Test Part 2 - Dev Flashcards
Describe the motion of the sacrum during the extension phase of CS motion?
1 Mark
Apex of the sacrum moves posteriorly in extension phase
Describe in detail the dural attachments of the sacrum and coccyx.
2 marks
Foramen Magnum thruout its circumference.
C2, C3: attachment to anterior wall of vertebral canal.
Sacrum, S2: the anterior wall within the sacral canal at S2 (this is where spinal cord ends).
Coccyx, Co1: The Filum Terminale continues from the end of spinal cord to attach to the posterior surface of the 1st coccygeal segment.
pg 33 CSIF
With a hand under the sacrum how might you stimulate the cranial sacral system using the rhythmic motion?
1 Mark
Focusing on the rhythmic motion and noticing if there is a preference to expansion or contraction (or choosing a preference if there is none) and following the preference with awareness to encourage it into an extreme of motion (like pushing a swing) until a still point is induced.
Stimulus Chap 9 or energy drive page 417 or still point induction chap 33 or rhythmic motion chap 35.
In taking up a double contact with one hand under the sacrum and the other hand under the vertebral column, what do you consider to be the function of the a) sacral hand b) hand under spine c) connection between both hands 3 Marks
a) to harness the energy in the sacrum, a powerhouse of cranial sacral energy.
b) a target area and focus to which the therapeutic forces can be applied.
c) a channel for the enhanced flow of vitality between the two points.
How does the Spheno-Basilar Synchrondosis differ anatomically from most other joints in the skull?
1 Mark
It’s a cartilaginous joint, whereas most joints in the skull are fibrous sutures.
BONUS) A synchondrosis is a cartilaginous joint which starts life as a cartilaginous joint and gradually ossifies. The ossification in the SBS is considered to be complete by around the age of 25. The SBS starts life with a pliable section of rubbery cartilage between the 2 bones of the joint.
How does this anatomical difference affect the SBS function?
1 Mark
The SBS is more mobile than most joints in the cranium. Cartilaginous joints are able to move more freely that sutures especially in early life.
Why is the functional difference of the SBS to other joints considered to be significant in CS therapy?
1 Mark
The increased mobility and also because of its central position, means the SBS is affected by strains from elsewhere in the cranio-sacral system, particularly in early life. Asymmetries from all over the body are reflected into the SBS, creating corresponding asymmetrical patterns. Thus, the SBS provides a window from which we can view everything going on in the CS system, and also engage with these patterns from the SBS. Sutherland devised the theory of the 6 SBS patterns from this theory.
Describe a left side-bending pattern of the SBS in terms of what is happening at the SBS and how it feels to the therapist?
2 marks
At SBS - there is a gapping between the sphenoid body and the basi-occiput on the left side, with a narrowing on the right side. The therapist will experience the head bulging on the left side, with the right side seeming to caving in.
Describe a right sided torsion pattern of the SBS in terms of how it feels to the therapist?
1 Mark
With thumbs on the tips of the greater wings of the sphenoid, the therapist will experience the right hand thumb moving superiorly towards the therapist and the left thumb moving inferiorly away from the therapist.
Give the name and root origin of the peripheral nerve associated with Carpal Tunnel Syndrome.
2 marks
Median Nerve - C678, T1,
BONUS) Pathway from its roots at C678, T1, through neck, via brachial plexus below the clavicle and above the first rib, passing unimpeded (unlike ulnar nerve) thru soft tissues at the front fold of the elbow, thru the carpal tunnel at the wrist where its susceptible to injury (unlike ulna nerve), passing on its way thru the fascia of neck, shoulder, arm, forearm and hand to the thumb, forefinger and middle finger. - digits 1,2,3.
Give the name and root origin of the peripheral nerve that supplies the digits of 4 and 5 of the hand
2 marks
Ulna Nerve - C78, T1
BONUS) Pathway from its roots in C78,T1, through the neck, via brachial plexus below the clavicle and above the first rib, behind the medial epicondyle of the elbow (funny bone) where its susceptible to injury (unlike median nerve), (missing the carpal tunnel at the wrist, unlike the median nerve), passing on its way thru the fascia of neck, shoulder, arm, forearm and hand to digits 4,5.
