All test questions Flashcards
All past test questions
1
Q
How many layers in the membrane system and their names?
A
3 layers - Meninges (pia, arachnoid and Dura mater)
2
Q
What are the 3 names of the meninges
A
PAD Pia Mater (soft mother, Inner layer ) Arachnoid mater (middle layer , Spider layer) Dura mater (youth mother, outer layer )
3
Q
Main bones attach directly to the membrane system
A
All cranium bones
2nd + 3rd cervical vertebrae
Sacrum
Coccyx
4
Q
Bones of the cranium
A
Frontal bones 2 parietal bones 2 temporal bones Occipital bone Ethmoid bone Sphenoid
5
Q
6 Fundamental (essence) principles of CSC
A
Engage Allow Follow, Stillness Release Reorganisation
6
Q
What is the ventricular system
A
System of cavities and canals deep within the brain and spinal cord
7
Q
What is the subarachnoid space
A
Fluid fill space (CSF) btw the arachnoid and Pia mater (inside the arachnoid and outside the Pia mater)
8
Q
Venous sinuses what are they
A
Major drainage channels of venous blood (de-oxygenated) from the brain to the heart. Only in cranium
Sinus = space
9
Q
What is Fascia
A
A sheath of continuous Connective Tissue that runs thru out the whole body’s enveloping everything
10
Q
Three diff cranio rhythms
A
Long tide (complete cycle 100sec) Middle tide (2-2.5 cycles per min) Cranio sacral tide (cri) (4-14 cycles per min)
11
Q
What are the 2 phases the 3 rhythms exhibit
A
Expansion and contraction phases
12
Q
List the 4 stage integration treatment framework
A
Engagement
Opening up the system
Core treatment
Completion
13
Q
4 main areas of emotional centre
A
Heart
Solar plex
Pelvic centre
Sub occipital centre
14
Q
What is the core of the CS integration system
A
Membrane system - enveloping and containing the central nervous system
The bones attaching to the membrane system - cranium, sacrum and coccyx
The cerebrospinal fluid, with in the membrane system
15
Q
Where does CSF only circulating
A
In the subarachnoid space
16
Q
Which bones do the parietal bone articulate with
A
Frontal, occiput, 2 temporal, tip of greater sphenoid wing
17
Q
Where are coronal suture
A
Btw the frontal and parietal bones
18
Q
Where are the metopic suture
A
Btw the frontal bones (prominent in children)
19
Q
Three characteristics you look for when first tuning into the Cranio sacral system
A
Quality, symmetry and motion
20
Q
Where is the jugular foramen locates and what 2 bones form it
A
Anterior and lateral to the forum magnum. Near temporal bones .
(Abt 1-2 inch in from under the ear lobe)
21
Q
What is the most significant factor required in a Practitioner in order to enable effective engagement
A
Grounding, presence, relaxed within yourself, establishing your own fulcrum, appropriate attention
22
Q
Clinics process and what attaches to them
A
Bony protrusion front and back on the Stella turcica (Turkish saddle) on the sphenoid
Attached is the tentorium cerebellum
23
Q
4 portions of the occiput
A
Squamous portion, 2x condular portions
Basilar portion
24
Q
Where is The sphenoid basilar synchondrosis locates
A
bw the sphenoid anteriorly and posteriorly to basi-occiput
25
Which bones does the tentorium cerebelli attach to
4 clinics processes
Occiput
2x parietal
2x temporal bones
26
Which bones does the flax cerebri attach to
Midline of occiput
Frontal
Ethmoid (Crista galli)
Parietals
27
How is the cerebral spinal fluid produced
Chloride plexus - extracts cerebrospinal fluid from material blood
28
Where is cerebral spinal fluid mainly located
In subarachnoid spaces with in the membrane around the cranium and down the spine
29
Where is the straight sinus
Point where all the sinuses meet
| Connects to superior and inferior sagittal sinuses and confluences of sinuses
30
Approximate rate of
- cranio sacral rhythm
- middle tide
- long ride
4-14 cycles per min
2-2 1/2 cycles per min (20-25 sec full cycle)
complete cycle 100 sec
31
What steps could you take to help you connect with the middle tide
```
By gentle touch
Grounding
Settling
Entrainment
Midline
Deeper tissue level connection
```
32
What is meant by reciprocal tension membrane system
