervical radiographs to identify the radiographic signs of lower cervical spine trauma, recognizing which views are most diagnostic.
• Recognize, differentiate, and classify cervical hyperflexion and hyperextension injuries with respect to spinal stability.
• Identify and describe the imaging findings of neural arch trauma in the lower cervical spine.
• Discuss and categorize the complications of lower cervical spine trauma.
• Summarize the gravity as well as the evolving imaging and management protocols of penetrating neck injury.

• Summarize the radiographic findings of simple compression fractures and discuss how spinal biomechanics predispose to their occurrence.
• Describe the radiographic signs and sequelae of burst fractures and differentiate them from simple compression fractures.
• Identify the imaging findings of Chance type fractures and discuss their most common complications.
• Recognize the common radiographic manifestations of posterior arch trauma.
• Categorize the different types of intervertebral disc lesions and summarize their imaging findings.

• Examine common orthopedic hardware on plain film and what needs to be reported
• Explain Xray findings which require Orthopedic referral and the various options
• Determine when advanced imaging is appropriate and what modality to use
• Discuss possible complications when finding orthopedic hardware

Hour 1

• Examine common orthopedic hardware on plain film and what needs to be reported
• Explain Xray findings which require Orthopedic referral and the various options
• Determine when advanced imaging is appropriate and what modality to use
• Discuss possible complications when finding orthopedic hardware

Hour 2

• Discuss congestive heart failure: diagnosis, imaging, and treatment
• Understand the imaging and treatment of multiple myeloma
• Understand the nature of chronic obstructive pulmonary disease, specifically emphysema
• Evaluate the use of DXA in the diagnosis of osteoporosis
• Determining appropriate care for patients with osteoarthritis

Hour 3

• Determining common geriatric conditions that need special consideration in a patient assessment
• Identifying diabetic foot complications, specifically Charcot's foot
• Analyzing bone metastasis in the elderly, specifically carcinomas
• Understanding thoracic and abdominal aorta aneurysms and aorta dissections
• Explaining pneumonia, specifically community acquired pneumonia, from a clinical perspective

Hour 4

• Determining the risk factors, diagnostic imaging and pathophysiology of atherosclerosis
• Assessing patient risk for developing hip fractures
• Understanding prevention and diagnosis of lung cancer
• Identifying normal anatomy of the disc and what goes wrong in degenerative disc disease
• Reviewing common orthopedic hardware found in elderly patients

• Discuss congestive heart failure: diagnosis, imaging, and treatment
• Understand the imaging and treatment of multiple myeloma
• Understand the nature of chronic obstructive pulmonary disease, specifically emphysema
• Evaluate the use of DXA in the diagnosis of osteoporosis
• Determining appropriate care for patients with osteoarthritis

• Determining common geriatric conditions that need special consideration in a patient assessment
• Identifying diabetic foot complications, specifically Charcot's foot
• Analyzing bone metastasis in the elderly, specifically carcinomas
• Understanding thoracic and abdominal aorta aneurysms and aorta dissections
• Explaining pneumonia, specifically community acquired pneumonia, from a clinical perspective

• Determining the risk factors, diagnostic imaging and pathophysiology of atherosclerosis
• Assessing patient risk for developing hip fractures
• Understanding prevention and diagnosis of lung cancer
• Identifying normal anatomy of the disc and what goes wrong in degenerative disc disease
• Reviewing common orthopedic hardware found in elderly patients

• Explaining in layman’s terms the basics of cancer
• Determining prognosis when skeletal metastasis is found on plain film
• Identifying osteolytic versus osteoblastic metastasis on plain film and specifying what advanced imaging is appropriate based on the cancer’s radiographic appearance
• Exploring current literature on emerging treatment options
• Discussing pathophysiology of bone metastasis