Hawaii Chiropractic Continuing Education

• Define the terms communication, language, and a wide variety of descriptive terms for cortical language and knowledge impairments
• Review the functions classically associated with the cerebral cortex
• Categorize cortical deficits and associated patient conditions
• Identify neurological pathways used by the cerebral cortex
• Describe in detail concepts of lateralization of brain function and hemisphere "dominance" or "hemisphericity"
• Describe and demonstrate a schema to maintain a methodical approach to the patient with a communication disorder
• Visualize a patient with a "split brain disorder"
• Review and assess concepts and skills necessary to perform an examination of a patient with a communication disorder
• Compare and contrast loss of neurologic function at the level of the primary modality to disorders of the primary cortical receptive area as well as in the association cortex

• Define terms relevant to comprehending and performing various nervous system tests not typically a part of the motor, sensory and reflex examinations.
• Review various ancillary tests, including the purpose behind the test as well as test performance.
• Categorize ancillary neurological tests and explain their use and purpose.
• Identify, describe and discuss meningeal stretch tests.
• Identify, describe and discuss neurodynamic tests.
• Identify, describe and discuss nerve tension tests.
• Identify, describe and discuss peripheral nerve palpation and Tinel's sign.
• Identify, describe and discuss Dix-Hallpike test.
• Identify, describe and discuss pressure algometry and introduce the instruments to perform this test.
• Identify, describe and discuss sensory threshold testing and introduce the instruments to perform these tests.
• Discuss the nature and performance of tests used to diagnose defects in function of the neurovascular bundle in the upper and lower extremities (Thoracic Outlet Syndrome).
• Identify, describe and discuss use of the stethoscope and points to auscultate in the head and neck area

• Perform an examination of the systems involved with Movement and Coordination
• Discuss cerebellar anatomy
• Differentially Diagnose by applying clinical signs of cerebellar dysfunction
• Recognize cerebellar syndromes by their anatomical areas
• Apply specific principles of examination to improve the Chiropractic Spinal Examination
• Describe specific procedures of the spinal examination

• Define terms relevant to comprehending and performing various aspects of the mental status examination.
• Categorize the components of the mental status examination.
• Identify, define and discuss dementia and Disease of the Alzheimer's Type (DAT).
• Identify, define and discuss the five levels of consciousness.
• Define and discuss the components of the mental status examination.
• Compare and contrast dementia and depression.
• Discuss and describe methods of charting mental status examination findings.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with an acute onset of headache and facial paralysis
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with an acute onset of headache and facial paralysis
• Improve interpretation of relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with an acute onset of headache and facial paralysis
• Differentially diagnose patients with acute onset of headache and facial paralysis

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with an acute onset of post traumatic headache
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with an acute onset of post traumatic headache
• Improve interpretation of relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with an acute onset of post traumatic headache
• Differentially diagnose patients with acute onset of post traumatic headache

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with an acute onset of post traumatic neck pain and unusual “burping” upon neck manipulation
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with an acute onset of post traumatic neck pain and unusual “burping” upon neck manipulation
• Improve interpretation of relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with an acute onset of post traumatic neck pain and unusual “burping” upon neck manipulation
• Differentially diagnose patients with acute onset of post traumatic neck pain and unusual “burping” upon neck manipulation

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with a shoulder complaint
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a shoulder complaint
• Improve interpretation of relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with a shoulder complaint
• Differentially diagnose patients with a shoulder complaint

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with a sudden onset of dizziness, sensory complaints and ataxia
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a sudden onset of dizziness, sensory complaints and ataxia
• Improve interpretation of relevant clinical findings
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with a sudden onset of dizziness, sensory complaints and ataxia
• Differentially diagnose patients with a sudden onset of dizziness, sensory complaints and ataxia

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with shoulder and arm pain.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with shoulder and arm pain.
• Improve interpretation of relevant clinical findings in a patient with shoulder and arm pain.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with shoulder and arm pain.
• Differentially diagnose patients with shoulder and arm pain.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with a brachial plexus injury, severe arm pain and a “flail” upper extremity.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a brachial plexus injury, severe arm pain and a “flail” upper extremity.
• Improve interpretation of relevant clinical findings in a patient with a brachial plexus injury, severe arm pain and a “flail” upper extremity.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with a brachial plexus injury, severe arm pain and a “flail” upper extremity.
• Differentially diagnose patients with a brachial plexus injury, severe arm pain and a “flail” upper extremity.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with a tremor of the left upper extremity.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a tremor of the left upper extremity.
• Improve interpretation of relevant clinical findings in a patient with a tremor of the left upper extremity.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with a brachial plexus injury, severe arm pain and a tremor of the left upper extremity.
• Differentially diagnose patients with a tremor of the left upper extremity.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting with chronic spasm of the muscles of the lower face and tongue.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a oromandibular dystonia.
• Improve interpretation of relevant clinical findings in a patient with oromandibular dystonia.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient oromandibular dystonia.
• Differentially diagnose patients with oromandibular dystonia.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting following treatment for a malignant nerve sheath tumor involving the L4 nerve root.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with a malignant nerve sheath tumor involving the L4 nerve root.
• Improve interpretation of relevant clinical findings in a patient with a malignant nerve sheath tumor involving the L4 nerve root.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with a malignant nerve sheath tumor involving the L4 nerve root.
• Consider the differential diagnosis of patients with a malignant nerve sheath tumor involving the L4 nerve root.

