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TRANSCRIPT
P-DTR Foundations Series Curriculum
MODULE 1
INTRODUCTION
• What is P-DTR?
o Origins
o How does it work?
o What does it treat?
▪ Software vs. Hardware analogy
• Core Principles of P-DTR
• Receptor classes
• Proprioception
o Exteroception
o Interoception
• Myotatic Stretch Reflex
o Autogenic excitation
o Reciprocal inhibition
o Gamma motor neurons
• Deep Tendon Reflex
o Technique
o Location of DTR’s and corresponding nerve roots
o Superficial reflexes
• Paired Receptor Model
o Components
▪ Primary
▪ Main Secondary
▪ Virtual Secondary
▪ Tertiary
RULES OF P-DTR
• Application of muscle testing to P-DTR
• Therapy Localization
o What is TL?
▪ Sensory and motor homunculi
o What does TL do?
o How is it used?
• Muscle Testing Outcomes
o Facilitated
o Inhibited
o Neurologic Switching
▪ Normal autogenic responses to X and II’s
o Hypertonicity
▪ Global Hypertonicity
• Receptor rules
o Stimulus
o Opposite stimulus
o Anti-stimulus
• TL rules
• DTR rules
• Tertiary rules
• Modes of Dysfunctions
o Classifications
▪ Basic mode
▪ Multi modes
▪ Hyper modes
o Frequency of Firing
• Rules of Indicator Muscles
o Qualifying a valid indicator muscle
• Universal Therapy Localization
• Double Therapy Localization
MUSCLE SPINDLE CELL DYSFUNCTIONS
• Intrafusal muscle fibers
o Nuclear bag fibers
o Nuclear chain fibers
• Classes of stimuli
o Proper stimulus
o Opposite stimulus
o Anti-stimulus
▪ Regional Hypertonicity
▪ Local Hypertonicity
• Assessment and Treatment Protocol
o History
o Observation
o Palpation and orthopedic testing
o Normal autogenic responses
o Muscle testing
o P-DTR treatment
• Reactor/Reactive
o Location of reactor and reactive
o Proper stimulus
o Options for treatment
SINGLE TRAUAMATIC EVENTS
• Indications
• Testing
• Treatment
NOCIOCEPTION
• Fast pain vs. slow pain
• Excitatory stimuli
o Mechanical stimuli
o Thermal stimuli
o Chemical stimuli
• Peripheral nociceptive fibers
• “Double” system of pain innervation
• Dual nociceptive pathways
o Neospinothalamic tract
o Paleospinothalamic tract
• Dual nociceptive neurotransmitters
o Glutamate
o Substance P
• Nociceptive Inhibition Patterns
o Nociceptive Withdrawal Reflex/Flexor Reflex Afferent
o PMRF
o Extrapyramidal Inhibition Pattern
o Thalamic Inhibition Pattern
• Gate Control Theory of Pain
MODULE 2
NEUROGAIT II
• Location of Nerve Endings
o Type I Golgi
o Type II Golgi
o Type III Golgi
o Type IV Golgi
• Rules of muscles
o Flexor stretching rule
o Extensor stretching rule
• Ligaments
o Golden rules of ligament testing
o Ligament physiology
o Rules of ligaments
▪ Limb rotation during gait
o Nutrition for ligaments
• Rules of Joint Capsules
• Joint Capsule Golgis vs. Non-Joint Capsule Golgis
• Rules of Joint Hyaline Cartilage
• Rules of Joint Fibro Cartilage
• Rules of the Spinal Ligaments
o Anterior Longitudinal Ligament
o Posterior Longitudinal Ligament
o Supraspinous Ligament
o Interspinous Ligament
o Ligamentum Flavum
o Intertransverse Ligament
• Rules of the Talus
• Rules of the hyoid, earlobes, nose, and lips
• Ligament Palpation and Muscle/Ligament Relationships
o Pelvic ligaments
o Hip ligaments
o Knee ligaments
o Ankle/foot ligaments
o Sternal and clavicular ligaments
o Shoulder ligaments
o Elbow/wrist ligaments
o Organ suspension ligaments
• Rules of bones
NEUROGAIT I
• Gait: Types of Sensory Input
o Effect of stepping rate in stance and swing phases
• Automatic gait
• Cerebellum and gait
• Gait phases
o Phase 1: Initial contact
o Phase 2: Loading response
o Phase 3: Mid stance
o Phase 4: Terminal stance
o Phase 5: Pre-swing
o Phase 6: Initial swing
o Phase 7: Mid swing
o Phase 8: Terminal swing
• Mechanical breakdown of stance phase
o Chopart joint
o Lisfrank joint
o Foot divisions
▪ Talar foot
▪ Calcaneal foot
• Joint ligaments and involved muscles
o Talonavicular joint ligaments
o Cuneonavicular joint ligaments
o Calcaneocuboid joint ligaments
o Talocalcaneal/subtalar joint ligaments
