Midline bones lab Flashcards
palpating sacral motion
pt supine; doc one side
ask pt to bend one or both knees
pt rotates torso towards physician allowing placement of docs caudal hand on sacrum
sacral hand: thenar + hypothenar eminence on ILAs of sacram and finger pads on sacral base
coronal suture
transverse suture bw frontal and parietal bones
parietosquamous suture
suture bw temporal and parietal bones
lambdoidal suture
dense, fibrous connective tissue joint - connects the parietal bones with the occipital bone `
pterion
region where the frontal, parietal, temporal, and sphenoid bones join together
asterion
posterior end of the parietomastoid suture
occipitomastoid suture
bw occipital bone and the mastoid portion of the temporal bone
lambda
point of meeting of the sagittal and the lambdoid suture
bregma
point of meeting of the sagittal and coronal suture
when is it common to find sphenobasilar compression findings?
migraines
Occipital condylar decompression indications:
poor infant feeding
infant colic
head and neck pain
post trauma to head and neck
Occipital condyle decompression treatment:
contact as near to the foramen and condyles as possible (add slight OA flexion)
gently apply traction, then pull the occipital tissues in posterior and lateral direction
await slight occipital regional give in both directions (maybe 20-30s)
re-examine for efficacy
how would you perform occipital condyle decompression in infants?
“V” spread technique
Difference before age 7 vs adult
before age 7 treating the cartilaginous pre-ossification strains vs adults treating fascial strains
CV4 compression treatment
aka still point induction
thenar eminences are inferior to superior nuchal line and MEDIAL to the patients OM sutures (*compression lateral to sutures may induce OM suture compression or ER of temporals)
gently encourage extension by leaning back (induces SUP and ANT force)
gently RESIST its inferior motion (FLEXION) by not reducing pressure (ratchet pattern)
motion will seemingly diminish to point where you question if it has disappeared (still point)
slowly release pressure and await CRI return (may take 1-2 mins)
indications for CV4 compression tx
decreased CRI
URI
HA/migraine
indications for SBS decompression
diminished CRI, mood disorders, cranial n. entrapment, URI/head congestino, pediatric development problems
SBS decompression treatment
hold: frontoccipital or vault or can use post molars (direct)
indirect= BMT compression first, followed by release
direct= gently engage temporal bones to distract against the occiput–> PULL in ANTERIOR + slightly superior direction (not to level of barrier engagement; posterior molars may be used instead of frontal bone)
respiration or CRI may be used to augment movement–> await tissue release–> reassess CRI rate and amplitude
Balanced Membranous tension is an ____technique
indirect cranial manipulative tx
balanced membranous tension tx
identify asymmetry of cranial motion (membranes of brain)
gently exaggerate membranous asymmetry until sense of balance is noted (CRI will move or wiggle against your force but you should resist changing your force + position)
resist a return to CRI midpoint (neutral) until CRI stops at still point
gently release forces + return to CRI midpoint, monitoring for return of motion and symmetry
indications for balanced membranous tension
asymmetrical or diminished CRI
cranial n. entrapment
sx related to dural strain or venous sinuses
HAs
Direct cranial motion impulse correction tx:
aka Guiding, “ricochet,” LVLA lol
identify asymmetry of cranial motion
at CRI midpoint of motion bw flexion + extension, apply very gentle and brief force in corrective direction***
observe several cycles of flexion + extension to confirm return of ideal motion and symmetry of motion
repeat once or twice if necessary
(“little nudge its tricky but powerful)
