Test 1 Flashcards
When assessing ones CRI, we are assessing the ____
R-RADS
^** Rate, Rhythm, Amplitude, Direction, and Strength
For the vault hold, your index fingers are placed on the ____, middle in front of the ear and ring finger on the ____ of the temporal bone; and your pinkie finger on the ____
Also make sure your thumbs are ____ (On or Off?) the clavarium
The frontal-occipital hold, the doc contacts the ____ with the thumb and long finer while the other hand cups the ____
Greater wings of the sphenoid, mastoid process, occiput
Off
Greater wing of the sphenoid, occiput
Cranial flexion and extension occur around the ___/____ axis
1) During cranial flexion, the GWOS move ___/____ and the squamous portion of the occiput moves ____/_____, the SBS moves ____
^** Cranium changes include ____ A/P diameter, ____ Superior/Inferior diameter, and _____ R/L diameter
2) During cranial extension, the GWOS move ___/____ and the squamous portion of the occiput moves ____/_____, the SBS moves ____
^** Cranium changes include ____ A/P diameter, ____ Superior/Inferior diameter, and _____ R/L diameter
R/L Axis (aka transverse axis)
Anterior/Inferior, Posterior/Inferior, cephalad (aka superior)
Decreased, Decreased, Increased
Posterior/Superior, Anterior/Superior, Caudad (aka Inferior)
Increased, Increased, Decreased
During SBS flexion phase of the CRI, the sacral base moves ___ and this is called _____
During SBS extension phase of the CRI, the sacral base moves ____ and this is called ____
The sacrum for both nutation and counternutation is moving around the ___/___ axis
Posterior, Counternutation
Anterior, Nutation
R/L aka transverse (from OSCE), Superior sacral transverse axis (from Competency sheet), sagittal
BMT (Balanced Membranous Tension) is an ____ cranial manipulative treatment
You place the SBS or other cranial bones/joints in the ___ of the available range of motion and you resist CRI movement until it dampens and disappears, which is now called the ___… You maintain your hold until you feel the CRI return, and it should now be more symmetrical than before
*** So just know the Sill Point = Inability to feel the CRI
^ During the still point, some membranes stretch while others contract and once the tensions balance out, the CRI becomes more symmetrical and the ability to feel the CRI returns
Indirect
Midpoint, still point
During cranial flexion, your fingers will _____ and during cranial extension, your fingers will ____
So if your fingers slide apart, but have trouble coming together, you know it likes to live in cranial flexion, meaning it is restricted to cranial extension aka ___ SBS somatic dysfunction
Slide apart, come together
Flexion
The ethmoid bone is influenced by the ___ and ____
The ethmoid rotates around the ___ axis in the ___ plane in the ___ direction as the occiput
The lateral masses behave as paired bones into ____ rotation during cranial flexion and ___ rotation during cranial extension
The vomer moves in the same direction as the ____ and also moves in the transverse axis/sagittal plane
Sphenoid and falx cerebri
Transverse, sagittal, SAME
External, Internal
Sphenoid
For SBS Lateral strain, the sphenoid and occiput rotate in the ___ direction around 2 ____ axes in the ___ plane
^** The lateral strain is a side-to-side shearing of the _____, usually caused by trauma from a lateral force to one side of the anterior cranium or opposite side of the posterior cranium
The head takes on the resemblance of a ____**
^** So realize the parallelogram is seen in ___ strain patterns
SAME, vertical, transverse
Sphenobasilar symphysis
Parallelogram
Lateral
For a left lateral strain, the Basi-sphenoid has sheared to the ____ around its vertical axis and therefore both rotate to the ____ aka ___terior and your __ hand would slide on top
For a right lateral strain, the Basi-sphenoid has sheared to the ____ around its vertical axis and therefore both rotate to the ____ aka ___terior and your __ hand would slide on top
Left, right, posterior, left
Right, left, anterior, right
For SBS Vertical strain, the sphenoid and occiput rotate in the ___ direction around 2 ____ axes in the ___ plane