o Interphalangeal joint of the 1st toe ligaments
o Tibiotalar joint ligaments
o Metatarsophalangeal joint of the 1st toe ligaments
o Metatarsophalangeal joint of the 2nd toe ligaments
o Metatarsophalangeal joint of the 3rd toe ligaments
o Metatarsophalangeal joint of the 4th toe ligaments
o Metatarsophalangeal joint of the 5th toe ligaments
o Anterior tibiotalar deltoid ligament
o Tibionavicular deltoid ligament
o Posterior tibiocalcaneal deltoid ligament
o Posterior tibiotalar deltoid ligament
o Anterior talofibular ligament
o Calcaneofibular ligament
o Posterior talofibular ligament
GAIT INHIBITION
• Background
• Symptoms
• Testing procedure
• Inhibition patterns
• Treatment
o Forward gait
o Backward gait
• Iliolumbar ligament
PALO-ALTO
• Background
• Testing procedure
o Posterior
o Anterior
o Lateral
o Oblique
o Adductor
o K1
PiLUS
• Background
o Hypothesis of Illi
o Hypothesis of Kapandji
o Location of receptors
• Symptoms
• Testing procedure
• Treatment
PELVIC CATEGORIES
• Pelvic category I
o Location of receptors
o Symptoms and presentation
o Related muscles
o Treatment
• Pelvic category II posterior ilium
o Location of receptors
o Symptoms and presentation
o Related muscles
o Treatment
• Pelvic category II posterior ischium
o Location of receptors
o Symptoms and presentation
o Related muscles
o Treatment
• Pelvic category II symphysis pubis
o Location of receptors
o Symptoms and presentation
o Related muscles
o Treatment
• Pelvic category III
o Location of receptors
o Symptoms and presentation
o Related muscles
o Treatment
• Sacral distortion
o Location of receptors
o Symptoms and presentation
o Related muscles
o Treatment
GOLGI ORGAN DYSFUNCTIONS
• Golgi-golgi dysfunctions
o Location of receptors
o Pathways
▪ Spinocerebellar Pathway
▪ Dorsal Column Medial Lemniscus
o Joint capsule golgis vs. non-joint capsule golgis
▪ Normal vs. dysfunctional responses
o TS Line and golgi dysfunctions
• Golgi-pacini dysfunctions
o Pacinian corpuscles
o Differentiating golgis vs. pacinis
▪ Rules and application of “rebound”
▪ Determining golgi-golgi pairs vs. golgi-pacini pairs
PRESSURE AND VIBRATION DYSFUNCTIONS
• Pacinian corpuscles
• Vibratory receptors
o Ruffini endings
▪ Frequency
▪ Location
o Meissner’s corpuscles
▪ Frequency
▪ Location
o Krause’s corpuscles
▪ Frequency
▪ Location
• Use of tuning forks
o Universal vibratory challenge
▪ Locations
▪ Rules of universal vibratory points
MODULE 3
LONG KINEMATIC CHAINS
• The Science of Mechanics
o Statics
o Dynamics
o Kinematics
o Kinetics
• Mechanisms vs. Structures
• Long Kinematic Chains
o Open Kinematic Chain
o Closed Kinematic Chain
• Dynamic Kinematic Chain Testing
• Rules of Long Kinematic Chains
• Common locations
THERMAL NOCIOCEPTION
• Three types of thermal receptors
o Cold receptors
o Warm receptors
o Nocioceptive stimuli
• Cold receptors
o Fiber type
o Pathway
o Stimulation
o Symptoms
o Inhibition pattern
o Treatment
• Warm receptors
o Fiber type
o Pathway
o Stimulation
o Symptoms
o Inhibition pattern
o Treatment
TICKLE AND ITCH
• Tickle
o Fiber type
o Pathway
o Stimulation
o Symptoms
o Inhibition pattern
o Treatment
• Itch
o Fiber type
o Pathway
o Stimulation
o Symptoms
o Inhibition pattern
o Treatment
FINE AND CRUDE TOUCH
• Fine touch
o Meissner’s corpuscles
o Merkel’s discs
▪ Iggo dome receptors
o Fiber type
o Pathway
o Stimulation
o Symptoms
o Inhibition pattern
o Treatment
• Crude touch
o Fiber type
o Pathway
o Stimulation
o Symptoms
o Inhibition pattern
o Treatment
CLOACAL SYNCHRONIZATION
• Equilibrium reflex synchronization
o Labrynthine reflex
▪ Symptoms
▪ Location
o Head-on-neck reflex
▪ Symptoms
▪ Location
o Visual righting reflex
▪ Symptoms
▪ Location
o Anterior pelvic reflexes
▪ Symptoms
▪ Location
o Posterior pelvic reflexes
▪ Symptoms
▪ Location
• Appositional testing
o Flexion tests for anterior reflexes
o Extension tests for posterior reflexes
• Treatment
VERTEBRAL FIXATION AND LIMBIC FIXATION
• What is a spinal fixation?