Membrane system of top of cranium to tip of coccyx
| Tension or imbalance in any part influences all other parts of membrane system
33
Describe temporal bone motion
Wobbly wheel motion
| Rotation external and internal from parietals
34
In what direction is the ear hold process carried out
Down and out to side slightly, lateral and posterial
35
What steps could you take to become more grounded during a treatment
Breathing, presence, checking own fulcrum, appropriate attention
36
Explain the importance of stillness in cranio-sacral therapy
When the cranium sacral rhythm , mid tide or long ride slow down to a stop bf starting back up again. This is where the greatest healing is achieved and repair (reorganisation)
37
Describe the motion of the sacrum during the extension phase of cranio sacral motion
Flextion - Apex (tip of sacrum) moves anteriorly (forward )
| Extension - apex moves posteriorly (back)
38
Describe the dural attachments to the sacrum and coccyx
```
Dural and arachnoid matter terminates in sacral canal at anterior wall , S2
Filum terminale (thin membrane thread) attaches to the coccyx, posteriorly. C1
```
39
With a hand under sacrum how might you stimulate the cranio system using the rhythmic motion
Still point induction
40
In a double contact, one hand under sacrum and other somewhere under vertebral column what do you consider to be the function :-
- of the sacral hand
- Hand under spine
- Combined effect of the two hands together
Find resistance, expressions of resistance in system
Focus point
Create poles for energy for balance
41
How does the sphenoid basilar synchondrosis differ anatomically from other joints in the skull
Cartilaginous joint
42
How does the sphenoid basilar synchondrosis anatomical difference affect its function
More mobile
43
Why is the sphenoid basilar synchondrosis functional difference considered to be significant in CST
Fulcrum by which system operates.
| Asymmetry from elsewhere in body is displayed in patterns
44
6 patterns of Sbs
Flexion / extension (flexion - sphenoid moves forward and down. Extension moves back and up)
Torsion ( sbs greater wings move twist inferior or superior)
Side bending (gap is created btw sphenoid body and basi- occiput on one side creating a narrowing on op side)
Lateral shift (sphenoid moves to one side while occiput moves to op side)
Vertical shift (sphenoid shifts superiorly or inferiorly to basi occiput)
Compression (sphenoid is compressed posteriorly toward occiput and occiput anterior to sphenoid)
45
Explain left side bending pattern of SBS , how it feels and happening at Sbs
The Sbs and basi-occiput creates a gap on one side and narrowing on the other side.
Therapist will feel a bulge one side of head while other feels caved in. (Caves in Thumb and little finger drawn towards each other, bulge thumb and little finger pushed apart)
46
Describe Right side torsion pattern of the SBS , feels to therapest and description
The therapist will feel as if thumb is twisting up to top of head (superiorly) while other thumb moves down towards feet (inferiorly)
Like twisting a peach in half
Right side torsion- sphenoid greater wing twists superiorly on right and inferiorly in left, relative to occiput
47
Give the name and the root origin of the peripheral nerve associated with carpal tunnel syndrome
Median C6,7,8 and T1
48
Give the name and root origin of the peripheral nerve that supplies digits 5 and 4 of the hand
Ulnar C7,8 and T 1
49
What are the root origin of the sciatic nerve
L4,5 S 1,2,3
50
Which nerve root emerges btw vertebrae C7 and T1
C8
51
What sympathetic levels are associated with
- head / eyes
- thoracic viscera (lungs + heart)
- upper abdominal viscera (stomach, liver, gallbladder, pancreas etc)
- lower abdomen and pelvic viscera (colon, uterus, prostate, general is)
- T1-T2
- T2 - T6
- T6 - T10
- T10- L2
52
What visceral and other (mechanical, emotional) associations would you associate with :-
- the thoracic / lumber junction T12/L1
- T9
- T4
- bladder, intestines, kidney , sacral
- solar plexus, adrenals, liver sympathetic stimulation, anger, fear.
