Cranial Strains and Mvnt Patterns + DSA Flashcards
What are the paired bones of the cranial vault?
- Frontal
- Parietal
- Squamous temporal
- Squamous occiput
- Greater Wing of Sphenoid
What are paired facial bones?
- Inferior nasal concha
- Lacrimal
- Maxilla
- Nasal
- Palatine
- Zygoma
- Frontal
What are the midline (unpaired) cranial and facial bones?
Cranial:
- Occiput
- Sphenoid
Facial:
- Mandible
- Vomer
- Ethmoid
- Frontal
When the midline bones move in a flexion/extension direction, how do the corresponding paired bones move?
Paired bones move in internal/external rotation as the cranial midline bones (the occiput and sphenoid) move in flexion/extension
The midline cranial bones (occiput and sphenoid) rotate about what axis in what direction?
Transverse axis in an anterior/posterior direction
The paired bones rotate about what axis in what direction?
Anterior/Posterior axis in a sidebending/lateral motion (coronal plane)
What is the “SBS”
Spheno-basilar symphysis = basically where the sphenoid and the base of the occiput come together
What motion occurs at the SBS during inhalation
Flexion
Sphenoid: rotates about transverse axis so the alae (wings) move anterior (think of it as falling forward)
Occiput: the base (SBS) will move superiorly (think of th the base of the occiput moving up)
so BOTH bones move about the SAME axis but in OPPOSITE directions
What are the four parts of the ethmoid? (you only need to have a basic idea so you understand the motion of the bone)
- Horizontal = cribriform plate & crista galli (the pointy part)
- Perpendicular plate (mostly know this one for motion)
- Lateral masses (make the orbita plate, middle, and superior concha)
When the sphenoid moves into flexion (tips anteriorly), in what direction does the ethmoid move?
ethmoid moves posteriorly but this is called FLEXION of the ethmoid (weird but go with it)
basically the sphenoid moves the perpendicular plate of the ethmoid but both move about the SAME TRANSVERSE axis, but in OPPOSITE directions
crista galli (pointy part of ethmoid that sticks up) moves superiorly and posteriorly
In which direction does the sphenoid move in order for the ethmoid to move into extension?
Spehnoid moves “backwards” causing the ethmoid to fall forwards = “EXTENSION” of the ethmoid
What bones does the vomer articulate with?
- Sphenoid
- Ethmoid
- Nasal septum
- Maxillae
- Palatines
When the SBS is in FLEXION, the Ethmoid will move in the same direction as?
Ethmoid moves same direction as Occiput
“E” and “O” = vowels move together
When the SBS is in FLEXION, the Vomer will move in the same direction as?
Vomer moves same direction as Sphenoid
“V” and “S” = consonants move together
Describe finger placement for vault contact
- Index Finger: rest on greater wing of sphenoid, just posterior to frontozygomatic suture
- Middle Fingers: anterior to ear
- Ring Fingers: posterior to ear, on mastoid process
- Pinky Fingers: on occiput
- Palms: slightly resting on parietals
- Thumbs: gently contact frontal
A lateral strain is named for what?
Named for the direction of the base of the sphenoid
What direction is the axis in a lateral strain? (axis through sphenoid and occiput bone)
There are two axes – one for sphenoid and one for occiput
BOTH axes are vertical (superior/inferior)
A vertical strain is named for ?
The direction of the base of the sphenoid
What are the axes in a vertical strain?
There are two axes (one for the sphenoid and one for the occiput)
BOTH are transverse (horizontal; left to right)
What is the motion in a vertical strain and how does it compare to normal SBS motion?
In a vertical strain, the sphenoid and occiput BOTH move in the SAME anterior/posterior direction
In a normal SBS, they move in OPPOSITE anterior/posterior directions
In what direction does rotation about the axes occur in a superior vertical strain vs an inferior vertical strain
Superior Vertical Strain: ANTERIOR rotation
Inferior Vertical Strain: POSTERIOR rotation
What is a torsion strain pattern named for?
Named for the higher greater wing of the sphenoid
What is the axis in a torsion strain pattern?
There is ONE axis = Sagittal (anterior-posterior axis)
Sidebending rotation strain pattern is named for?
The convexity developed in the cranium (which side bulges out/ side which gets fuller)
What are the axes of motion for a sidebending rotation strain pattern?
3 total!
– 1 sagittal (anterior-posterior; going through both sphenoid and occiput)
– 2 vertical (superior-inferior; one each for the sphenoid and occiput)
In what directions does motion of the sphenoid and occiput occur in a sidebending rotation strain pattern?
– motion happens in the SAME direction about the sagittal (anterior-posterior) axis
– motion happens in OPPOSITE directions about the vertical (superior-inferior) axis
Describe the airhands in a sidebending rotation strain
** named for the side that feels FULLER
ex. right sidebending rotation strain:
- - 1st finger and pinky of right hand move away from each other (spread out more)
– fingers of opposite side “shrink”; 1st and pinky move closer together to each other
When the occiput goes into flexion (base moving up; occiput falling back) how does the sacrum move?
The dural sleeve gets pulled; it attaches to the anterior sacrum
Occiput flexion = sacral base moving posteriorly = COUNTERNUTATION
**Nutation = “nodding”
When the occiput goes into extension (falling forward), how does the sacrum move?
Sacrum moves into NUTATION (anteriorly)
What are the motion characteristics of the CRI (cranial rhythmic impulse)
R-RADS
R: RATE –> usually 10-14 bpm
R: RHYTHM–> usually palpated as regular, like tide of the ocean
A: AMPLITUDE–> significant SD may diminish amplitude
D: DIRECTION–> in healthy individuals it’s plapated as longitudinal and rhythmic, SD makes it asymmetric
S: STRENGTH–> significant SD and overall vitality of patient impacts strength
5 components of the PRM (Primary Respiratory Mechanism)
- Inherent mobility of brain and spinal cord
- Fluctuation of CSF
- Fascial mobility and continuity significantly impacts the PRM
- Articulatory mobility of the cranial bones
- Involuntary mobility of sacrum between ilia
*honestly I don’t know what these mean and I don’t think you need to have them memorized, maybe just recognize them ?