What are the root origins of the Sciatic Nerve
1 Mark
L45, S123
BONUS) Pathway is from the spinal cord at or above L2, then travel through lumbar cistern as cauda equina, then penetrating the dura at or above S2 to leave the actual vertebral column as nerve roots at levels L45,S123. Then onto the posterior thigh and lower leg dividing into common peroneal nerve to the lateral and anterior leg and foot, and tibial nerve to the posterior leg and sole of the foot.
Which nerve root emerges between C7 and T1
1 Mark
C8
BONUS) Cervical nerves emerge ABOVE the vertebra of the same number, while all other nerves of the spine emerge BELOW the vertebra of the same number, leaving a nerve BELOW C7 and above T1, the unicorn C8.
What sympathetic levels are associated with the head and eyes?
1 Mark
T1, T2.
BONUS) The sympathetic nerves of head and eye synapse in the SCSG at level C4321.
What sympathetic levels are associated with the thoracic viscera (heart and lungs?)
1 Mark
T2 - T6
What sympathetic levels are associated with upper abdominal viscera - stomach; pancreas; spleen; liver; gall-bladder
1 Mark
T6 - T10
What sympathetic levels are associated with lower abdominal viscera - colon; uterus; prostate; genetalia
1 Mark
T10 - L2
What viscera and other mechanical and emotional associations would you associate with the thoraco-lumbar junction T12/L1?
1 Mark
Mechanical; Transition area between the thoracic spine above the lumbar spine below, and the junction between the thoracic kyphosis above and the lumbar lordosis below. Consequently, it is an area of postural stress from standing on 2 legs, and compressive forces and injury from sport; jogging; horse riding; falls.
Attachment of crura (tendinous legs) of diaphragm to vertebral column. Thus, its a emotional holding which causes shallow breathing will impact this area, or vice versa.
Neurological; Major sympathetic outflow T10 to L2 to:
Kidneys; adrenals; bladder; large intestine (colon); uterus; ovaries; prostate; genetalia and all pelvic organs. Thus T12/L2 is crucial in dysfunction related to these viscera eg menstrual disorders; IBS; cystitis; erectile dysfunction; kidney disease.
What viscera and other mechanical and emotional associations would you associate with T9?
2 mark
Mechanical; Apex of thoracic curve subject to strain due to anterior-posterior postural imbalances.
Neurological; T9 is vertebral level most associated with Solar plexus and coeliac ganglia. It has strong empirical links with adrenal glands. Thus associated with stress and pressure, and over stimulation of the SNS.
What viscera and other mechanical and emotional associations would you associate with T4?
2 mark
Mechanical; T4 is the root of the neck and the base of Littlejohn’s upper triangle. So conditions of the neck affect T4 and vice versa.
T4 is the junction of Littlejohn’s Upper Triangle and Large Triangle and thus a meeting point for stresses, strains, injuries from above and below intertwining with whole person ramifications.
Neurological; T4 is the focal area of sympathetic outflow to heart and lungs and the cardiac and pulmonary plexi. And so likely involved in conditions affecting heart and lungs, including asthma.
Emotional; T4 is associated with Heart chakra and so involved in anxiety and grief (often asthma has an anxiety component).
Physical therapies recognise T4 syndrome, at the physical level, CST considers the integrated effects of physical and emotional interactions.
Also, Thymus chakra, Thymus gland,
Thoracic inlet - transverse structure
What vertebral levels would you associate with the eyes?
2 marks
T1, T2 for sympathetic outflow, with the nerves synapsing in the SCSG at level C4321.
What vertebral levels would you associate with the lungs?
1 Mark
T2 to T6
What vertebral levels would you associate with the duodenum?
1 Mark
past exam = T7 to T9
book = T6 to T10
Pt6a = T6 to T11
What vertebral levels would you associate with the Ileo-caecal valve?
1 Mark
past exam = T10 to T11
book pg 394 = T10 to T12
Pt6a = T10 to L2
