Bep2

Front 1

Regarding cranial motion, on inspiration, the tip of mastoid moves how?

Back 1

The tip of the mastoid moves posterior medially.

Front 2

Regarding cranial motion, on inspiration, the squamous portion moves how?

Back 2

The squamous portion flares laterally like the gills of a fish.

Front 3

Regarding cranial motion, on inspiration, the sphenobasilar junction moves how?

Back 3

The sphenobasilar junction goes into flexion - like thumbs pressing into the base of an orange.

Front 4

Regarding cranial motion, on inspiration, the sagital suture moves how?

Back 4

The sagital suture seperates.

Front 5

Regarding cranial motion, on inspiration, the mitopic suture (frontal bone) moves how?

Back 5

The mitopic suture (frontal bone) goes internal.

Front 6

Regarding cranial motion, on inspiration, the ilium moves how?

Back 6

The ilium moves just like the temporal bone - the ischial tuberosity (like the mastoid) moves postero-medially and the ASIS flares laterally like the gills of a fish.

Front 7

Regarding cranial motion, on inspiration, the apex of the sacrum moves how?

Back 7

The apex of the sacrum goes into flexion.

Front 8

Regarding cranial motion, on inspiration, the tip of the coccyx moves how?

Back 8

The tip of the coccyx moves into extension.

Front 9

Regarding cranial motion, on inspiration, the appendicular skeleton moves how?

Back 9

The appendicular skeleton goes into external rotation.

Front 10

Where do cranial nerve 9, 10, and 11 exit the skull? And what are the names of those cranial nerves?

Back 10

The glossopharyngeal, vagus, and spinal accessories cranial nerves exit the skull at the jugular foramen. The jugular foramen is formed in front by the petrous portion of the temporal, and behind by the occipital bone.

Front 11

How many bones make up the orbit of the eye? For extra credit, what are they and where are they found?

Back 11

Seven - The roof of the orbit is composed of 2 bones, the frontal bone (ant part) and the lesser wing of the sphenoid bone (post roof). The medial wall of the orbit is composed of 4 bones: lesser wing of the sphenoid, ethmoid, lacrimal and maxillary bone. The floor of the orbit is composed of 3 bones: maxillary bone; zygoma and posteriorly, the palantine bone.

Front 12

Which scientist/s showed the inter-relationship of the TMJ to the rest of the body and how much of an inter-relationship did they find?

Back 12

Penfield and Rasmussen's research shows that 35-40% of all motor and sensory nerves of the body are related to the TMJ.

Front 13

Who discovered cranial motion and wrote about it? (2 people)

Back 13

William Garner Sutherland, DO discovered in 1899, started teaching in 1929, wrote a book in 1939.
Nephi Cotum, DC, discovered in 1895, and wrote a book in 1936.

Front 14

Who was the first to objectively measure cranial bone motion?

Back 14

Viola Fryman, discovered on May 30, 1963 (TQ). Published in JAOA May 1971, Vol 70, No. 9. She attached transducers (screwed in) to the skulls of monkeys and recorded the cranial sacral rhythm seperate from thoracic respiration rates.

Front 15

What is the rate of cranial respiration?

Back 15

Cranial respiration is 10-14 cycles/minute, and is independent but enhanced by thoracic respiration.

Front 16

What are some of the mm that cause the cranium to "lock up?"

Back 16

The SCM, upper trapezius, TMJ mm, and hyoid mm.

Front 17

How many cranials (basic types) do we correct in AK? On what basis?

Back 17

There are 14 basic types of cranials in AK and all are corrected on a rebound basis. We correct them by loading up the reciprocal tension membrane and the correction is made when we let go.

Front 18

Which suture, if jammed, locks up the whole cranium? This suture must be moving properly prior to fixing any other cranials.

Back 18

The cruciate suture when jammed locks up the whole cranium.

Front 19

On average how often do we swallow? And how much pressure is placed on the teeth and their ligaments during swallowing? What is the effect of this pressure?

Back 19

On average we swallow 2x/minute.
When we swallow 6 pounds of pressure is placed on the teeth and their ligaments. When the periodontal ligament is stimulated it should turn off (inhibitory effect) all jaw closing mm.

Front 20

At what age does the sphenobasilar junction ossify? Describe the type of bone and joint at the sphenobasilar junction.

Back 20

The sphenobasilar junction ossifes at age 25. It is made of cancellous/spongy bone and is a synchondrosis and therefore can still flex slightly.

Front 21

How much CSF do you make per day? Where is it made?

