SINUS Flashcards
Sinus SNS innervation
- T1-4, passes through cervical ganglia
- check in these areas for viscera-somatic changes
- superior cervical ganglia
Sinus PNS innervation
- CN VII (sphenopalatine ganglion)
- treat dysfunctional temporals, sphenoid, maxillary, and palatine bones
- also can treat ganglia with the pterygoid fascial stretch
Goals of Sinus OMT treatments
- relieve obstruction and pain, improve venous and lymphatic flow from the area, affect reflex changes, and improve mucociliary clearance
- upper thoracic and cervical dysfunctions should be evaluated and treated
- increase SNS; decrease PNS (runny nose=PNS)
Contraindications to Sinus OMT treatment
- fever greater than 102
- not on antibiotics if bacterial infection
- inflamed LN at the site
Pre- and Post-auricular drainage indication
-any dysfunction or lymphatic congestion in the ear region (i.e. otitis media or external with goal of improving lymphatic drainage of the anterior and posterior LN
Pre-and Post-auricular drainage treatment
- patient supine with head turned slightly toward physician seated at the side
- physician stabilizes patients head with cephalad hand and caudad hand is placed flat against side of head with finger pads over nodes with ear between third and fourth fingers
- caudad hand makes clockwise and counterclockwise circular motions, moving the skin and fascia over surface of skull
- procedure applied for 30 seconds to 2 minutes
Galbreath’s Technique (mandibular drainage) indications
- any dysfunction or lymphatic congestion in the ENT or submandibular region (speicfic aim of opening eustachian tubes) such as otitis media or increased barometric pressure (altitude changes) that induce ear pain or symptoms
- caution in patients with active TMJ dysfunction
Galbreath’s technique
- patient supine with head turned slightly toward doc standing or seated opposite side of dysfunction
- physician’s cephalad hand stabilizes the patient’s head, while caudad hand grasps the posterior ramus of the mandible with third, fourth, and fifth fingertips and hypothenar eminence resting alone the body of the mandible
- patient opens mouth slightly and doc applies an anterior (forward), medial and caudal traction and is then released
- procedure applied and released in a slow rhythmic fashion for 30 seconds to 2 minutes
Ear pull
-pull posteriorly and laterally along axis of the external auditory canal and wait for tissue release
Submandibular “walking” technique
-fingertips under angle of jaw and walk fingers toward chin and then walk them back
Anterior tracheal/deep cervical technique
- physician places fingers along lateral borders of trachea and gently induces movement from side to side
- may also pull superior to inferior to increase lymph and blood flow
Direct pressure and sinus milking
-patient supine, eyes closed and relaxed while doc is seated at head of table
Sinus milking for frontal sinus
- with thumbs, apply direct pressure over the frontal sinuses
- increase pressure gradually and release in a gentle, rhythmic motion
- cycle is repeated several times
Sinus milking for supraorbital notch
- gentle pressure applied over the supraorbital notch
- slide thumbs laterally along the eyebrow ridge bilaterally
Sinus milking maxillary sinus
- apply pressure over sinuses with thumbs
- milk nasal passages by applying downward pressure on either side of nose while sweeping laterally across the maxilla
Crossed thumb technique
- patient supine with the student seated at the head of the table
- the student crosses the thumbs so that the left thumb contacts the right nasal region and the right thumb contacts the left nasal region
- the student applies a force with the left thumb towards the midline and then releases followed by the same force with the right thumb
- this is continued by alternating the forces in a rhythmical manner
- this can be followed by a liking motion laterally across the maxillary sinuses bilaterally
Direct pressure to temporal area
- patient supine, eyes closed and relaxed while doc is seated at head of table
- direct pressure may be applied over the temporal areas by gently placing the thenar eminences in the temporal fossae bilaterally and compressing these areas between the hands.
- pressure is applied and released in gentle, rhythmic motions
Steps of counterstrain
- diagnose SD
- find a significant tender point
- establish pain scale
- wrap around the TP while monitoring
- reduce pain at least 70% (patient in position of comfort)
- slowly and passively return patient to neutral
- reassess somatic dysfunction (tender point)
Maxillary sinus TP counterstrain
- TP located just inferior to the infraorbital notch
- contact lateral curve of the zygoma with the thenar eminence of your hand
- compress medially and lift
Supraorbital TP counterstrain
- TP located over the supraorbital notch
- physician places one hand on forehead, pulling superiorly
- physician uses the other hand to pinch the nose and pull in the caudad direction
Condylar decompression
-physician cradles occiput with fingers and translates occiput superiorly, spreading the condyles apart
CV4 technique
- patient is supine with physician seated at the head of the table
- physician places thenar eminences on occiput medial to OM suture
- Follow extension (motion of the occiput is anterior) and resist cranial flexion until you reach a still point, then let CRI come back