- heart , lungs, heart chakra, anxiety
53
What vertebral levels would you associate with:-
- eyes
- lungs
- duodenum
- llio- caecal valve
- bladder
- T1 , T2 (sympathetic)
- T2-6
- T7 - 9
- T10 - 11
- T10 - L2
54
What movement is felt at the feet during the expansion and contraction phase of the CS motion
Expansion phase - feet External rotation
| Contraction phase - feet internal rotation
55
For what conditions or under what circumstances might you use fascial unwinding
```
relief of Tension in body, emotional release
scar tissue release
Muscle strain (sprain)
Sport injuries
Emotional tension or trauma
```
56
Standard listening post to evaluate the fascia from different perspectives
Feet, shins, thighs, iliac crest , lower thorax and upper thorax
57
What is Tissue memory
Fascia is a thin web of connective tissue that envelop all
| Fascia records and holds the memory of all physical or emotional event.
58
Where does the sympathetic synapses for the cardiac plexus take place
In the back , in the sympathetic chain
59
Advantages of the combined heart and solar plexus contact
Effective in engaging with both emotional centres simultaneously.
Advantage is - being able to feel the emotional interaction btw them. Emotional response in the heart and control of emotions from the solar plexus.
60
Benefits of the rhomboid release
Release tension in shoulder, shoulder girdle, upper thorax, emotional holdings, postural tension, occupational tension + physical injuries
Engagement - pericardium + heart plexus, lungs, brachial plexus
61
Aim of the double contact
Greater focus
62
What type of contact is the scapular contact
Symmetrical bilateral contact
| Both hands under the back near the scapular
63
Describe the process of Falx Release, hold and response?
Process- One hand, central under occiput, curve of occiput sitting in palm of hand, fingers pointing towards sacrum. Other hand over the frontal region, fingers pointing towards maxilla but not covering the eye brows.
Heal of hands will feel as if moving away or drawn in.
Response -
follow extremes of rhythmic motion,
build up of tension or pressure,
stillness
release and softening.
64
Describe the process of Mastoid Tip Contact and the purpose of this process is particularly useful?
Process - place one hand under the back of the head (as with suboccipital release), other hand on top of the bottom hand so fingers are crossing over the fingers of the other hand, tips of fingers extending into upper neck. Rest pads of thumbs lightly on the tips of the mastoid processes. While holding follow motion into twists, turns, and flexion and into points of tension. Wait until it returns to normal cranial sacral rhythm
Purpose - To assess the release of occiput-mastoid suture, jugular foramen, balance of temporal and upper cervical spine, glue ear, ear infections, tinnitus, headaches, possible digestive/ respiratory and cardiac symptoms, to integrate the area of temporal /occiput/cervical region. Drainage of the eustachian tubes from the middle ear.
65
Describe specifically the symptoms of the sciatica and it's nerve root origin
neurological pain running down the posterior thigh to knee, pins and needles in the leg/ ankle/ front of foot, unable to flex foot without feeling pain, then split to either side or bilateral. Can be due to slipped disc, trauma, stress, emotional holding.
Origin - L4,5 S 1,2,3
66
What is the superior cervical sympathetic ganglion + location
Upper most ganglion of the sympathetic chain
Location:- C2 -3 Suboccipital region, (supplies throat and neck muscles, receives sensations from around the ear, throat, neck and upper chest.)
67
What is the superior cervical sympathetic ganglion function and significance
Pathway and area of synapse for sympathetic nerve supply to head , eyes and neck
68
compare and contrast the functions of the Sympathetic and parasympathetic nervous systems.
