Cranial OMM Flashcards
Nutation
During cranial EXTENSION of SBS, sacral base moves ANTERIORLY around R/L axis.
Counternutation
During cranial FLEXION of SBS, sacral base moves POSTERIORLY around R/L axis.
Five characteristics of CRI
RRADS Rate Rhythm Amplitude Direction STrength
Vault Hold Pt supine or prone? Doc seated where? Index fingers where? Third finger? Fourth finger? Fifth finger? Thumbs above what?
Pt is supine Doc seated at head of table. Index fingers on greater wings of sphenoid (temple) Third finger in front of ear. Fourth finger behind the ear. Fifth finger on occiput. Thumbs above the calvarium.
Frontal Occipital Hold Pt supine or prone? Doc seated where? Caudad hand where? Cephalad finger and long finger?
Pt supine.
Doc at head of table.
Caudad hand under head, cupping occiput.
Cephalad hand on greater wing of sphenoid (forehead).
Flexion (normal) -
Motion of sphenoid? About what axis?
Motion of occiput? About what axis?
Motion of SBS?
Head gets shorter or longer in AP diameter?
Head gets narrower or wider in transverse diameter?
Sphenoid - anterior/inferior, around transverse axis
Occiput - posterior/inferior, transverse axis
SBS - cephalad
Head gets SHORTER in AP diameter.
Head gets WIDER in transverse diameter.
Extension (normal)
Motion of sphenoid?
Motion of occiput?
Motion of SBS?
Head gets shorter or longer in AP diameter?
Head gets narrower or wider in transverse diameter?
Sphenoid - posterior/superior
Occiput - anterior/superior
SBS - caudad
Head gets LONGER in AP diameter.
Head gets NARROWER in transverse diameter.
Balanced Membranous Tension
indirect or direct cranial manipulative treatment?
Indirect
Holds used for Balanced Membranous Tension
Frontal occipital hold or vault hold
Balanced Membranous Tension
evaluates what?
amount of motion in flexion and extension
SBS is held at midpoint of what?
Held until what?
SBS is held at MIDPOINT of the amount of AVAILABLE MOTION.
Held until STILL POINT is obtained.
What is still point?
Point at which you are unable to feel CRI.
What happens during still point?
Some membranes stretch, others contract.
What are you waiting for during still point?
Feel CRI again and for it to become symmetrical.
What is PRM?
What is PRM definition?
Primary Respiratory Mechanism -what makes the bones move.
Primary - main internal tissue process of metabolism.
Respiratory - exchange of gases.
Mechanism - movement of tissue and fluid for a purpose.
Basic tenants of the classical cranial model.
A. Inherent MOTILITY of the CNS.
B. PLASTICITY and ELASTICITY of the intracranial and intraspinal membranes.
C. Fluctuation of the CSF.
D. Articular mobility and involuntary motion of the CRANIAL BONES.
E. Articular mobility and involuntary motion of the SACRUM between the ilia.
Four main fontanelles
Bregma
Lambda
Asterion
Pterion
Difference between motility and mobility
Mobility - requires something else to move it
Motility - inherent ability to move
Why does sacrum move?
Dural attachment to sacrum at S2.
Structures of the PRM
Brain/SC
CSF
Intracranial membranes
Articular mechanism of cranial bones.
Dynamic relations of the PRM:
Bone mobility is related to and controlled by what?
The reciprocal tension membrane.
cranial and spinal dura, falx cerebri and cerebelli, tentorium cerebelli
Functioning of the PRM:
what is the motor for the PRM?
the brain
CRI - definition
What is it?
Cranial Rhythmic Impulse The PALPABLE (not visible) expression of primary respiratory mechanism.
CRI is __phasic
BIphasic
**Flexion of midline bones with ____ rotation of paired bones.
Extension of midline bones with ___ rotation of paired bones.
Flexion of midline and EXTERNAL rotation of paired.
Extension of midline and INTERNAL rotation of paired.
**Normal CRI rate and range
Rate - 10-14 times/min
Range of rate - 6 to 14
Microns of lateral movement at sagittal suture
30-70microns
Microns of rotational movement at parietal bones
250microns
SBS
Sphenobasilar Synchondrosis
Clinical significance of occipital-mastoid suture
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