• Evaluate an unrehearsed real doctor/patient encounter of a patient presenting carpal tunnel syndrome (CTS) and chronic neck pain.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient with carpal tunnel syndrome (CTS) and chronic neck pain.
• Improve interpretation of relevant clinical findings in a patient with carpal tunnel syndrome (CTS) and chronic neck pain.
• List the clinical presentations of various complaints and the approach to diagnosis of a patient with carpal tunnel syndrome (CTS) and chronic neck pain.
• Consider the differential diagnosis of patients with carpal tunnel syndrome (CTS) and chronic neck pain.
• Comprehend the principle of ongoing, medically necessary chiropractic treatment of a patient with carpal tunnel syndrome (CTS) and chronic neck pain.

• Evaluate two unrehearsed, real doctor/patient encounter; the first of a patient presenting with simultaneous radiculopathy, polyneuropathy and mononeuropathy and the second of a patient presenting with migraine headache and related trigeminal neuralgia.
• Develop improved skills in obtaining an accurate case history and performing an examination of patient’s presenting with radiculopathy, polyneuropathy and mononeuropathy, migraine headache and trigeminal neuralgia.
• Improve interpretation of relevant clinical findings of patient’s presenting with radiculopathy, polyneuropathy and mononeuropathy, migraine headache and trigeminal neuralgia.
• List the clinical presentations of various complaints and the approach to diagnosis of patient’s presenting with radiculopathy, polyneuropathy and mononeuropathy, migraine headache and trigeminal neuralgia.
• Consider the differential diagnoses of patient’s presenting with radiculopathy, polyneuropathy and mononeuropathy, migraine headache and trigeminal neuralgia.

• Evaluate an unrehearsed, real doctor/patient encounter involving an elderly women presenting with a sudden onset of lower extremity paralysis.
• Develop improved skills in obtaining an accurate case history and performing an examination of a patient presenting with a sudden onset of lower extremity paralysis.
• Improve interpretation of relevant clinical findings of patient’s presenting with a sudden onset of lower extremity paralysis.
• List the clinical presentations of various complaints and the approach to diagnosis of patient’s presenting with a sudden onset of lower extremity paralysis.
• Consider the differential diagnoses of presenting with a sudden onset of lower extremity paralysis.

• Evaluate two unrehearsed, real doctor/patient encounters; the first case is that of an adult male patient with multiple sclerosis.  The second case is that of an adult male with cerebral palsy.
• Develop improved skills in obtaining an accurate case history and performing an examination of patient’s presenting with multiple sclerosis and cerebral palsy.
• Improve interpretation of relevant clinical findings of patient’s presenting with multiple sclerosis and cerebral palsy.
• List the clinical presentations of various complaints and the approach to diagnosis of patient’s presenting multiple sclerosis and cerebral palsy.
• Consider the differential diagnoses of patient’s presenting with multiple sclerosis and cerebral palsy.

• This allows you to purchase all 24 hours of 205 level courses.  Please see the educational objectives listed for each individual 205 course

• List the electrodes necessary to perform in Electrodiagnosis nerve conduction study
• Describe the placement of the various electrodes in conduction studies of the median nerve at the wrist
• Draw a simple diagram of the carpal tunnel, defining the boundaries
• Itemize parts of a thorough chiropractic management plan for carpal tunnel syndrome

• List the differential diagnoses that may accompany various symptoms
• Describe various essential elements of the history taking process
• List several components of the mini mental status examination
• Itemize and describe several tests of cerebellar function
• Contrast and compare aspects of malingering and somatoform disorders
• Use proper language and nomenclature when producing a report for referring physicians
• Recognize aspects of functional illness

• Evaluate an unrehearsed, real doctor/patient encounter; regarding a case of an adult female patient who complains of lower back pain; pain radiating down her left lower extremity to her heel; weakness in her thighs; and unsteadiness.
• Develop improved skills in obtaining an accurate case history and performing a neurological examination of patient’s presenting with pain, weakness and unsteadiness.
• Improve interpretation of relevant clinical findings of patient presenting with pain, weakness and unsteadiness.
• List the clinical presentations of various complaints and the approach to diagnosis of patient’s presenting with pain, weakness and unsteadiness.
• Consider the differential diagnoses of patient’s presenting with pain, weakness and unsteadiness.

• List the differential diagnoses that may accompany various symptoms.  
• Describe various essential elements of the history taking process.
• List differential diagnoses for this and similar cases.
• Itemize and describe several tests of lower extremity motor and reflex function.
• Recognize a true extensor toe sign from an equivocal or false finding.
• Contrast and compare aspects of various disorders causing cervical spine myelopathy.   
• Use proper language and nomenclature when producing a report for referring physicians.
• Recognize aspects of spinal cord disease.

• List the differential diagnoses that may accompany various symptoms. 
• Describe various essential elements of the history taking process.
• Use proper language and nomenclature when discussing brain injury.
• Recognize aspects of so called “post concussion syndrome” or Mild Traumatic Brain Injury (mTBI).
• Recite levels of consciousness.
• Discuss scoring criterion when using the Glascow Coma Scale.
• Identify abnormal imaging findings associated with concussion on diffusion tensor tractography.
• Define and describe “myoclonic jerks”.

