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CCST Quizzes & Worksheets 2021 > Articulation of Bones & Bony Features > Flashcards

Articulation of Bones & Bony Features Flashcards

1
Q

What bones does the occiput articulate with?

A

PARIETALS
TEMPORALS
SPHENOID
Parietals at lambdoid suture
Temporals at mastoid potions and petrous portions
Sphenoid - basilar portion of occiput articulates with sphenoid at SBS
SBS is PIVOTAL FULCRUM ROUND WHICH THE WHOLE BONY STRUCTURES OPERATE IN THE CS SYSTEM.

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2
Q

Name some features of the occipital bone?

A

Squamous portions
Occipital condyles x 2
Basi-occiput
External occipital protuberance (inion) - the trapezius muscle attaches here.
Internal occipital protuberance - the falx c and falx c and tentorium AND venous sinus pathways ALL COME TOGETHER at the Internal Occipital Protuberance to form the CONFLUENCE SINUSES.
Forms the Foramen Magnum with the Sphenoid body at the SBS
Sutures - Occipito- Mastoid - Jugular Foramen
Sinuses - occipital, running down the occipital border of the falx cerebri and transverse sinuses passes along occipital border of tentorium.
Membranes - tentorium has it’s attachment at the internal occipital protuberance and projects forward - runs along the petrous portion of the temporal bone
POSTERIOR CRANIAL FOSSA
New-born - in 4 parts -(Basi-occiput/2 condylar portions and squamous portion) prone to compression through forces exerted through buttocks of baby. Foramen magnum may become distorted = impingement of spinal cord.

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3
Q

What is the purpose of the sub-occipital release?

A

To address restrictions at the sub-occiput, where occiput meets atlas (C1) and is held by 4 small muscles.
These 4 muscles tilt the head back into extension, assist with rotating the head and stabilise the skull on C1 and C2.

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4
Q

What is the occipital CS rhythm?

A

LONGITUDINAL MOTION - Flexion -
occiput tucks under towards neck;
basilar portion moves anteriorly and superiorly as SBS moves into flexion.
LATERAL MOTION - Flexion
occipital region widens round midline, so moves at squamous portions

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5
Q

Where does the sacrum have membranous attachments?

A

S2 anteriorly and Coccygeal 1 posteriorly.

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6
Q

What are the articulations of the sacrum?

A

L5
Laterally with wings of iliac bones of pelvis forming 2 SI joints
coccyx

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7
Q

What is the CS motion of the Sacrum?

A

Flexion - apex of sacrum moves anteriorly - rocks forward
Extension - apex of sacrum moves posteriorly - rocks back
Midline structure

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8
Q

Name 5 ASYMMETRIES of Sacrum and explain

A

1) Side-bending - base of sacrum pulling to SI joint on one side.
2) Torsion - sacrum twisting posteriorly on one side
3) Side-shift - whole sacrum shunted to one side
4) Flexion - apex moving more strongly anteriorly
5) Extension - apex moving more strongly posteriorly

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9
Q

What is the role of the temporals?

A

House organs for hearing and balance

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10
Q

What do you associate with the temporals?

A

Emotional nature of the person with specific conditions eg LD; epilepsy; autism; recurrent ear infections; balance or hearing issues.

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11
Q

What does each temporal bone consist of? (8 examples)

A

1) Squamous portion - level with tops of ears
2) Mastoid portion
3) Mastoid processes - bony lump for attachment to SCM muscles
4) Styloid process - attaches to SCM muscle and ligament - Behind Styloid process is Styloid Mastoid Foramen = exit for Facial Nerve
5) External Auditory Maetus (ear hole) - opening into external auditory canal - sound waves pass through to tympanic membrane.
6) Mandibular Fossa - receives condyle from mandible to form TMJ (in front of external auditory meatus)
7) Zygomatic process - projecting bone from mandibular fossa to form zygomatic arch.
8) Temporal Fossa to attach to the Temporalis muscle
9) INTERNAL PETROUS PORTION - organs of hearing and balance are contained in petrous portion.
10) Sutures -
a) Squamosal suture - bevelled - temporals overlap the parietals - can get wedged.
b) Occipto-mastoid sutures - with connection to JF and structures - can become restricted - affects venous drainage and
11) Eustachian tube - originates at petrous portion of temporal and passes through petrous portion and greater wing of sphenoid, runs along spheno-temporal suture. Opens in external rotation
12) Membranes - Tentorium along petrous portion
13) Sinuses - Sigmoid - S shaped twists along grooves in petrous portions towards jugular foramina
MIDDLE CRANIAL FOSSA = petrous portions; SBS; spheno-temporal suture; OM suture
POSTERIOR CRANIAL FOSSA = petrous ridge; OM suture(
14 ) Internal acoustic meatus - canal - vestibulocochlear and facial nerve.

