Lab 3: Parietal Bones/Lecture 4: Paired Bones Flashcards
Describe the correct positioning and technique for the Parietal Lift?
- Both forearms resting on table; place fingertips on both parietal bones just superior to parietal-squamous sutures
- Cross thumbs above the sagittal suture (thumbs DO NOT touch pt)
- Doc pushes thumbs against other & inc pressure at fingertips –> inducing IR of the parietal bones at the parietal-squamous suture
- While maintaining light pressure, traction superiorly until fullness is felt at fingertips; this fullness = ER of parietal bones
- Gently release and reasses ROM and PRM rate /rhythm
Describe the correct positioning and technique for the Frontal Lift?
- Forearms rest on table; doc lace fingers above frontal bone and puts hand on lateral/inf edge. Hook under zygomatic arch
- Apply anterior force w some torque until equal release felt on both sides
- Reasses for frontal mobility
What are the points of contact for the 5-finger Temporal Hold?
- Doc places mid finger in EAC
- Pinch zygomatic arch with thumb and index finger
- Place pads of 4th and 5th digits on the mastoid process
- Opposite hand cradles the occiput
What is the objective of the Rocking the Temporals technique?
List 5 disorders it may help with.
- Release or relieve CN 9/10/11 entrapment/dysfunction
- Eustachian tube compression
- Jugular vein compression
- Restricted temporal/occipital articulation
- Tinnitus
Using the Rocking the Temporals technique what is the setup and technique to encourage internal rotation?
External rotation?
- Use bilateral or unilateral 5-finger temporal hold
- IR = Thumb and index finger move supmed, 4th/5th digits move infmed
- ER = thumb and index move infmed, 4/5th digit move suplat
Move back and forth in ER/IR until bones achieve equality in motion
Leaving the temporal bones in an asynchronous motion will often result in?
VERTIGO or other temporal bone problems
What is the correct setup/technique for the Temporal Pull?
Must assess what first?
- Pinch pinnae as close to temporal bones as possible
- Apply traction lat/post/sup along a vector that parallels the petrous ridge of the temporals
- Encourage inhalation phase (done inherently by lateral pull) and take up slack maintaining tension at the feather’s edge of the RB until release is felt
- Reassess motion of temporal bones
What is the correct setup and technique for the Compression of the Fourth Ventricle (aka CV4) technique?
What is the correct setup and technique for the V-spread?
- Pt is supine, doc seated at table head.
- Ipsilateral hand w/ 2nd and 3rd digits on either side of suture to be released, contralateral hand 180° opposite (palm or 2 fingers contact head)
- Spread the finger pads on both sides of restricted suture to disengage the articulation
- Gently apply a force w/ opposing hand towards dysf. suture
- Adjust until response (fluid flow or tide) felt at V-spread fingers and then reassess motion of paired bones and at suture
Which cranial bone is the only bone that contacts all 4 fontanelles?
Parietal bone
What are the relevant grooves/sulci on the inner surface of the parietal bone?
- Sagittal sulcus: a groove in which sagittal sinus runs
- Groove of the middle meningeal a. (anterior and posterior)
- Lateral part of the groove for the Transverse Sinus: carries marginal insertion of the tentorium cerebelli
During SBS flexion how does the sagittal and temporal articulation of the parietal bone move?
- Sagittal articulation moves inferiorly –> move down
- Temporal articulation moves laterally —> move out
*Cranium widens laterally = ER of the parietals
During SBS extension how does the sagittal and temporal articulation of the parietal bone move?
- Sagittal articulation moves superiorly –> moves up
- Temporal articulation moves medially –> moves in
*Cranium narrows laterally = IR of the parietals
The OM and asterion are often involved in what type of HA’s?
Tension
The Pterion is often involved in what type of HA’s?
Temporal
Head, face, and tooth pain are often related to what trigger point?
Temporal SD (TrP)
What is the most common form of Synostosis?
Sagittal Synostosis
- Premature fusion of the sagittal suture restricts the transverse growth of the skull
Which type of synostosis is most commonly mistaken for posterior positional deformational plagiocephaly and must be closely evaluated?
Lamboidal synostosis
- Premature fusion of one lambdoid suture causes flattening of the back of the head. Causes a tilt to the back of the head
What is the effect of IR and ER of the temporals on the Eustachian Tube?
- IR of temporals places pressure on eustachian tube –> HIGH pitched tinnitus
- ER of temporals produces low roaring sound or LOW pitched tinnitus
During SBS flexion/extension the motion of the temporal bone is driven by?
The OCCIPUT through the OM articulation
Bell’s Palsy (CN VII) can be associated with SD of which cranial bone?
Temporal bone
How does the frontal bone move with SBS flexion (i.e., lateral side and glabella)?
- Into ER
- Lateral side moves anterior/lateral and slightly inferior
- Glabella moves posterior
How does the frontal bone move with SBS extension (i.e., lateral side and glabella)?
- Into IR
- Lateral side moves posterior/medial and slightly superior
- Glabella moves anteriorly
Which type of HA’s are the coronal suture and pterion involved in with Frontal Bone SD?
- Coronal often involved in tension HA
- Pterion often involved in temporal HA
Frontal bone SD can cause what 3 clinical disorders?
- Sinusitis (allergic or infectious)
- Visual problems (double vision)
- Anosmia - frontal influence cribiform plate
Bicoronal Synostosis results in which head shape?
Bracycephaly —> shorter and wider skull
- Ant fossa results in shorter and wider head shape
Unicoronal Synostosis results in which head shape?
Anterior Plagiocephaly –> “C-shaped” deformity or “facial twist”
- Fused coronal suture on one side causes affected side to be flat and contra side to be more anterior
What is the associated facial deformity of Anterior Plagiocephaly and the key to differentiating it from positional/deformational plagiocephaly?
- Base of the nose drawn towards affected side, tip of the nose pointing away
- Affected forehead is flat, contra pushes anterior
- Affected side ear is more anterior
Which 4 fontanelles does the parietal bone contact?
1) Anterior fontanelle
2) Sphenoid fontanelle
3) Mastoid fontanelle
4) Posterior fontanella
Why is the frontal bone considered a paired bone?
Presence of Metopic suture
Which axis does the frontal bone(s) rotate around and in which plane?
- 2 AP axes
- Movment in coronal plane
Temporal bone SD may be associated with mechanical/pain where?
- TMJ pain
- Head pain
- Neck pain - SCM and other muscle SD
Which 5 organ/nerve/muscle dysfunctions can arise from Temporal Bone SD?
- Dizziness
- Ear infections
- Swallowing and Chewing dysf. –> Stylohyoid, Stylomandibular, and Styloglossus
- Tinnitus and Eustachian tube dysf.
- Bell’s Palsy - CN VII
Where does the eustachian tube exit the skull?
Btw the sphenoid and temporal bones (petrous portion)
Temporal bone of a newborn lacks what?
Mastoid process
Petrous portion of the Temporal bone encloses which artery?
Internal Carotid A.
What is found in the petrous portion of the Temporal bone at the border of foramen lacerum (with sphenoid)?
Which of these structures is associated with lacrimation?
- Greater superficial petrosal nerve
- Lacrimation via the ptergopalatine ganglion
What resp motion is paired with extension of the SBS?
Exhalation
How many articulations does the parietal bone have?
The parietal bone has 5 articulations
Flexion of the SBS causes what motion of the temporal bone?
Extension?
Flexion of SBS = ER of temporal bone
Ext of SBS = IR of temporal bone
What’s this?
Parietosquamous suture
What’s this?
Lambdoid suture
What’s this?
Occipitomastoid suture