• This allows you to purchase all 20 hours of 206 level courses. Please see the educational objectives listed for each individual 206 module

• Compare and contrast neuronal cells from the neuroglial cells.
• Identify various types of neurons of the peripheral and central nervous system.
• Describe the types of neuroglial cells found in the central nervous system and peripheral nervous system.
• Categorize the types of mammalian nerve fibers by neuron a diameter, conduction velocity and susceptibility to compression.
• Describe the incidence and prevalence of dizziness as a complaint.
• Define the term “motor unit” from a clinical perspective.
• Compare and contrast type one and type two muscle fibers.
• Identify anatomical components and describe physiological function of the cell membrane.
• Define the terms summation and generator potentials.

• Define the terms “electrodiagnosis, nerve conduction study, needle electrode examination, late responses and evoked potentials”.
• Identify the various components of the action potential recording.
• Compare and contrast synaptic versus electrical nerve stimulation.
• Recite the components of the modern electromyographic machine.
• Describe the different types of electrodes used in an electrodiagnostic examination and include the purpose and benefits/drawbacks to each type.
• Categorize the types of electrodiagnostic testing.
• Discuss performance and use of electrodiagnostic testing, including conduction studies and latencies, late responses (including the “H” reflex and “F” wave) and evoked potentials.
• Properly order and interpret the results of electrodiagnostic testing.

• Define the terms “spasm, interexaminar and intraexaminer reliability, global myoelectric activity and muscle fatigue”.
• Identify the various components of the modern paraspinal electrode EMG machine. recording.
• Compare and contrast the use of surface electrodes in the traditional electromyographic examination versus the paraspinal surface electrode electromyographic examination.
• Recite several scientific studies regarding paraspinal surface electrode electromyographic, and strengths and weaknesses of each study.
• Describe tissue filtering, best ways to overcome it, and explain its significance in obtaining useful data.
• Recite the names of the paraspinal musculature organized by their depth, action and activation response.
• Discuss performance and utility of the test for the “flexion relaxation” phenomenon.

• This allows you to purchase all 12 hours of 207 level courses. Please see the educational objectives listed for each individual 207 module

• List several textbooks on electrodiagnostic medicine and discuss the benefits and limitations of each text.
• Recite several applications of electrodiagnostic medicine and discuss the utility of each of the tests performed.
• Describe the components required to perform an electrodiagnostic examination.
• Compare and contrast peripheral nerve injury classifications.
• Define some of the current terminology used in electrodiagnostic medicine.
• Compare and contrast the different types of electrodes used in electrodiagnostic medicine.
• Describe terminal motor latencies.
• Describe sensory and motor conduction velocities and studies.
• Describe electromyography.
• Discuss orthodromic and anti-dromic testing.
• Define motor unit potentials and discuss the normal and abnormal phases.
• Describe the varieties of evoked potentials and discuss the clinical utility of ordering each test.
• Describe the varieties of late potentials and discuss the clinical utility of ordering these tests.
• Identify the relevant neuroanatomy of the peripheral nervous system.
• Demonstrate median and ulnar nerves and the position of the various electrodes in common motor and sensory electrodiagnostic studies of the median and ulnar nerves.
• Discuss the conditions and circumstances when electrodiagnostic testing of the central nervous system may be beneficial or necessary.
• Describe the various electrodiagnostic procedures for the peripheral nervous system.
• Differentiate between motor unit potentials (MUP’s), fibrillations, positive sharp waves and sensory nerve action potentials (SNAP’s). 
• Contrast and compare electrodiagnostic tests for extremity complaints such as weakness and sensory loss.
• Define the role of electrodiagnosis in clinical practice.

• Compare and contrast Compound Muscle Action potential (CMAP), Sensory Nerve Action Potential (SNAP) and Motor Unit Potential (MUP).
• List the components of a spinal cord alpha motor neuron.
• Describe the basic structure of Schwann Cells and myelin.
• Discuss the role of Schwann Cells and myelin in action potential transmission.
• Recite the levels of the neuraxis which may be involved in disease that is detectable by electrodiagnostic testing.
• List the types and levels of nervous system compression.
• List common reasons and disorders for referral for electrodiagnostic testing.
• Describe a routine electrodiagnostic encounter.
• Demonstrate the position of electrodes in a typical median nerve study through the carpal tunnel.
• List the most common neuropathies of the upper and lower extremities.
• Compare and contrast typical electrodiagnostic findings for radiculopathy versus neuropathy. 
• Define and discuss the “Gold Standard” portions of the electrodiagnostic examinations.
• Discuss single fiber EMG.
• Identify the components of the needle EMG examination and discuss how various pathological conditions might be demonstrated by each component of the examination.
• Describe the morphology of positive sharp waves, fibrillations and motor unit potentials.
• Describe the morphology of positive sharp waves and fibrillations.
• Identify normal from abnormal patterns of muscular recruitment under minimal, moderate and maximal muscle contraction. 
• List various causes of radiculopathy.
• Discuss the history of radiculopathy through time.
• Contrast and compare various causes of radiculopathy.
• Discuss the need for and types of advanced imaging following abnormal findings on an electrodiagnostic examination.
• Discuss the utility of electrodiagnosis to the Doctor of Chiropractic.