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12
Q

Which other bones do the temporal bones articulate with?

A

Parietal - along squamosal suture
Occiput - along occipito mastoid suture
Sphenoid - at spheno-temporal suture
Temporal FOSSA = 4 bones (above plus frontal)
Pterion = meeting point of temporal; sphenoid; parietal and frontal or Antero-Lateral Fontenelle

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13
Q

What membranes do the temporal bone attach with>

A

Tentorium cerebelli along PETROUS RIDGE

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14
Q

What is the CS motion of the temporal bone?

A

Flexion -
Temporals open out into external rotation with mastoid portions moving medially. Creates a wobbly wheel movement. External rotation opens Eustachian tube. Medially compressed mastoid portions affect venous drainage.

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15
Q

What is the axis for the external rotation of the temporal bone (wobbly wheel motion?)

A

Petrous ridge

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16
Q

What happens to the tentorium during the flexion phase of CS motion?

A

It flattens as it stretches laterally which affects the whole reciprocal tension membrane system. Also opens the straight sinus.

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17
Q

Where do the 2 parietal bones meet?

A

At the sagittal suture

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18
Q

What other bones do the parietals articulate with?

A

Frontal bone - at coronal suture
Occipital bone - at lambdoid suture
2 temporal bones at squamosal sutures
Greater wings of sphenoid - at pterions

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19
Q

What membranous attachments do the parietals receive?

A

Falx cerebri - either side of sagittal suture along midline
Tentorium - small attachment

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20
Q

Describe the CS motion of the parietals?

A

Flexion - 2 parietals flare - hinged around sagittal suture.
FALX CEREBRI acts as a fulcrum for rhythmic motion of parietals.

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21
Q

Which suture is bevelled?

A

squamosal suture - with temporals overlapping parietals.

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22
Q

Are sutures more often interdigitated or bevelled?

A

Interdigitated.

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23
Q

What is significant about the sphenoid bone>

A

Central, pivotal bone in the cranium and CS system
Fulcrum of the craniosacral system
Articulates with all bones of cranium

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24
Q

What is significant about the sphenoid bone and where is it located?

A

Central, pivotal bone in the cranium and CS system
Articulates with every other cranial bone and some facial bones - zygomatic, ethmoid, vomer and palatines.
The sella turcica in sphenoid body houses pituitary gland (endocrine gland) which releases hormones regulates functions throughout body

It is located at the centre of the base of the cranium in the middle fossa.