A superior vertical strain is when the sphenoid moves into ____ and the occiput moves into ____ aka they are both rotating ____ around their transverse axes and the docs thumbs move ____ aka forward
A inferior vertical strain is when the sphenoid moves into ____ and the occiput moves into ____ aka they are both rotating ____ around their transverse axes and the docs thumbs move ____
**Note, side to side findings are symmetrical
SAME, transverse, sagittal
Flexion, extension, anteriorly, away
Extension, flexion, posteriorly, back (towards the doc)
For SBS torsion strain, the sphenoid and occiput rotate in the ___ direction around the ____ axes in the ___ plane
The pattern is named for the more ___ greater wing of the sphenoid
A RIGHT torsion strain pattern occurs when the SBS moves into cranial flexion and the ___ GWOS moves more cephalad and the RIGHT occiput moves more caudad (aka the RIGHT basi-sphenoid is more SUPERIOR) and the docs hands has the ___ thumb point towards the doc and the ___ thumb moves away
A LEFT torsion strain pattern occurs when the SBS moves into cranial flexion and the ___ GWOS moves more cephalad and the LEFT occiput moves more caudad (aka the LEFT basi-sphenoid is more SUPERIOR) and the docs hands has the ___ thumb point towards the doc and the ___ thumb moves away
OPPOSITE, Anterior/Posterior, Coronal
Cephalad (superior)
Right, Right, Left
Left, Left, Right
For the torsion strain patterns, other changes are taking place in the bones and membranes including the
1) Temporal and Parietal bones have ____ rotation on the side of torsion
2) Mandible is shifted ___ the side of torsion
3) Orbit is ____ on the side of torsion
4) Falx cerebri has the ___ end rotate with the sphenoid and ___ end rotate with the occiput
5) Tentorium Cerebelli is ____ in the ___ direction that the occiput rotates
6) Spinal dura is ___ on the side of the low occiput
1) External
2) Towards
3) Smaller
4) Anterior, Posterior
5) Sidebent, Same
6) Inferior
For the side-bending/rotation strain patterns, there are 2 distinct motions that occur
1) Side-bending, which is referred to as the rotation of the occiput and sphenoid in the _____ direction around 2 ____ axes in the ___ plane
^** The pattern is named towards the side of _____
2) Rotation of the occiput and sphenoid in the ___ direction around the _____ axis (the same axis as torsion)
^** The rotation occurs towards the side of ____
So for an example, a RIGHT SB Rotation pattern = Sphenoid SB L, RR and Occiput SB R, RR
1) OPPOSITE, vertical, transverse
Convexity
2) SAME, A/P axis
Convexity
So RIGHT side-bending means that there is a convexity on the ___ side, which means the sphenoid has rotated to the ____ around its vertical axis and the occiput has rotated to the ___ around its vertical axis
Since the convexity is on the right, BOTH of them will rotate towards the ____ around the AP axis
Therefore, this is a RIGHT side-bending/rotation strain pattern
The docs hand has the right one moving more ____ and the distance between the fingers _____, while the left hand moves more ____ and the distance between the fingers gets ____
LEFT Side-bending/rotation strain pattern is the OPPOSITE
Right, Left, Right
Right
Caudad, increases (down and out), up, in (up and in)
For the side-bending/rotation strain patterns, other changes are taking place in the bones and membranes including the
1) Temporal and Parietal bones have ____ rotation on the side of convexity
2) Mandible is shifted ___ the side of convexity
3) Frontal bone and Orbit is ____ on the side of convexity
4) Falx cerebri is side-bent towards the side of convexity
5) Tentorium Cerebelli follows ____ motion
6) Spinal dura is ___ on the side of convexity (inferior occiput), which drops the sacral base ____ on that side
1) External
2) Towards
3) Anterior
5) Occipital
6) Inferior, inferior
For compression strain pattern, which occurs from pressure or trauma to the front of the head/face/back of head/ or entire periphery (like an infant cranium at birth), the strain manifests as a restriction (Mild OR Severe) to ALL motions at the SBS
With ___ compression, the cranium feels rigid
The CRI is slow, low amplitude, difficult to feel, and weak and the doc must use the ____ hold ONLY in order to apply the BMT technique
Severe
