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ECOS IV > clinical application of cranial manipulative medicine > Flashcards

clinical application of cranial manipulative medicine Flashcards

1
Q

what are the goals of craniosacral treatments?

A

reduce venous congestion

mobilize articular restrictions

balance the SBS

enhance any reduced force, rate or amplitude of the cranial ryhtmic impulse (CRI)

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2
Q

any dyfunctional bone position places stress on the brain, _ , _ and _ sinuses through direct connections to the dura and _

A

arteries
veins
venous sinuses

and arachnoid

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3
Q

treatment of the cranium can be aimed at (3 locations)?

A

outer fascial layers
sutural ligaments
intracranial membranes

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4
Q

sutural ligaments are?

A

fibrous joints connected by dense connective tissues : synarthrosis

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5
Q

treatment of the cranium influences structures that pass through, between or out of bones, has a subtle and indirect effect on the brain

A

just know

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6
Q

palatine SD may produce _ _ involvement and a _ _ reflex

A

pterido/sphenopalatine ganglion

somato-somatic reflex

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7
Q

pteriogopalatine ganglia influences _ output

A

trigeminal

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8
Q

trigeminal output as _ function that activates the muscles of _ and tensor tympani, tensor veli palatini, mylohyoid, and the _ belly of the digastric

A

motor

mastication

anterior belly

inhbition of the gaglion will decrease output to the trigeminal and aid in TMJ, swallowing and speech

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9
Q

the estachian tube passes within the _ bone and exits in the _ _

the tube lies in between the _ _ bone and the _

A

temporal

auditory canal

petrous portion of the temporal bone and the greater wing of the sphenoid

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10
Q

if there is SD involving the temporal bone what can happen

A

ETD- fluid buildup and reduces motion of the tympanic membrane for hearing or an infection may occur

otitis media- impaired drainage from the tube (improve drainage the infection will clear)

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11
Q

SD of the palatine bone can cause

A

TMJ, chewing disorders, swallowing, and speech problems

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12
Q

cephalgia

A

headache

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13
Q

what is known to cause headaches

2 well known arteries known to cause headaches

A

distention, traction or dilation of intracranial oe extracranial arteries

arteries: middle meningeal and superficial temporal

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14
Q

the _ lies right over major arteries like the internal carotid and cerebral arteries

A

dura

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15
Q

impaired _ drainage will also cause headaches

A

venous

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16
Q

cranial strains can cause traction or displacement of large intracranial _ or _ through their dural envelope

A

veins or sinuses

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17
Q

what bones does the facial nerve pass through

A

the temporal bone

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18
Q

what can temporal bone torsion cause

A

bell’s palsy

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19
Q

symptoms of bells palsy

A

weakness on one side of the face exluding the frontalis

may have a change in taste due to chorda tympani involvement on the anterior 2/3 of the tongue

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20
Q

how can OMT help bells palsy

A

realign the temportal bone
release tissue strain and improve lymphatic flow

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21
Q

what is trigeminal neuralgia

A

this is really bad facial pain that lasts for a few seconds that is incapacitating

it can be stimualted by chewing or brushing your teeth

has V2 distribution

can cause cephalgia (headaches)

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22
Q

where does the trigeminal ganglion rest

A

in meckels cave on the superior surface of the petrosal ridge of the temporal bone and is covered by dura

affected by temporal, sphenoid, or occipital position change

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23
Q

the tentorium cerebri is tightly attached at the

A

petrosal ridge

24
Q

if the temporal bone is rotated this would put pressure on the structures deep to the tentorium cerebelli including

A

the trigeminal nerve

25
Q

what did the study of rythmic motions of the living cranium find (1971)

A

they used a pick to touch the parietal bones of the human skull and measured its motion

it found: rthym of bones that varied between subjects with an average of 1mm change thar was independent of breathing

articfacts limitied study

26
Q

what did the parietal bone mobility in an anesthized cat study show

A

motion was spontaeous in the skull and can be induced or modified, it changed in respect to CO2 levels, CSF pressurem blood pressure and could inducea apnea

27
Q

external pressure on temportal bones caused

A

observable changes in respiration, blood pressure, and csf pressure

28
Q

external pressure on sagitial suture showed

A

no change in blood pressure or respiration

but lateral and rotation movement of the parietal bones

29
Q

what did the nasa research do

A

confirmed cranial bone motion

that the AP distance increased - ICP increased amplitude of the cranial motion

30
Q

what did the russian cosmonaut research do

A

stated that cranial dimensions are continuosly changing from A-P and side to side with up tp 1mm

incracranial volume increases by 12 mm and moves the bones

CRI was 6-14 cycles per minute

31
Q

mobility of the cord and membranes is witnessed in cranial _ and _ (1978)

A

extension (relax)
and
flexion (tension)

32
Q

what is the traube hering meyer wave

A

this is a pattern of changes in the blood pressure

found to be synchronous to occillations of the sympathetic nervous system

33
Q

when was the traub hering wave compared to the CRI

A

2001

34
Q

what is a still point

A

a period where there is decrease in the traube-hering amplitude after treatment

35
Q

post treatment there shows changes in the _ wave

A

TH (traube-hering-myer)

greater amplitude

36
Q

there is continuous _ changes in cranial dimensions and there is also cranial _ changes that pump CSF to bathe the rest of the CNS