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25
What does the sphenoid bone articulate with and name features?
Every other bone in the cranium and some facial bones - zygomata; ethmoid; vomer and palatines. Lesser wing with frontal bone Sphenoid body with ethmoid Tips of greater wings with parietal bones Edges of greater wings with temporal bones Sphenoid body with occiput. With occiput if forms the SBS. MIDDLE CRANIAL FOSSA. Location of sella turcica in sphenoid body. Sella turcica houses pituitary gland and stalk which is washed by CSF and covered by diaphragma sellae which attaches to clinoid processes of sphenoid body. Tentorium attaches to anterior and posterior clinoid processes. Optic chiasma is in front of pituitary gland. Superior Orbital Notch - between sphenoid G and L wings - Nerves 3,4,5 (ophthalmic division), 6 and ophthalmic vein enter orbit here. Inferior Orbital Notch - between sphenoid G wing and Maxilla = maxillary division Trigeminal nerve enters orbit here. Optic canal - optic nerve and ophthalmic artery in sphenoid - between body and lesser wing). The pterygoid process of the sphenoid - Each process divides into a medial pterygoid plate and a lateral pterygoid plate which terminate behind the nasal cavity and palate. The lateral pterygoid plate is the origin of the medial and lateral pterygoid muscles and assists the jaw to move side to side whilst chewing. The medial pterygoid plate (along with the masseter muscle) allows the jaw to move up and down during chewing.
26
What is the SBS and why is it so important?
SBS is PIVOTAL FULCRUM ROUND WHICH THE WHOLE BONY STRUCTURES OPERATE IN THE CS SYSTEM. Cartilaginous joint between sphenoid body and basiocciput. Because its mobile and central, SBS is affected in patterns in early life which will follow through to later life. It is pivotal, meaning it reflects imbalances and tensions from all systems, therefore to restore balance and CS rhythm here means restoring at a deep level.
27
What is the sphenoid made up of?
2 greater wings - form part of the floor of middle cranial fossa. 2 lesser wings - emerge top of sphenoid body to run along back edge of front cranial fossa. 2 pterygoid processes - project down from sphenoid body and each dividing into a medial and lateral pterygoid plate which terminate behind the nasal cavity and palate. Superior surface of sphenoid body is shaped to form SELLAE TURCICA - houses pituitary gland (ENDOCRINE). Sellae Turcica - 2 anterior clinoid processes (project from front) 2 posterior clinoid processes (project from back)
28
What are membranous attachments to the sphenoid?
Lined with membrane Tentorium cerebelli projects forward and attaches to anterior and posterior clinoid processes to form a double membranous sheet. Sella Turcica of sphenoid is covered by a membrane which stretches across the 4 clinoid processes and down sides of sphenoid body. It covers pituitary glands and stalk to ensure it stays in subarachnoid space and washed by CSF. Blends into surrounding membranes.
29
What is the CS motion of the sphenoid?
Flexion - sphenoid arcs forward and down (with frontal bone) and occiput tucking in towards neck. Basilar portion moves anteriorly and superiorly. Extension - sphenoid comes back and up hinging around SBS. Occiput draws back and up. Basilar portion of occiput moves posteriorly and inferiorly.
30
What is the SBS release?
Sphenoid may follow into flexion or extension - follow - notice build up of tension to release. Sphenoid may draw into compression at SBS -
31
What does a compression at the SBS reflect?
Reflecting fall, birth trauma, trauma to head, compression to occiput or lumbosacral area, could reflect personality - depression, contracted, withdrawn.
32
Who devised the framework of 6 SBS patterns?
Sutherland
33
What is the purpose of the 6 SBS patterns?
To evaluate the CS system more fully BUT see what is reflected in the WHOLE system
34
What is perfect fluency of SBS Flexion and Extension?
Motion is fluent; fluidic; easeful and balanced.
35
What is a Torsion SBS pattern reflect?
A twist in the body - pelvis; vertebrae; knee; neck; membrane; birth pattern. Might be same side or other.
36
Describe the SBS Torsion pattern?
The sphenoid twists superiorly on one side in relation to the occiput, while the other side twists inferiorly in relation to the occiput.
37
Describe a Left Sided SBS Torsion?
The sphenoid greater wing twists superiorly on the left and inferiorly on the right, relative to the occiput.
38
What would the therapist feel in an SBS torsion?
1 thumb twists superiorly towards the top of the therapists head whilst the other thumb twists superiorly towards the patients feet.
