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CCST > Pathologies > Flashcards

Pathologies Flashcards

1
Q

What is AMNOSIA and what CN would you think of?

A

Loss of smell - Olfactory Nerve

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2
Q

What can AMNOSIA be caused by?

A

Fracture of cribiform plate;
Restrictions to ETHMOID and frontal; vomer; sphenoid
Membranous tensions affecting Olfactory nerve fibres
Congestion in nasal cavity blocking receptors and foramina

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3
Q

Name some causes of OPTIC nerve dysfunction?

A

Cranial bone displacement - sphenoid
Optic nerve compression in OPTIC CANAL and SELLA TURCICA of sphenoid
Membranous tensions
Neuritis - inflammation of optic nerve
Systemic diseases - MS; diabetes; pituitary tumour

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4
Q

What is Strabismus?

A

Squint

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5
Q

What CNs would you associate with Strabismus?

A

Oculo-Motor; Trochlea and Aducens

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6
Q

What is Diplopia?

A

Double Vision

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7
Q

What CNs would you associate with Diplopia?

A

Oculo-Motor; Trochlea and Abducent

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8
Q

What is Ptosis?

A

Drooping of upper eye lid.

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9
Q

What causes Ptosis?

A

Injury to Levator Palpbrae muscle - Oculo-Motor nerve

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10
Q

What is Photophobia?

A

Persistently dilated pupil on affected side.

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11
Q

How is Photophobia caused?

A

Injured parasympathetic nerve fibres from Oculo-Motor Nerve

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12
Q

If the Abducent Nerve is injured causing Strabismus, how might the eyes look?

A

Cross eyed

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13
Q

What is Bells Palsy?

A

Paralysis of face on affected side - muscles on one side droop and become expressionless, one side is immobile; smile is crooked; tears trickle from affected side, food collects in cheek.

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14
Q

What causes Bell’s Palsy?

A

Damage to FACIAL nerve.
Other causes - stroke; tumours; surgery; mumps; middle ear infections; head injury, neuritis. Also connects to CN 2,3,4,5,6,8 - movements of eyelids, eyeballs and blinking and ears.

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15
Q

Name 2 conditions related to the Cochlea division of the Vestibulo- Cochea Nerve?

A

Deafness
Tinnitus

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16
Q

Name 3 conditions related to the Vestibular division of the Vestibulo- Cochea Nerve?

A

Dizziness
Vertigo
Motion sickness

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17
Q

What causes damage to the Vestibulo-Cochlea NErve?

A

Infection of inner ear
Menieres disease
Meningitis
Encephalitis

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18
Q

Name 4 conditions related to the Trigeminal Nerve?

A

1) Middle ear infections / glue ear
2) Hearing disorders
3) Hyperacusis
4) Trigeminal Neuralgia

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19
Q

How are middle ear infections and glue ear related to the Trigeminal Nerve?

A

Mandibular division of the Trigeminal nerve innervates the Tensor Veli palatini muscle which opens the Eustachian tube which drains the middle ear. Overstimulation of mandibular branch of Trigeminal nerve may involved with recurrent middle ear infections and glue ear.
The Trigeminal mandibular branch and motor branch travel together throughout much of their pathway. The Motor branch supplies the medial pterygoid muscle that also gives off two smaller branches to tensor tympani muscle and tensor veli palatini muscle, which assist with the opening of the Eustachian tube.”

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20
Q

What is Trigeminal Neuralgia?

A

Most painful condition in medical world.
Recurrent and severe facial pain, electric shock type.
Affects any of the areas supplied by Trigeminal Nerve but maxillary and mandibular divisions are most common.
Attacks can be triggered by slightest stimulus - eating; breeze, brushing teeth.
1 side of face affected.
Causes: not known. Possible damage to Trigeminal nerve along pathway; compression along pathway; latent herpes virus complex lying dormant in nerve fibres.

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21
Q

How would approach treating Trigeminal Neuralgia?

A

CS Integration - whole person.
Local area - checking tissues; bones; nerves; membranous. Check Trigeminal ganglion. Stress/ overstimulated system.
Quality in system of being rigid; solid; compressive in cranium or face.
CS approach:
Engage - overall quality of system
Explore - Area around Trigeminal Ganglion - free mobility of temporals and sphenoid
Explore - surrounding membranes - remember ganglion is enveloped by membranous sheath so will be continuous with all surrounding membranes so tensions in those membranes will be relevant.
Trace the pathway of affected nerve - through foramina
Identify trauma to face and cranium - though be aware that contact may trigger an episode
Enhance immune system; any other causal factors eg injury, medication, viral.

