Cranial Introduction Anatomy and General Movement

Question 1

who is the founder of cranial osteopathy?

Answer 1

William Garner Sutherland

Question 2

history of cranial osteopathy

1931

1939

1943

1944

1947

1953

2013

Answer 2

1. people though the head did not move

1931: introduction of osteopathic cranial manipulative medicine concepts (blunt bone bill)

1939: techniques to treat cranial dysfunction (the cranial bowl)

1943: presented at osteopathic convention

1944: publishe din JAOA

1947: osteopathic cranial academy estab;ished by his students to provide greater knowledge and research

1953: sutherland cranial teaching foundation

2013: glymphatics was discovered

Question 3

what are the two definitions of cranial manipulative medicine

Answer 3

1. diagnosis and treatment by an osteopathic practitioner using primary respiratory mechanism and balanced ligamentous tension
2. system og diagnosis and treatment first described by william G. southerland

Question 4

prior to sutherland the cranium was considered?

Answer 4

fused with no capacity for movement or dysfunction

Question 5

what are the 5 anatomical-physiological elements of primary respiratory motion?

Answer 5

there is motility of the brain and spinal cord

the csf fluctuates

the intracranial and intraspinal membranes move

the cranial bones move

the movement between the sacrum and ilium depend on the motion at the SBS

Question 6

what does “primary” in primary respiratory mechanism mean

Answer 6

cranial motion is a fundamental life process that is it controls all other processes like cellular and lung respiration

Question 7

what does “respiratory” in primary respiratory mechanism mean

Answer 7

cranial motion has an ebb and flow like the breath (the breath of life)

Question 8

what does mechanism in primary respiratory mechanism mean

Answer 8

pattern of tissue and fluid movement occur with a purpose

Question 9

indications for craniosacral treatment

Answer 9

stresses affect the PRM
after birth
trauma (suture overlap)- orthodontics/posture/car accident
dentistry (holding jaw open)
toricolis
plagiocephaly (flat head)
feeding difficulties (compression of cranial nerves 9,10,11)
vertigo
concussion
headache
tmj
tinnitus

Question 10

mechanical stresses of birth and dural membrance occur during delivery, treatment facilities _ remodeling

persistant suture overlap may result in the bones growing together forming a _

Answer 10

vault

synostosis

Question 11

side effects of cranial OMM

Answer 11

headache, tinnitus, dizziness

Question 12

SBS strain treatment may cause an alteration to?

Answer 12

heart rate, blood pressure, respiration, and GI tract

Question 13

absolute contraindications for cranial OMM

Answer 13

acute (24hr) intracranial bleed of CVA

acute skull fracture

Question 14

relative contraindications for cranial OMM

Answer 14

coagulopathy
seizure history
increased intracranial pressure
**exacerbation of neurologic condition

Question 15

in the inherent motility of the brain and spinal cord what is the contractile element in the brain

Answer 15

the glial cells which are mobile (have the capacity of moving spontaenously)

Question 16

csf is produced in the

Answer 16

choroid plexus which is in the ventricles

pumped across the brain and spinal cord

Question 17

what is the driving force of CSF expansion/movement

Answer 17

cranial ryhtmic impulse (CRI)

Question 18

what is the rate of CRI

Answer 18

10-14

Question 19

motion characteristics of the CRI

Answer 19

RRADS

rate: 10-14 bpm

rhytmn: regular/tide of an ocean with some variations

amplitude: amount of movement (mm of movement)- somatic dysfunction may have decreased amplitude

direction: linear and symmetric, in SD it will be assymmetric

strength: good strong motion? does it have vitality, is it weak?

Question 20

the contiguous dural folds become the _, _ , and _

this gives the mobility of the intracranial membranes

Answer 20

falx cerebri

falx cerebelli

tentorium cerebelli

(inside is the venous sinus)

Question 21

the tentorium and the falx create a _ _ _

Answer 21

reciprocal tension membrane

Question 22

what is the reciprocal tension membrane (RTM)

Answer 22

this is a functioning unit that holds the bones of the vault and base uunder constant tension

dura is so tough

Question 23

the RTM allows but limits _

Answer 23

motion

Question 24

the RTM acts as a _ storing energy in _ and releasing in _

Answer 24

spring

flexion

extension

Question 25

a study was done in 2018 looking at the brain there were slices done every 45 seconds that revealed _ motions of brain tissue. there was a change in _ but no change in _ of the head

Answer 25

sub-voxel motions area, widthm heightm feret, major axis no change in perimeter and minor axis

