Paired Bones Lab

Question 1

Describe Parietal Lift treatment

Answer 1

1. Fingertips on both parietal bones just superior to parietal-squamous sutures
2. Hook thumbs to create a pivot but do NOT touch patient’s head
3. Maintain light pressure and traction superiorly until superior give or lateral fullness is noted (fullness = external rotation of parietal bones)
4. Gently reassess head for ROM and PRM rate & rhythm

Question 2

Describe Frontal Life treatment

Answer 2

1. Gently engage lateral inferior edge of frontal bone (hook under zygomatic arch) (* can use middle fingers bilaterally or use thumb on one side and middle finger of same hand on other side, like wrapping your hand on their forehead)
2. Apply anterior force with some anterior rotation torque until release is felt equally on both sides
3. Reassess for frontal mobility

Question 3

Parietal lift can be useful for treating what clinical conditions?

Answer 3

Tx of compressed parietal-squamous suture d/t clinching/grinding teeth

Question 4

Frontal life can be useful for treating what clinical conditions?

Answer 4

Tx of frontal headaches, sinus congestion, pediatric development issues

Question 5

5 - Finger Temporal Hold & temporal assessment and rocking

Answer 5

• done unilaterally OR B/L
  1. Place middle finger gently in patient’s external auditory canal (eww)
  2. Using thumb and index finger pinch hold of zygomatic arch
  3. 4th and 5th digits pinch hold the mastoid process
  4. * if done unilaterally, the opposite hand cradles contralateral side of head or occiput for stabilization
  5. Encourage free directions of motion first (indirect treatment)
  6. Then do back-and-forth IR/ER motions until bones achieve equality of motion
  7. Release slowly at neutral between flexion and extension
  8. Reassess for ROM and PRM rate & rhythm

With flexion (idk what this mean): external rotation = thumb and index finger move infermedially; 4th and 5th digits ride along with superolateral motion

With extension (idk what this means either): internal rotation = thumb & index finger move superior and laterally; 4th and 5th digits move inferomedially

Question 6

If physiologic synchronous motion does not return with the temporal assessment and rocking what should you do?

Answer 6

gently induce a STILL point (I think it means to hold the 5 finger hand position still), this will likely correct patterns

Question 7

What clinical situations is the temporal assessment and rocking treatment used?

Answer 7

tx of TMJ, Bell’s palsy, lateral head/suture pain, cranial torsions

Question 8

Clinical situations for use of the temporal pull treatment

Answer 8

1. Balances tentorium cerebelli
2. Disengages the jugular foramen
3. May help release the petrosphenoid (idk what that means)
4. BLT for occipitomastoid
5. Temporal headache
6. Vertigo
7. Tinnitus
8. TMJ issues

Question 9

Describe temporal pull treatment

Answer 9

1. Use pincer grip on antitragus as close to temporal bones as possible
2. Apply GENTLE traction laterally, posteriorly, and superiorly along a vector that parallels petrous ridge of temporals
3. Encourage inhalation phase and take up slack maintaining tension at the feather’s edge of restrictive barrier until release is felt on both sides

Question 10

Describe TMJ decompression treatment

Answer 10

1. Begin INDIRECT with compression of mandible towards TMJ until general tissue relaxation is felt
2. Switch to lateral mandible and gently push inferior and slightly anterior until slight give is noted on both sides
3. Retest by palpating motion at TMJ while patient opens the mouth

Question 11

What are the clinical situations you would use the TJM depression treatment for?

Answer 11

TMJ restriction (duh), mandible restriction, neck pain

Question 12

Describe V spread technique

Answer 12

1. Spreading pressure is used to follow and just slightly encourage motion
2. Fingerpads of pressure hand are on longest contralateral diameter (i have no idea what this means)

Question 13

Describe occipitomastoid release (suture disengagement)

Answer 13

1. Wrap ipsilateral hand around mastoid process
2. Wrap contralateral hand under occiput with fingers posterior to suture
3. Roll head towards affected side until OM suture is most posterior
4. Gently apply anterior traction on mastoid
5. Hold until gentle release is noted
6. Release slowly and retest suture for motion

Question 14

Describe sagittal suture release (suture disengagement)

Answer 14

1. Fingers at inferior portion of parietal bone bilaterally
2. Hold and apply traction
3. Thumbs cross at sagittal suture at midpoint or at restriction
4. Gap joint with lateral pressure
5. Hold gently until a release at sagittal suture is noted
6. Release slowly and retest for motion

Question 15

Describe pterigo (Spheno) palatine ganglion inhibition/stimulation

Answer 15

1. Posterior and just lateral to molars (finger in patient’s mouth)
2. Medial to pterygoid
3. Direction of force = superior, slightly medial, slightly posterior, and slightly medial rotation
4. Hold gently and await relaxation
5. Rotatory stimulation thins nasal mucus and increases tears –sinus effects

Question 16

CV4 treatment

Answer 16

1. thenar eminences on occiput
2. gently sequentially encourage extension with each extension motion until there is no further movement in extension phase
3. await still point
4. slowly relax pressure once still point is met
5. await CRI to resume
6. reassess for ROM and PRM rate & rhythm

Question 17

CV4 pump

Answer 17

1. thenar eminences on occiput
2. after tuning into the flexion and extension motions through the occiput, gently add medial and cephalad compressing pressure through the FLEXION PHASE ONLY
3. Release pressure completely allowing full extension again
4. repeat 10 -14 cycles or until overall decreased resistance is felt during compression

**pump encourages CSF from 4th ventricle into spinal cord region