Savarese Ch 9: Craniosacram Motion Flashcards
What makes up the primary respiratory mechanism (PRM)?
CNS + CSF + Dural Membranes + Cranial bones + Sacrum
What does the PRN do?
Control and regulate pulmonary respiration (secondary respiration), circulation, digestion, and elimination.
What 5 anatomical-physiological elements compose the PRM?
- The inherent motility of the brain and spinal cord.
- Fluctuation of CSF
- The movement of the intracranial and intraspinal membranes.
- The articular mobility of the cranial bones.
- The involuntary mobility of the sacrum between the ilia.
What happens to the brain and spinal cord in the exhalation phase?
Lengthens and thins
What happens to the brain and spinal cord in the inhalation phase
shortens and thickens
Normal Cranial Rhythic Impulse rate:
10-14 cycles per minute
What are 4 factors that decrease the rate and quality of the CRI?
- stress (emotional, physical)
- Depression
- Chronic fatigue
- Chronic infections
What are 3 factors that will increase the rate and quality of the CRI?
- Vigorous physical exercise
- systemic fever
- Following OMT to the craniosacral mechanism.
What are the dural attachments?
Trigger Point
Foramen magnum, C2, C3, and S2 (posterior, superior surface)
What is the Reciprocal Tension Membrane (RTM)?
The dura. it is inelastic - and due to its connections combined with the inherent motility of the CNS - you get cranial bone motion
Through what axis does the involuntary mobility of the sacrum between the ilia occur?
slight rocking motion of the sacrum occurs about a transverse axis that runs through the superior transverse axis of the sacrum
What are the articulations that make up the sphenobasilar synchondrosis (SBS)
sphenoid with the occiput.
KEYSTONE OF ALL CRANIAL MOVEMENT
What are the midline bones of the cranium?
sphenoid, occiput, ethmoid, vomer
During flexion of the SBS and midline bones, what happens to paired bones?
External rotation
What happens to the sacral base during flexion of the SBS? aka COUNTERNUTATION
it moves posterior through the superior transverse axis.
What does crainoflexion due to the AP diameter of the cranium/
DECREASES IT.
widen the head
What axis is used for torsions
Anterio-posterior axis
How are torsions named?
Named for the greater wing of the sphenoid that is more superior
What motions and through which axis do we find in Sidebending/Rotation?
Rotation: through AP axis through the SBS
Sidebending occurs about two parallel vertical axes - one axis passes through foramen magnum and the other through the center of the sphenoid.
In torsions, the occiput and the sphenoid rotate in the ______(Same/opposite) direction?
Opposite
In Sidebending/Rotation strain pattern, the sphenoid and the occiput rotate in the _____(Same/opposite) direction?
Same
What are the physiologic strain patterns?
Torsions and
Sidebending/Rotation
For a sidebending/rotation strain pattern:
If the sphenoid and occiput are inferior on the left, how is this named?
Left sidebending
What happens in a Vertical Strain?
Is present when the sphenoid deviates cephalad (superior vertical strain) or caudad (inferior vertical strain) in relation to the occiput.
What axis is involved with vertical strain?
2 transverse axis:
one through center of the sphenoid
other superior to the occiput
When is a lateral strain present?
sphenoid deviates laterally in relation to the occiput
Lateral strain: the sphenoid deviates to the right. How would this be named?
Right lateral strain
What axis are present in lateral strain patterns?
two vertical axis:
one through the center of the sphenoid
Other through foramen magnum
What can cause a compression strain pattern?
trauma to the back of the head
CN: I
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Cribiform plate;
sphenoid; frontal; ethmoid
altered sense of smell
CN: II
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Optic canal;
Sphenoid, occiput;
Visual changes
CN: III
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Superior orbital fissure;
Sphenoid, temporal
Diplopia, ptosis, or accommodation problems
CN: IV
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Superior orbital fissure;
Sphenoid, temporal
Diplopia
CN: V1
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Superior orbital fissure
sphenoid; temporal
Decreased sensation to eyelid and scalp
CN: V2
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Foramen rotundum;
Sphenoid, temporal, maxillae, mandible
Tic Douloureux
CN: V3
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Foramen ovale;
Sphenoid;
Decrease sensation to the mandible
CN: VI
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Superior orbital fissure;
Sphenoid, temporal
Diplopia, esotropia
CN: VII
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Enteres internal acoustic meatus and exits the stylomastoid foramen;
sphenoid, temporal; occiput
Bell’s Palsy
CN: VIII
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Internal acoustic meatus;
Sphenoid, temporal, occiput;
Tinnitus, vertigo, or hearing loss
CN: IX
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Jugular foramen;
Temporal, occiput
CN: X
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Jugular foramen;
Temporal, occiput, OA, AA, C2;
Headaces, arrhythmias, GI upset, respiratory problems
CN: XI
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Spinal divisions enter formaen magnum joins with cranial divisions and exits the jugular foramen;
Temporal; occiput;
Tenderness in the SCM or trapezius
CN: XII
Exits the cranium:
Somatic dysfunction of:
Symptoms associated with dysfunction:
Hypoglossal canal;
Occiput;
Dysphagia
What is the goal of craniosacral treatment?
…. is to reduce venous congestion, mobilize articular restrictions, balance the SBS and enhance the rate and amplitude of the C.R.I.
What is the purpose of the venous sinus technique?
To increase venous flow through the venous sinuses (responsible for 85-95% of drainage from cranium into jugular) so that blood may exit the skull through the jugular foramen.
What is the purpose/effect of the CV4
To enhance the amplitude of the CRI
CV4 will increase the amplitude of the CRI
What is the purpose of the vault hold?
To address the strains at the CBS
What is the purpose of the V spread?
To separate restricted or impacted sutures.
What is the purpose of the lift technique?
Frontal and parietal lifts are commonly used to aid in the balance of membranous tension.