39
What does a Side Bending SBS pattern mean?
There is a sidebend restriction somewhere in the body.
40
What happens at the SBS in a side bending pattern?
At the SBS, there is a gapping between the sphenoid body and basi-occiput on 1 side with a narrowing on the other side - therapist will experience this as a bulge on one side of the head, with the other side of the head seeming to cave in.
41
What are the causes of a side bend restriction at the SBS?
Scoliosis; pelvic imbalance; muscular tension on one side; contraction around pericardium; head injury.
42
What does a Lateral Shift mean at the SBS?
There is a lateral shift pattern held in the body.
43
Describe a lateral shift SBS pattern?
At the SBS, the sphenoid will shift directly to one side in relation to the occiput.
44
What causes a lateral shift at the SBS?
Blow to the side of head or pelvis causing a physical shunt to one side. Therapist will feel a parallelogram.
45
What does a vertical shift at the SBS mean?
There is a vertical shift pattern affecting the body.
46
Describe a vertical shift SBS pattern\>
At the SBS, the sphenoid body shifts superiorly or inferiorly in relation to the basi occiput.
47
What will the therapist experience in a vertical shift SBS pattern?
Thumbs being drawn straight down towards the patients feet (superior vertical shift) & occiput shift in different direction. OR Thumbs being drawn straight up towards the top of head (inferior vertical shift) & occiput will shift in opposite direction.
48
What are the differences between a Vertical Shift and Flexion/ Extension - what will therapist feel?
Vertical shift - thumbs & little fingers move in opposite directions. Feel straight line between feet & top of head. Flexion/Extension - thumbs & little fingers move together. Feel arcing movements.
49
What is a compression at the SBS?
There is a compression force held in the body
50
What is a compression SBS pattern?
The sphenoid is compressed posteriorly towards the occiput, compressing the SBS joint.
51
What will the therapist experience in an SBS compression pattern?
Both thumbs being drawn posteriorly (down) towards the occiput (down towards the couch).
52
What is SBS integration?
Allow system to express itself through inherent treatment process. SBS patterns occur in combinations, reflecting all lifes accidents. Stacking - several SBS patterns on top of each other - difficult to untangle so work through patterns. Physical and emotional patterns can become locked. IF JAMMED UP - ask if would like SBS compression, the decompression; survey patterns in turn; opposing patterns - address each.
53
What is SBS projection?
Using SBS patterns to survey whole body; see whole picture; use as a window - see whether local or further away; emotional or physical.
54
What are the internal bones of the face and what do they make up?
MAXILLAE - horizontal portions project internally to form anterior 2/3 of hard palate PALATINES - horizontal portion posterior 1/3 hard palate AND vertical portions form lateral wall of nasal cavity. VOMER - Inferior part of nasal septum ETHMOID - between eyes; behind nose; above palate; in front of sphenoid body.
55
What does the Ethmoid bone articulate with?
Sphenoid Frontal Lacrimal Nasal Vomer
56
What membrane does the Ethmoid attach to?
Falx Cerebri
57
Where is the Ethmoid located?
Between orbits; in front of sphenoid; behind nasal bones; above the palate; forms good part of nasal cavity.
58
Describe in detail the Ethmoid bone?
= Roof = cribriform plate = Cribriform plate sits in ethmoid notch = Olfactory nerves pass through cribriform plate to synapse in olfactory bulbs on top surface of ethmoid bone. = Ethmoid notch separates the 2 orbital plates of frontal bone. = 2 lateral walls of ethmoid form inner wall of orbit = ethmoid is hollow and spacious = ethmoid sinus is in upper nasal cavity = perpendicular plate passes down midline of nasal cavity to form nasal septum - dividing nasal cavity into 2 halves) and is continuous with the vomer below = perpendicular plate passes up to form Christ Galli - attach Falx cerebri The superior and middle nasal conchae belong to the ethmoid bone. The inferior nasal concha is a separate bone.- create turbulence for air flow.
59
What is an important drainage role for the Ethmoid?
Foramina in cribriform plate allow passage of Olfactory nerve AND drainage of CSF from brain to lymphatic system. So damage to ethmoid = affects drainage = reduced CSF flow in cranium = increased intracranial pressure.
60
Why is the ethmoid bone considered a bridge between the face and cranium?