• Recite relevant anatomy of the peripheral nervous system including the brachial plexus, upper limb nerves, lumbosacral plexus and lower limb nerves.
• Define and draw the brachial plexus.
• List the nerves of the upper limb.
• Compare and contrast the anatomy of the median and the ulnar nerves.
• Describe innervation of the major nerve branches of the major nerve divisions of the brachial plexus.
• Discuss the most common compressive lesions of the upper extremity involving the peripheral nervous system.
• List the muscles most commonly tested during EMG of the upper extremity.
• Define and draw the lumbosacral plexus.
• List the nerves of the lower limb.
• Discuss the most common compressive lesions of the lower extremity involving the peripheral nervous system.
• List the muscles most commonly tested during EMG of the lower extremity.
• Discuss the distinction between motor and sensory neural fibers and salutatory versus local circuit conduction.
• Compare and contrast the two types of compound potentials and discuss waveform morphology and parameters.
• Describe effects and patterns of demyelination.
• Describe the effects of axonal loss.
• Identify the electro-physiologic changes that may be noted in disease of the neuromuscular junction.
• Discuss late responses (F-waves and H-Reflexes) and describe the performance and clinical significance of each.
• Identify components involved in the tendon tap response.
• Thoroughly discuss all aspects of median and ulna nerve testing, including common congenital anomalies that are like to be encountered in the patient population.

• This allows you to purchase all 18 hours of 208 level courses. Please see the educational objectives listed for each individual 208 module

Hour 1

• Recite general information regarding incidents and prevalence of multiple sclerosis in the United States, the United Kingdom and Canada.
• Describe the pathophysiological process believed to be responsible for the most common types of multiple sclerosis.

Hour 2

• Recognize the common signs and symptoms of a patient presenting with demyelinating disease.
• Recognize typical lesions in the brain and spinal cord associated with multiple sclerosis on MRI studies.
• Define the McDonald criteria for the diagnosis of multiple sclerosis.

Hour 3

• Identify various blood tests for diseases that may mimic multiple sclerosis.
• Compare and contrast the category types of multiple sclerosis.
• Describe the common medical treatment for multiple sclerosis.

Hour 4

• Recite studies associated with complementary and alternative approaches to management of patients with multiple sclerosis.
• Synthesize a plan for the management of patients with multiple sclerosis.

Hour 1

• Recite statistics regarding the percentage of primary versus secondary tumors found in the central nervous system.
• Recognize the signs and symptoms of a patient with an intracranial or spinal canal tumor.

Hour 2

• Describe the pathophysiological process associated with neoplasia.
• Discuss the most common types of primary intracranial tumors, metastatic neoplasms and other spinal cancers.

Hour 3

• Identify advanced imaging studies of various types of nervous system tumors.
• Describe mechanisms of cerebrospinal fluid flow in their association with symptoms caused by intracranial tumors.

Hour 4

• Contrast and compare the signs and symptoms associated with tumors arising in various parts of the spinal cord.
• Discuss various forms of medical treatment for patients with nervous system tumors.

Hour 1

• Discuss the etiology of congenital conditions of the brain and spinal cord.
• Recite statistics regarding incidence and prevalence of neural tube defects.

Hour 2

• Describe common forms and categories of neural tube defects.
• Recognize various forms of neural tube defects at birth, in infant life as well as on advanced imaging studies.

Hour 3

• Identify defects of the cranial cervical junction including categorizing Chiari Malformation and discuss clinical significance and management of patients with Chiari Malformation I, II and III.
• Utilize plain film radiometrics to identify multiple forms of cranial cervical junction deformities.

Hour 4

• Discuss various congenital syndromes including Dandy-Walker Syndrome and Mobius Syndrome.
• Compare and contrast different types of developmental defects such as hydrocephalus, crainiosynostosis, achondroplasia, microcrania, and others.

• Define Neurodegeneration.
• Identify some of the core mechanisms of Neurodegeneration.
• Define and discuss oxidative stress and damage of neurons.
• List most common neurological illnesses thought to be due to long-term Neurodegeneration.
• Cite specific biochemical pathways to target therapeutically to slow down or reverse Neurodegeneration.
• Itemize common clinical findings in Parkinson’s disease, Alzheimer's disease, and multiple sclerosis.
• List the mechanisms involved in the neurodegenerative process.
• Define free radicals, articulate the issue with free radicals and describe their role in the neurodegenerative process.
• Discuss the role of glial cells in regard to Neurodegeneration.
• Itemize ways to increase the Nrf2 pathway.
• Discuss glutathione and list specific methods to increase glutathione levels.
• List dangers found in regard to genetically modified foods.
• Compare and contrast normal mitochondrial structure and function with dysfunctional mitochondria with attention to free radical damage to my no conjugal proteins and mitochondrial DNA.
• Discuss the therapeutic role of essential fatty acids (EFA's), Acetyl-L-Carnitine, and coenzyme Q-10.
• List and discuss methods for laboratory evaluation of systemic inflammation.
• Itemize issues associated with the "leaky gut" syndrome, including aspects of inflammation, relation to diabetes, and Zonulin.

Hour 1

• Describe the most common laboratory procedures used to diagnose infections of the central nervous system, including lumbar puncture indications, contraindications and complications.
• Recite characteristics and components of normal cerebrospinal fluid.

Hour 2

• Define the acquired immunodeficiency syndrome and how it affects the nervous system.
• Discuss Lyme disease, its vectors of transmission, pathogenesis, clinical presentation, clinical diagnosis and therapeutic options.
• Compare and contrast stage I, stage II and stage III Lyme disease.

Hour 3

• Identify multiple types of infections capable of producing spinal meningitis and encephalitis.
• Compare and contrast bacterial meningitis from viral meningitis.
• Discuss serious nervous system toxins such as tetanus and botulism.

Hour 4

• Discuss other nervous system infections including brucellosis, psittacosis, syphilis, tuberculosis, sarcoidosis, rickettsial, protozoan, viral and fungal infections of the nervous system.
• Recognize and act appropriately in cases of suspected Reye syndrome.
• Recite and perform appropriate universal precautions necessary to avoid the transmission of communicable diseases in the chiropractic practice.

