Sinuses & Cerebral Drainage Flashcards
Name the 4 pairs of air sinuses
Frontal; maxillary; sphenoidal; ethmoidal
How do these air sinuses drain?
Through openings in the nasal cavity
Where does the frontal sinus drain into?
Nasal cavity
Where is the maxillary sinus and what drainage problems might occur due to its location?
Forms the floor of the orbit - the hole to drain into nasal cavity is small and is overlapped by lacrimal bone
Where is the sphenoidal sinus and what drainage or other problems might occur due to its location?
Hollow space in Sphenoid body - drains into nasal cavity. OPTIC NERVE; CAROTID ARTERIES; CAVERNOUS SINUS lies laterally so there is a risk of infection spread.
Where is the ethmoidal sinus and what drainage or other problems might occur due to its location?
20 small cavities drain into nasal cavity BUT bony wall between sinus and ethmoid is thin - possible spread could cause eye infections or spread up through cribriform plate = meningitis or encephalitis.
Why is sinus drainage difficult?
Because holes for drainage are tiny and location means drainage is difficult.
Excess mucus production clogs nasal cavity = inflammation of nasal cavity which both reduce size of holes and reduce effectiveness of cilia to move mucus towards nasal holes.
What factors contribute to sinusitis?
Hard nose blowing - pushes infectious organisms back up the nasal cavity into the sinuses.
Allergies
Hard for the body to clear naturally.
Sympathetic overstimulation may inhibit secretions, leading to dryness and irritability of mucous membranes. Excessive sympathetic overstimulation will mean hypersensitivity to irritants, allergens = dry nose, mouth, skin, hay fever, sinusitis. Many of these sympathetic fibres travels with parasympathetic fibres from facial nerve passing through pterygopalatine ganglion.
What are sinuses lined with?
Mucus membranes
What is the role of the cilia in sinuses?
To trap and clear inhaled particles and infectious organisms.
To move mucus towards holes for drainage.
What factors contribute to effective sinus drainage?
1) Structural - restrictions in bones in cranium and ;face/ mobility of bones and CS rhythm. CS motion PUMPS to promote drainage.
2) Immunity - decreased immunity = increased colds; infections. Allergies; sensitivities; dust; pollen - increase mucus.
3) Lifestyle - chemical irritants; smoking; drugs
4) ANS Stimulation
How does ANS Stimulation effect sinus drainage?
Sympathetic overstimulation may inhibit secretions, leading to dryness and irritability of mucous membranes. Excessive sympathetic overstimulation will mean hypersensitivity to irritants, allergens = dry nose, mouth, skin, hay fever, sinusitis. Many of these sympathetic fibres travels with parasympathetic fibres from facial nerve passing through pterygopalatine ganglion.
Parasympathetic ganglia in the head. Receive parasympathetic fibres from the facial nerve to lacrimal and nasal glands, mucus membranes and sinuses.
Dysfunction of parasympathetic fibres of facial nerve =
Dry eyes or excessive lacrimation
Reduced or excessive secretions of mucus in nose and sinuses and saliva in mouth
Whole person
Integration of face, cranium and system as a whole.
Consider nerve pathways, location of parasympathetic ganglia, foramina, membranous attachments,
Use cranial or facial contacts
Addressing disturbances to pterygopalatine ganglion = palatines, maxilla, vomer and sphenoid.
How would you approach treating sinusitis - what would be the aims?
To reduce inflammation
Improve drainage
Increase mobility of bones
Improve CS rhythm
Reduce ANS sympathetic stimulation
Address lifestyle factors eg smoking; stress; diary; sugar
How would you treat someone with sinusitis?
CS integration
Case history - bacterial or viral
Heart Centre - stress/ immune system
Thymus gland - immune system
Solar Plexus - stress and reduce symp. overstimulation - sinusitis can often cause congested chest area.
Cranium - free mobility as a whole
Facial bones - free mobility
CV4 - pump
Sympathetic supply into head
Parasympathetic supply - facial and glossopharyngeal nerves - attention to pterygopalatine ganglion and disturbances there so attention to palatines, maxilla, vomer and sphenoid.
