Cranial Introduction Flashcards
Who founded cranial osteopathy? When?
- William Sutherland in 1939
What are the five anatomical-physiological elements of the primary respiratory mechanism (PRM)?
- The inherent motility of the brain and spinal cord
- Fluctuation of CSF
- Mobility of the intracranial and intraspinal membranes
- Articular mobility of the cranial bones
- Mobility of the sacrum between the ilia that is interdependent with the motion of the SBS
What are some indications for craniosacral treatments?
- Feeding difficulties
- Plagiocephaly
- Torticollis
- Vertigo
- HA, orofacial pain, otitis media, sinusitis, TMJ, tinnitus
What are some side effects of craniosacral treatments?
- HA, tinnitus, or dizziness
- Alteration to HR, BP, respiration, and GI irritability
What are the absolute contraindications of craniosacral treatment?
- Acute intracranial bleed or CVA
- Acute skull fracture
What are some relative contraindications of craniosacral treatment?
- Coagulopathy
- Seizure history
- Increased intracranial pressure
- Care must be used in order not to exacerbate any neurologic condition
What is the driving push from CSF expansion?
- Cranial rhythmic impulse (CRI)
What is RRADS?
- Rate
- Rhythm
- Amplitude
- Direction
- Strength
What is the normal rate of the CRI?
- 10-14 bpm
* * May be 8-12**
What is the rhythm of the CRI?
- Palpated as “regular”, like the tide of the ocean
- Irregularities are hard to determine
What is the direction of the CRI?
- Palpated as linear and symmetric
What do the tentorium and the falx create?
- Reciprocal tension membrane (RTM)
What is the RTM?
- Functioning unit
- Holding bones of the vault and base under constant tension
- Acts as a spring, storing energy in flexion and releasing in extension
What significantly impacts the PRM?
- Fascial mobility and continuity
What are some fascial layers that impact the PRM?
- Pannicular fascia
- Axial and appendicular fascia
- Meningeal fascia
- Visceral fascia
What is the axial and appendicular fascia?
- Continuous fascia
What occurs in SBS flexion?
- SBS rises superiorly as the distance decreases between the inferior angle of the sphenoid and occiput
- Head will widen and decrease its AP diameter
What happens to the SBS in cranial inhalation and exhalation?
- Inhalation = flexion
- Exhalation = extension
What occurs in SBS extension?
- SBS moves inferiorly as the distance increases between the inferior angle of the sphenoid and occiput
- Head gets tall and narrow
How do the wings of the sphenoid in SBS flexion?
- Inferiorly and anteriorly
How do the wings of the sphenoid in SBS extension?
- Superiorly and posteriorly
How does the sacrum move in cranial flexion?
- Superior movement of the occiput creates traction on the dura
- Counternutation –> SBS flexion (sacral extension)
- Base moves posterosuperior and apex moves anterior
How does the sacrum move in cranial extension?
- Tension on dura is relaxed
- Nutation –> SBS extension (sacral flexion)
- Sacrum base moves anteroinferior and apex moves posterior
How do midline bones move?
- In flexion and extension
What axis do midline bones move on?
- Transverse axis in an anterior/posterior direction
How do paired bones move?
- External rotation in FLEXION
- Internal rotation in EXTENSION
E.g. Extension = IR –> temporal articulation moves medially
How do to temporal bones move?
- ER –> Flexion
- IR –> Extension
How does the frontal bone move?
- Flexes as if 2 bones –> metopic has hinge action
What is the plane and axis of the frontal bone?
- Horizontal plane
- Vertical axis
What is ER of the frontal bone?
- Lateral portion moves anterior/lateral and slightly inferior
- Glabella moves posterior
What is IR of the frontal bone?
- Lateral side moves posterior/medial and slight superior
- Glabella moves antieror
How does the ethmoid bone move?
- Flexion –> perpendicular plate is rotated by the sphenoid around transverse axis which swings crista galli superior and posterior
- Extension –> perpendicular plate is rotated by the sphenoid around transverse axis which swings crista galli anterior and inferior
What does vomer motion do?
- Drives palatines and maxillaries
Follows sphenoid like the beak of a winged bird
How does the vomer move?
- Flexion –> wide flat palate
- Extension –> narrow tall palate
What CN goes through the optic canal?
- Optic –> 2
What CN goes through the superior orbital fissure?
- 3
- 4
- V1
- 6
What CN goes through the foramen rotundem?
- V2
What CN goes through the foramen ovale?
- V3
What CN goes through the internal acoustic meatus?
- 7
- 8
What CN goes through the jugular foramen?
- 9
- 10
- 11
What CN goes through the hypoglossal canal?
- 12