• This allows you to purchase all 15 hours of 209 level courses. Please see the educational objectives listed for each individual 209 module

• Define and discuss professional boundaries
• Define and discuss sexual misconduct
• Sensitize the D.C. To Issues Relating to Sexual Interaction with The Patient
• Discuss the problem of sexual misconduct, either real or perceived
• Define and discuss specific examination procedures
• Provide methods for recording examinations and incidents
• Discuss case of alleged sexual misconduct
• Discuss strategies to avoid misunderstandings that may lead to charges of sexual misconduct

• Recite the incidence and prevalence of Carpal Tunnel Syndrome.
• Discuss the cost of Carpal Tunnel Syndrome on society.
• Identify disorders and situations that Carpal Tunnel Syndrome.
• Describe the common symptoms of Carpal Tunnel Syndrome.
• Define the anatomical boarders of the Carpal Tunnel Syndrome.
• Differentiate the methods of Carpal Tunnel Release Surgery.
• Describe the scientific literature comparing different methods of Carpal Tunnel Release Surgery.

• Review items included in the State and American Chiropractic Association "Principles of Chiropractic Ethics".
• Define and distinguish between principles of philosophy, ethics and morality. 
• Explore the concept of "The Greater Good".
• Differentiate general concepts of what is right and wrong, from personal decisions of what is right and wrong.
• Define the term "Fiduciary Responsibility".
• Give examples of "Ethical Dilemmas" that might face a doctor of chiropractic and provide discussion of alternative thoughts.
• Discuss issues of “boundary crossings & violations” in regard to chiropractic practice.

• Recite the types of Thoracic Outlet Syndromes and identify which types are “real” and which are disputed.
• Demonstrate different clinical maneuvers designed to identify Thoracic Outlet Syndromes.
• Identify the anatomical structures thought to be responsible for entrapment in the various Thoracic Outlet Syndromes.
• Discuss the significance of the nine fibrous bands discussed by Roos.
• Describe the anatomical and physiological changes that are thought to occur post-accident, resulting in a traumatic variety of Thoracic Outlet Syndrome. 
• Differentiate the compressive causes of upper extremity paresthesia using orthopedic and neurological testing.
• Contrast and compare the resultant clinical profile expected with upper extremity compression of vascular structures versus compression of neural structures.
• Define and perform orthopedic and neurological tests used to determine upper extremity compression of neurovascular structures.

• Outline topography and discuss internal anatomy of the cortex.
• Illustrate and list functions of the various lobes of the brain.
• Identify and describe anterior and posterior intracranial circulatory patterns.
• Relate cortical anatomy with electrode placement when eliciting somatosensory evoked potentials.
• Identify irrigation distribution of all major intracranial arteries.
• Diagram irrigation to the levels of the spinal cord.
• Describe intracranial venous drainage of the skull and differentiate between dural sinuses, boney sinuses and cerebral veins.
• List areas of the cortex responsible for vision, hearing and touch and explain their interaction with the association cortex.
• Give examples traits and characteristics which are associated with hemisphere dominance.
• Define and differentiate the agnosias, such as apraxia, aphagia, etc.
• Define constructional apraxia, and discuss the clinical significance.
• Quantify the incidence of various types of neurovascular disease.
• Contrast and compare strokes from a vascular anatomical and etiology viewpoint.
• List and discuss choices for various forms of imaging based upon suspected stroke etiology.
• Identify treatable, untreatable and possible risks for cerebrovascular accident. 
• Identify medical and conservative options for treatment of cerebrovascular accident risk factors.

• Compare and contrast chiropractors of the 1940s with modern day chiropractors.
• Define neuropathy.
• Recite the major points related to chiropractic physical rehabilitation of neuropathy.
• Contrast and compare medical treatment of polio in the 1940s, to chiropractic treatment of polio at the same time.
• List potential reasons related to public hygiene which may account for disease epidemics.
• Discuss facts related to "Sister Kenny" in regard to her credentials, her claims, and her notoriety.
• Itemize the early chiropractic colleges and discuss Willard Carver school of thought and the "mixers".
• Critically evaluate the world health organization's campaign to eradicate polio.
• Discuss the ethics of herd immunity.
• Compare and contrast individual interests vs. societal interests.
• Discuss the types, risks and benefits of the inactive polio virus (injected).
• Discuss the risks and benefits of the oral polio virus (live, attenuated).
• List the types of wild polio virus.
• Define vaccine associated paralytic polio mile items (VAPP)
• Define circulating vaccine derived polio virus.
• Discuss the concepts of risk: benefit ratio.
• Discuss the transmission and pathophysiology and list the presenting signs and symptoms of a polio virus infection.
• List the different types of Polio virus infection.
• Quantify the various affects of the polio virus on different groups of individuals.
• Itemize ethical concerns regarding Dr. Jonas Salk.
• Graph the incidence of polio cases after other vaccines were introduced and after the definition of a polio diagnosis was altered.
• Discuss SV40 tainted vaccines.
• Define acute flaccid paralysis as it relates to new “non-polio” outbreaks.

