Block 3

Question 1

What are the finger positions for the vault hold?

Answer 1

Index finger over great wings of sphenoid
Middle finger anterior to ear on temporal w/ tip touching zygomatic process
Ring finger near asterion (junction of temporal, parietal and occiput) aproximating mastoid process
Little finger on squamous portion of occiput
Thumbs off head

Question 2

What is happening to the sacrum with SBS rising in flexion?

Answer 2

sacrum is counternutating along its superior transverse axis

Question 3

what is happening to the sacrum with SBS falling in extension?

Answer 3

sacrum is nutating along its superior transverse axis

Question 4

Anatomically what does it mean to have flexion at the SBS?

Answer 4

sphenoid is flexing forward, moving counterclockwise around its transverse axis
this allows the SBS to rise
Occipit is moving clockwise around its transverse axis

Question 5

Anatomically what does it mean to have extension at the SBS?

Answer 5

sphenoid is extending backward, moving clockwise around its transverse axis

Question 6

is cranial flexion/extension a physiologic strain pattern?

Answer 6

yes

Question 7

what are the axes in flexion/extension?

Answer 7

2 transverse axes

Question 8

what is happening with your phantom hands with cranial flexion?

Answer 8

away from you and they get wider

Question 9

what is happening with your phantom hands with cranial extension

Answer 9

towards you and your fingers get closer together

Question 10

are vertical strain patterns physiologic or non physiologic?

Answer 10

non physiologic

Question 11

what primarily causes vertical strains?

Answer 11

trauma

Question 12

what is a vertical strain?

Answer 12

when the sphenoid and occiput are moving in the same direction around its transverse axis

Question 13

what axes are associated with vertical strain?

Answer 13

2 transverse axes

Question 14

where is the transverse axis of the sphenoid?

Answer 14

Across sphenosquamous pivots of the sphenoid

Question 15

where is the transverse axis of the occiput?

Answer 15

Just above the jugular processes of the occiput

Question 16

what is happening anatomically with a superior vertical strain?

Answer 16

Sphenoid base moves superior relative to the occiput base
Sphenoid in flexion
Occiput in extension
Temporals in internal rotation

both moving counterclockwise around their axes

Question 17

what is happening anatomically with an inferior vertical strain?

Answer 17

Sphenoid base moves inferior relative to occiput base
Sphenoid in extension
Occiput in flexion
Temporals in external rotation

both moving clockwise around the axes

Question 18

what is the palpatory experience for a superior vertical strain?

Answer 18

forefinger moves down and away
little fingers move superiorly

**both hands are rotating down and away

Question 19

what is the palpatory experience for an inferior vertical strain?

Answer 19

forefinger moves superiorly
little finger moves inferiorly

**both hands up and towards you

Question 20

How many axes are associated with torsion?

Answer 20

1- AP from nasion to opisthion

Question 21

is a torsion a physiologic or non physiologic strain pattern?

Answer 21

physiologic

Question 22

how do you name torsion patterns?

Answer 22

named for the most cephalad forefinger or greater wing of the sphenoid

Question 23

when can a torsion strain happen?

Answer 23

trauma or just other pulls on the body

Question 24

palpatory experience with a torsion?

Answer 24

One hand seems to rotate posteriorly or towards the operator :
the index finger moves superiorly (cephalad)
little finger moves inferiorly (caudad)
While the other hand rotates anteriorly or away from the operator
forefinger goes inferiorly (caudad)
little finger goes superiorly (cephalad)

Question 25

is a lateral strain physiologic or non physiologic?

Answer 25

non physiologic

Question 26

what are the axes associated with lateral strain patterns?

Answer 26

2 vertical axes through the body of the sphenoid through the foramen magnum of the occiput

Question 27

what is the palpatory experience for a lateral strain?

Answer 27

hand form a parallelogram Your forefingers shift to one side, while your little fingers shift to the opposite side

Question 28

what do your fingers do for a left lateral strain?

Answer 28

Forefingers shift lateral to the right (sphenoid base turns to the left), and the little fingers shift to the left (occipital base turns to the right) The lateral shear occurs with the sphenoid base to the left and the occipital base to the right

Question 29

what do your fingers do for a right lateral strain?

Answer 29

Forefingers shift lateral to the left (sphenoid base turns to the right), and the little fingers shift to the right (occipital base turns to the left). The lateral shear occurs with the sphenoid base to the right and the occipital base to the left.

Question 30

what is happening anatomically for a lateral strain pattern?

Answer 30

Sphenoid base shears L or R Both bones move in the same direction around these axes, as a result of a lateral shearing force at the SBS base, with a resultant shearing-like motion, and the sphenoid relatively to the right or left of the base of the occiput

Question 31

is a sidebending rotation strain pattern physiologic or non physiologic?

Answer 31

physiologic

Question 32

how do you name the sidebending rotation

Answer 32

named for the sign of convexity which also moves inferiorly

Question 33

what are the axes of motion for a sidebending rotation strain?