Contained in ethmoid notch of frontal bone and received direct attachment to falx cerebri - contained in the cranium. CS motion - moves with mouth parts - maxillae-palatine-vomer so more facial. SO seen as bridge between face and cranium.
61
What is the CS motion of the ethmoid?
Flexion - rises and sphenoid arcs forward and down = pushes ethmoid forward (rotates in opposite direction to sphenoid) & moves with mouth parts - maxillae - palatine - vomer.
62
How does the ethmoid develop?
Embryologically in 3 parts Ossifies age 5-6 In birth acts as a shock absorber.
63
How does the ethmoid bone become compressed?
Birth trauma; facial injuries; cranial compression; sinus congestion - nasal symptoms
64
Why would you work with ethmoid?
Nasal congestion; loss of smell; deviated septum; birth trauma; head trauma; higher self; ethereal connection; for direction and insight; third eye
65
What is an ethmoid pump?
Vertically compressed ethmoid - help clear congestion, CSF flow, drainage for cribriform plate - 2 hands compress and release.
66
Describe the vomer?
Thin slice of bone Flares at top to form 2 alae (wings) with groove between Passes down inferior surface of sphenoid body to top of hard palate. Forms lower part of nasal septum which divides in 2 halves. FORMS BRIDGE BETWEEN MAXILLAE AND SPHENOID - ACTS AS A SHOCK ABSORBER
67
What fits into the groove formed by the 2 alae of the vomer?
The Rostrum of the sphenoid.
68
What is a deviated septum?
Nasal septum is off centre or crooked, can make breathing harder.
69
Which bone do you relate a deviated septum to?
Vomer
70
Why does the nasal septum become deviated?
Reflects function as shock absorber between maxillae and sphenoid.
71
What is a torus palatinus?
Bony growth, ridge or lump palpated in roof of mouth along cruciate suture? May mean vomer is pressing down through roof of mouth.
72
What is the CS motion of the vomer?
Vomer moves with maxillae and rest of face. Flexion - Front portion rises up to meet frontal bone as it arcs forward and down. OPPOSITE movement to sphenoid so vomer needs to glide freely at vomer-sphenoid articulation.
73
What is the vomer - sphenoid articulation?
Where rostrum of sphenoid glides between alae of vomer for free CS motion. When restricted causes lock up.
74
If vomer - sphenoid articulation is locked how would you approach?
ROCKING THE VOMER - engage with CS motion to free up movement - good for chronic fatigue, post viral syndrome, energise CS system?
75
Where are the palatine bones?
Between maxilla and sphenoid Also form bridge between cranium and face (like ethmoid)
76
What do palatine bones consist of?
Horizontal plate - small - posterior 1/3 of hard palate Vertical plate - large Together they form the POSTERIOR part of nasal cavity.
77
What is the name of the suture where the horizontal plates of the palatine bone meet?
Inter-palatine suture
78
What is the name of the suture where the anterior 2/3 of hard palate formed of maxillae meet with the posterior 1/3 of palatines?
Maxillary-palatine suture
79
What is the cross shaped junction between the 2 palatine bones and 2 maxillae bones?
Cruciate suture
80
What is the cruciate suture?
Cross shaped junction where the 2 palatine bones meet with the 2 maxillae bones.
81
What bones form the posterior part of the nasal cavity?
Horizontal and vertical pates of the palatine bones.
82
What is the CS motion of the palatines?
Flexion - palatines move with maxilla and rest of face so front of face rises with maxillae as frontal arcs forward and down. Rotates in opposite direction to sphenoid. Palatines also flare slightly away from each other along with posterior maxillae.
83
What is the interaction between palatine and sphenoid regarding CS motion?
There are 2 grooves on the surface of each palatine bone which the lateral and medial pterygoid plates of the sphenoid sit. Surfaces are smooth to allow free gliding of pterygoid plates as the sphenoid and palatines move together.
84
What is significant about the maxillae
Pivotal bone of face. Articulate with every bone in face.
85
Which bones do the maxillae articulate with?
Sphenoid; palatines; vomer; nasal; lacrimal; frontal; zygomata; form orbits; inferior nasal conchae
86
What is the function of the maxilla?
Upper jaw Forms orbit, nose and palate Holds upper teeth (alveolar process) Role of mastication Role of communication
87
What does the maxillae consist of?
BODY & 4 PROJECTIONS = Frontal process Zygomatic process Palatine process Alveolar process
88
What is the premaxilla?
Front portion of each maxilla is known as the pre-maxilla.
89
What is the suture running medially from between the lateral incisors and canine tooth on each side (2nd and 3rd upper)
No name that separates the premaxilla from the posterior maxilla.
