The 4-Star Clinical Assistant
© 1997-1998 R. C. SCHAFER, DC, PhD, FICC
Table of Contents
1. Introduction To A Rewarding Career -19
Who Are Involved in Administering Chiropractic Health Care? -19
The Doctor of Chiropractic -19
The Chiropractic Assistant -20
The Clinical Assistant -20
The Certified Chiropractic Assistant -20
Health-Care Education in America -21
Medical Education -21
Modern Chiropractic Education and Professional Development -21
Professional Requirements -21
Clinical Experience -24
Academic Accreditation -24
Postgraduate Continuing Education -24
Forms of Chiropractic Practice -25
Solo Practice -25
Specialty Practice -25
Partnership -25
Associate Practice -26
Corporate Practice -26
Group Practice -26
2. The Important Role Of The Chiropractic Assostant -27
Basic Qualifications of a Chiropractic Paraprofessional -27
Not Everyone Can Qualify -28
Assigned Duties -29
Role of the Clinical Assistant -29
Foresight -31
Professional Appearance -31
Acquainting Yourself with the Doctor's Practice Goals -31
Developing Your Contribution and Assuring Career Growth -32
Health-Team Consciousness -33
Creativeness and Adaptability -33
Efficiency Consciousness -34
Emergency Situations -34
Continuing Education -35
3. The Health-Service Role Of The Doctor Of Chiropractic -37
Diagnostics: The Art of Deciding What Is Wrong -37
Background -37
Overview of the Diagnostic Process -38
Therapeutics: The Art of Correcting What Is Wrong -40
Rehabilitation: The Art of Aiding Natural Healing Processes -42
Nutritional Considerations -42
Autointoxication -43
Food Alteration -43
Physiologic Needs -44
Posture and Physical Fitness -44
Counseling: The Art of Preventive Therapy and Enhancement -47
General Practice and Specialized Interests -48
Pain and Preventive Care -48
Common Complaints -48
Resistance to Disease -49
Sports Injuries -50
Prenatal and Postnatal Care -50
Pediatric Care -51
Professional Groups -51
4. The Language Of The Health-Care Prpfessions 53
The Universal Language of Health Care: Why It Is Necessary -53
Phonetics: The Quick Way to Grasp Meanings -53
How the Words Are Formed -54
Common Latin and Greek Word Roots -55
Common Latin and Greek Prefixes -63
Common Latin and Greek Suffixes -70
Singulars and Plurals -72
Traditional Style -72
Modern Style -75
Common Anatomical Terms -76
Terms of Patient Position -76
Terms of Direction and Location -77
The Planes of the Body in Biodynamics -77
Structural Motion -77
Describing Positions in Space -78
Axes -79
Linear and Circular Motion -80
Degrees of Joint Movement Freedom -80
Combined Movements -81
Plane Motion -81
The Instantaneous Axis of Rotation -82
Out-of-Plane Motion -82
Terms of Motion -82
Common Diagnostic and Procedural Terms -86
Background Review -86
Terminology -87
5. Understanding The Human Body -91
Body Systems and Landmarks -91
The Ten Systems -91
Body Cavities -92
The Abdominal Quadrants -93
The Thoracoabdominal Membranes -93
The Skeletal System -94
Skeletal Functions and Divisions -94
General Bone Structure and Classes -94
Shape -95
Long Bone Features -95
Bone Marrow -95
Landmarks -96
The Skull and Face -96
The Cranial Bones -96
The Facial Bones -97
The Vertebral Column -97
Vertebral Structure -97
Spinal Curves -98
Classification of Vertebrae -98
The Thorax -98
The Shoulder Girdle and Upper Limbs -99
The Pelvis and Lower Limbs -99
Joints (Articulations) -101
Joint Movements -101
Bursae -102
The Muscular System -102
Skeletal Muscle Function -102
Muscle Structure and Motion -103
Principles of Skeletal Muscle Action -104
The Skin -105
Function -105
Structure -105
Temperature Regulation -106
The Circulatory System -107
The Heart -107
Structure -107
Heart Chambers -108
Function -108
Nerve Control -109
Blood Vessels -109
Capillaries -110
Veins -110
Pulse -110
Blood Pressure -111
The Lymphatic System -111
The Blood -113
Functions -113
Plasma -113
Serum -114
Demands -114
Hemoglobin -114
Leukocytes -114
Platelets -115
Empiric Systems -115
The Respiratory System -116
The Nose -116
Cilia -117
The Air Sinuses -117
The Pharynx -117
The Larynx -117
The Epiglottis -118
The Trachea -118
The Bronchi -118
The Lungs -118
Alveoli -119
Pleurae -119
The Physiologic Processes of Respiration -119
The Mechanical Processes of Respiration -119
Inhalation -120
Exhalation -120
The Digestive System -120
The Alimentary Canal and Accessory Organs -121
The Teeth -121
The Salivary Glands -122
Salivation -122
The Tongue -122
The Pharynx -123
The Esophagus -123
The Stomach -123
Gastric Juices -124
The Small Intestine -124
Mesentery -124
The Pancreas -124
The Liver -125
The Gallbladder -125
The Ileum -126
The Large Intestine (Colon) -126
The Rectum and Anus -127
Digestion Time, Absorption, and Defecation -127
The Urinary System -128
The Kidneys -128
Nephrons -128
The Ureters -129
The Urinary Bladder -128
The Urethra -129
Urination -129
The Nervous System -130
Overview -130
Neurons -131
Neuroglia -131
The Central Nervous System -132
The Peripheral Nervous System -135
The Autonomic Nervous System -137
The Special Senses -138
The Eye -139
The Eyeball -139
The Lens -140
Aqueous Fluid -140
