S.O.A.P.: 1. Acronym for subjective symptoms, objective signs, assessment and prognosis or plan of management. 2. Method of recording information in a patient's record based on a problem-oriented clinical approach.

SACCULAR (BERRY) ANEURYSM - Sac-like bulging on one side of an artery. Usually arises at an arterial branching.

SACROILIAC JOINT (SI JOINT) ? The joint formed between the sacrum and ilium. The upper joint is synovial (ligament encapsulated/fluid filled), and the lower joint if fibrous (fibrous connective tissue).

SACRUM ? A heart-shaped bone that is part of the pelvic ring. It articulates with the ilia at the sacroiliac joints and articulates with the lumbar spine at the lumbosacral joint. The sacrum consists of five fused vertebrae that have no intervertebral discs when mature. At birth, it consists of five un-fused segments.

SAFETY: A judgment of the acceptability of any risk in a specific situation during the application of a specific procedure or group of procedures provided by an individual with specified and appropriate training.

SAGITTAL ? in the plane that lies front-to-back, splitting our body from top to bottom, e.g. side view. This is opposed to the transverse plane, which lies front-to-back, but splits our body cross-wise, e.g. birds-eye view, or the coronal plane, which lies left-to-right, splitting our body from front-to-back.

SCIATICA - A condition caused by direct pressure or chemical irritation on a lower back nerve root (part of the sciatic nerve bundle). The term indicating pain (sometimes numbness or cramping) along the course of a sciatic nerve, especially noted in the calf, leg, or foot, and often with accompanying gluteal or thigh pain. Pain from the lower back or pelvis that refers into the gluteal or thigh regions, not below the knee, is NOT sciatica.

SCOLIOSIS - Lateral (sideways) curvature of the spine.

SCOTOMA - An area of decreased vision surrounded by an area of less depressed or normal vision.

SCREENING: The application of a test to detect a potential illness or condition in a person who has no known signs or symptoms of that illness or condition. Screening is performed on "at risk" populations in order to determine appropriate intervention.

SENSITIVITY: The likelihood of a positive test in a patient with a disorder (also called true positive rate, TPR). Sensitivity indicates the value of a test in identifying the diseased.

SEPSIS - A state of infection of tissue due to disease-producing bacteria or toxins.

SEPTUM - A thin wall dividing two cavities or masses of softer tissue.

SHUNT - A tube or device implanted in the body, usually made of silastic, to redivert excess CSF away from the brain to another place in the body.

SIGNS ? What a patient does not feel, but what a healthcare provider finds through physical examination and testing. Signs often are objective, like blood pressure, muscle weakness, or loss of joint range of motion. Signs often do not correlate with symptoms.

SKELETON - The rigid framework of bones that gives form to the body, protects and supports the soft organs and tissues, and provides attachments for muscles.

SPASM ? The automatic, often reflexive, tightening-up of a muscle, with the muscle clenching tightly.

SPECIALIST: A health care provider who has obtained a professionally accepted or recognized level of advanced training and competence with respect to specific procedures or disorders.

SPECIFICITY: The ability to correctly identify negative results among subjects who truly do not have a specific disorder. The likelihood of a negative test in a patient without the disorder (also true-negative rate, TNR). Specificity indicates the value of a test in identifying the non-diseased.

SPINA BIFIDA - A congenital defect of the spine marked by the absence of a portion of the neural arch of the spine. Spina bifida oculta is benign.

SPINAL "ADJUSTMENT" - A chiropractic term that most chiropractors use to describe whatever method (s)) they use to correct spinal problems, whether by hand or with an instrument. See Adjustment.

SPINAL CANAL - The bony channel that is formed by the intravertebral foramen of the vertebrae and in which contains the spinal cord and nerve roots.

SPINAL CORD - The longitudinal cord of nerve tissue that is enclosed in the spinal canal. It serves not only as a pathway for nervous impulses to and from the brain but as a center for carrying out and coordinating many reflex actions independently of the brain.

SPINAL FUSION - Operative method of limiting motion of the spinal column. Can be performed with a variety of metal instruments and bone grafts or bone grafts alone.

SPINAL MANIPULATIVE THERAPY (SMT): This term refers to the range of manual care delivered by chiropractors. It includes adjustive/manipulative and mobilization procedures.