• This allows you to purchase all 8 hours of 210 level courses. Please see the educational objectives listed for each individual 210 module

• Evaluate the subluxation complex and the chiropractic adjustment.
• Develop a working knowledge of the neurology of spinal joints and how this may be altered by a spinal subluxation complex.
• Consider the safety and effectiveness of chiropractic adjustments through a review of the scientific literature and understanding of a decline in literature integrity and literature bias.
• Consider the scientific literature regarding chiropractic adjustments and a measurable decrease in pain.
• List and identify the components of the synovial joint and spinal joint mechanoreceptors.
• Consider activities in and around the nervous system that occur after nerve tissue injury.
• Distinguish different levels of nervous system involvement in neuropathic pain, including the peripheral neuron, the dorsal root ganglia and the dorsal horn neurons, as well as concepts of descending inhibition.
• Analyze the goals and effects of the chiropractic adjustment on pain.
• Examine the scientific literature regarding the physiological effects of a subluxation and adjustment upon non-musculoskeletal systems.

• Explain how and why documentation of a subluxation is so important for Medicare patients in chiropractic practice.
• Compare and contrast the Medicare reimbursement of chiropractic providers vs. Medical and other providers for similar services.
• Describe payments made to chiropractors, calculate the actual dollars per visit and explain what portion of payments made are considered inappropriate as medically unnecessary according to a report issued by the Department Of Health And Human Services (HHS).
• Compare and contrast non-provider services, such as drugs and durable medical devices with costs associated with chiropractic care.
• Define requirements for chiropractic services to be covered by Medicare.
• List and discuss how a subluxation may be properly documented in the medical record for Medicare patients.
• Evaluate your understanding of subluxation compared to other chiropractic providers. 
• List the various types of subluxation which may be demonstrated on xray and are acceptable to Medicare.
• List the components of the physical examination which are required by Medicare to be demonstrated in order to verify the existence of a subluxation.
• Identify the specific requirements accepted by Medicare for the initial and subsequent visits of the chiropractic patient.

• This allows you to purchase all 23 hours of 211 level courses. Please see the educational objectives listed for each individual 211 module

• Perform a clinical assessment of pain and function
• Explain the psychophysiological profile of pain patients
• Discuss the treatment of pain
• Define spinal decompression therapy
• Demonstrate decompression table structure and use
• Describe the relevant anatomy of the lumbar spine
• Critically examine published reports of clinical outcomes of decompression therapy
• Present and discuss clinical outcomes of decompression therapy
• Determine spinal decompression table treatment protocols
• Define dizziness
• Define vertigo and other associated symptoms
• Discuss cervicogenic dysequilibrium
• Discuss diagnostic tests to determine the cause of vertigo
• Explore current understanding of pain concepts, physiology and theories behind neuropathic pain
• Discuss in detail the relevant neurological anatomy and functional neurology
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to pain receptors and neural integration
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to neural plasticity, articular neurology, and mechanisms of pain
• Explore current understanding of pain concepts, physiology and theories behind neuropathic pain and allodynia
• Discuss the importance of the neurological implications of a nerve injury
• Describe mechanisms of neural plasticity
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to neural plasticity, articular neurology, and mechanisms of pain
• Analyze current literature regarding spinal adjustments, and break down concepts, physiology and theories behind chiropractic treatment
• Appraise new and existing ideas related to mechanisms involved whereby chiropractic spinal adjustments might effect the vascular and nervous system
• Describe the anatomy and physiology of relevant components of human nervous system as it relates to chiropractic adjustments, neural plasticity, articular neurology, and mechanisms of pain
• Explore current understanding of pain physiology and theories behind neuropathic pain, allodynia and proposed treatment using chiropractic adjustments

• Explore current role of the art and science of obtaining a relevant patient history at the bedside
• Discuss and demonstrate relevant neurological examination procedures required to examine and diagnose pathological conditions of the nervous system
• Outline considerations regarding the relationship of the upper cervical spine and headache
• Summarize characteristics of several clinical headache syndromes, emphasizing recognition and differential diagnosis of pathological conditions
• Illustrate levels of the central and peripheral nervous system and relate that to the clinical presentation resulting from disease of the various brain and cord areas
• Outline and organize various categories for headache

• Define vertigo and differentiate vertigo in the "dizzy" patient population
• Identify disorders that cause dizziness and vertigo.
• Discuss modes of presentation, providers consulted and other aspects.
• Differentiate primary and secondary dizziness.
• Understand aspects of serious and other uncommon causes of dizziness.
• Describe basic anatomy and physiologic function of components of the vestibular system.
• Demonstrate and comprehend performance of the Dix-Hallpike and Eply Maneuvers.
• Define and diagnose Benign Positional Paroxysmal Vertigo (BPPV).
• Perform a bedside examination for evaluation of the dizzy patient.

• Describe the incidence and prevalence of dizziness as a complaint.
• Define the term vertigo from a clinical perspective.
• Identify anatomical components and describe physiological function of the vestibular system.
• Perform a brief bedside examination for basic evaluation of the dizzy patient.
• Categorize varieties of conditions causing dizziness and identify which are likely to be amenable to conservative care.
• Compare and contrast the function of the utricle, saccule and semicircular canals.

• Describe the anatomical structures involved and the overall significance of the Dix-Hallpike Maneuver.
• Perform the Dix-Hallpike Maneuver.
• Describe the anatomical structures involved and the overall significance of the Epley Maneuver.
• Perform the Epley Maneuver.
• Compare and contrast the use of the Dix Hallpike and the Roll Test.
• Discuss in detail the proper use of various vestibular function tests (past pointing, veering, balance, gait, etc.), Swivel Chair Test, Swinging Stool Test, Semont Procedure and the Brandt-Daroff exercises.
• Perform vestibular function tests (past pointing, veering, balance, gait, etc.), Swivel Chair Test, Swinging Stool Test, Semont Procedure and the Brandt-Daroff exercises.