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22
Q

What is Hyperacusis?

A

Sensitivity to noise. Loud noises contract the tensor tympani muscle causing ear ache; fullness; fluttering in ear.

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23
Q

What is Otitis Media?

A

Middle ear infection

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24
Q

What causes Otitis Media?

A

Infectious organisms passing up nose and throat into middle ear and Eustachian tube.

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25
Q

Why are babies more prone to Otitis Media?

A

Shorter Eustachian tubes and less developed immune systems.

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26
Q

What is a burst ear drum?

A

Ruptured tympanic membrane - releases pus as body clears infection. Repairs in few days. Shows inadequate drainage of the Eustachian tube.

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27
Q

What is Otitis Media with effusion?

A

Glue ear

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28
Q

How does glue ear occur?

A

Build up of fluid in middle ear because Eustachian tube isn’t draining properly. Creates fullness and loss of hearing, may affect learning at school.

29
Q

What is the CS motion of the Eustachian Tube>

A

External rotation of temporals = E tube opens
Internal rotation of temporals = E Tube closes.

30
Q

How does the CS rhythm of temporals affect Eustachian tube?

A

If temporals are stuck in internal rotation, the occipito mastoid suture is likely to be restricted and compressed. Sutures - Occipito- mastoid - release internal rotation of temporals and Spheno-temporal to open E tube -Eustachian tube cant open and therefore cant drain, leading to recurrent middle ear infections.
Birth trauma causes temporals to get stuck in internal rotation.

31
Q

What is mastoiditis?

A

Complication of middle ear infection. Infection may spread from mastoid air cells in mastoid process of temporal bones into cranial cavity = meningitis and encephalitis.

32
Q

What nerve innervates the Eustachian Tube?

A

Motor branch of Glosso-pharyngeal
Vagus nerve

33
Q

What nerve innervates the veli palatini and tensor tympani muscles?

A

Motor branches of the mandibular division of the trigeminal nerve

34
Q

What do the tensor tympani and veli palatini muscles do?

A

Open the Eustachian tube

35
Q

What is the Eustachian tube?

A

Tube connecting middle ear to nasopharynx at back of NASAL CAVITY each side

36
Q

What is the function of the Eustachian Tube?

A

Adjusts pressure in ear
Drains middle ear

37
Q

Where does the Eustachian tube originate and terminate?

A

Originate - bony canal of temporal bone
Teminates - nasopharynx - close to top of Pterygoid plate

38
Q

What causes the Eustachian tube to open?

A

Swallowing (swallowing relieves pressure in ears)q
Blowing nose

39
Q

Why would having a cold cause an ear infection?

A

Infectious organisms in throat pass up from nasopharynx to middle ear causing an ear infection. Blowing nose hard opens Eustachian tube.

40
Q

Why are babies more at risk from ear infections?

A

Spend more time lying down and E Tube is shorter.

41
Q

What is a Patulous Eustachian Tube?

A

Means the Eustachian tube remains open most of the time.

42
Q

What are grommets?

A

Tiny plastic tubes inserted into tympanic membrane to help ear equalise and improve middle ear function.

43
Q

How would you approach someone suffering with Otitis Media; Glue Ear; Mastoiditis?

A

Look to release the Eustachian tube to promote =
Free drainage of fluid and mucus throughout cranium
which helps air sinuses to drain, supports cranial membranes and promotes bodies immune function.
Address - restrictions in -
Temporals
Sub-occipital area
Sutures - Occipito- mastoid - release internal rotation of temporals and Spheno-temporal to open E tube -
Jugular foramen
Improve CS rhythm to support free opening and closing of Eustachian tube.
Root cause of Otitis Media is birth trauma - so explore this and all relevant factors
Contacts - HC and SP; Sub-occipital release; Mastoid Tip, Falx Release; Spheno-basilar release; Temporals; Ear Hold; Energy drive.

44
Q

What is the root cause of Otitis Media?

A

Birth Trauma

45
Q

Why does birth trauma cause Otitis Media?

A

Physical forces compress occiput and sub-occiput and cranial base = tight muscles = poor drainage
Shock effects = agitation;; poor sleep; tension in sub-occipital area; contracted intracranial membranes
Restrictions in sub-occiput - held by shock and tension will be reflected throughout system - HC, SP and sympathetic plexi
Temporals may be medially compressed by use of forceps

46
Q

Describe vertigo?

