2. Intro the Osteopathic Cranial Manipulation Flashcards
Who is credited for starting cranial manipulation?
William Garner Sutherland
Explain the basis (not componenets) of primary respiratory mechanism (PRM)
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
What are the five components of PRM?
- Inherent mobility (passive) of brain and SC
- Fluctuation of cerebral spinal fluid
- Mobility of intracranial and intraspinal membranes
- Articulatory mobility of cranial bones
- Involuntary (passive) mobility of sacrum b/t ilia
What is the driving push in CSF and how many times is CSF cycled through?
Cranial Rhythmic Impulse is the driving force that moves CSF through 10-14 cycles/minute
What are the motion chracracteristics of the Cranial Rhythmic Impulse? R-RADS
Rate: 10-14 BPM
Rhythm: regular, but can have variation
Amplitude: SD may diminish
Direction: healthy is linear, SD is asymmetric
Strength
What is the intracranial and intraspinal membranes and what do they come together to create?
Intracranial membranes are the falx cerebri and the tentorium cerebelli that make the “Sutherland Fulcrum”
What is the Sutherland Fulcrum?
A name for the straight sinus as the origin of the falx cerebri and tentorium cerebelli
Describe the Reciprocal Tension Membrane?
The meninges and spinal cord make a link from cranium that correlates with movement in the sacrum
-the “core link”
What do the tentorium and falx come together to create?
the reciprical tension membrane, which allows for constant tension and acts like a spring to store energy
Why is the straight sinus, or sutherland fulcrum, said to be a suspended automatic shifting fulcrum?
Suspended: pivot point of fulcrum remains within RTM created by falx and tentorium
Automatic: passive motion
Shifting: straight sinus moves up and down
What is the anterior/superior pole of the RTM?
Crista galli
What is the anterior/inferior pole of the RTM?
Clinoid process of sphenoid
What is the lateral pole of the RTM?
Mastoid angle of parietals and petrous ridges of the temporal bones
What is the posterior pole of the RTM?
Internal occipital protuberance and transverse ridges
What is the suture between the parietal and temporal bones?
Parietosquamous
What is the suture between the parietal and occipital bones?
Lambdoidal
What is the suture between the occipital and temporal bones?
Occipitomastoid
What is the point where temporal, parietal, and occipital bones all meet?
Asterion
What is the suture between the sphenoid and temporal bones?
Sphenosquamous
What is the point where temporal, parietal, and sphenoid bones all meet?
Pterion
What is the suture between the parietal and frontal bones?
Coronal
What is the suture between the temporal and zygomatic bones?
Temporozygomatic
What is the point where the two parietal parietal and frontal bones all meet (front of head)?
Bregma
What is the point where the two parietal parietal and occipital bones all meet (back of head)?
Lambda
What is the suture between the two parietal bones?
Sagittal
What is the name of the synchondrosis between the sphenoid bone and clivus of the occipital lobe?
Sphenobasilar Synchondrosis (SBS) -relatively rigid hyaline cartilagenous junction like the ones at the sternomanubrial joints
Which way do the occiput-sphenoid synchondrosis move during flexion of the SBS?
Superior
Which way does occipital squama move move during flexion of the SBS?
Posteriorly and inferior
Which way does the greater wing of the sphenoid move during flexion of the SBS?
anterior and inferior
Which way do the occiput and sphenoid move during extension of the SBS?
Inferior
Which way does occipital squama move move during extension of the SBS?
Superior and anterior
Which way does the greater wing of the sphenoid move during flexion of the SBS?
Anterior and inferior
Where does the dural attachment from the foramen magnum attach to the sacrum?
Disc of S2
Which axis involves motion of the sacrum with repiration?
Superior Transverse
What axis involves motion of the sacrum that changes with posture?
Middle Transverse
What axis of the sacrum involves movement of the ilia on the sacrum
Inferior Transverse
-S3
Nutation correlates with what SBS motion
SBS Extension
- base moves anterior
- Apex moves posterior
Counternutation correlates with with what SBS motion?
SBS flexion
- Base moves posterior
- Apex moves anterior
What is the current view as to what is causing the fluctuations of the CSF?
Glial cells may contribute and the brain could be capable to inherent motion on its own.
