Lecture 5: Clinical Applications of OCMM

Question 1

Which area is most likely to cause a constriction or blockage of the eustachian tube?

Answer 1

Cranial base where the sphenoid and temporal bones meet

Question 2

Pain in the cranium can often be localized to the dura where?

Answer 2

Base of the brain

Question 3

Which arteries/parts of arteries are “pain sensitive” within the dura of the cranium?

Answer 3

• Proximal parts of the ACA and MCA
• Intracranial portion of the Internal Carotid a.

Question 4

C2 is in close proximity to what part of the cervical plexus?

Answer 4

Superior cervical ganglion

Question 5

C1 is in close proximity to which ganglion?

Answer 5

Inferior ganglion of vagus n.

Question 6

CN VII is associated with Bell’s Palsy and this nerve passes through which bone?

Answer 6

Temporal

Question 7

What are 2 primary examples of arteries related to pain in the cranium?

Answer 7

1. Middle meningeal a. (carried by the dura)
2. Superficial temporal as.

Question 8

Which 4 cranial veins have a dural envelope and may be implicated in cranial pain (i.e. HA’s)?

Answer 8

• Superior sagittal sinus
• Inferior sagittal sinus
• Straight sinus
• Transverse sinuses

Question 9

Which cranial bones relevant to OCMM are connected to the dura?

Answer 9

All cranial vault bones!

Question 10

70-75% of the cranial drainage exits where?

SD of which suture can impair this drainage?

Answer 10

• Jugular foramen
• OM suture

Question 11

Which ganglion are located in the C1-C3 area?

Which Tx may help relieve pain in the neck/face/head?

Answer 11

• Superior cervical ganglion (sympathetic to head/face)
• Inferior ganglion of CN X (vagus)
• Suboccipital release!

Question 12

What is the mnemonic for remembering the foramina that the distributions of the Trigeminal (CN V) exit?

Answer 12

• “Standing Room Only”
• Superior orbital fissure = V1
• Foramen Rotundum = V2
• Foramen Ovale = V3

Question 13

In which bone can you find the foramen ovale and rotundum?

Trigeminal ganglion?

Answer 13

• Foramen ovale (V3) and rotundum (V2) –> Sphenoid bone
• Trigeminal ganglion –> Temporal bone

Question 14

What’s found on the superior surface of the petrosal ridge of the temporal bone?

Answer 14

Meckel’s cave —> contains Trigeminal ganglion, COVERED w/ Dura

Question 15

Which type temporal bone SD would put pressure on the structures deep to the tentorium cerebri (i.e., Trigeminal Ganglion)?

Answer 15

ER Temporal bone SD —> Trigeminal Neuralgia

Question 16

Which 2 SD’s need to be treated for Trigeminal Neuralgia?

Answer 16

Treat the SBS and Temporal dysfunctions

Question 17

What 4 things to treat for Plagiocephaly in a child?

Answer 17

• SBS
• Paired bones
• Sutures
• Compensatory changes in MS