90
What is the incisive canal?
Passes through the hard palate - anterior 2/3 near front end of intermaxillary suture at junction between premaxilla and posterior maxillae.
91
What is the anterior 2/3 of the hard palate made of?
Horizontal portions of maxillae Articulates posteriorly with palatines which form back 1/3 of hard palate.
92
Where is the infraorbital foramen and what passes through it?
Below each inferior rim of the orbit on the surface of each maxilla. MAXILLARY division of Trigeminal Nerve
93
What does the Maxillary division of the Trigeminal NErve supply?
Sensation from maxillary portion of face; upper teeth.
94
What is the alveolar process?
Bony ridges containing upper teeth?
95
What is the CS motion of the Maxilla?
Flexion - Front portion of maxilla rise superiorly coming up to meet the frontal bone (as frontal arcs forward and down). At same time 2 maxillae spread laterally at the posterior part of the intermaxillary suture (back teeth move apart). Maxillary - palatine- vomer complex is pushed slightly forward with each flexion phase as it arcs to meet frontal bone.
96
What is the relationship between the cranium and face and CS motion of whole face in relation to sphenoid and occiput.
Sphenoid arcs forward and down. Ethmoid is pushed forward WITH rest of facial features and facial features rotate in opposite direction to sphenoid.
97
What is IMPACTION in relation to maxillae?
Maxillae is compressed back towards sphenoid - as in being hit from the front. THINK FRONT IMPACT
98
What is DISIMPACTION in relation to maxillae?
Maxillae is decompressed (following compression) and maxillary complex draws out anteriorly away from sphenoid.
99
What is TORSION in relation to maxillae?
Left or right side of maxillary rises superiorly towards the frontal bone, while the other side drops down/inferiorly.
100
What is SIDESHIFT in relation to maxillae?
Maxillary complex shifts left or right relative to sphenoid.
101
What is HYPEREXTENSION in relation to maxillae?
Frontal area arcs back and up and maxillary drops away from frontals AND maxillary complex narrow. SO upper incisors fall and upper molars narrow.
102
What is SIDEBEND in relation to maxillae?
Front of mouth turns to the left or right relative to sphenoid.
103
What organ would you associate with maxillae?
Tongue - Hypoglossal nerve CN X11 - self expression; breast feeding issues.
104
Name the anatomy of the mandible?
Body 2 rami - 1 rami projects up from body of mandible into 2 TMJ (tempero mandibular joints) - where the mandible articulates with the temporal bones. Each ramus divides to form: A condyle portion - articulates with mandibular fossa of temporal bone on each side forming TMJ A coronoid process - anteriorly - for the attachment of the muscles of mastication. Alveolar process - contains lower teeth Submandibular glands - each side of mandible, close to jaw angle. Submandibular ganglion above each gland. PRODUCES saliva. Sympathetic supply - inhibits via superior cervical sympathetic ganglion. Parasympathetic supply - FACIAL NERVE to submandibular ganglion.
105
How is the mandible bone formed embryologically?
2 separate bones meeting at symphysis mentis - CS motion is expressed throughout life here.
106
What is the CS motion of mandible?
Flexion - Temporal bones externally rotate and CONDYLES, RAMI and BODY of mandible follow. Externally rotate at symphysis mentis.
107
Why would the mandible be disturbed?
Mechanical - fractured jaw; bruised jaw; imbalance at temporals; = cranium bones affected AND tentorium = reciprocal tension membrane system. Muscular - muscles of mandible to: 1) THROAT - via suprahyoid muscles 2) MUSCLES OF MASTICATION - Masseter; Temporalis: Medial and Lateral Pterygoids. 3) Sub-occipital muscles 4) Sterno-cleido mastoid muscles 5) Postural muscles of neck and spine MANDIBLE RECEIVES ATTACHMENT FROM 16 MUSCLES Emotional - fear from a trauma; emotion held causing tension Energetic - forces of impact locked in system
108
What is the role of the nasal conchae
The nasal concha system includes three pairs of spongy bones, the superior, the middle and the inferior conchae, that direct the flow of air in a steady pattern over a large area of tissues that warm and humidify the air before it enters the lungs. The humidifying function also improves the sense of smell. Cilia extend from the tissues and filter impurities out of the air. The tissues are rich in lymphatic vessels and are covered in a mucus membrane to provide an initial defence against germs that are present in the air.

CCST Quizzes & Worksheets 2021 (21 decks)

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