• Evaluate a case of an adult female patient who presents with facial spasms and other complaints including facial weakness, slurred speech, and drooling.
• Differentiate central causes of facial spasm from central causes of facial spasm.
• Consider the effect of chiropractic adjustments on intracranial arterial function.
• Develop improved skills in obtaining an accurate case history and performing a neurological examination of patient’s presenting with facial spasms.
• Improve interpretation of relevant clinical findings of patients presenting with facial spasms.
• List the differential diagnoses to consider in a patient presenting with facial spasms.
• Identify portions of the brainstem, origins of the cranial nerves and the relationship between arteries and cranial nerves at the brainstem.

• This allows you to purchase all 19 hours of 212 level courses. Please see the educational objectives listed for each individual 212 module

• Identify the anatomical components of the peripheral arterial system.
• Identify the anatomical components of the peripheral venous system.
• Identify, define and discuss commonly presenting disorders of the vascular system.
• Briefly describe methods of medical and conservative treatment for select vascular illnesses.
• Compare and contrast clinical findings in arterial versus venous disease involving the lower extremity.

• Identify the anatomical components of the thyroid gland.
• Identify the anatomical components and drainage areas of the lymphatic vascular system.
• Identify, define and discuss commonly presenting disorders of the thyroid gland and lymphatic vascular system.
• Briefly describe methods of medical and conservative treatment for select thyroid and lymphatic illnesses.
• Define and discuss landmarks of the human thorax and their implication in the clinical examination.

• Identify the surface anatomy of the 5 lobes of the lungs.
• Identify anatomical landmarks related to the lung lobes.
• Identify, define and discuss normal and abnormal breath sounds.
• Briefly describe methods of stethoscope use and placement.
• Define and discuss methods used to analyze breaths during auscultation.

• Recall normal chest ratios and differentiate from abnormal chest ratios.
• Compare and contrast clinical findings associated with various breathing abnormalities.
• Recognize the location of the cardiac auscultation points and distinguish which structures are best heard at each point.
• Identify pain producing structures in the thorax.
• Describe the physics of sound transmission.
• Define and discuss physical signs in selected abnormalities of the bronchi and lungs.

• 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

• Outline relatively common but sometimes challenging patient cases.
• Comprehend diagnostic and therapeutic considerations in multiple pathological conditions.
• Demonstrate knowledge of laboratory tests for alcoholic cirrhosis.
• Recite abnormal blood pressure parameters in malignant hypertension.

• Relate relatively common but sometimes challenging patient cases including vitamin B12 deficiency, metabolic conditions, drug toxicity, neuropathy, lymphoma and drug diversion.
• Explain diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.
• Give examples of diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.
• Describe diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.
• Demonstrate diagnostic and therapeutic considerations in vitamin B12 deficiency, neuropathy, drug toxicity, neuropathy, lymphoma and drug diversion.

• Relate relatively common but sometimes challenging patient cases including myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Explain diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Give examples of diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.
• Describe diagnostic and therapeutic considerations in myocardial infarction, alcoholic hepatitis, A-V malformation and misdiagnosed limb paralysis.

• List common signs and symptoms of Perinephric Abscess.
• List common signs and symptoms of Adenocarcinoma of the Esophagus.
• List common signs and symptoms of Methanphetimine use and Complications.
• List common signs and symptoms of Cavernous Hemangioma.
• List common signs and symptoms of Cardiomyopathy.
• Discuss use of Zoll Lifevest.
• List common signs and symptoms of Quinolone toxicity.

• Compare and contrast use of PRP injections for joints versus tendons.
• Itemize criticisms of Stem Cell injections and discuss the current state of the science.
• Contrast characterized and uncharacterized Stem Cell therapies.
• List the relative indications for hip replacement.
• List common hip injuries that may require surgical referral, and discuss the surgical procedure most likely to be employed.
• List Indications for knee replacement.
• Describe progression from normal knee to a knee with severe osteoarthritis.
• Compare and contrast the indications and procedures for a partial knee replacement and a total knee replacement.
• List the benefits of robotic joint replacement surgery.
• List the rational for surgical referral for surgical treatment and possible joint replacement.
• List common knee injuries that may require surgical referral, and discuss the surgical procedure most likely to be employed.
• Compare and contrast shoulder replacement and reverse shoulder replacement, emphasizing the relative indications for each.
• List common shoulder injuries that may require surgical referral, and discuss the surgical procedure most likely to be employed.
• List common elbow injuries that may require surgical referral, and discuss the surgical procedure most likely to be employed.
• List common hand and wrist injuries that may require surgical referral, and discuss the surgical procedure most likely to be employed.

• Recall the location of the organs in the abdomen.
• Define various regions of the abdomen.
• Describe techniques of examination including observation, palpation, percussion and special tests and their relevant clinical findings associated with abdominal disease.
• Recognize signs and symptoms of abdominal visceral disease including differentiation of symptoms by hollow versus solid viscera.
• Identify somatic locations of pain associated with abdominal visceral disease.
• Describe changes in stool and vomitus associated with various pathological conditions.

