Stage D Flashcards
Describe the process of a Falx release
a) how you would do it
Hand over Frontal, hand under Occiput.
Follow Cranio-Sacral motion and twists and turns
Hold onto stillness until release occurs
During the process of a Falx release
b) what you might feel in the patients CS system
1) CS MOTION
In flexion - frontal area arcs forward and down and occiput tucks under towards the neck - HEELS OF HANDS MOVE AWAY FROM EACH OTHER
In extension - the opposite motion occurs and the HEELS OF HANDS DRAW TOWARDS EACH OTHER.
2) TAKING UP THE SLACK
After a release, instead of returning to neutral can take up the slack which means that therapists follow deeper into the softened and released tissues, until it draws into the next point of balanced tension, stillness and release. Hands keep moving through the different layers moving deeply into the cranium towards the jugular foramen or foramen magnum until you find the source. When the source of restriction is found, slowly come out of slack back to neutral. Reorganise.
- FOLLOW INTO EXTREMES OF MOTION
When in a balanced neutral state, with CS motion in CSR or mid tide, see if system wants to draw more into flexion or extension. IF unsure - ask the system. Useful to bring certain patterns into focus and address persistent patterns. - SUBTLE INTEGRATION
Just sitting with neutral and seeing what else evolves in the system - giving space. Rhythmic cycles may stop as system deepens. - RECIPROCAL TENSION MEMBRANE SYSTEM
Falx cerebri above and Falx Cerebelli below blend into the tentorium cerebelli at the straight sinus which affects the whole reciprocal tension membranes in other parts of the body, so may notice other transverse diaphragms relaxing or realigning because tentorium is being released through falx contact. Includes membranous attachments to C2, C3, S2 and coccyx so working at falx may feel repercussions all the way down the spine. Powerful for whole longitudinal membrane system.
Describe the process for the Mastoid Tip contact?
1) Gently roll head from side to side and lift the head
2) Place hands under back of head, fingers of one hand crossing fingers of the other to create a V shape and comfortably support the occiput.
3) PADS of thumbs on TIPS of the MASTOID PROCESSES.
4) Check levels of physical contact, attention and tissue connection.
5) Evolution of inherent treatment process - Engage, Allow, Follow, Stillness, Release, Reorganise
6) Rhythmic motion may surface as CSR or Mid Tide - follow into any extremes
7) Thumbs may feel the Mastoid processes drawing medially, follow this until it reaches balanced point of tension, stillness and release.
8) Feel system soften.
For what purposes is the mastoid tip contact useful?
Choose any - taken from book:
1) MASTOID TIPS MOVING MEDIALLY = encourages the squamous part of temporal bones into external rotation - which will stretch the tentorium and straight sinus. - Impact reciprocal tension membrane system.
2) ENGAGING WITH WHOLE SYSTEM - so whole system will respond
3) HELPS RELEASE OCCIPITO-MASTOID SUTURES - so releasing restrictions and compressions in the Jugular Foramina which many structures pass through, including Jugular Vein for venous drainage.
4) HELPS RELEASE SUB-OCCIPITAL AREA - and structures associated with this region - arterial blood to brain, sympathetic nerve supply to head;
JUGULAR FORAMEN - Spinal Accessory Nerve; Vagus etc
6) DRAINAGE OF EUSTACHIAN TUBE - from middle ears
7) INTEGRATION OF WHOLE TEMPORAL/OCCIPITAL and CERVICAL REGION
8) CLEAR VANTAGE POINT FOR SPINE and REST OF BODY.
9) CONDTIONS - ear infections; tinnitus; headaches from poor venous drainage, colic, nausea, respiratory or digestive issues
What are the nerve root origins of the Sciatic Nerve?
L45, S123
What are the symptoms of sciatica?
Shooting pain down the back of one leg or both from buttocks downwards
Sometimes also pins and needles, numbness or weakness
Sciatic nerve = longest and largest nerve in body
Nerve travels through opening in pelvis called Greater Sciatica Foramen.
Where nerve divides (peroneal and tibial) to serve posterior lower leg and foot - so pain anywhere along this pathway.
Can cause foot drop (L5)
What are the causes of sciatica?
Causes - spinal stenosis; degenerative discs; sacro-iliac joint dysfunction - L5 sits on top of SI joint; pregnancy; scar tissue; spinal tumour; inflammation of spine. Falls compressing spine.
L5 is principle site of outflow for sciatic nerve
L5 - significant mechanical pivotal area - carries whole weight of vertebral column above;
accommodates twists, turns and bends;
Angle between L5 and S1 is acute and vulnerable
Piriformis muscle sits above Greater Sciatica Foramen - if piriformis spasms, causes sciatic symptoms
What is the Superior Cervical Sympathetic Ganglion?
The uppermost ganglion of the sympathetic chain
Located at level C1-C4 bilaterally (sub-occiptital region)
Pathway and area of synapse for the sympathetic nerve supply to the head and eyes
Where is the Superior Cervical Sympathetic Ganglion located?
C2 and C3 which is also the same as where the bony attachments to the membrane at C2 and C3.
What is the Superior Cervical Sympathetic Ganglions function and significance?
Part of the pathway of sympathetic nerve supply from the body to the head, neck and heart.
Hypothalamus sends pre-ganglionic fibres down spinal cord which emerge T1/T2 of sympathetic chain.
Travels up through inferior, middle and synapses at superior cervical sympathetic ganglion. Contributes to carotid plexus.