Question 26

what are the main poles of attachement for the RTM (reciprocal tension membrane)

Answer 26

frontal, sphenoid, temporal, occipital

Question 27

the RTM and dura have a signifigant role in _ flow

Answer 27

vascular

Question 28

the _ sinus runs between the two folds of the dura

Answer 28

sagital sinus ## Footnote there is also the confluence of sinues, tranverse sinus, and straight sinus is the venous sinus space in between the folds

Question 29

_ mobility and _ signifigantly impacts the PRM (primary respiratory movement)

Answer 29

fascial continuity

Question 30

what are the 4 main fascial layers

Answer 30

pannicular, axial/appendicular, menningial, visceral

Question 31

what fascial layer includes the dura and surrounds the nervous system

Answer 31

meningeal fascia

Question 32

there is _ of the fascia from head to toe

Answer 32

continuity

Question 33

in flexion what does the SBS do

Answer 33

it rises superiorly distance between the inferior angle of the spenoid and ossiput DECREASES the head will widen and DECREASE its AP diameter becoming more spherical and increasing total internal volume

Question 34

cranial inhalation = sbs _

Answer 34

flexion

Question 35

in SBS extension what happens

Answer 35

the SBS moves inferiorly and the distance INCREASES between the inferior angle of the sphenoid and occiput greater wing moves superiorly and posteriorly (head tall and narrow) people die with exhalation

Question 36

cranial exhalation= sbs _

Answer 36

extension

Question 37

dura attaches from the _ _ to the posterior body and disc of _ in the spinal canal

Answer 37

foramen magnum S2

Question 38

the dura forms the _ _ between the occiput and the sacrum

Answer 38

core link

Question 39

in cranial flexion _ movement of the occiput creates _ on the duraand the force is translated to the sacrum

Answer 39

superior traction

Question 40

in cranail extension the tension is _ and the sacrum _

Answer 40

released return

Question 41

sacrum nutation (towards the nuts) is matched with SBS _

Answer 41

extension

Question 42

sacral extension base moves: apex moves:

Answer 42

base: anteriorinferior apex: posterior ## Footnote on palpation of the sacrum the sacral body pushes into the palm of the hand

Question 43

sarcum counternutation is matched with SBS _

Answer 43

flexion

Question 44

sacrum counternutation base moves: apex moves:

Answer 44

base: posterior superior apex: anterior ## Footnote on palpation the sacrum pushes into finger tips

Question 45

what kindof junction is the SBS

Answer 45

a synchondrosis - hyaline cartilage

Question 46

midline bones

Answer 46

occiput and sphenoid

Question 47

midline bones motion axis

Answer 47

flexion and extension transverse axis

Question 48

paired bones movement

Answer 48

internal/external rotation

Question 49

flexion of the midline bones results in _ of the paired bones

Answer 49

external rotation flex + external rotation= flexternal rotation

Question 50

the parietal bone in SBS flexion and SBS extension

Answer 50

SBS flexion: the sagital articulation moves inferiorly and temporal articulation moves laterally (cranium widens)- external rotation SBS extension: sagital articulation moves superiorly, temporal articulation moves medially (narrows)- internal rotation

Question 51

the temporal bones axis is?

Answer 51

inferior to the petroud ridge

Question 52

axis of the frontal bone motion:

Answer 52

acts like a hinge: 2 vertical axis with a horizontal plane of motion axes from center of orbital roof through frontal eminence

Question 53

motion of the frontal bone glabella motion:

Answer 53

external rotation during sbs flexion: glabella moves posteriorly internal rotation during SBS extension; glabella moves anteriorly

Question 54

flexion of the ethmoid - crista galli does what

Answer 54

the crita galli moves superiorly and posterioly

Question 55

flexion of the ethmoid the crista galli does what

Answer 55

swings inferiorly and anteriorly

Question 56

vomer motion drives the _ and _

Answer 56

palatine and maxillaries

Question 57

the vomer follows the _ like the beak of a winged bird

Answer 57

sphenoid

Question 58

the vomer depresses the _ _ with SBS flexion

Answer 58

hard palate

Question 59

vomer flexion gives what kind of palate

Answer 59

wide flat palate

Question 60

vomer extension gives what palate

Answer 60

narrow tall palate

Question 61

the posterior part of the vomer does what

Answer 61

depresses the palatine and flattens the roof of the mouth

Question 62

the anterior part of the palatine does what

Answer 62

decesnds to externally rotate the premaxillae