A

Perceived spinning; nausea, vomiting, tinnitus, hearing, fullness or pain in ear.

47
Q

What is the most common cause of Vertigo?

A

Benign Paroxysmal Positional Vertigo - loose calcium carbonate particles enter semi-circular canals creating a sense of motion. EPLEY Manoeuvre.

48
Q

What is Menieres disease?

A

Disorder of inner ear with 4 main symptoms:

1) Severe vertigo
2) Tinnitus
3) Hearing loss
4) Fullness in ear

49
Q

What is Tinnitus and how would you approach?

A

Persistent sound in one or both ears. - ringing, humming, clicking. Causes - restricted temporal bones, nerve compression, neuritis, congestion in ear, teeth clenching, TMJ, stress.
Treatment - whole body/mind complex; temporals; membranes; if sympathetic - spine to T1 - Carotid nerve and carotid canal to head.

50
Q

What contacts would you use to treat the ears?

A

Mandibular contact - release tension in muscles of mastication; TMJ; cranial base, temporals
Heart centre and upper thorax - improve drainage of cranium; immune; shock, tension in cervical area; sympathetic plexi
Solar plexus - shock and birth - coeliac plexus
Sub-occiput - cranial base mobility; sutures; soft tissues and muscles
Facial unwinding neck and throat - restrictions in spine and cranial base, SCM muscles attach to temporals, scalene muscles of throat attach to temporals.
Bowl hold - restricted cranium and integration
Falx release - tensions, venous drainage
Temporals - release OM suture to release medial compression and internal rotation.
Ear hold - to draw temporals out of wedged position between sphenoid and occiput.
Mandibular - temporals attach to TMJ so all Muscles of M relevant. Bony exit of E Tube lies medially to TMJ.
Medial and Lateral Ptgerygoid plates - attach to malleus in ear.
Face - congestion, sinuses.
Diet/ sugar/ breastfeeding/

51
Q

What is TMJ dislocation?

A

Caused by opening the mouth too wide or yawning or dentistry. Condyle moves out of its socket anteriorly and then settles back when mouth closes.
DISLOCATION - condyle moves too far forward and gets stuck in front of articular eminence = spasm in muscles; lock jaw; pain. - CS integration.

52
Q

What is TMJ intra-articular disc displacement?

A

Articular disc is dislocated anteriorly. Disc moves forward and forms an obstacle when mouth opens and jumps over it, causing a clicking or popping and the sae on closing.

53
Q

What is the TMJ?

A

Joint between mandible and the temporal bone.
Articulation between condyle of mandible and mandibular fossa socket of temporal bone.

54
Q

What does the TMJ do?

A

Responsible for fine movement and is the most used joint in the body.

55
Q

What is the unique feature of the TMJ?

A

Has an articular disc - elastic and flexible cartilage which acts as a cushion between 2 bone surfaces - the condyle and mandibular fossa. It lacks nerve endings so insensitive to pain. Anteriorly the disc attaches to lateral pterygoid muscles (chewing).

56
Q

How does the mouth open wide>

A

Condyle and articular disc have to move out of the socket forward and down the articular eminence.

57
Q

What is a primary TMJ?

A

When a primary dental disturbance is involved.

58
Q

Name some primary dental causes of TMJ?

A

Growth and development - maxilla and mandible disturbances eg protrusion; retraction; medially compressed maxilla.
Inappropriate dentistry - extracting teeth in childhood, overclosure of bite, retraction of mandible.
Long term malocclusions - bite uneven
Loss of vertical dimension - teeth grinding or missing teeth
Habit patterns - thumb sucking
Injury - dislocation or displacement
Strain on TMJ - joint degeneration
Articular disc displacement - no symptoms

59
Q

What is TMJ SYNDROME?

A

1) Persistent symptoms involving the jaw eg headache, earache
2) General debilitation without local TMJ symtoms

60
Q

What are the symptoms of TMJ?

A

Jaw pain - popping, clicking, crepitis
Difficulty opening or closing properly
Tooth pain
Tonsillitis
Headaches
Sinusitis
Facial Pain
Tinnitus

61
Q

How would you diagnose TMJ?

A

Whole person dentisty

62
Q

What CS approach would you take to address TMJ?

A

Whole person evaluation - history of dental primaries
Consider dental or orthodontic assessment
Be alert symptoms could be TMJ Disorder
Contacts - mandible; maxillae - vomer - palatines; muscles of mastication; temporal bones. External contact for TMJ - energy drive.

63
Q

What are non dental factors affecting TMJ?

