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22 Cards in this Set

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How is the cranial treatment outcome rated after treatment?
4. excellent - normal CRI, no restrictions, symmetric SBS mechanics

3. good - CRI improved, minimal restriction, mobile/asymmetric SBS

2. fair - CRI altered, residual restriction, asymmetric SBS

1. poor - no CRI altered, significant restriction, asymmetric SBS
Where should your fingers be in the vault hold?
finger placement
1. greater wing of the sphenoid above the zygomatic arch
2. temporal bone toward squama
3. mastoid process behind the ear
4. occiput
Where should your fingers NOT be in the vault hold?
stay off the zygoma
stay off the orbit
What rotation component do flexion and extension pair with, respectively?
flexion - external rotation
extension - internal rotation
While in a vault hold, what sutures are restricted with a restriction between:
A) fingers 1, 2
B) fingers 3, 4
C) level of knuckles
D) fingers 2, 3
A) 1, 2 = gws/temporal suture or squamo-sphenoid suture
B) 3, 4 = occipital or mastoid suture
C) knuckles = temporal or parietal suture
D) 2, 3 = petrous portion of temporal bone; 2 is mainly petrous-sphenoid, 3 is mainly petrous-occipital
During craniosacral extension, the base of the occiput (__________), and the temporal bones (_________)?
During craniosacral extension, the base of the occiput (descends), and the temporal bones (internally rotate)?
How does one treat an internally rotated temporal bone with an Indirect Treatment Action?
rotate the temporal bone internally, hold it, wait for softening
How does one treat an internally rotated temporal bone with an Direct Treatment Action?
rotate the temporal bone externally, hold it, wait for softening. can further emphasize with CRI flexion
How does one treat an internally rotated temporal bone with an Disengagement Action?
distract the temporal bone at the zygoma in order to disengage the suture. whatever suture is jammed, distract it and feel for softening.
*What are the contraindications for OPP cranial?*
absolute - acute intracranial bleed, acute /\ ICP, depressed or basilar fracture

relative - meningitis, encephalitis, seizure states (never restrain them)
*What is the cranially relevant venous circulation?*
- superior sagittal sinus follows the sagittal suture (connects to straight sinus at the confluence of sinuses)
- inferior sagittal sinus inferior to superior sagittal sinus. both connect to straight sinus
- lateral/transverse sinus - follow along superior nuchal line and converge with the straight sinus at the confluence of sinuses
- straight sinus connects confluence of sinuses at the external occipital protuberance
What technique is relevant to the cranially venous circulation?
venous sinus technique
How does one perform the venous sinus technique?
1. place 2 middle fingers on ext. occipital protuberance and wait for softening
2. move inferioposterior toward the occipital sinus and wait for softening
NOTE: continue to slowly move down and wait for softening until off of bone
3. decompress the condylar occiput from the atlas
4. come back to up to the transverse sinus to decompress along the superior nuchal line
5. cross thumbs and decompress sagittal suture to release the superior sagittal sinus, working up to bregma
6. decompress the metopic suture on the forehead by kinda pulling apart the forehead with 4 fingers from both hands
How do you perform a frontal spread?
cross thumbs over the forehead
1. disengage the frontal bone from the greater wings of the sphenoid
2. gently spread metopic suture waiting for softening
How do you perform a frontal lift and what is it used for?
place palms at lateral frontal bone, lock fingers and gently grip and lift lateral anterior attachements

used for migraines
How do you perform a parietal release?
with crossed or uncrossed thumbs over the sagittal suture and distract
How do you perform a parietal lift?
cross thumbs, gently grab the lateral aspects of the parietal bones and pull superio-posterior and wait for softening
What bevel portion is most susceptible to trauma?
pivot point/bevel change/sutural transition
How do you perform a motion test of the temporal bone?
use one hand to stabilize the occiput with the palm
use the other hand with fingers places around the ear to monitor temporal motion

(5 finger hold)
*What is significant about the articular restriction of the occipito-mastoid suture?*
well, we need to know it for the exam, for one.

- most common articular restriction in the posterior quadrant
- vertical and horizontal limb with bevel change at junction
- commonly related to occipital condylar compression and occipito-atlantal joint dysfunction
During cranial flexion, what happens to the temporal bone?
external rotation, remember? this causes the skull to feel like it's increasing it's width and decreasing it's AP depth
In motion testing your partner's head, you note the following: the sphenoid prefers relative anterior rotation, and the base of the occiput is inferior relative to the base of the sphenoid. What strain pattern are you palpating?
superior vertical strain