Cranial Paired Bones Flashcards
Paired bones
Parietal
Frontal
Temporal
Parietal Bone motion during flexion
external rotation during cranial F
Parietal Bone axis/panes
AP axis in coronal plane
Parietal Bone clinical associations or symptoms of disease
HA, alteration of seizure threshold, localized pain
Parietal Lift Technique:
Is IR or ER more common?
IR is more common
Parietal Lift Technique Position of patient. Position of physician. Points of contact. Movement
Position of patient - supine
Position of physician - at head
Points of contact - MODIFIED VAULT HOLD. Thumbs INTERLOCKED AT SAGITTAL SUTURE, fingers contact inferior aspects of parietal bones.
Movement - Pull thumbs against each other, increasing pressure at fingretips to move bones toward IR. Disengages inf sutures from temporal bones. DISENGAGE PARIETALS by gaping and DISTRACTING CEPHALAD.
When are you done with parietal lift technique?
when CRI quality/quantity changes
Frontal Bone motion during cranial F?
Cranial E?
Flexion - ER (low slowing forehead - toboggan slide)
Extension - IR (high bulging/prominent forehead - ski jump)
Rotation related to inferior edge of bone.
Frontal Bone axis/planes
Dual AP axis in CORONAL plane
Frontal Bone clinical association/symptoms of disease
HA, visual or smell disturbances (anosmia)
Frontal Lift Objective
Allow frontal bone to perform its normal physiological motion and to free the inferior aspects of the coronal suture.
Parietal Life Technique Objective
Restore proper physiologic motion to parietal bones when restricted in either IR or ER
Frontal Lift position of patient.
supine
Frontal Lift position of physician.
at patient’s head
Frontal Lift points of contact
Fingers interlaced on forehead with hypothenar eminences on lateral angle of frontal bone. Heels of hand at coronal suture.
Frontal Lift Movement
During Extension/IR:
interlaced fingers exert pressure on each other, resulting in medial pressure against hypothenar eminences, raising frontal anteriorly into ER - hold for release of tension.
Temporal Bone motion.
What is it named for?
Motion - ER during Cranial F (sup border moves anterolatera”forward and out”l/slightly superior)
Named for the superior border of petrous portion.
Temporal axis/plane
oblique axis, modified coronal plane
Temporal Bone clinicial
Damage can be attributed to
OM, mastoiditis, tinnitus, hearing loss, Bell’s
Damage - trauma, whiplash, chronic neck tension, detanl exraction
IR of Temporal can do what to the eustacian tube and result in what type of tinnitus?
close eustachian tubes - high pitched tinnitus
ER of temporal can result in what type of sound?
Low roaring sound or tinnitus
Temporal bone holds
Five finer temporal hold and rocking the temporals
Five finger temporal hold is uni or bilateral?
Either!
Five finger temporal hold
PATIENT POSITION
PHYSICIAN POSITION
POINTS OF CONTACT
supine
doc at head of table
Points of Contact - middle finger on EAC, index finger and thumb pinch the zygomatic arch. Ring anterior to mastoid process and little finger posterior to mastoid process
Rocking the temporals objective
release CN 9, 10, 11 entrapment, eustacian tube compression, jugualr vein copmression, restricted temporal or occipital articulation, tinnitus
Rocking the temporals PATIENT POSITION PHYSICIAN POSITION POINTS OF CONTACT MOVEMENT - indirect or diret and describe
Supine
Doc seated at head
Points of contact - five finger temporal hold
Movement - indirect
encourage ER, mastoid = medial pressure with ring and little finger, zygomatic arch = direct sup/lat with index and thumb (IR opposite)
Left temporal prefers ER and right temporal prefers IR.
What should doc’s left hand exaggerate?
What should doc’s right hand exaggerate?
Left hand exaggerates left temporal flexion/ER
Right hand exaggerates right temporal extension/IR (zygomatic arch = direct sup/lat with index and thumb)
Get asynchronous motion –> reverse –>
Goal of rocking the temporals
Asynchronous motion of the temporals THEN REVERSE THE PROCESS until bones are to balance and symmetrically moving in IR and ER.
What can result if pt left in asynchronous motion?
vertigo
What suture can V-SPREAD be used on?
any suture
V-Spread OBEJCTIVE PATIENT POSITION PHYSICIAN POSITION POINTS OF CONTACT MOVEMENT -
objective - release any peripheral suture
patient SUPINE
DOC AT HEAD OF TABLE
Points of contact - ipsilateral hand with second and thrid fingers on either side of suture to be released.
Contralateral hand 180 degress opposite, palm or two fingers contact head.
Movement - disengage suture by spreading fingers, apply force with oppsoing hand toard dysfunctional suture - push fluid flow toward
CV 4 technique OBEJCTIVE PATIENT POSITION PHYSICIAN POSITION POINTS OF CONTACT MOVEMENT -
objective - stimulate the body’s inherent capacity to deal with whatever dysfunction is present
Patient is supine
Physician is at head of table, volleyball hands
Contact lateral angles of occiput medial to occipitomastoid sutures
Movement - encourage EXTENSION (hand move toward you) and discrouage FLEXION
Wait for motion to flow to STILL POINT
How do you know you’ve hit still point?
Feel warmth in your hands.
Perspiration on brow of patient.
What’s the only bone that contacts all four fontanelle?
Parietal bone
Bregma
junction of coronal and sagittal suture
Lambda
junction of sagittal and lambdoidal suture
ASTERION and PTERION
Asterion - at mastoid fontanella, confluens of the parietal occipit, and temporal
Pterion - at temporal area, confluens of the (deepest) frontal, parietal, sphenoid, temporal (most superficial)
What artery is deep to the pterion?
What sinus is deep to the asterion?
MMA
Sigmoid sinus
Parietal bone articulates with what other bones?
Occipital, temporal, frontal, other parietal, sphenoid
Parietal motion during cranial flexion and extension.
Cranial flexion - ER
Cranial extension - IR
What exits between the petrous portion of the temporal bone and sphenoid?
EUSTACIAN TUBE
In the petrous portion of the temporal bone, what travels at the border of foramen lacerum
Greater superficial petrosal nerve - LACRIMATION
Temporal bone touches what.
Problems with the temporal?
What is below the tentorium, which is attached to the petrous ridge?
occiput, parietals, sphenoid, zygomae, mandible
Cavernous sinus - torsion to tentorium can affect CN3,4,6,V1
Below tentorium - hindbrain, medulla, pons, 4th ventricle, cerebellum