• Occipital fixation
o Use of therapy localization
o Testing
o Treatment
• Sacral fixation
o Use of therapy localization
o Testing
o Treatment
• Vertebral fixation
o Use of therapy localization
o Testing
o Treatment
• Limbic fixation
o Location
o Use of therapy localization
o Testing
o Treatment
JOINT POSITION PROPRIOCEPTORS
• Joint position sense
o Conscious joint position
▪ Pathway
▪ Symptoms
▪ Treatment
o Unconscious joint position
▪ Pathway
▪ Symptoms
▪ Treatment
SPINOTHALAMIC DYSFUNCTIONS
• Ascending sensory systems
o Anterolateral system
▪ Spinotectal
▪ Spinomesencephalic
▪ Spinohypothalamic
▪ Spinoreticular (Paleo)
▪ Spinothalamic (Neo)
o Dorsal column medial lemnical pathway
▪ Fasiculus gracilis
▪ Fasiculus cuneatus
▪ Medial lemniscus
o Somatosensory pathways to the cerebellum
▪ Spinocerebellar tracts
▪ Cuenocerebellar tracts
• 1st, 2nd, and 3rd order neurons
• Spinothalamic dysfunctions
o Spinotectal
▪ Course
▪ Function
▪ Stimulus
o Spinomesencephalic
▪ Course
▪ Function
▪ Stimulus
o Spinohypothalamic
▪ Course
▪ Function
▪ Stimulus
o Spinoreticular (Paleo)
▪ Course
▪ Function
▪ Stimulus
o Spinothalamic (Neo)
▪ Course
▪ Function
▪ Stimulus
ADRENALS
• Histology
o Location
o Structure
▪ Medulla
• Chromaffin cells
o Catecholamines (adrenaline and noradrenaline)
▪ Cortex
• Glomerulose zone
o Mineralcorticoids (aldosterone)
• Fasiculata zone
o Glucocorticoids (cortisol)
• Reticularis zone
o Androgens (DHEA and DHEA-S)
o Estrogens
o Blood supply
o Function
▪ Maintaining metabolic processes
▪ Regulate balance of salt and water
▪ Control “flight or fight” response to stress
▪ Maintaining pregnancy
▪ Initiating and controlling sexual maturation during childhood and puberty
▪ Synthesis of corticosteroid hormones in cortex
• Cortisol
• Corticosterone
• Androgens
• Aldosterone
• Metabolism
o Role of cholesterol
o Hormones of the adrenal cortex
▪ Glucocorticoids
▪ Mineralcorticoids
▪ Androgens
• Adrenal pathology
o Cushing’s syndrome
o Addison’s disease
• General Adaptation Syndrome
o Categories of stress
▪ Physical stress
▪ Chemical stress
▪ Emotional stress
▪ Thermal stress
o Stages of GAS model
▪ Alarm reaction
▪ Resistance stage
▪ Exhaustion stage
o Triad of chronic stress
▪ Adrenal cortex enlargement
▪ Atrophy of thymus gland and lymphatic tissues
▪ Stomach and duodenal ulcers
o Symptoms of adrenal stress
o Signs of adrenal stress
o Relationship of DHEA to cortisol
▪ Pregnenolone steal/cortisol escape
• Treatment
MODULE 4
MERIDIAN DYSFUNCTIONS
• Meridian electromagnetic dysfunctions background
o Meridians vs. Reactor/Reactives
o Meridian alarm points
o Meridian associated muscles
o Over vs. Under meridians
o Meridian dysfunction classifications
o Hand/finger polarity
• Signs and symptoms
• Common cycles
o Outer sheng
o Inner sheng
o Elemental
o Ko
o 24 hour
• Diagnosis
• Treatment
o Primary and secondary meridians
o Associated points along bladder meridian
EMOTIONAL FAULTS
• Triad of health
• Fast emotional corrections
o Memory recall fast correction technique
o Emotional stress reduction technique
o Localization, quality memory
• Psychological reversal
o Qualification
o Treatment
o Nutrition
• Full emotional correction
o Neurolinguistic programming eye vectors
o Visceral referred pain patterns
o Treatment
STOMATOGNATHIC DYSFUNCTIONS
• Stomatognathic dysfunctions
o Cranial faults
o Cranial sutures
o Sacral dysfunction
o TMJ dysfunction
o Hyoid
o Neurologic tooth
• Cranial motion
o Sphenoid bones
o Occiput
o Temporal bones
o Frontal bone
o Parietal bones
• Cranial faults
o Inspiration assist
o Expiration assist
o Sphenobasilar inspiration assist
o Sphenobasilar expiration assist
o Glabella
o “Banana head”
▪ Temporal bulge
▪ Parietal descent
o Internal frontal
o External frontal
o Nasosphenoid
o Universal
• Sutural cranial faults
o Saggital suture
o Squamosal suture
o Lambdoidal suture
o Zygomatic sutures
o Palatine suture
• Sacral dysfunction
o Sacral respiratory function
o Sacral faults
▪ Sacral inspiration assist
▪ Sacral expiration assist
▪ Sacral wobble
• Inspiration assist
• Expiration assist
▪ Atlanto-occipital countertorque
• Inspiration assist
• Expiration assist
• TMJ anatomy
o Muscles of mastication and mandibular movement
o Assessment and testing
• Hyoid anatomy
o Muscles of the hyoid
o Assessment and testing
• Neurologic tooth
o Background
o Indications
o Challenge and manipulation of teeth
o Nutrition