• Recall the structural anatomy of the external eye.
• Define various functions of components of the external eye.
• List local disorders affecting the external eye.
• Differentiate local conditions of the external eye with cranial nerve II, III, IV, V, VI and VII.
• Describe techniques of examination of the internal eye such illumination, observation, and special tests and their relevant clinical findings associated with local external eye disease.
• Recognize the appearance of common eyelid conditions such as chalazion, internal and external hordeolum, blepharitis, blepharospasm, dacrocystitis, and a wide variety of others.
• Identify and perform methods for examining the external eye for conjunctivitis, episceritis and others.
• Perform the technique of removing a foreign body from the external eye.
• Identify and describe pathological changes associated with disease of the cornea.

• Recall the structural anatomy of the internal eye.
• Define various functions of components of the internal eye.
• List local disorders affecting the internal eye.
• Describe techniques of examination of the internal eye such illumination, observation, and special tests and their relevant clinical findings associated with local internal eye disease.
• Identify and perform methods for examining the internal eye for uveal tract disease, cataracts, and vitreous disease.
• Identify and describe pathological changes conditions associated with disease of the uveal tract disease, cataracts, and vitreous humor.

• This allows you to purchase all 5 hours of 213 level courses. Please see the educational objectives listed for each individual 213 module

• Review the categorizations for the specialty of radiology and its related subspecialties
• Compare and contrast typical analog x-ray suites with Computed Radiography (CR) and Digital radiology (DR) detection systems
• Review and describe equipment, concepts and various types of CT Scanning
• Review and describe equipment, concepts and various types of magnetic resonance imaging (MRI/MRA), and angiography
• Discuss newer technologies for assessing neurological tissue function, including SPECT,  PET and fMRI scanning
• Review and describe equipment, concepts and various types of diagnostic ultrasoundography
• Identify and define other techniques of diagnostic imaging

• This allows you to purchase all 29 hours of 214 level courses. Please see the educational objectives listed for each individual 214 module

• Define professional ethics and morals
• Sensitize the DC to issues related to common ethical dilemma in chiropractic practice
• Discuss specific ethical considerations in situations and scenarios related to patients, former patients and society

• Maintain proper records of neurological examination in the SOAP format
• Write narrative reports reflecting the neurological examination
• Apply an outline of fundamental procedures in performing a complete chiropractic neurological examination

• Correctly assess the level of the lesion in case scenario questions.
• Identify the components of the neurological examination.
• Demonstrate a basic examination flow from sitting to standing, to the supine and prone positions.
• Outline "Ferezy's MSR's" which is a pneumonic devise to help recall areas needing to be tested.
• Summarize implications of neurological findings for lesions in various parts of the central nervous system.
• Summarize implications of neurological findings for lesions in various parts of the peripheral nervous system.

• Describe areas of concern in the history taking process
• List areas of concern in the mental status examination
• Identify and perform methods for eliciting a patient history
• Identify and perform methods for examining the patient’s mental status

• Identify the areas of proper placement of the stethoscope bell in order to auscultate various arteries and other vascular structures available in the head and neck.
• Perform palpation of the thyroid gland.
• Perform an examination of the cranial nerves.
• Evaluate the head and neck for signs of nervous system trauma.
• Draw out the visual pathways from retina to striate cortex of the occipital lobe.
• Associate patterns of visual field losses with various portions of optic pathway disease.
• List retinal areas to evaluate and associated parameters during the fundoscopic examination.
• Correlate disorders of eye position and movement with peripheral cranial nerve disease, internuclear ophthalmoplegia and gaze palsy’s.
• List current vertebrobasilar risk assessment options as well as the value and limitations of each.
• Outline the position of the Association of Chiropractic Colleges (ACC) in regard to vertebrobasilar ischemia (VBI) provocative testing in the chiropractic office.
• Identify suggested effects of elevated homocystine levels above 7.2 umol/L.
• Perform procedures recommended by the author to evaluate candidates for manipulative therapy.
• Summarize implications of neurological findings for lesions involving the cranial nerves or their central connections.

• Define the terms somatoform disorder, hysteria, malingering, organic and non organic disease.
• Contrast and compare organic and non organic disease.
• Contrast and compare somatoform disorder and malingering.
• Identify the most common symptoms described by patients suffering from Somatoform disorder, and develop a strategy to what degree the symptoms may have a somatoform component. 

• Locate cortical areas responsible for language and describe the relationship between the areas and describe pathways of cortical information processing.
• Define the term “hemisphericity” in relation to hemisphere dominance and itemize various methods to determine hemisphere dominance for functions such as language, handedness, hearing, vision, etc.
• Describe results of “split brain” experiments regarding cortical processing of faces and items in regard to distribution of visual information and speech.
• Draw the relationships between the reception and expression categories in The Schema of Monrad Crone to illustrate the “inputs and outputs” of human interaction.
• Identify the cortical pathways involved from hearing and understanding to formulating speech and speaking, and discuss the relevance of pathway location to other cortical systems.
• Define common terms associated with cortical disorders including aphasia, agraphia and apraxia.

• Contrast and compare the physical neurological examination with the physical examination of other body systems.
• Perform a neurological examination in a logical, physical sequence from sitting to standing, supine and prone.
• Describe and perform “Waddell’s Tests and six other special tests described in the literature to detect complaints without a physical basis.
• Itemize pitfalls and critically review special tests described in the literature to detect complaints without a physical basis.

• Identify the correlation of resistance exercise and lipoprotein Patterns
• Discuss the effect of Boswellia on arthritis
• Review the effect of green tea on weight loss
• Establish the relationship of exercise and water replacement
• Identify the relationship of red wine and the cardiovascular system

• 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.

• 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