Sympathetic -
- fight and flight
- release of adrenaline from adrenal glands
- Catabolic reaction
- A release of ATP to cells (muscles) for energy to run away
- Temp control
- Dilation of pupils and bronchi
Parasympathetic
- anabolic
- rest and digest
- salivary glands release more saliva
- pupils constrict
- lowers blood pressure and heart rate
- build up of resources in system
69
Why is an understanding of the anatomy of the nervous system, in terms of both spinal outflow and distribution, potentially useful in diagnosis and treatment in CS therapy? 2 examples one relating to the somatic and automatic nervous system.
clear picture and diagnosis of cause, so appropriate and effective treatment can be given.
Parasympathetic - Asthma T2-6 lungs
Somatic - Ulnar nerve C 7,8 T1, affects digits 4 + 5
70
How might you identify emotional characteristics in a patient through CS process
QSM , Observation, case history, breathing, relevant area of body holds, (heart, solar plexus, suboccipital, sacrum)
71
Give 4 ways in which Personal development can be helpful to you as a CS Therapist
- Allows Greater opening up to stillness for the therapist
- settling of fulcrums
- clearing own issues, grounding, boundaries
- awareness of transfer and counter transfer
- allows for greater release and healing of patient
72
8 factors in fascial unwinding
- Identify location,
- Following not imposing
- breathing
- articulation
- grounding and comfort
- stillness
- release
- holding at resistant point
- allows greater integration of whole person
73
List 6 ways in which the use of Breathing might be useful in the CS process
- settling of patient
- change state of patient and self
- greater grounding
- Therapist has more presence with in
- relaxation of patient
- encourages and enhance release
74
Why do we need a Code of Ethics
Protection and safety of patients rights and our own,
establish own professional identity
Stops anyone saying they are a CS therapist.
75
Which nerves and other structures pass thru the Superior Orbital Fissure?
Opthalmic Vein - venous drainage from orbit to cavernous sinus
Cn III -oculomotor nerve,
Cn IV - trochlear nerve,
Cn V1 - Trigeminal nerve (opthalmic division)
Cn VI - abducent
76
Where does the Facial nerve CR VII, exit from the cranium
styloid mastoid foramen
77
Describe, left side bending pattern of the maxillae
Front of maxillary turns to the left relative to the sphenoid.
78
How does the Optic nerve relate anatomically to the pituitary gland and why might this be clinically significant
The optic chiasma is located anteriorly to the sella tercica in the sphenoid body which houses the pituitary gland.
A pituitary tumour affecting medial fibres within the chiasma can lead to tunnel vision.
Optic nerve compression caused by restrictions in sella turcica.
79
Describe the origin, pathway, and function of Cr XI, the accessory (Spinal Accessory) nerve
Cn XI - accessory nerve - arises outside the cranium at C1-C4 thru dura > travels up thru foramen magnum > jugular foramen to briefly bind with the cranium division > passes down to target trapezium and sterno-cleido mastoid muscles of neck and shoulder
80
Which nerve pathways regulate:
1) pupil constriction
2) pupil dilation
1) pupil constriction - Oculomotor CN III - parasympathetic division, ciliary ganglion
2) pupil dilation - Oculomotor CN III- sympathetic supply from sympathetic chain T1/T2. Travels on the carotid artery
81
Describe the pathway of the Mandibular branch of the Trigeminal Nerve Cr V from its root to its final destination
Trigeminal nerve V3
Motor division - Pons> underside of trigeminal ganglion > foramen ovale > mandibular foramen to target muscles of mastication
Sensory division - Pons > trigeminal ganglion > foramen ovale > mandibular foramen > mental foramen to sensations of teeth, jaw and lower face
Recurrent Meningeal branch passes back up through foramen spinosum to meninges.
82
What are the symptoms of Bells Palsy and which Cr is affected
Cn VII - Facial nerve
Lower eyelid droops
facial muscles on affected expressionless
Mouth of affected side droops.
83
What are the symptoms of Meniere's disease and which cranial nerve is affected?
