OCMM: Landmarks And Holds

Question 1

Indications for OCMM

Answer 1

Somatic dysfunctions of the head and neck and sacrum

Question 2

Contraindications of OCMM

Answer 2

Absolute:

• acute intracranial bleeding
• skull fractures
• strokes or TIAs

Relative:

• coagulopathies
• space occupying lesion in the cranium
• increased intracranial pressure

Question 3

What are the TART criteria for OCMM?

Answer 3

Tissue texture: changes, heat, muscle tightness, intraosseus changes

Asymmetry: symmetry of landmarks including sutures and fontanelles

Range of motion: in joints and membranes

Tenderness: counterstrain tender points for TMJ and cranium

Question 4

Sphenoid, temporal, parietal, frontal and occipital bone axis of rotation

Answer 4

Sphenoid = through the sphenoid bone

Occipital = through the jugular process

Temporal = through the petrous portion of the temporal bone

Parietal = through the parietal eminence

Frontal = through the frontal eminences

Question 5

How does the skull grossly change during cranial flexion?

Answer 5

Width widens

Length shortens

Height shortens

Eye sockets widen diagonally

Eye ball becomes more prominent

Question 6

How does the skull grossly change during cranial extension?

Answer 6

Width shortens

Length widens

Height widens

Eye sockets shortens diagonally

Eye ball becomes more sunken

Question 7

Vault hold

Answer 7

Used to assess primary respiratory mechanisms and motion along the SBS

1) patient supine with physician seated at head of table
2) physician has hips./knees at 90 degrees with feet flat
3) physician rests forearms on table establishing fulcrum
4) place hands on either side of head cradling it and making palmar contact
5) thumbs should be touching each other just above the sagittal suture (dont touch patient head

6) finger pads on head not tips
- index = greater wings of sphenoid
- middle fingers = anterior to ears on temporal and parietal bones
- ring fingers = posterior to ears on temporal and partial bones
- little fingers on occiput

7) palpating cranal flexion = fingerpads should move inferior (towards patients feet)and separate
8) palpating cranal extension = finger pads should move superior (towards physician) and approximate

Question 8

Fronto-occipital hold

Answer 8

Used to assess primary respiratory mechanism and the motion fo the cranial base at the SBS
- also assesses frontal bone motion in relation to the rest of the CRI

1) patient supine with physician seated at side of head and table
2) place caudad hand under the occiput bone resting your hand on the table and cupping the occipital squama
3) place cephalad hand over frontal bones resting elbow if possible on the table

4) use two digits to contact the sphenoid bone
- either middle finger or 5th digit and the thumb should contact the sphenoid bones just lateral to each eye on both sides

5) the entire hand and not just the finger pads should contact the patients head

Question 9

Occipital cradle hold

Answer 9

Used to assess primary respiratory mechanism, the motion of the cranial base at the SBS and the occipital bone in relation tot he rest of the CRI and cervical spine

1) patient supine with physician seated at the head of the table
2) physician hips and knees at 90 degrees resting flat on floor
3) put forearms on table establishing a fulcrum
4) place both hands under the patients occiput, with thumbs on mastoid processes on both sides