6. Osteopathic Cranial Manipulative Medicine Review Flashcards
Describe Occipital Condylar Decompression
Contact near to foramen and condyles
-add slight OA flexion
Gently apply traction and pull the occipital tissues in a posterior and lateral direction
Await occipital regional give and reassess
Clinical use for Occipital Condylar Decompression
Poor infant feeding
Infant colic
Head/Neck pain and post trauma
Describe CV4 Still Point Induction
Thenar eminences are inferior to the superior nuchal line and medial to OM sutures
-compress lateral to sutures to ensure ER of temporal
Gently encourage extension and then sequentially resist its inferior motion by not reducing pressure
Motion will get to a point where pt feels it has disappeared
-slowly release and await CRI return
Clinical use for CV4 Still Point Induction
Decreased CRI
URI
Headache/Migraine
Describe SBS decompression (indirect)
BMT Compression followed by release
Describe SBS decompression (direct)
Gently engage the frontal bones to distract against the occiput
Pull in an anterior and slightly superior direction
Await elastic release, then reassess
Clinical use for SBS decompression
Diminished CRI Mood disorders Cranial nerve entrapment URI Pediatric developmental problems
BMT Indirect Cranial Manipulative Treatment
Gently exaggerate membranous asymmetry until a sense of balance is noted
-Resist any movement by CRI
Hold hand position until CRI stops at still point
Gently release forces and return to midpoint
Clinical Use for BMT Indirect Cranial Manipulative Treatment
Asymmetric or diminished CRI
CN entrapment
Dural strain
Headaches
Parietal Lift
Fingers on parietals, thumbs crossed behind head
Add parietal traction until superior elastic release is noted
-gently release head and reassess
Clinical use of Parietal Lift
TMJ
Headaches
Decompress the Squamosal Suture
Frontal Lift
Gently engage the lateral inferior edge of frontal bone by hooking under the initiation of zygomatic arch
Apply anterior force with some anterior rotation torque until release
Reassess
Clinical use for a frontal lift?
Restricted frontal mobility Augment SBS flexion Frontal headaches Sinus congestion Pediatric developmental issues
Temporal Rocking
Switch back and forth between external and internal rotation to encourage temporal motion
- ER: thumb and index fingers move inferomedial, 4th and 5th digits move along with superolateral motion
- IR: thumb and index fingers move superior and lateral; 4th and 5th digits move inferomedial
Slowly release and return to neutral after motion feels symmetric
Clinical Use of Temporal Rocking
Eustachian Tube Dysfunction TMJ Bell's Palsy Lateral Head/suture pain Cranial torsion
Temporal Pull
Use pincer grip on pinnae as close to temporal bone as possible
- Apply gentle traction laterally, posteriorly, and superior that parallels the petrous ridge
- Maintain tension on the feather’s edge until release
Clinical use of temporal pull
Temporal headache Vertigo Tinnitus TMJ Balance the tentorium cerebelli
TMJ Decompression
Begin with Indirect compression of mandible towards TMJ until relaxation felt
Switch to Direct at lateral mandible pushing inferior and slightly anterior until release
Retest by palpating motion at TMJ with mouth open
Clinical Use of TMJ Compression
TMJ restriction
Mandible Restriction
Neck pain
V-Spread
At any suture restriction, apply a spreading pressure to encourage motion
Finger pads of pressure hand are usually near the longest contralateral diameter
Clinical use of V-spread
Any vault suture restriction
Occipitomastoid release (suture disengagement)
Wrap contralateral hand under occiput with fingers behind suture and ipsilateral hand around mastoid process
Roll head towards affected side until the OM suture is most posterior
-Gently traction mastoid anterior
Hold until release and reassess
Clinical Use of Occipitomastoid Release
Trauma
Migraine
TMJ
Vertigo
Saggital Suture Release (suture disengagment)
Use traditional OCMM position, cross thumbs at sagittal suture
-gap joints with lateral thumb pressure
Hold until elastic release is felt
-release and retest
Clinical use for Sagittal suture release
Migraine
Tension Headache
Pterigopalatine Ganglion Inhibition
Ganglion located just lateral to molars, medial to pterygoid
-direct force superior, medial, and slightly posterior with slight medial rotation
Hold until releaxation
What does rotary stimulation of the Sphenopalatine ganglion do?
Thins nasal mucus and increases tears
Clinical use for pterigo (sphenopalatine) ganglion
TMJ
Migraine
Tension headache
Sinusitis
CV 4 Pump
Thenar eminences are on the occiput
-medial and cephalad comressing pressure through flexion phase
Release pressure completely allowing full extension again
-repeat until overall decreased resistance felt (10-14 cycles)
What does CV 4 pump do?
Pumps CSF from the 4th ventricle into spinal cord region
Clinical use for CV 4 pump
Fatigue
Depression
Insomnia