Cn VIII - vestibulo-cochlear nerve
| Symptom - motion sickness, vertigo, loss of hearing, tinnitus
84
Describe the motion of the Maxillae and Zygomae during the flexion phase of CS motion
Maxillae - front portion of maxillae rises superiorly coming up to meet the frontal bone while at same time, spread laterally at posterior part of intermaxillary suture (back teeth move apart)
Zygoma - externally rotate with temporals and arching down and out (with frontal).
85
Which bone does the vomer articulate with
ethmoid, palatine, maxillae and sphenoid bones
86
Describe the CS motion of the Orbit during flexion phase
Orbit flattens on vertical plane and gets larger on horizontal plan as they get squeezed between frontal and maxillae.
87
What aspect of a person do you associate with the ethmoid
enlightenment, 3rd eye - spiritual aspect, foresight, vision
88
What reasons might draw you to treat the face
Birth trauma, recent dentistry work, sinus infections, Meniere's disease, torticollis, Face is asymmetry, Tension at TMJ, grinding teeth.
89
List 2 cranial contacts and 1 facial contact which might be specifically relevant to assisting drainage of the middle ear and treatment of ear infections
Why?
2 cranial holds - Ear hold/ Mastoid process / temporal hold
1 facial - TMJ/ palatine hold
All hold engage and allow closer contact to - Cr VIII vestibular-cochlear nerve and internal auditory meatus, engage with Cn V to target the tensor veli palatini muscle in middle ear to held open eustachian tube for better drainage of middle ear and release of any blockages.
90
How would you approach treatment of a client with sinusitis?
target eustachian tube, venus and air sinuses, (frontal, ethmoid, maxillary sphenoid sinuses) through face holds
Sub- occipital release - jugular foramen > jugular vein carries venous blood back to the heart.
The jugular vein is the main structure of drainage
Cn VII - Facial nerve for mucus secretions and lacrimal glands.
Whole CS integration.
91
How might direct trauma to face affect rest of system
any trauma to the face (ie car accident, birth trauma, dentist etc ) which causes restriction and compression to the bone, fissure and foramen in the cranium and pinching to associated nerves may result in physo emotional holding in the fascia (as tissue tension/memory) and viscera.
Trauma to temporal, mastoid process or occiput may affect jugular foramen that is housed between these bones. affecting nerves Cn IX glossopharyngeal nerve, X vagus , XI accessory.
Read Notes Test stage E
92
What reasons might draw you to treat the face?
```
Face appearing asymmetry
Dental work or orthodontics
Birth trauma, torticollis
Sinusitis, tinnitus
Middle and inner ear infection
Bells palsy; Trigeminal neuralgia, Meniere disease
```
93
What nerve passes through the stylo-mastoid foramen?
Motor branch of Facial Nerve CN VII
94
What is Eustachian Tube?
Tube between the middle ear to nasopharynx
95
What structure would you associate with the Foramen Lacerum?
Carotid Artery
96
Name the fontanelles that are present in a new born baby and give the approximate age of closure?
Anterior Fontanelle (Bregma) - 18 to 24 months
Posterior Fontanelle (Lambda) - 3 months
Antero-Lateral Fontanelle (Pterion) - 3 months
Postero-Lateral Fontanelle (Asterion) - 1 year
97
How does an occiput of a newborn differ from that of an adult and what age is it considered to be completely fused?
Newborn occiput is in 4 portions separated by cartilage.
Gradually fuses over first 6 years.
Squamous portion - posteriorly
Basilar portion (basi occiput) - anteriorly
2 x Condylar portions - laterally
Condylar-squamous portions fuse - by 3 years
Condylar-basilar portions fuse - by 6 years
Cartilaginous areas are less able to self correct than membranous structures
All areas of incomplete ossification are sites for possible distortion.
98
How does the Sphenoid of a baby differ from that of an adult?
Sphenoid of a baby is in 3 parts:
Central body, Lesser wings
Right + Left Greater Wing + Pterygoid Plates
All parts unite within first few months of birth
Pterygoid plates are usually short at birth. It is the sucking motion during feeding that causes them to lengthen.