Answer 33

1 AP axis-rotation | 2 vertical axes-sidebending

Question 34

what is happening anatomically for a sidebending rotation strain pattern?

Answer 34

The sphenoid and the occiput rotate in opposite directions each around it’s own vertical axis. The sphenoid and the occiput rotate in the same direction around the AP axis.

Question 35

what are the palpatory findings for right sidebending rotation?

Answer 35

Right hand is spread wider, moves inferior, and has an externally rotated temporal bone. The right head feels fuller in the right hand

Question 36

what are the palpatory findings for a left sidebending rotation?

Answer 36

Left hand is spread wider, moves inferior, and has an externally rotated temporal bone. The left head feels fuller in the left hand

Question 37

when does a lateral strain usually occur?

Answer 37

after trauma

Question 38

what is the axis associated with SBS compression?

Answer 38

AP axis

Question 39

palpatory experience for SBS compression?

Answer 39

Hard, rigid, “cement like” head with little or no cranial flexion and extension.

Question 40

compression strain patterns usually occur after what?

Answer 40

trauma

Question 41

what are the physiologic strain patterns?

Answer 41

torsion flexion/extenstion sidebending rotations

Question 42

what are the non physiologic strain patterns?

Answer 42

lateral vertical SBS compression

Question 43

is compression a physiologic or non physiologic strain pattern?

Answer 43

non physiologic

Question 44

who is most effected by tmj?

Answer 44

women in child bearing years

Question 45

what are the 3 classifications of tmj?