Back 21

You make as much CSF as you do urine each day via the choroid plexus.

Front 22

How many bones does the sphenoid articulate with?

Back 22

The sphenoid is the center of cranial bone motion and it articulates with 12 other bones.

Front 23

What is the rule regarding the relationship between cranial and sacral insp/exp faults?

Back 23

You always find the same type (ex. right insp assist) on the same side. If you find a left insp assist at the cranium and a left exp assist at the sacrum then the patient is switched.
Also, you will always have a cranial fault with a sacral fault, but you don't always have a sacral fault with a cranial fault.

Front 24

Regarding cranials what is the quadriceps related to? And what other named protocol in AK?

Back 24

The quadriceps is related to a lambdoidal sutural fault and to a spastic ICV.

Front 25

When does the bregma start to ossify?

Back 25

The bregma starts to ossify when the child starts to walk.

Front 26

There is a rebound phenomen in the cranium, just like in the spine, except for when?

Back 26

Except for children under age 6. In a child under age 6 you correct the cranial faults in exactly the opposite direction you would an adult (ex. push P-->A on exp at the mastoid and A-->P on insp at the mastoid).

Front 27

What is the nutrition for cranials? How is that nutrient related to cranials?

Back 27

Zinc. Zinc is necessary for the body to make HCl and to make the CSF electrolytic.

Front 28

What are some signs and symptoms of zinc deficiency and what muscle is best to test for zinc deficiency?

Back 28

White spots on fingernails, not being able to taste food well (putting tons of salt, pepper, butter, etc on their food for flavor), + zinc taste test.
The teres major is the best mm to use to test zinc deficiency.

Front 29

Name and give examples of the different types of sutures (true and false).

Back 29

True sutures: dentate (ex. sagittal), serrate (ex. temporosphenoidal), and limbus (ex. coronal).
False sutures: squamous, plane (cruciate), schindylesis, and gomphosis.

Front 30

What are the three basic groups of cranials? Give examples of each.

Back 30

1. Flexion/extension = inspiration and expiration assist and sphenobasilar insp & exp.
2. Rotational = temporal bulge and parietal descent.
3. Sutural = sagittal, cruciate, zygomatic bone faults, squamosal, lambdoidal, and coronal.

Front 31

Describe everything about an inspiration assist cranial.

Back 31

Dx: a weak mm in the clear that strenthens to a breath held IN. Treat on side of mm strength change. Can also find with a strong mm that weakens to a breath held OUT.
Tx: pushing P-->A on the mastoid during inspiration.
TL: occipital mastoid suture
S: palpable pain in the frontal bone at the mid-pupillary line.
51%'er: pt breathes all the way out and if mm re-weakens more tx is needed.

Front 32

Describe everything about an expiration assist cranial.

Back 32

Dx: weak mm in the clear that strengthens to a breath held out.
Tx: push A-->P on the mastoid with expiration.
TL: occipital mastoid junction.

Front 33

Describe everything about a sphenobasilar inspiration assist.

Back 33

Dx: weak mm in the clear that strengthens to a FORCED breath held in.
Tx: "two hand correction" - pushing P-->A on the mastoid and I-->S on the ipsi hard palate (stay off the cruciate suture) on inspiration.
TL: both thumbs on the hard palate (will weaken a strong indicator on breath held in or out).

Front 34

Describe everything about a spenobasilar expiration assist.

Back 34

Dx: weak mm in the clear that strengthens to a FORCED breath held out.
Tx: "two hand correction." Push A-->P on the mastoid and P-->A on the hard palate ("stay off the teeth") during expiration.

Front 35

What are common correlations with a sphenobasilar inspiration assist cranial?

Back 35

CAT II, disc problems, hypo-endocrine patient (a patient that needs to be "pumped up")

Front 36

What are common correlations with sphenobasilar expiration assist cranials?

Back 36

Hyper-endocrine patient (pt needs to be turned down), disc problems, and CAT II.

Front 37

Which cranial fault is associated with blood pressure?

Back 37

A glabellar fault.

Front 38

What is the Dx and Tx for all sutural faults? What is the one exception to this rule?

Back 38

Dx: strong indicator mm, challenge the suture together or pulled apart, if mm weakens then check phase of respiration that negates the weakness.
Tx: correct in the challenge direction on the phase of respiration that negates the positive challenge.
Sagittal suture is always seperated on inspiration.

Front 39

How do you treat the sagittal suture and what is correlation?

Back 39

The sagittal suture is always seperated on inspiration. The sagittal suture is related to weak abdominal mm.
Weak abdominals - TL to sagittal suture - if strengthens then seperate the sagittal suture on inspiration.