The External Eye and Accessory Structures -140
Extraocular Muscles -141
The Ear -141
The External Ear -142
The Middle Ear -143
The Inner Ear -143
The Endocrine System -144
The Thyroid -144
The Parathyroids -144
The Adrenals -145
The Pituitary -145
The Pancreas -146
The Testes and Ovaries (Gonads) -146
The Genital System -147
The Male Reproductive System -147
The Female Reproductive System 149
The Building Blocks of the Systems -151
Cells -151
Tissues -152
Organs -155
Chiropractic's Holistic Approach to Health -155
Structure/Function Relationship-155
Healing Forces-156
6. Medicolegal Considerations -158
Introduction -158
The Legal System -159
Record Management -159
Confidential Communications -160
Office Procedures -162
Medicolegal Reports -164
Subpoenaed Records -166
Record Ownership, Disposal, and Transfer -166
The Patient's Right to Privacy -168
Typical Information Releases -168
Unessential Observers -169
Photographs -170
The Doctor-Patient Contract -170
Professional Responsibilities -170
The Professional Contract -171
Patient Consent and Its Legal Implications -172
Simple Consent -172
Informed Consent -173
Related Factors -174
Qualified Consent -174
Written Consent -175
Invalid Consent -175
Quality of Care -176
Medical Necessity - 176
Objectives of Care -176
Treating Minors and Incompetents -177
Clinical Releases -177
Protection Against Malpractice Claims -178
Background -179
Professional Standards -181
Common Causes of Suit -183
Defensive Actions -186
Human Relations -186
Controlling Patient Quality -187
Recognizing Basic Medicolegal Criteria -187
Employing the Diagnostic Rationale -188
Determining Treatment Methods -189
The Postexamination Conference -191
Monitoring Progress -191
Consultations and Referrals -192
Keeping Up with the Times -193
Working Within the Law -194
Maintain Accurate Clinical Records -194
Vicarious Liability -195
Dangerous Situations -198
Emergency Cases -198
Warranties: Actual and Implied -199
Binding Contracts -200
Careless Case Dismissal -200
Accusations of Abandonment -202
Infection and Contagious Diseases -204
Unethical Conduct -204
Failure to Report or Advise -205
Criminal Behavior -205
Misrepresentation -206
Fraud -206
Gross Negligence -207
Assault and Battery -207
Malicious Injury -208
Manslaughter and Murder -208
Court Actions -208
Defensive Appearances -208
Depositions -210
7. Introduction To Duties Of A Clinical Assistant -212
The Assistant in a Clinical Role -213
Interpersonal Relationships in the Clinical Setting -213
Legal Aspects of Clinical Health Care -215
Laws Governing Licensure -218
General Characteristics of Technical Assistants -219
Basic Attributes -219
Classification of Procedures -221
Accident Prevention in the Office -222
Promoting a Safe Environment -222
Measuring and Reporting Clinical Data -223
Observation of Patients -224
Recording Initial Case History Data -226
Maintaining a Hygienic Environment -230
Disease and Injury -230
Classification of Injuries -231
Microorganisms -232
Classification of Pathogenic Organisms -233
Body Defenses Against Pathogenic Organisms -234
Body Reactions to Disease and Injury -235
Psychodynamic Pain Control -239
The Prevention of Aids Transmission -239
Chiropractic Pediatrics -240
Chiropractic Geriatrics -243
The Aging Process -243
The Assistant's Approach -246
8. Typical Functions Of A Clinical Assistant -248
Assisting the Disabled Patient -248
Applied Biomechanics -248
The General Scope of Orthopedics -250
Assisting with the Orthopedic Patient -252
General Emergency Protocols Following Injury -253
Fractures -257
Understanding the Patient in Pain -257
False Notions About Pain -258
The Components of Pain -259
Types of Pain -259
Pain Classifications -259
Assisting the Patient in Pain -263
Assisting During Physical Examinations -264
Basic Instruments -265
General Objectives -265
Typical Protocol -266
Summary Review: Typical Preparation Checklist -269
Assisting with a Spinal Examination -270
Assisting with a Vaginal (Pelvic) Examination -270
Recording Vital Signs -271
Temperature -271
The Pulse -274
Respiration -276
Blood Pressure -277
Assisting with Basic Laboratory Tests -279
Hematology -279
Urinalysis -284
Glossary of Common Tests and Their Abbreviations -285
Chiropractic Physiologic Therapeutics -285
The Rationale -286
The Stages of Healing -287
Types of Applications -289
Maintenance of Equipment -290
Therapeutic Nutrition and Dietary Assistance -290
Case Management Fundamentals -291
Effects of Food Processing and Storage -292
Teaching Healthy Dietary Habits -292
Dietary Supplementation -294
Assisting in the X-Ray Department -295
Why Doctors of Chiropractic Use Roentgenography -296
Basic Principles of Radiology -297
Dangers of X-Radiation to Patients -298
Personnel Monitoring -300
Patient Preparation -301
Film Information: Patient -304
Film Information: Part and Position -305
Radiographic Terms of Position -306
Patient Positioning Routines -306
Record Keeping and Filing -307
Film and Film Handling -309
Film Processing -310
Removal of Stains from White Fabrics -310
Care of the Skin -312
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