Osteopathic Cranial Manipulative Medicine Flashcards
2 primary treatment modalities for Cranial Manipulation
Primary Respiratory Mechanism (PRM)
Balanced membranous tension
Who developed OCMM?
William Sutherland
What is the primary respiratory Mechanism?
Philosophy that cranial motion has an ebb and flow like breathing
5 components of the PRM
- Mobility of brain and SC
- CSF fluctuation
- Mobility of intracranial and intraspinal membranes
- Articulatory mobility of cranial bones
- Passive mobility of the sacrum
What is Cranial Rhythmic Impulse?
The driving push that is created from CSF flow that occurs 10-14 cycles/min
How do we describe the CRI?
R-RADS Rate- 10-14/min Rhythm amplitude Direction- should be linear and symmetric Strength
Where is the sutherland fulcrum located?
Straight Sinus where fall cerebri and tentorium cerebelli meet
What is the reciprocal tension membrane (RTM)
Philosophy that meninges and SC link the cranium to the sacrum and create reciprocal motion.
AKA the “core link”
Poles of attachment for the RTM
A/S- Crista Galli
A/I- Clinoid Process of Sphenoid
Lat- Mastoid angles of parietals
Pos- Internal occipital protuberance and transverse ridges
Name the primary dural sinuses
Superior Sagittal Inferior Sagittal Straight Transverse Confluence Sigmoid
what suture is between the Frontal and Parietal bones
Coronal
what suture is between the sphenoid, frontal, parietal and temporal bones
Pterion (weakest point in the skull that causes a middle meningeal artery hemorrhage)
what suture is between the parietal and occipital
Lambdoidal
what suture is between the temporal and parietal
Parietosquamous
what suture is between the temporal and occipital
Occipitomastoid
what suture is between the temporal and zygomatic process?
temporozygomatic
what suture is between the two parietal bones
Sagittal
What are the Anterior fontanelle and posterior fontanelle referred to as in an adult, respectively?
Bregma
Lambda
The basisphenoid and basiocciput join to make what structure?
Sphenobasilar Synchondrosis (SBS)
SBS flexion
SBS moves superiorly and the occiput moves inferiorly, closing the angle between them
SBS extension
SBS moves inferiorly and the occiput moves superiorly to open the angle between them
SBS extension causes what change in the shape of the skull and is paired with what respiratory motion?
Elongates the face and makes the cheekbones. prominent during exhalation
Think Bert’s head
SBS flexion causes what change in the shape of the skull and is paired with what respiratory motion?
Makes the skull more spherical during inhalation
Ernie’s head
What travels through the Foramen Rotundum?
CN V2 (Maxillary)
What travels through the Foramen Ovale?
CN V3 (Mandibular)
Accessory Meningeal Artery
Lesser Petrosal Nerve (Efferent CN IX to Parotid Gland)
What travels through the Foramen Spinosum?
Middle Meningeal Artery
Meningeal branch of mandibular nerve
What travels through Foramen Lacerum?
Internal Carotid A
Which Sacral Axis does Respiratory motion occur?
Superior Transverse
Which sacral axis does postural movement (flexion/extension) occur?
Middle Transverse
What sacral Axis does movement of the ilia occur?
Inferior Transverse
Nutation
sacral base moves anteriorly
Paired with SBS extension during exhalation
Counternutation
sacral base moves posteriorly
Paired with SBS flexion during inhalation
T/F: CRI stops if patient holds their breath
False, respiration is not the only driver of CRI
CRI is a product of CSF, Volume, Pressure, and Metabolite changes
What is a Trade Hering Wave (TH)?
change in arterial blood pressure what occurs about 6/min that coincides with SBS flexion and Extension in a 2:1 fashion (2 TH to get back to starting position)
What is a still point?
Decreased TH waves
What cell regulates blood flow to the brain?
Glial Cells