Front 40

What are some other names for a cruciate suture?

Back 40

Cruciate suture = plane suture = intermaxillary suture (Dip TQ)

Front 41

Which two sutural faults go together?

Back 41

Cruciate and sagittal suture go together.

Front 42

What are some correlations with a cruciate sutural fault?

Back 42

Palpable tenderness B/L in the massetters and mid-cervical neck extensors.
Pt will be unable to swallow with their mouth open.
Possible B/L coracobrachialis weakness.
Maxillary splints jam the cruciate suture.

Front 43

How many zygomatic bone sutural faults are there? What correlations are there with these cranials?

Back 43

There are 3 zygomatic bone sutural faults = frontal, temporal, and maxillary.
Best mm to use to test = iliacus.
Related to protein deficiencies and chronic open ICV. (Cross TL the ICV to the zygomatic bones - per Dick Schroeder, DC dip in Fresno, CA).

Front 44

Name all the rotational group faults. What is the other name for rotational group?

Back 44

Rotational = Compensatory group
Faults (5) = temporal bulge, parietal descent, internal frontal, external frontal, and universal.

Front 45

Name all the sutural faults?

Back 45

Sutural faults (8) = sagittal, squamosal, lambdoidal, zygomatic (at frontal, temporal, and maxillary bones), coronal, and cruciate.

Front 46

Name all the flexion/extension group cranial faults.

Back 46

Inspiration and expiration assist. Sphenobasilar insp and exp assist. Glabellar fault.

Front 47

What type of cranial is characterized by a one-sided headache?

Back 47

A squamosal (sutural) fault per Upledger.
Also, when many TS line points are found, check the temporalis for problems, then correct the squamosal sutural fault.

Front 48

What correlations are associated with a lambdoidal sutural fault?

Back 48

Pulse amplitude differences (Dip TQ).
Often found with whiplash injuries, spastic ICV, digestive disturbances, and weak neck flexors.
Best mm to use to test for this cranial = quads (related to spastic ICV).

Front 49

What mm weakness goes with a coronal sutural fault?

Back 49

Oblique abdominal weakness per David Leaf, DC.

Front 50

What structures are found in sutures?

Back 50

Myelinated nn fibers, unmyelinated nn fibers, nerve receptor endings, vascular elements, and collagen elastic fiber complexes.

Front 51

A patient states that "they can't stand the taste of water." What are you thinking?

Back 51

Copper toxicity can cause a patient to dislike the taste of water.

Front 52

If a patient says they "can't eat meat - it makes me sick or feel bad" what are you thinking?

Back 52

Zinc deficiency. If zinc is low, HCl in the stomach will be low, they will not digest meat properly and IT WILL MAKE THEM FEEL SICK.

Front 53

Which cranial fault goes with blood pressure - either hyper or hypotension?

Back 53

A glabellar fault.

Front 54

What is the other name for a universal cranial fault?

Back 54

Interosseos cranial fault (Dip TQ)

Front 55

Describe what a universal cranial fault is?

Back 55

A universal cranial fault is a torsioning between the occiput and sphenoid.

Front 56

What are some causes of a universal fault that should be checked for an corrected?

Back 56

Related to being born - either right or left occiput coming out of the birth canal first.
Whiplash, spastic ICV, chronic upper c/s subluxation, chronic neurological disorganization, B/L neck flexor weakness, atlanto-occiptal counter-torque.

Front 57

Which cranial fault is associated w/ B/L neck flexor weakness?

Back 57

Universal cranial fault.

Front 58

What is the breathing pattern (Dx) associated with a universal cranial fault?

Back 58

Strong indicator mm weakens to inspiration through 1 nostril (R or L). Must be differentiated from a ionization problem - use a challenge (a universal fault challenges, you cannot challenge for an ionization problem).

Front 59

How can you differentiate b/w a universal cranial fault and an ionization problem?

Back 59

Both weaken to 1 nostril inspiration. However, you can challenge for a universal cranial fault and you cannot challenge for an ionization problem.

Front 60

How do you challenge for a universal cranial fault?

Back 60

You challenge the occiput and sphenoid in opposite directions.

Front 61

How do you correct a universal cranial fault?

Back 61

It is a two part correction:
Part 1: this is a DIRECT correction (not a rebound correction). Therefore, you correct OPPOSITE to the chalenge direction and ALWAYS ON INSPIRATION.
Part 2: challenge the PSIS apart and if necessary thrust them apart with a drop.