Review: Clinical Applications of OCMM Flashcards
Otitis media may result in association with cranial SD. Where does the eustachian tube anatomically lie?
In the groove between the petrous temporal bone and greater wing of the sphenoid
Note that the narrowest caliber of the tube is as it leaves the cranium before entering the nasopharyngeal tissue — thus the area most likely to cause restriction or blockage is at the cranial base where the sphenoid and temporal bones meet
Head pain may be related to distention, traction, or dilation of intracranial or extracranial arteries. What are some examples of arteries that may be implicated?
Middle meningeal, superficial temporal
Arteries within the dura: proximal parts of anterior and middle cerebral aa and intracranial portion (pain sensitive) of internal carotid — proximity to tentorium!
Impairment of veins can also lead to headache with traction or displacement of the large intracranial veins or their dural envelope. What are some cranial vv with a dural envelope?
Superior and inferior saggital sinus
Straight sinus
Transverse sinus
If there are dural strain patterns secondary to impaired motion of cranial bones, restoration of normal motion to cranium can improve venous drainage.
If a pt presents with frequent headaches and exam reveals hypertonic cervical muscles, and you treat with suboccipital release, what additional structures are you addressing?
C1-C2-C3 in cervical plexus
Note relationship of superior cervical ganglion (sympathetic to head/face) to second cervical vertebra
Note relationship of C1 to inferior ganglion of vagus
Pt presents with paralysis of right side of face with sudden onset and no hx of trauma. You dx them with Bell’s palsy. What bone does the facial nerve pass through and what tx may help the pts symptoms resolve?
Temporal
Case study: Correction of marked external rotation of the temporal with sphenobasilar flexion and SB rotation led to improvement in paralysis
[other clinical considerations are supratentorial sensory info referred anteriorly via trigeminal n., infratentorial sensory info referred to vertex and posterior head and neck by the upper 3 cervical nn; CN 7, 9, and 10 refer pain to nasoorbital area, ear, and throat]
Pt presents with trigeminal neuralgia with distribution in maxillary region (V2). How might cranial dysfunction lead to these symptoms?
Sensory impulses from the forehead, orbit, anterior and middle fossae of the skull, and the upper surface of the tentorium are all transmitted by trigeminal n. (Mostly V1 and V2)
V1 emerges from superior orbital fissure
V2 emerges from foramen rotundum
V3 emerges from foramen ovale
Both ovale and rotundum are located in sphenoid bone and the trigeminal ganglion lies on temporal bone (in meckel’s cave on superior surface of petrosal ridge) - where the tentorium cerebri is tightly attached!; if the temporal bone has an external rotation SD, there would be pressure on this ganglion via the tentorium
Examples of nervous system and balance benefits of OCMM
Babies with plagiocephaly (“crooked head”)
Healthy geriatric pts improved balance and equilibrium
Dizzy pts had reduction in symptoms
Healthy college students able to fall asleep faster and sleep longer
Concussion and TBI tx
A blow just above the left asterion or to the right temple would result in what type of cranial SD?
Left lateral strain
An inferiorly directed blow to the lambda/posterior sagittal area OR a superiorly directed blow to the mentum of the mandible would result in what type of cranial SD?
SBS inferior vertical strain
A superiorly directed blow to the inion/subocciput OR an inferiorly directed blow to the forehead would result in what type of cranial SD?
SBS superior vertical strain
A blow to the left temporal squama would cause what type of cranial SD?
Right sidebending rotation
[and vice versa with blow to right temporal squama —> left SB rotation]
