Midline Bones Clinical Applications

Question 1

What are clinical considerations with the ethmoid bone?

Answer 1

1. Sinusitis

2. Septal deviation

3. HA

Question 2

How do the ethmoid bones contribute to sinusitus?

Answer 2

• Lateral masses move as paired bones, into ER with widening of the ethomoid notch and ER of the maxilla => opening the nasal passage.
• The ER/IR effects on the ethmoid create a pumping action on the ethmoid sinus and contribute to the pumping action of the other sinuses

Question 3

How does the ethmoid bone contribute to septal deviation?

Answer 3

Ethmoid spine (hinge-like area where the perpendicular plate joins the cribriform plate) allows some lateral deviation, like when someone is breathing through only one nostril

Question 4

how does ethmoid bones contribute to HA?

Answer 4

30% of CSF drains via lymphatic, with most of it draining through the cribiform plate. If backup d/t ethmoid SD or sinusitis =>

1. Increased dural tension => migraine or tension HA.
2. Vascular effects => migraine

Question 5

Vomer SD is due to

Answer 5

• 1. Position of sphenoid
• 2. Trauma to face
• 3. May cause nasal edema => influence sinusitus

Question 6

Treatment of cranial tissue is aimed at

Answer 6

1. Outer fascia layers
2. Sutural ligaments
3. Intracranial membranes

to effect structures that pass through, between or out of bones.

Question 7

Changes in the position of bones places stress on brain, arteries, veins and venous sinuses through what?

Answer 7

Direct connections to dura and arachnoid

Question 8

How does the dura influence the CNS?

Answer 8

Cranial dura and OA is continuous with SC dura => influences all spinal nerves and has indirect pull on vertebra. Influences are reciprical

Question 9

Palatine SD may be indicative of _________ involvement

Answer 9

Sphenopalatine ganglion involvement

Question 10

Pterigopalatine ganglia influences what?

Answer 10

Trigeminal output => actives the muscles of mastication.

Thus, working on pterygopalatine ganglia can help with TMJ and influence swalling/speech problems

Question 11

Clinical experience finds that cranial treatments are often very successful in reducing or ending active _____, as well as decreasing the frequency.

Answer 11

migraines

Question 12

What is known to cause HA?

Answer 12

1. Distension, traction or dilation of the intracranial arteries (middle meningeal/superficial temporal arteries), because of their relationship WITHIN the dura.
2. Problems with venous drainage

Question 13

What parts of the arteries are thought to cause HA?

Answer 13

1. Proximal parts of the ACA and MCA
2. Intracranial portion of the internal carotid.

Question 14

What nerve passes through the temporal bone and could be damaged if there is a temporal bone torsion?

Answer 14

Facial Nerve (CN 7)

Question 15

Patient has pain in their face when simply chewing, brushing teetch or AIR that lasts few seconds => 2 minutes. It is incapacitating.

What is their problem?

Answer 15

Trigemenal neuralgia: distribution of CNV2: change in temporal bone => change tension of dura (which overlies the trigmeninal ganglion) => problem

Question 16

What SD of the temporal bone could cause trigmenial neuralgia?

Answer 16

Temporal bone ER SD (ER and stays that way) => puts pressure on structures deep to the tentorium cerebri (aka dura mater)

Question 17

Patient has weak side facial muscles, is at increase risk of drying effect and ulceration/abrasion of the cornea and possibly a change in taste (chorda tympani - taste to anterior 2/3 of tongue). What does he have and how can we cure

Answer 17

Bells PAlsy: OMT can fix with temporal bone problem