Midline bones lecture and COMP Flashcards
On what axis do midline bones typically rotate on and what direction?
Transverse axis. Rotates in an anterior/posterior direction
On what axis do paired bones usually move about? and in what plane?
Move about the AP axis and the motion is on the coronal plane.
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
F. A and C.
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?
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.
Motion of the ethmoid is influenced by what two structures?
Sphenoid and falx cerebri
On what axis does the ethmoid rotate on and in what plane is the motion on?
Transverse and motion is the saggital plane.
During cranial flexion, the lateral masses of the ethmoid behave as paired bones and has what motion?
External rotation during cranial flexion. Internal rotation during cranial extension
Lateral strain, In what axis and plane does motion occur for the occiput and sphenoid?
Vertical axes. motion is in the transverse plane
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?
Left lateral strain. SBS sheared to the left. Doc’s left hand moves more anteriorly and slides over the right hand.
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
Superior vertical strain. The thumbs move away from the physician toward the patient.
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?
Inferior vertical strain. Doc’s thumbs move toward the doc.
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?
They rotate in opposite directions about the anterior/posterior axis. Motion is in the coronal plane.
How is a SBS torsion named?
Named for the more cephalad greater wing of the sphenoid.
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?
Right side. pt has right Torsion strain. Pt will also have tentorium cerebelli sidebent to right. Spinal dura will be inferior on the right.
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?
Vertical axis and the motion is in the transverse plane. Motion is in the opposite of each other.
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?
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.
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.
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.
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
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.
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/
CRI will be slow, low amplitude, difficult to feel, and weak.
BMT technique can be applied for this train using a frontal-occiptal hold
During SBS flexion, in what direction does the sacrum move? what is that termed as?
with SBS flexion, sacrum moves posteriorly and is termed counter-nutation. SBS extension = sacral nutation
What is the motion at the base of the sacrum with SBSflexion?
Posterior
What is the motion of the apex of the sacrum in SBS flexion?
anterior
Where is the axis of motion of the sacrum?
Body of S2, right left axis.
Why does the spinal membrane cause this sacral motion with the CRI?
sacral dura tube.
Explain how a balanced membrane tension technique is performed.
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.
Explain the cranial diameter changes during cranial flexion.
A/P diameter decrease; R/L diameter increase; sup/inf diameter increase