Falx release - membrane tension/ restrictions - common contracted membranes and pain in the cranium
Nasal and lacrimal bones - compressions
Bones with sinuses - frontal; ethmoid; maxillary and sphenoidal.
Eustachian tube - support drainage so temporal contacts; spheno-temporal suture; free mobility of temporal and sphenoid bone.
Jugular Foramen - venous drainage and healthy vagus nerve to promote overall health. Prolonged cranial congestion - the symptoms of headaches; tired eyes; unclear thinking; poor memory; reduced concentration.
can lead to sinusitis.
Advice re diet eg avoid dairy - mucus producing and foods causing inflammation.
What do you need to be mindful about if a client says they have sinus pain
To check its not an infected nerve root tooth decay.
What are mastoid air cells?
Similar sinus like structures forming smaller air spaces in mastoid portion of temporal bone. NOT connected to sinuses. DO NOT drain into nasal cavity. Located posterior to middle ear - susceptible to infection spreading from middle ear.
What is mastoiditis?
Complication of recurrent middle ear infections and glue ear. Can break through mastoid portion of temporal bone into cranial cavity = meningitis; encephalitis.
How would you treat mastoiditis?
Be aware of potential spread
Treat as would do middle ear infection.
Why is cerebral drainage important? - CALV
Promote free flow of:
CSF
Arterial blood
Lymphatic drainage
Venous blood and drainage
It is important for the proper functioning of brain and because restriction to flow is common.
What causes restriction to cerebral drainage?
Restriction of free mobility of bones - affecting free CSF flowing
Sub-occipital tension
Restriction around the cranial base
Constriction of venous sinuses
Meningeal inflammation
Emotional tension affecting transverse structures
What are the symptoms of cranial congestion?
Headaches; tired eyes; unclear thinking; poor memory; reduced concentration.
If prolonged leads to: sinusitis; migraines; cranial nerve dysfunction; hormonal dysfunction.
To improve cerebral drainage where would you start?
Whole person - case history; observation; palpation.
Open system - emotional centres:
1) heart centre (to reduce sym stim in cardiac and pulmonary plexi; jugular vein passes through thoracic inlet back to heart.
2) Solar plexus - (reduce tensions in caeliac plexus which creates sympathetic stim up through T1 and into cranium; diaphragm)
3) Combined release balances heart and SP and sym overstim held in these areas.
4) Sacrum - if sacrum unbalanced, rest of system can not be balanced - power house for vitality.
5) Sub-Occip - pathway of sym nerve supply to head via Carotid nerve and Jugular Vein passes through JF to drain venous blood back to heart.
Core Treatment:
1) Fascial unwinding of neck = release tensions in neck area, subocciput down to T4.
2) Mastoid Tip - open base of cranium, release occipito-mastoid sutures and open JF for venous drainage. Stretch tentorium = reciprocal tension membrane system, affects sinuses, particularly TRANSVERSE and STRAIGHT sinus.
3) Ear Hold - draw along petrous portions of temporal bones which is the axis for rotation for temporal bones.
Visualise - temporals opening up along spheno-temporal sutures and occipito-mastoid sutures. Easing out of wedged position between sphenoid and occiput.
Visualise - JF opening - create more space for JV.
Visualise - straight sinus opening in response to tentorium being stretched. All sinuses along their path towards the jugular vein opening.
4) Falx Release - fluid flow is formed and contained within membrane system. Connect with intra-cranial membranes and whole reciprocal tension membrane system - release intracranial membranes down to FM and spinal dura down to coccyx. AS membranes release = sinuses become looser; expanded = more free flow. Can introduce still point through following CS motion of falx.
5) Treat venous sinuses - Transverse; Confluence; Superior Sagital
Completion - integration - Temporals
Why is free flow of CSF essential to a healthy CNS?
Provides nutrition and drainage for brain and spinal cord.
Not good if CSF is static or stagnant
CSF is produced and constantly reabsorbed so fresh flow is essential to health.
Where is CSF found?
Ventricular system and subarachnoid space
