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78 Cards in this Set

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primary respiratory mechanism (PRM)
a unit of fx concerned w/ cellular respiration, underlying all other physiologic functions. It is observed through the cranial articulations
5 components of PRM are
1)articular mobility of the cranial bony mechanism
2)reciprocal tension dural membrane
3)fluctuation of the CSF
4)inherent motility of the CNS
5) respiratory motion of the sacrum between the ilia
The MIDLINE cranial bones have physiologic motion of _________ about a ________ axis
flexion/extension
transverse
name the midline cranial bones (5)
1) occiput
2) sphenoid
3) ethmoid
4) vomer
5) the sacrum is also a midline bone
what is the axis of the sacrum
transverse through S2
The PAIRED cranial bones have a physiologic motion of _________ about their respective axis
ER/IR
The paired cranial bones are:
zygoma
frontals
inferior conchae
lacrimals
maxillae
nasals
palantines
parietals
temorals
given the paired cranial bones give the axis:
zygoma
oblique axis
given the paired cranial bones give the axis:
frontals
verticle axiss
given the paired cranial bones give the axis:
maxillae
verticle axis
given the paired cranial bones give the axis:
parietals
arbitrary axis
given the paired cranial bones give the axis:
temporals
oblique axis
As SBS Rises:
Midline bones _______
paired bones _______
Respiratory phase-PRM _______
Sacral Base ______
Flexion
External Rotation
Inhalation
Post/Sup
As SBS Decends:
Midline bones _______
paired bones _______
Respiratory phase-PRM _______
Sacral Base ______
Extend
Internal Rot
Exhalation
Ant/Inf
Medial dural attachment
Anterior clinoid processes
Lateral dural attachments
Petrous ridges
Mastoid portion
Post-inf angles of parietal
Transverse ridge of occiput
Posterior clinoid processes
sacrum has _______ axis through the ______ sacral segment
transverse
second
In the primary respiratory mechanism, as the occiput moves into flexion, the SBS moves _________ "tugging the dura" and the sacral base tips ______ and _______.
superiorly
posteriorly and superiorly
In the primary respiratory mechanism, as the occiput moves into extension, the SBS moves _________ relaxing the "tug on the dura" and the sacral base tips ______ and _______.
inferiorly
anteriorly and inferiorly
axis of rotation:
sphenoid
TRANSVERSE AXIS through the body, immediately anterior to, and on the same level as, the floor of the sella turcica
axis of rotation:
Occiput
TRANSVERSE AXIS just above the jugular processes of the occiput
axis of rotation:
Temporalis
ALONG PETROUS RIDGE
Diagonally between the petrous apex and the jugular surface of the petrous portion
How would you're fingers move on an imaginary head?
flexion
Hands away from me and out
How would you're fingers move on an imaginary head?
extension
hands back towards me and closer together
How would you're fingers move on an imaginary head?
Left torsion
the left index finger moves superiorly (toward the physician) and the little finger moves inferiorly (towards the pts feet). Simultaneously, the right index finger is perceived as moving inferiorly and the little finger moves superiorly.

note: as if one held a pensil by its ends in each palm and turned the hands like two whels in opposite directions
How would you're fingers move on an imaginary head?
Right torsion
the right index finger moves superiorly (toward the physician) and the little finger moves inferiorly (towards the pts feet). Simultaneously, the left index finger is perceived as moving inferiorly and the little finger moves superiorly.

note: as if one held a pensil by its ends in each palm and turned the hands like two whels in opposite directions
How would you're fingers move on an imaginary head?
temporal external rotation
lateral rotation of hands (thumbs)-open up hands
How would you're fingers move on an imaginary head?
temporal internal rotation
medial rotation of hands (thumbs)-open up hands
How would you're fingers move on an imaginary head?
Left sidebending/rotations
left hand spread wider, moves inferiorly, and has an externally rotated temporal in the physicians palm.
named: for externally rotated inferior segment.
How would you're fingers move on an imaginary head?
Right sidebending/rotations
left hand spread wider, moves inferiorly, and has an externally rotated temporal in the physicians palm.
named: for externally rotated
How would you're fingers move on an imaginary head?
Superior verticle strain
parallel hands, tips of fingers point down?
How would you're fingers move on an imaginary head?
inferior verticle strain
parallel hands, tips of fingers point up?
How would you're fingers move on an imaginary head?
left lateral strain
parallel hands, pinky fingers point to the left
How would you're fingers move on an imaginary head?
SBS compression
head is still compression prevents true flexion & extension. May induce alternating verticle strains
This type of disfunction is a physiologic adaptation to trauma to one quadrant of the head.
torsion
this type of disfunction is a physiologic response to a lateral force exactly at the level of the SBS.
sidebendign rotation
this disfunction is a traumatic effect of 1) a blow on the vertex behind the plane of the SBS but anterior to the occipital axis, or 2) below through the mouth, anterior to the plane of SBS, but posterior to the sphenoid axis
superior verticle strain
this disfunction is a traumatic effect of 1) a blow on the vertex anterior to the plane of the SBS but posterior to the sphenoid axis, or 2) below through the heels or mandible, posterior to the plane of SBS, but anterior to the occipital axis
inferior vertical strain
this disfunction is due to a traumatic effect of a blow on the side of the head anterior or posterior to the plane of the SBS
lateral strain
venous sinus technique
1) external occipital protuberance (confluence of sinuses)
2) down the occipital sinus to condylar parts
3) condylar decompression
4) transverse and straight sinuses
5) sagittal sinus - sagital suture, stop at bregma
6) then metopic suture
Give three indications for venous sinus technique
1)hard, rigid head
2) headache
3) SBC compression
CV-4 technique
using the occiput and sacrum=follow towards extension