Travels via carotid canal as carotid nerve (with carotid artery) - up through cavernous sinus to be distributed in cranium.
Name 5 sympathetic functions and 5 parasympathetic differences?
P - Pupils constrict - Parasympathetic fibres from Oculo-motor nerve
S - Pupils dilate - sympathetic fibres from sympathetic chain emerging from T1/T2 via SCSG as carotid nerve to head.
P - Increases stomach movement and secretions - vagus
S - Decreases stomach movement and secretions - T6 to T10
P - Saliva production increases - parasympathetic fibres from Facial and Glossopharyngeal nerve.
S - Saliva production decreases - Facial and Glossopharyngeal nerve.
P - Increase in urinary output - Pelvic Splanchnic Nerves S2234
S - Decrease in urinary output - T10 to L2
P - neurons are cholinergic: acetylcholine
S - neurons are mostly adrenergic: epinephrine / norepinephrine (acetylcholine)
P - Rest and digest
S - Fight-or-flight
P - Longer pathways, slower system
S - Very short neurons, faster system
P - Counterbalance; restores body to state of calm.
S - Body speeds up, tenses up, becomes more alert. Functions not critical to survival shut down.
P - Decreases heart rate - vagus
S - Increases contraction, heart rate
P - Bronchial tubes constrict - vagus
S - Bronchial tubes dilate - via T2 to T6
P - Muscles relax
S - Muscles contract
The parasympathetic nervous system is one of the two main divisions of the autonomic nervous system (ANS). Its general function is to control homeostasis and the body’s rest-and-digest response.
The sympathetic nervous system (SNS) is one of two main divisions of the autonomic nervous system (ANS). Its general action is to mobilize the body’s fight-or-flight response.
Function
P - Control the body’s response while at rest.
S - Control the body’s response during perceived threat.
Originates in
P - S234 and Cranial nerves 3, 7, 9, and 10
S - Thoracic and lumbar regions of spinal cord T1 - L2
Why is an understanding of the anatomy of the nervous system, in terms of both SPINAL outflow and distribution, potentially useful in diagnosis and treatment in CS therapy? Give 2 examples (so this is peripheral nerves).
As a therapist we need to think about not just about treating the presenting symptom but think about tracing the symptoms to the root cause.
Understanding the relationship between the dural levels (and therefore the vertebral levels) and the viscera (organs, muscles, limbs)
Enables a better diagnosis so appropriate treatment can be given with a clearer treatment plan.
- Sciatic Nerve - originates in SPINAL root origin L45, S123. So pain in posterior thigh, lower leg, foot or toes may originate in the lumbar spine (Lumbo-sacral plexus)
- Ulnar Nerve - originates in SPINAL root origin the C78 - T1. Neurological symptoms - numbness; pins and needles; pain - may originate in the lower neck (Brachial plexus).
How might you identify emotional characteristics in a patient through the CS process?
From 1st interaction - noticing breathing, pace of speech, level of eye contact, how the body is being held - open and expressive, hunched and carrying the weight of the world, facial expressions - expressive or flat affect; obvious emotion through talking - becoming teary or sounding angry; non-verbal body language - what the person isn’t saying; how the person talks about trauma - in touch with feelings or absent of feeling - deeply buried.
What does the quality of the system feel like on tuning in.
What organs am I drawn to work on and what emotional characteristic are associated.
Is there avoidance during the treatment which prevents emotion being released - fidgety; coughing.
What does the quality of the emotional centres feel like.
Are they in touch with their feelings.
Is breath being held in the system.
What do the sympathetic plexi feel like - agitated; calm; volcanic - name the quality.
In core treatment are temporals jumpy suggesting restlessness.
What is the quality of certain viscera?
What does the quality of the emotion feel like at completion?
Can the patient ‘map’ where they hold emotion?
1) Observe - manner; posture; breathing
2) Symptoms - physical has emotional connection
3) Case history - what’s being said; what’s not being said
4) Palpation - psycho-emotional factors lie in quality of system.
Assess - quality of system, tissue tension; fascia; sympathetic nervous system; breathing; response of system eg is it contained?
Know areas that hold emotion - emotional centres and sympathetic plexi; sub-occipital region; throat; shoulders and neck; viscera
Give four ways which personal development can be helpful as a CS therapist?
Know your own fulcrums and what triggers them, becoming more self aware.
Knowing what you need to do to stay grounded and be present.
Knowing about transference, counter-transference and projection how that can unfold in the treatment.
Knowing what is the patients and what is the therapists ‘stuff’.
Establishing safe and clear boundaries as professional therapist
Self care during and outside of treatments, in better space for the client
To be able to hold the space no matter what comes up in the treatment
Name eight factors in fascial unwinding? ABUFOSSE
1) Articulation - check for range of movement, loosen limb, relax patient, release superficial tensions, assess overall quality.
2) BREAK - to ensure distinction from articulation and unwinding as these are very different.
3) Unwinding - engage, allow, follow, softness, fluency, own fulcrums, take care not to impose
4) Maintain Focus - calm meditative state, balanced elastic attention
5) Maintain Overview - whole limb, whole person, finer detail and wider picture, connections
6) Points of Stillness - identify - most important factor in unwinding
7) Staying with Stillness - dynamic quality in tissues - feel edge of resistance, stay with stillness -
CONTAINMENT
8) Ending - reach natural conclusion following release