Answer 45

``` myofascial pain syndrome (psychophysiologic) internal derangement (malposition of disc) degenerative joint disease (organic change) ```

Question 46

what type of joint is the tmj?

Answer 46

synovial

Question 47

what muscle connects to the tmj?

Answer 47

lateral pterygoid

Question 48

where is the articular disc of the tmj located

Answer 48

between the condyle and the glenoid fossa

Question 49

where does the disc attach ant. and post.?

Answer 49

ant- joint capsule | post- bilaminar zone

Question 50

what are the upper and lower layers of the bilaminer zone made out of?

Answer 50

upper- elastin-stretchable | lower-collagen-limits disc motion

Question 51

What is the function of the masseter muscle?

Answer 51

jaw closure

Question 52

what are the connection points for the superficial masseter?

Answer 52

zygomatic arch | angle and lower ramus

Question 53

what are the connection points for the deep masseter?

Answer 53

zygomatic arch | coronoid process and upper ramus

Question 54

which muscle trigger point can be confused with sinusitis?

Answer 54

superficial masseter

Question 55

which muscle has the trigger symptoms upper teeth pain, lower teeth pain, and maxillary pain?

Answer 55

superficial masseter

Question 56

which muscle has the trigger symptoms of ear pain, reduced opening and tinnitus?

Answer 56

deep portion

Question 57

which muscles form the masticatory sling?

Answer 57

masseter and medial pterygoid

Question 58

where does the superior division of the lateral pterygoid arise from?

Answer 58

great wing of the sphenoid to neck of condyle and articular disc

Question 59

where does the inferior division of the lateral pterygoid arise from?

Answer 59

lateral pterygoid plate to neck of the condyle

Question 60

what are the major functions of the superior lateral pterygoid?

Answer 60

maintains relationship of condyle and disc w/ jaw closure | lateral motion of jaw

Question 61

what are the major function of the inferior lateral pterygoid?

Answer 61

movement of condyle anteriorly w/ jaw opening | lateral motion of jaw

Question 62

which muscle has the trigger point s/s: | reduced opening, altered occlusion, maxillary region pain, tmj pain, clicking

Answer 62

lateral pterygoid

Question 63

which muscle has the trigger point s/s: mouth and throat pain painful swallowing stuffiness in ear

Answer 63

medial pterygoid

Question 64

what is the function of the medial pterygoid?

Answer 64

closure of jaw | and deviation to one side

Question 65

where does the medial pterygoid arise from?

Answer 65

lateral pterygoid plate to medial aspect of the jaw angle

Question 66

where does the temporalis m. arise from?

Answer 66

temporal fossa to coronoid process

Question 67

what is the function of temporalis?

Answer 67

closure of the jaw

Question 68

which muscle has the trigger point s/s: | zig-zag deviation pattern, headache, upper teeth pain

Answer 68

temporalis

Question 69

what is the range for a normal jaw opening?

Answer 69

50 mm

Question 70

what is a hypomobile jaw? hypermobile jaw?

Answer 70

30mm | 70 mm

Question 71

what is the most common symptom of tmj dysfunction?

Answer 71

dull achey pain in tmj region

Question 72

s/s of tmj loss of integrity

Answer 72

pain, reduced/asymmetric opening, clicking, malocclusion

Question 73

tmj dysfunction most commonly caused by?

Answer 73

poor coordination and spasm of maticatory muscles

Question 74

tmj loss of integrity commonly caused by?

Answer 74

internal joint derangement

Question 75

which way does the jaw usually deviate?

Answer 75

towards the affected side

Question 76

what is jaw deflection

Answer 76

when the jaw opens to one side then returns to middle

Question 77

when can the jaw deviate to the opposite side of dysfunction?

Answer 77

if the medial pterygoid is involved

Question 78

how does a closed lock occur?

Answer 78

when disc prevents condyle from moving anteriorly

Question 79

what is the key symptom of serious joint derangement?

Answer 79

reduced range of motion

Question 80

what bones does the temporalis m. cover?

Answer 80

sphenoid, frontal, temporal and parietal

Question 81

ear pain can be reffered from which two m.?

Answer 81

temporalis and masseter

Question 82

which m. is associated with eustachian tube dysfunction?

Answer 82

rectus capitus lateralis

Question 83

what is the SNS for the head and neck?

Answer 83

T1-4

Question 84

what is the PNS for the head and neck?

Answer 84

CN 3, 7, 9, 10

Question 85

ant and post chapman's points for the retina and conjunctiva?

Answer 85

ant: upper lateral humerus post: posterolateral occiput

Question 86

ant and post chapmans for middle ear

Answer 86

ant: sup. aspect of clavicle (junct of R1 and clavicle) post: TP of C1

Question 87

ant and post chapmans for nasal sinuses

Answer 87

anterior R1 where it crosses under the clavicle | TP C1

Question 88

ant and post chapmans for sinuses

Answer 88

ant: sup aspect of R2 just medial to MC line post: C2 between TP and SP

Question 89

ant and post chapmans for pharynx

Answer 89

ant: R1 at sternal attachment post: C2 between SP and TP

Question 90

ant and post chapmans for tonsils

Answer 90

ant: R1-2 intercostal space at sternal border post: NONE

Question 91

ant and post chapmans for tongue

Answer 91

ant: sternal border, between R1-2 (inf. to tonsillar chapmans) post: C2 between SP and TP

Question 92

if the occiput is in extension what are the paired bones doing? in flexion?

Answer 92

internal rotation | external rotation

Question 93

what happens to the sacrum when there is a flexion strain pattern? extension strain pattern?

Answer 93

counternutation | nutation

Question 94

what motion is rib 1-5?

Answer 94

pump handle

Question 95

what motion is rib 6-10?

Answer 95

bucket handle

Question 96

what motion is rib 11-12?

Answer 96

caliper motion

Question 97

what does exhalation somatic dysfunction (inhalation restriction) mean?

Answer 97

that the rib is stuck in exhalation so its the top rib

Question 98

what does inhalation somatic dysfunction (exhalation restriction) mean?

Answer 98

stuck in inhalation so bottom rib stuck

Question 99

what does L5 do when the sacrum is extended?

Answer 99

L5 is Type II | will be rotated opposite the sacrum

Question 100

what does L5 do when the sacrum is flexed?

Answer 100

L5 is Type I | will be rotated opposite the sacrum

Question 101

chapmans for prostate?

Answer 101

ant: lateral aspect of femur post: between L5 and PSIS

Question 102

chapmans for uterus?

Answer 102

ant: where ramus and ishium meet post: L5 TP

Question 103

chapmans for ovaries?

Answer 103

ant: sup. pubic ramus, lateral to symphysis post: T10-T11 intertransverse space

Question 104

chapmans for urethra?

Answer 104

ant: sup. pubic ramus, lateral to symphysis post: L3 TP

Question 105

chapmans for bladder?

Answer 105

ant: periumbilical post: L2 TP

Question 106

small intestine viscerosomatics?

Answer 106

SNS:T9-T11 PNS: vagus

Question 107

kidney viscerosomatics?

Answer 107

SNS: T10-L1 PNS: vagus

Question 108

Ureters viscerosomatics?

Answer 108

SNS: T10-L2 PNS: vagus and SN2-4

Question 109

urinary bladder viscerosomatics?

Answer 109

SNS: T10-L1 PNS: S2-4

Question 110

ovary/testes viscerosomatics?

Answer 110

SNS: T10-T11 PNS: S2-4

Question 111

ascening colon viscerosomatics?

Answer 111

SNS: T10-T12 PNS: vagus

Question 112

descending colon, sigmoid colon and rectum viscerosomatics?

Answer 112

L1-2 | S2-4

Question 113

prostate viscerosomatics?

Answer 113

L1-L2 | S2-4

Question 114

vas deferens viscerosomatics?

Answer 114

T10-L1 | S2-4

Question 115

uterus viscerosomatics?

Answer 115

T10-L2 | S2-4

Question 116

fallopian tubes viscerosomatics?

Answer 116

T10-L2 | S2-4

Question 117

rostral floor of the v4?

Answer 117

pons

Question 118

caudal roof of v4?

Answer 118

cerebellum

Question 119

lateral contacts of v4?

Answer 119

middle cerebellar peduncles

Question 120

contraindications to cv4?

Answer 120

epileptic seizures, encephalitis

Question 121

which nerves pass through the jugular foramen

Answer 121

9, 10, 11

Question 122

what nerves traverse the cavernous sinuses?

Answer 122

CN 3,4,5 and internal carotid artery