A

Stress - most common - teeth clenching and grinding
Injury to mandible
Temporal bone imbalance
CS imbalance anywhere in body - muscular pulls eg SCM muscles = asymmetry of temporals
Habit patterns - postural imbalances
Splints/ Bite plates - headaches and compression in upper jaw.

64
Q

What is cystitis?

A

Inflammation of the bladder.
Most common type of UTI.
Can be caused by UTI - bacterial
Symptoms - painful to urinate; burning sensation.
Infection may cause irritation to T12/L1 nerve roots - increased neurological activity which reinstates symptoms of recurrent cystitis even when the infection has passed.
TREAT - T10 to L2 - sympathetic supply to bladder
Pelvic Plexus - Inferior Hypogastric Plexus - where sympathetic nerves synapse
Sacral Levels: S234 - parasympathetic supply to bladder (pelvic splanchnic nerves)
Nerve pathways
Bladder itself
Fascial connections and epineurium around nerves

65
Q

What is IBS and how would you treat?

A

AKA Spastic colon - can include Ileo-caecal valve dysfunction. Bowel is irritated or in spasm due to excessive nerve stimulation - ANS stimulation due to stress. IBS can affect any part of the colon.
TREAT -
T10 to L2 and lower (can affect lower)
S234 - pelvic splanchnic nerves (as lower half of colon on left)
IBS on left might be caused by a fall on sacrum, horse-riding etc so treat holistically. Maybe restricted sacrum.
Ileo-caecal valve dysfunction would be right side - parasympathetic from vagus.

66
Q

What is Ileo-caecal valve dysfunction and how would you treat?

A

Junction between the Ileum (last part of small intestine) and Caecum (first part of colon/large intestine) which becomes contracted.
LOCATION - lower RIGHT of abdomen - locate McBurneys point between the top of the iliac crest on the right and 1/2 way towards the umbilicus.
SYMPTOMS - pain; tension; bloating
CAUSES - overstimulation of ANS due to stress - emotional tensions are transmitted here via ANS
Persistent stress = contracted ileo-caecal valve sphincter (THINK ANS SYMPATHETIC RESPONSE IS TO SHUT DOWN DIGESTION)
TREAT -
T6 to T10
Sympathetic synapse in superior and inferior mesenteric plexus
Solar plexus and coeliac ganglia.
Parasympathetic supply from VAGUS nerve
Emotions - solar plexus

67
Q

What is asthma and how would you treat?

A

Autonomic disturbance of lungs
T2 to T6 of sympathetic supply to lungs
Synapse at Pulmonary plexus
Parasympathetic from vagus nerve
CAUSES - shock in childhood or birth, near drowning accident, loss of O2 at birth, perpetual held shock.
SYMPTOMS - shallow breathing; breath holding; tension in upper thorax and T4; tightness in lungs.
CREATES - increased reactivity to allergens
sensitised emotional state - more activated by stress or anxiety
persistent anxiety - upper thorax contraction and breath holding
TREAT -
release underlying shock held in system
tight T2 to T6 is tight relating to disturbed ANS so all emotional centres particularly combined heart centre and SP; shock in diaphragm, shock in system; sub-occiput.

68
Q

What nerve innervates the stapedius?

A

The facial nerve via the chorda tympani.
The stapedius is a small muscle in the tympanic cavity of the middle ear. This tiny muscle attaches to the neck of the smallest human bone, which is called the stapes.
Clinical significance. Paralysis of the stapedius muscle may result when the nerve to the stapedius, a branch of the facial nerve, is damaged, or when the facial nerve itself is damaged before the nerve to stapedius branches. In cases of Bell’s palsy, a unilateral paralysis of the facial nerve, the stapedius is paralyzed and hyperacusis may result.

69
Q

What is the difference between ganglia and plexus?

A

Nerve plexus is a network of intersection nerves and made up of ganglia.

They are nerves originating in the spine whose destination is the same and they are grouped into one large nerve (like many lanes on a highway instead of several isolated roads).
There are six of these plexuses in the body:
Cervical (head, neck, and shoulders),
Brachial (chest, shoulders, arms, and hands),
Lumbar (back, abdomen, thighs, knees, and calves),
Sacral (pelvis, buttocks, genitals, thighs, calves, and feet),
Solar (internal organs)
Coccygeal (internal organs)

A ganglion is a mass of nerve cell bodies.
A plexus is made up of ganglia.
They are essentially the relay points of the entire nerve.

CCST (21 decks)

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