Craniosacral Flashcards
What is secondary respiration?
Pulmonary respiration
CSF circulates with a pulsating rhythm which can be palpated on the skull. Name the term that describes this and the rate of pulsation.
Cranial rhythmic impulse or CRI, 10-14 cycles per minute.
What’s the Monroe Kellie doctrine?
It describes the relationship between the venous, arterial, and cerebrospinal fluids, by stating that an increase in the volume of one must be at the expense of the other two.
Where are the Dural attachments located?
Foramen magnum C2,C3, and S2
Describe the relationship between the elements of the PRM in simple unifying terms.
Motion of the brain and spinal cord along with the fluctuations of the CSF will cause the Dural membranes to move. Since the dura is inelastic and attached to the cranial bones and sacrum any motion of the dura will affect these attachments.
What is the RTM?
The reciprocal tension membrane or dura.
Motion of the RTM will cause the sacrum to move about what axis?
Transverse
What is the keystone of all cranial movement? Which structures are involved and what direction do they move?
Sphenobasilar synchondrosis (SBS). Is the articulation of the sphenoid bone with the occiput. It moves through a biphasic cycle of flexion and extension in response to the RTM.
Flexion at the SBS causes what type of motion to occur to the midline bones of the cranium, the sacrum, AP diameter of the cranium, and paired bones of the cranium?
Flexion of midline bones
Sacrum extension/ counternutation (posterior attachment of S2)
Decreased AP diameter
External rotation of paired bones.
The venous sinuses drain what portion of the blood from the cranium, what drains the remaining portion?
85-95%
The facial veins and external jugular drain the rest
Describe cranial synostosis and risk factors
Premature fusion of cranial bones leading to increased inter cranial pressure, facial abnormalities, and if severe enough decreased IQ because of impairment of brain growth in the skull.
Risk factors traumatic birth, forceps delivery, vacuum suctioning, falls, sleeping positions.
What are the components of the PRM?
Cranial bones, dura, Brain and spinal cord, CSF, sacrum
These 5 elements elaborated include: articular mobility of the cranial bones, movement of intracranial and intraspinal membranes, motility of the brain and spinal cord, fluctuation of CSF, and the involuntary mobility of the sacrum between the ilia.
A patient presents to your clinic will long term head pain and headache that they’re tired of dealing with. Upon examination you notice that there is hypertrophy of the rectus capitus posterior major and the obliquus capitus inferior. What structure connected to these muscles maybe putting excess tension of the dura leading to headache?
Myodural bridge
During a pediatric examination you notice a child with a head that has an extreme forehead incline and who has a head that seems taller than normal. What condition do they likely have?
Brachycephaly
During another pediatric head exam you notice a child with unilateral flattening of the back of the head with one ear that seems more forward than the other. Describe their condition in one word
Plagiocephaly
What’s the order of treatment for venous sinus drainage
Confluence of sinuses, occipital sinus, condylar decompression, transverse sinus, strait sinus, sagittal sinus: parietal portion, sagittal sinus: frontal and metopic portion.
What hand position do you need for the transverse sinus technique?
Fingers are along the superior nuchal line
What hand position do you need for the strait sinus technique?
Thumbs on the sagittal sinus, little finger on inion
What hand position do you need for the sagittal sinus technique; parietal portion?
Cross thumbs contacting each side of the sagittal suture and work from the inion to the bregma (coronal and sagittal suture converge)
What hand position do you need for the sagittal sinus technique; frontal and metopic portion (bregma to the nasion)?
Place finger tips of each hand along the metopic suture and separate the suture.
Which side of the head has a larger transverse, sigmoid sinus and internal jugular vein?
Right side
The internal jugular vein return 80% of the venous blood supply in what position: supine or standing? What returns the majority of blood in the other position?
Supine
Deep cervical plexus when standing
What is the vault hold? What are the finger positions?
Volcan “live long and prosper” hold on the head
Index sphenoid, middle anterior ear on temporal bone, ring at asterion (junction of three cranial bones), little finger on occiput, thumbs off head.
What are some clinical indications for the venous sinus procedure?
Newborn suckling difficulty
spitting up
bluish around the mouth
Otitis media
can also help with headache and sinusitis
