Midline bones lecture and COMP

Question 1

On what axis do midline bones typically rotate on and what direction?

Answer 1

Transverse axis. Rotates in an anterior/posterior direction

Question 2

On what axis do paired bones usually move about? and in what plane?

Answer 2

Move about the AP axis and the motion is on the coronal plane.

Question 3

Which of the following bones move in the same direction? 
A. Occiput and ethmoid
B. Vomer and Ethmoid
C. Vomer and sphenoid
D. Occiput and Vomer
E. A and B
F. A and C

Answer 3

F. A and C.

Question 4

The basiocciput will move vertically in a cephalad direction in SBS flexion. This causes, a cogwheel fashion, rotation of the ethmoid bone in what direction?

Answer 4

Ethmoid has the same motion as the occiput. For example with SBS flexion, the occiput moves posterior inferior and thus the ethmoid will also move posterior inferior.

Question 5

Motion of the ethmoid is influenced by what two structures?

Answer 5

Sphenoid and falx cerebri

Question 6

On what axis does the ethmoid rotate on and in what plane is the motion on?

Answer 6

Transverse and motion is the saggital plane.

Question 7

During cranial flexion, the lateral masses of the ethmoid behave as paired bones and has what motion?

Answer 7

External rotation during cranial flexion. Internal rotation during cranial extension

Question 8

Lateral strain, In what axis and plane does motion occur for the occiput and sphenoid?

Answer 8

Vertical axes. motion is in the transverse plane

Question 9

Upon cranial evaluation you notice that pt’s occiput and sphenoid are both rotated to the right (posteriorly). What dysfunction does the pt have? What is the position of doc’s hands in this evaluation?

Answer 9

Left lateral strain. SBS sheared to the left. Doc’s left hand moves more anteriorly and slides over the right hand.

Question 10

During an evaluation you notice that as sphenoid moves into cranial flexion, it is accompanied by extension motion at the occiput. What is the dysfunction? Describe the motion of doc’s thumbs

Answer 10

Superior vertical strain. The thumbs move away from the physician toward the patient.

Question 11

During an evaluation you notice that as sphenoid moves into cranial extension, it is accompanied by flexion motion at the occiput. What is the dysfunction? Describe the motion of doc’s thumbs?

Answer 11

Inferior vertical strain. Doc’s thumbs move toward the doc.

Question 12

During an SBS torsion strain, in what direction do the sphenoid and occiput rotate in relative to each other? In what axis and plane is the motion?

Answer 12

They rotate in opposite directions about the anterior/posterior axis. Motion is in the coronal plane.

Question 13

How is a SBS torsion named?

Answer 13

Named for the more cephalad greater wing of the sphenoid.

Question 14

Upon evaluation you notice as pts SBS moves into cranial flexion, the right greater sphenoid wing moves cephalad while the right occiput moves caudad. You also noticed abnormal flexion/extension while sphenoid twists left, occiputs twists right at the SBS with right basi-sphenoid superior. Due to this dysfunction, the temporal and parietal bones will be externally rotated on which side?

Answer 14

Right side. pt has right Torsion strain. Pt will also have tentorium cerebelli sidebent to right. Spinal dura will be inferior on the right.

Question 15

In an SBS side-bending/rotation strain, in what axis and plane does side bending of the occiput and sphenoid occur? in what direction are the motion relative to each other?

Answer 15

Vertical axis and the motion is in the transverse plane. Motion is in the opposite of each other.

Question 16

In an SBS sidebending/rotation strain, in what axis, plane does rotation of sphenoid and occiput occur? In what direction are the motions relative to each other?

Answer 16

Rotation is in the anterior/posterior axis and motion is in the coronal plane just like torsion. Motion is same direction (unlike in torsion). moves toward the side of the convexity produced by the change during sidebending.

Question 17

Upon evaluation, you notice that upon SBS flexion, the sphenoid rotated left and the occiput rotated to the right and they both rotated on the A/P axis to the right. Explain the motion of the doc’s hands during this dysfunction.

Answer 17

The dysfunction is right side-bending/rotation strain pattern. The right hand moves caudad and the distance increase between the index and little finger. Right hand moves down and spread out with left hand moving up and in.

Question 18

During an Right side-bending/rotation strain pattern, in which side you'd see the following changes: 
A. Temporal and parietal bones:
B. Mandible:
C. Frontal bone and orbit:
D. Falx cerebri
E. Tentorium cerebelli
F. Spinal dura

Answer 18

A. Externally rotated to the right 
B. deviated to the right
C. anterior on the right
D. Sidebent to the right
E. Rotated to the right
F. inferior on the right.

Question 19

Pt has a SBS compression due to head trauma. What changes are you likely to notice to the pt’s CRI? what technique can you perform to treat this strain/

Answer 19

CRI will be slow, low amplitude, difficult to feel, and weak.
BMT technique can be applied for this train using a frontal-occiptal hold

Question 20

During SBS flexion, in what direction does the sacrum move? what is that termed as?

Answer 20

with SBS flexion, sacrum moves posteriorly and is termed counter-nutation. SBS extension = sacral nutation

Question 21

What is the motion at the base of the sacrum with SBSflexion?

Answer 21

Posterior

Question 22

What is the motion of the apex of the sacrum in SBS flexion?

Answer 22

anterior

Question 23

Where is the axis of motion of the sacrum?

Answer 23

Body of S2, right left axis.

Question 24

Why does the spinal membrane cause this sacral motion with the CRI?

Answer 24

sacral dura tube.

Question 25

Explain how a balanced membrane tension technique is performed.

Answer 25

Using either a frontal occipital hold or a vault hold, SBS dysfunction is evaluated for the extremes of motion between cranial flexion/extension. the SBS is held in midpoint of the two extremes of the motion until a still point is obtained. Concentration is maintained until CRI motion begins to return and is noted to be more symmetrical than before.

Question 26

Explain the cranial diameter changes during cranial flexion.

Answer 26

A/P diameter decrease; R/L diameter increase; sup/inf diameter increase