using the parietals and temporalis=follow toward internal rotation
parietal lifts
?
Frontal lifts
?
what is the vault hold points of contact on the skull
forefingers on _________
4th finger on ________
5th finger on _________
greater wings of sphenoid
mastoid process of temporal bones
lateral angle of occiput
indications of CV 4technique
tension headache
Any acute illness – normalize functions, ↓ temp
Allergies
Asthma
Acute low back painIf something needs to be expelled, e.g. fetus post-term gestation
Emotional reactions and states
describe the endpoint for the CV 4 technique described as the "still point" (4 points)
diaphragmatic respirations
sensation of bone softening
sense of warmth
gentle, low amplitude rocking of flexion/extension
common cranial nn entrapment neuropathies which cause:
difficulty swallowing
CN IX
common cranial nn entrapment neuropathies which cause:
vomiting
CN X
common cranial nn entrapment neuropathies which cause:
difficulty sucking/protrusion of the tongue
CN XII
what cranial nerve can be compromised by the petrosphenoid ligament
CN VI
which cranial nerves pass through the cavernous sinus
CN III, IV, V1, V2, VI
Which cranial nn passes through the foramen ovale
CV V3 (motor division)
which cranial nn pass through the jugular foramen
CN IX, X, XI
Which cranial nn have a close relationship with the occiput
CN IX, X, XI, XII
Which cranial nn have a close relationship with the temporals
IV, V, VI, VII, VIII, IX, X, XI
what cranial bone can be damaged secondary to a forceps delivery
sphenoid
pt presents w/ migranes, what cranial bones, suture, and artery do you suspect
sphenoid and temporal bone
sphenosquamous suture
middle menengial aa
which bones for the orbit of the eye
ethmoid
frontal
lacrimal
maxilla
palantine
sphenoid
zygomatic
monroe kelly docterine
Given an intact cranium and vertebral canal together with an inelastic dura; any increase in the volume of the cranial contents (e.g. brain, blood or CSF), will elevate intracranial pressure. Further, if one of these three elements increase in volume, then the other two must decrease in volume.
pteryon is the intersection of what bones (give them from deepest to most superficial)
frontal, parietal, sphenoid, temporal
occiput is in ___ parts when born
4
the _____ canal passes through condyles
hypoglossal
midline bones engage in this type of movement
flexion/extension
paired bones engage in this type of movement
IR/ER
When you flex the occiput you do this to the sacrum-meaning this happens to the base and this happens to the apex
sacrum flexes
(base->posterior/superior; apex->anterior/inferior)
the sphenoid consists of ____ parts until 8 mo of life
2
what goes through the superior orbital fissure
CN 3,4,5(V1),6, opthalmic vv, sympathetics
newborn has difficulty sucking and swallowing what CN do you suspect and what type of compression could it be
CN VII, condylar compression
articulations of temporal bones (5)
Occiput
Parietal
Sphenoid
Zygoma
Mandible
____surrounds ALL nerves
CT
all nn are continuous with _____ and ____
meninges
dura
Perineurium continuous with the ______ surrounding it
fascia
pt presents with diplopia, tracking, learning d/o, what ligaments and CNs might be involved
petrosphenoid ligmament
3,4,5
pt presents w/ bells palsy. what cn?
7
pt presents w/ bell's palsy. What CN?
CN VII
pt presents w/ high pitch tinnitus. What CN?
CN IX
pt presents w/ condylar compression. What CN?
CN IX-XII