99
From what age is it possible to treat a baby?
Birth
100
What is a Ventouse birth?
A suction cup is placed on the babies head to ease it out of the birth canal during delivery if it gets stuck or there is urgency to deliver.
101
Why is early treatment of birth trauma recommended?
Essential to enable complete resolution and recovery from birth trauma.
Important to treat before bones fuse so patterns can be released.
Occipital bone fuses between age 3 and 6.
Temporal and Sphenoid bones fuse before 1 year old.
To ensure Foramen Magnum does not getting impinged and affecting the spinal cord and brainstem.
Compressive and rotational forces in the cranium from the birth becomes deeply embedded from the cranium down the vertebral column to the pelvis and sets up patterns for life.
Shock from a traumatic birth imprints into the tissues and sets up an early pattern about how the person handles episodes of stress and shock. Early cord clamping imposes shock.
Early release will support
- healthy CSF flow
- healthy growth and development,
- better bonding, sleep, feeding and digestion.
- prevent common childhood conditions such as asthma; allergies; ear infections; colic; reflux.
- optimal immune functions and a happy childhood.
102
What is Pyloric Stenosis?
Narrowing, constriction, blockage of the pyloric sphincter.
Causes forceful vomiting of undigested milk and dehydration.
Affects lower part of stomach and is a passageway between the stomach and small intestine (duodenum).
103
How would you treat Pyloric Stenosis?
Awareness of condition affecting baby between birth and 6 months.
Thickened pylorus muscle can be felt during feeding as a small hard lump on the right side of the stomach.
Release shock and trauma held in the system -
working with the emotional centres - solar plexus.
Superior cervical sympathetic chain and sub-occiput to release the Jugular foramen to support proper functioning of the vagus nerve.
104
Describe how you would release the sub-occiput in a newborn baby?
Soft flat fingers under the occiput.
Crown- Cranial Base contact.
Occipital Condyle contact - higher on the occiput
Treat the whole system
105
How would you approach the treatment of a baby with colic?
Get a sense of overall shock and sympathetic over stimulation in the system.
Identify fulcrums.
Work with sympathetic plexi - coeliac plexus and cardiac plexus.
Treat the whole system.
Sub-occipital release to release any restrictions in Jugular Foramen to release Vagus Nerve.
Emotional qualities in system.
Family field and life in relation to baby.
Diet/ allergies re mum.
106
What specific focal point would you expect to find with a baby with colic?
Tight, contracted and overstimulated in the solar plexus area.
Overstimulated ANS.
107
In what ways might you address a situation in which a baby does not wish to stay still and settle into the treatment?
Mother holds the baby, feeds the baby.
Treat the mother at the same time - work with the energetic field - if mum relaxes - baby relaxes.
Treat when asleep - if possible.
Allow baby to lead treatment.
108
How would you work with a young child that doesn't want to stay still and settle into a treatment?
Toys; books; audio CDs; allow system to come to you; work off the body; observe breathing and changes in QSM; gently introduce contact on the body.
109
Give 2 important pieces of advice to a new mother with her new baby - with regard to herself rather than the baby?
Self care - nourish self
Rest and recuperation
Get practical help and support
110
Why is learning about viscera relevant to CS Therapy?
Case history - may present with pathology of organ.
Need to know about location of organ for awareness of organ pathologies.
- understand emotional connections and sympathetic and parasympathetic nerve supply, sympathetic plexi.
111
What is the CS Integrated approach to treating viscera?
Whole body/mind complex;
Aim to improve underlying health and vitality of person to optimise health and combat disease
May address viscera separately
Viscera plays a part in primary, secondary or causative conditions.
112
What would you consider when thinking about upper thoracic viscera?
```
Cervical spine - C1 to C4
Cranial Nerves - Glossopharyngeal + Vagus
Parasympathetic supply - Vagus
Sympathetic Supply - T1 - T6 (facilitated segments)
Throat Chakra
Heart chakra/lungs
Emotions associated with the viscera
Fascia
QSM - whole body
```