Frontal-occipital
Parietal bones move into ___ rotation with cranial flexion and ___ rotation with cranial extension
This is all occurring around the ____ axis in the ___ plane
During external rotation, the inferior border moves ____ while the superior border (aka the sagittal suture line) moves _____/____ aka ______ R/L diameter
During internal rotation, the inferior border moves ____ while the superior border (aka the sagittal suture line) moves _____ aka more medially aka ______ R/L diameter
External, Internal
AP axis, Coronal
Laterally, inferior/medially, increased
Medially, superior/laterally, decreased
___ bone dysfunctions are associated with headache, alteration of seizure threshold, and localized pain
____ bone dysfunctions are associated with headache, visual or smell disturbances (anosmia due to association with ethmoid)
____ bone dysfunctions are associated with OM, mastoiditis, tinnitus, hearing loss, dizziness, migraines, Bell’s palsy, neuralgia
Parietal
Frontal
Temporal
One can apply the parietal lift treatment to restore motion to the parietal bones when they are restricted to internal or external rotation
Patient supine, modified vault hold, contact ___ aspect of parietal bones with thumbs interlocked above the ___ suture
You then attempt to pull fingers apart, which increases pressure in the fingertips and moves the bones into ___ rotation, which should disengage the ____ sutures from the ___ bones
Once the parietals are disengaged, you apply a ___ force to distract the sutures and wait until a change in the CRI is palpated (the fullness is the parietal bones externally rotating)
Inferior, sagittal
Internal, inferior, temporal
Cephalad
For the frontal bone, the ____ suture’s functional presence is why is is named a paired bone
Just like the other paired bones, this rotates around 2 _____ axes in the ____ plane
It moves into ___ rotation during cranial flexion and ___ rotation during cranial extension
Metopic
AP axis, coronal
External, Internal
During external rotation of the frontal bone, the inferior/lateral angles move ____/____ and the glabella moves _____
^** This is associated with a ___ sloping forehead
During internal rotation of the frontal bone, the inferior/lateral angles move ____/____ and the glabella moves _____
^** This is associated with a ___ forehead
Laterally/anterior, posterior
Low
Medially/posterior, anterior
High bulging (aka prominent)
The frontal lift technique allows the frontal bone to perform its normal motion, and to free up the ___ aspects of the ___ suture
Patient supine, doc at head of table
The doc interlaces fingers above the frontal bone, with the _____ placed on the lateral angles of the frontal bone, with the heels of the hand just anterior to the ____ sutures
The doc then exerts a pressure of the interlaced fingers against each other during cranial extension aka internal rotation, which causes a ___ pressure against the frontal eminences to occur
Then the doc raises the frontal bone ____ (either unilateral or bilateral) and holds the motion as the frontal bone moves into external rotation and when tension release is felt then one can release and reassess
Inferior, coronal
Hypothenar eminences, coronal
Medial
Anteriorly
The 5-finger hold is done by using the thumb and index finger to grasp the ____, the middle finger is placed in the ____, and the ring finger is ____ to the ____ and the pinkie is ___ to it
If this were to be done unilaterally, the opposite hand cradles the occipital squama, _____ to the ____ suture
Zygomatic arch, external auditory canal, anterior, mastoid process, posterior
Medial, occipitomastoid suture
The temporal bones rotate around the ____ axis, in the ____ plane from the ____ to the _____
During cranial flexion, aka external rotation of the temporal bone, the superior border of the petrous portion moves ____/___ and the mastoid tip moves ____/____ which gives a ____ motion
During cranial extension, aka internal rotation of the temporal bone, the superior border of the petrous portion moves ____/___ and the mastoid tip moves ____/____
Oblique, coronal, jugular surface, petrous apex
Anterior/laterally, posterior/medially, wobbly wheel
Posterior/medially, anterior/laterally