A

biphasic

volume

the cns movement can propell CSF

37
Q

CRi is a product of _ volume and _ and _ regulation

A

CSF

pressure

metabolite regulation

38
Q

stress of cranial nerves 9 and X at the _ _ and condylar compression causing cranial nerve _ dyfunction can cause sucking dyfunctions in the newborn

A

jugular foramen

12

39
Q

cranial nerve 9 vagal SD can be due to a _, _ or _ dysfunction

A

OA
AA
C2

40
Q

cranial nerve _ and _ _ strains may be related to the birthing process

A

11

brachial pleus

41
Q

_ compression is common in newborns

A

suture

42
Q

when do you use occipital condyle decompression

A
  1. poor feeding
  2. colic
  3. head and neck pain
  4. post trauma to head and neck
43
Q

what is occipital condylar decompression- how do you preform

A

this is when you contact as near to the foramen and condyles as possible and add slight OA flexion

you then apply traction, then pull the occipital tissues in a posterior and lateral direction until you feel regional give

*8reassess

44
Q

occipital condylar decompression before the age of 7 treats?

after 7-adults treats

A

before 7- treats catilaginous and pre occification strains

after 7- treats post fusion or interocceous strains

45
Q

when do you use balanced membranous tension?

A

abnormal CRI
cranial nerve entrapment
dural strain/venous sinus strain
headaches

46
Q

how do you preform BMT

A

exaggerate membranous asymmetry until balance is noted (CRI will move against you but resist it- do not change position)

hold until CRI stops

gently release to CRI midpoint

reassess

47
Q

when do you use SBS decompression

how do you preform SBS decompression

A

when the head feels like a bowling ball
diminished CRI
mood disorders
cranial nerve entrapment
URI/head congestion
pediatric developmental problems

  1. BMT compression first, then release
  2. direct : engage the frontal bones to distract against the occiput: pull in an anterior and slightly superior direction- then await release and reasses
48
Q

when do you use the frontal lift

how do you preform the frontal lift

A

use: treating restricted frontal mobility and to augent SBS flexion- frontal headaches, sinus congestion, pediatric development issues

treatment: engage lateral inferior edge of frontal bone and hook under the initiation of the sygomatic arch, apply anterior force with some anterior rotation until an elastic release is felt

49
Q

what is parietal lift used for and how do you preform it?

A

used for lack of parietal motion in TMJ, headaches, decompress squamosal suture
compresed with trauma/grinding of teeth

perform parieta traction until superior elastic release is noted: gently release the head

50
Q

when do you use sterigo/sphenopalatine ganglion inhibition/stimulation

how do you preform it

A

contact posterior and lateral to the molar and medial to the pterygpod

apply a superior and slightly medial and posterior with medial roated force- hold to await relaxation, or do rotary stimulation

hold- motor output

rotary stimulation- thins nasal mucus and increases tears

use in TMJ, migraine, tension headaches, sinusitis

51
Q

when do you use the temporal pull how do you preform it

A

use: lack of temporal motion: temporal headache, vertigo, tinnitus, TMJ issues, balance the tentorium, disengage the jugular foramen, release sutures

use a pincer grip on pinnae or antitragus as close to the temporal bone as possible

apply gental lateral traction posteriorly and superiorly along a vetor that parallels the petrous ridge of the temporalis. maintain tension at the FEATHER EDGE of the restrictive barrier until release is felt on both sides.

52
Q

TMJ decompression use and how do you preform it

A

use: TMJ restrictions, mandible restriction, neck pain

preform: begin indirect by balancing compression of the mandible towards the tmj until relaxation is felt

switch to a direct release at the lateral manidble pushing inferior and slightly anterior until release is felt on both sides

53
Q

V spread use

how to preform

A

use: any cranial vault suture restriction

treatment: spreading pressure is used to monitor and encourage motion on the longest contralateral diameter

encourage PRM with fluctuant flow between the opposing contact

54
Q

why do we use the occipitomastroid release and how do you preform it?

A

use: trauma, migraine, TMJ, vertigo

preform: wrap contralateral hand under occiput with fingers posterior to suture, wrap ipsilateral hand around the mastoid process, roll head towards the affected side until the OM suture is most posterior

traction mastoid anteriorly , hold until release

55
Q

sagital suture release use and how to preform

A

use: migrains, tension headaches, trauma

treatment: fingers at inferior portion of parietal bone , cross thumbs across the sagital suture at the point of restrictions, gap suture with lateral thumb pressure, hold until release

56
Q

use of CV4 still point induction

treatment

A

use: decreased CRI, URI, headache/migraine

treatment: place thenar eminence inferior to the superior to the superior nuchal line and medial to the occipitalmastoid suture, encourgae extension by leaning back (superior and anterior force) - resist inferior motion. once motion diassapear you have reached a still point. release and await CRI to return

57
Q

use of CV4 pump and treatment

A

use: fatigue, depression, insomnia

treatment: thenar eminences on the occiput, medial and cephalad compressing pressure through the flexion phase only, release pressure allowing full extension, repeat until there is decreased resistance to compression

“pumps CSF from 4th ventricle to spinal cord”

ECOS IV (9 decks)

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