2. Intro the Osteopathic Cranial Manipulation

Question 1

Who is credited for starting cranial manipulation?

Answer 1

William Garner Sutherland

Question 2

Explain the basis (not componenets) of primary respiratory mechanism (PRM)

Answer 2

Primary: cranial motion is the “funtamental process of life”

Respiratory: cranial motion has flow motion like breath “of life”

Mechanism: pattern of tissue and fluid movement with a distinct purpose

Question 3

What are the five components of PRM?

Answer 3

1. Inherent mobility (passive) of brain and SC
2. Fluctuation of cerebral spinal fluid
3. Mobility of intracranial and intraspinal membranes
4. Articulatory mobility of cranial bones
5. Involuntary (passive) mobility of sacrum b/t ilia

Question 4

What is the driving push in CSF and how many times is CSF cycled through?

Answer 4

Cranial Rhythmic Impulse is the driving force that moves CSF through 10-14 cycles/minute

Question 5

What are the motion chracracteristics of the Cranial Rhythmic Impulse? R-RADS

Answer 5

Rate: 10-14 BPM

Rhythm: regular, but can have variation
Amplitude: SD may diminish
Direction: healthy is linear, SD is asymmetric
Strength

Question 6

What is the intracranial and intraspinal membranes and what do they come together to create?

Answer 6

Intracranial membranes are the falx cerebri and the tentorium cerebelli that make the “Sutherland Fulcrum”

Question 7

What is the Sutherland Fulcrum?

Answer 7

A name for the straight sinus as the origin of the falx cerebri and tentorium cerebelli

Question 8

Describe the Reciprocal Tension Membrane?

Answer 8

The meninges and spinal cord make a link from cranium that correlates with movement in the sacrum
-the “core link”

Question 9

What do the tentorium and falx come together to create?

Answer 9

the reciprical tension membrane, which allows for constant tension and acts like a spring to store energy

Question 10

Why is the straight sinus, or sutherland fulcrum, said to be a suspended automatic shifting fulcrum?

Answer 10

Suspended: pivot point of fulcrum remains within RTM created by falx and tentorium

Automatic: passive motion

Shifting: straight sinus moves up and down

Question 11

What is the anterior/superior pole of the RTM?

Answer 11

Crista galli

Question 12

What is the anterior/inferior pole of the RTM?

Answer 12

Clinoid process of sphenoid

Question 13

What is the lateral pole of the RTM?

Answer 13

Mastoid angle of parietals and petrous ridges of the temporal bones

Question 14

What is the posterior pole of the RTM?

Answer 14

Internal occipital protuberance and transverse ridges

Question 15

What is the suture between the parietal and temporal bones?

Answer 15

Parietosquamous

Question 16

What is the suture between the parietal and occipital bones?

Answer 16

Lambdoidal

Question 17

What is the suture between the occipital and temporal bones?

Answer 17

Occipitomastoid

Question 18

What is the point where temporal, parietal, and occipital bones all meet?

Answer 18

Asterion

Question 19

What is the suture between the sphenoid and temporal bones?

Answer 19

Sphenosquamous

Question 20

What is the point where temporal, parietal, and sphenoid bones all meet?

Answer 20

Pterion

Question 21

What is the suture between the parietal and frontal bones?

Answer 21

Coronal

Question 22

What is the suture between the temporal and zygomatic bones?

Answer 22

Temporozygomatic

Question 23

What is the point where the two parietal parietal and frontal bones all meet (front of head)?

Answer 23

Bregma

Question 24

What is the point where the two parietal parietal and occipital bones all meet (back of head)?

Answer 24

Lambda

Question 25

What is the suture between the two parietal bones?

Answer 25

Sagittal

Question 26

What is the name of the synchondrosis between the sphenoid bone and clivus of the occipital lobe?

Answer 26

``` Sphenobasilar Synchondrosis (SBS) -relatively rigid hyaline cartilagenous junction like the ones at the sternomanubrial joints ```

Question 27

Which way do the occiput-sphenoid synchondrosis move during flexion of the SBS?

Answer 27

Superior

Question 28

Which way does occipital squama move move during flexion of the SBS?

Answer 28

Posteriorly and inferior

Question 29

Which way does the greater wing of the sphenoid move during flexion of the SBS?

Answer 29

anterior and inferior

Question 30

Which way do the occiput and sphenoid move during extension of the SBS?

Answer 30

Inferior

Question 31

Which way does occipital squama move move during extension of the SBS?

Answer 31

Superior and anterior

Question 32

Which way does the greater wing of the sphenoid move during flexion of the SBS?

Answer 32

Anterior and inferior

Question 33

Where does the dural attachment from the foramen magnum attach to the sacrum?

Answer 33

Disc of S2

Question 34

Which axis involves motion of the sacrum with repiration?

Answer 34

Superior Transverse

Question 35

What axis involves motion of the sacrum that changes with posture?

Answer 35

Middle Transverse

Question 36

What axis of the sacrum involves movement of the ilia on the sacrum

Answer 36

Inferior Transverse | -S3

Question 37

Nutation correlates with what SBS motion

Answer 37

SBS Extension - base moves anterior - Apex moves posterior

Question 38

Counternutation correlates with with what SBS motion?

Answer 38

SBS flexion - Base moves posterior - Apex moves anterior

Question 39

What is the current view as to what is causing the fluctuations of the CSF?

Answer 39

Glial cells may contribute and the brain could be capable to inherent motion on its own.