SPINAL STENOSIS - Reduction in the diameter of the spinal canal due to abnormal bone formation or congenital defect in bone. May result in pressure on the spinal cord or nerve roots.

SPINE - The flexible bone column extending from the base of the skull to the tailbone. It is made up of 33 bones, known as vertebrae. The first 24 vertebrae are separated by discs known as intervertebral discs and bound together by ligaments and muscles. Five vertebrae are fused together to form the sacrum and four vertebrae are fused together to form the coccyx. The spine is also referred to as the vertebral column, spinal column, or backbone.

SPINOUS PROCESS - The portion of the vertebrae that protrudes posteriorly from the spinal column. The spinous processes create the "bumps" felt on the midline of thre back.

SPONDYLITIS - Inflammation of vertebrae.

SPONDYLOLISTHESIS - A "slippage" or listhesis of one vertebra over another. A defect in the arch of the vertebra bone (at the pedicle or at the pars interarticularis, between the supeior and inferior facets), causes varying degrees of forward displacement of the vertebra. It is usually due to either a developmental defect, the result of a fracture from being forcefully bent backwards as a child or adolescent, or from degenerative decay of the bony arch of the vertebrae.

SPONDYLOLYSIS ? "lysis," or a breaking apart; "sponyl" or spine. The disintegration of bone at the posterior portion or arch of the vertebra. The lysis defect in the neural arch between the superior and inferior facets of vertebrae can cause a "listhesis" or can be evident without separation or displacement of the vertebrae.

STANDARDS: Standards of quality or standards of care are authoritative statements of minimal levels of acceptable performance or results, or excellent levels of performance or results, or the range of acceptable performance.

STRABISMUS - Deviation of eye movement which prevents the two eyes from moving in a parallel fashion.

Sub-acute: Describes a condition with onset between three and thirteen weeks prior to the patient seeking care.

SUBARACHNOID HEMORRHAGE - Blood in or bleeding into the space under the arachnoid membrane. Most commonly from trauma or from rupture of an aneurysm.

SUBDURAL HEMATOMA - A collection of blood (clot) trapped under the dura matter, the outermost membrane surrounding the brain and spinal cord.

SUBLUXATION ? Literally: the partial dislocation of a joint, a condition visible on x-ray films, in which the bony surfaces of a joint no longer face each other exactly but remain partially aligned. Chiropractors cannot completely agree among themselves what defines subluxation or what all of its ramifications are. Chiropractors have used the term subluxation to describe what seems like a bone that is out of place. Joint dysfunction is a more appropriate term.

SUBLUXATION COMPLEX - A chiropractic concept to describe the five parts of a "subluxation": Kinesopathology (altered motion of the joint), Neuropathophysiology (the nerve signals become aberrant), Myopathology (muscles become tight, spasmed, and develop taught fibers "knots" or adhesions), Histopathology (tissues surrounding the subluxation become irritated, inflamed, or congested since blood and lymph flow becomes impaired), and Pathophysiology (the pathologic changes that occur following long-term alterations in function, the late effects of tissue breakdown, and the body?s attempt to contain or stabilize the area, e.g. bone spurs, or degenerated spinal discs).

SUBLUXATION COMPLEX: A theoretical model characterized by a complex interaction of kinesiopathological, neuropathophysiological, histopathological and biomechanical changes in the spinal and other joints and their associated structures.

SUPERIOR - Situated above or directed upward toward the head of an individual.

SUPPORTIVE CARE: Necessary treatment/care for patients who have reached maximum therapeutic benefit, and for whom periodic trials of therapeutic withdrawal have led to deterioration and failure to sustain previous therapeutic gains. This form of care is initiated when the clinical problem recurs.

SYMPTOMS ? What a patient feels. Common symptoms are pain, tingling, numbness, dizziness. Symptoms vary from one person to another given the same condition. Symptoms are not always reflective of the severity of a disease, e.g. a common first symptom of a heart attack is sudden death, while a tumor can cause no symptoms at all. Joint subluxations often occur without any noticeable symptoms, until the subluxated joint starts to cascade into the subluxation complex (see above). Symptoms are also often a warning signal sent from the tissues, organs and muscles to the brain that something is wrong, or damage has occurred or still may be occurring. Providing medication simply to reduce a symptom is not always an effective way of solving health problems. Symptoms often do not correlate with signs. See "SIGNS" above.

SYRINGOMYELIA - A fluid filled cavity in the spinal cord.