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61 Cards in this Set

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Regarding cranial motion, on inspiration, the tip of mastoid moves how?
The tip of the mastoid moves posterior medially.
Regarding cranial motion, on inspiration, the squamous portion moves how?
The squamous portion flares laterally like the gills of a fish.
Regarding cranial motion, on inspiration, the sphenobasilar junction moves how?
The sphenobasilar junction goes into flexion - like thumbs pressing into the base of an orange.
Regarding cranial motion, on inspiration, the sagital suture moves how?
The sagital suture seperates.
Regarding cranial motion, on inspiration, the mitopic suture (frontal bone) moves how?
The mitopic suture (frontal bone) goes internal.
Regarding cranial motion, on inspiration, the ilium moves how?
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.
Regarding cranial motion, on inspiration, the apex of the sacrum moves how?
The apex of the sacrum goes into flexion.
Regarding cranial motion, on inspiration, the tip of the coccyx moves how?
The tip of the coccyx moves into extension.
Regarding cranial motion, on inspiration, the appendicular skeleton moves how?
The appendicular skeleton goes into external rotation.
Where do cranial nerve 9, 10, and 11 exit the skull? And what are the names of those cranial nerves?
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.
How many bones make up the orbit of the eye? For extra credit, what are they and where are they found?
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.
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?
Penfield and Rasmussen's research shows that 35-40% of all motor and sensory nerves of the body are related to the TMJ.
Who discovered cranial motion and wrote about it? (2 people)
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.
Who was the first to objectively measure cranial bone motion?
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.
What is the rate of cranial respiration?
Cranial respiration is 10-14 cycles/minute, and is independent but enhanced by thoracic respiration.
What are some of the mm that cause the cranium to "lock up?"
The SCM, upper trapezius, TMJ mm, and hyoid mm.
How many cranials (basic types) do we correct in AK? On what basis?
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.
Which suture, if jammed, locks up the whole cranium? This suture must be moving properly prior to fixing any other cranials.
The cruciate suture when jammed locks up the whole cranium.
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?
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.
At what age does the sphenobasilar junction ossify? Describe the type of bone and joint at the sphenobasilar junction.
The sphenobasilar junction ossifes at age 25. It is made of cancellous/spongy bone and is a synchondrosis and therefore can still flex slightly.
How much CSF do you make per day? Where is it made?
You make as much CSF as you do urine each day via the choroid plexus.
How many bones does the sphenoid articulate with?
The sphenoid is the center of cranial bone motion and it articulates with 12 other bones.
What is the rule regarding the relationship between cranial and sacral insp/exp faults?
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.
Regarding cranials what is the quadriceps related to? And what other named protocol in AK?
The quadriceps is related to a lambdoidal sutural fault and to a spastic ICV.
When does the bregma start to ossify?
The bregma starts to ossify when the child starts to walk.
There is a rebound phenomen in the cranium, just like in the spine, except for when?
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).
What is the nutrition for cranials? How is that nutrient related to cranials?
Zinc. Zinc is necessary for the body to make HCl and to make the CSF electrolytic.
What are some signs and symptoms of zinc deficiency and what muscle is best to test for zinc deficiency?
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.
Name and give examples of the different types of sutures (true and false).
True sutures: dentate (ex. sagittal), serrate (ex. temporosphenoidal), and limbus (ex. coronal).
False sutures: squamous, plane (cruciate), schindylesis, and gomphosis.
What are the three basic groups of cranials? Give examples of each.
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.
Describe everything about an inspiration assist cranial.
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.
Describe everything about an expiration assist cranial.
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.
Describe everything about a sphenobasilar inspiration assist.
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).
Describe everything about a spenobasilar expiration assist.
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.
What are common correlations with a sphenobasilar inspiration assist cranial?
CAT II, disc problems, hypo-endocrine patient (a patient that needs to be "pumped up")
What are common correlations with sphenobasilar expiration assist cranials?
Hyper-endocrine patient (pt needs to be turned down), disc problems, and CAT II.
Which cranial fault is associated with blood pressure?
A glabellar fault.
What is the Dx and Tx for all sutural faults? What is the one exception to this rule?
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.
How do you treat the sagittal suture and what is correlation?
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.
What are some other names for a cruciate suture?
Cruciate suture = plane suture = intermaxillary suture (Dip TQ)
Which two sutural faults go together?
Cruciate and sagittal suture go together.
What are some correlations with a cruciate sutural fault?
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.
How many zygomatic bone sutural faults are there? What correlations are there with these cranials?
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).
Name all the rotational group faults. What is the other name for rotational group?
Rotational = Compensatory group
Faults (5) = temporal bulge, parietal descent, internal frontal, external frontal, and universal.
Name all the sutural faults?
Sutural faults (8) = sagittal, squamosal, lambdoidal, zygomatic (at frontal, temporal, and maxillary bones), coronal, and cruciate.
Name all the flexion/extension group cranial faults.
Inspiration and expiration assist. Sphenobasilar insp and exp assist. Glabellar fault.
What type of cranial is characterized by a one-sided headache?
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.
What correlations are associated with a lambdoidal sutural fault?
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).
What mm weakness goes with a coronal sutural fault?
Oblique abdominal weakness per David Leaf, DC.
What structures are found in sutures?
Myelinated nn fibers, unmyelinated nn fibers, nerve receptor endings, vascular elements, and collagen elastic fiber complexes.
A patient states that "they can't stand the taste of water." What are you thinking?
Copper toxicity can cause a patient to dislike the taste of water.
If a patient says they "can't eat meat - it makes me sick or feel bad" what are you thinking?
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.
Which cranial fault goes with blood pressure - either hyper or hypotension?
A glabellar fault.
What is the other name for a universal cranial fault?
Interosseos cranial fault (Dip TQ)
Describe what a universal cranial fault is?
A universal cranial fault is a torsioning between the occiput and sphenoid.
What are some causes of a universal fault that should be checked for an corrected?
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.
Which cranial fault is associated w/ B/L neck flexor weakness?
Universal cranial fault.
What is the breathing pattern (Dx) associated with a universal cranial fault?
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).
How can you differentiate b/w a universal cranial fault and an ionization problem?
Both weaken to 1 nostril inspiration. However, you can challenge for a universal cranial fault and you cannot challenge for an ionization problem.
How do you challenge for a universal cranial fault?
You challenge the occiput and sphenoid in opposite directions.
How do you correct a universal cranial fault?
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.