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38 Cards in this Set
- Front
- Back
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Five Components of the Primary Respiratory Mechanism (PRM)
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1. Motility of brain/spinal cord
2. Fluctuation of CSF 3. Mobility of the intracranial and intraspinal membrane (reciprocal tension membranes, RTM) 4. Mobility of Cranial Bones 5. Involuntary mobility of sacrum |
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Define Cranial Base
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portion of skull made up of sphenoid and occiput formed by cartilagenous bone (NOT MEMBRANOUS)
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Define Synchondrosis
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union of 2 bbones formed by hyaline cartilage or fibrocartilage
allows slight movement |
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Sphenobasilar Synchondrosis (SBS)
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jxn btwn the sphnoied base (basisphenoid) and occiput (basiocciput)
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Where does the outer dura attach?
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interior cranial bones, foramen magnum, C2, C3 and S2
movement of dura moves cranial bones |
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Landmarks of Sphenoid
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central body
greater/lesser wings pterygoid process |
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What does the sphenoid articulate with?
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occiput
temporalis parietals frontals ethmoid palatines vomer zgomae |
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What are cranial base strains described by?
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Motion at the SBS
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Physiologic Strain Patterns
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Flexion/Extension
Torsion (right or left) Sidebending Rotations (Right and Left) |
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Non-physiologic strains (pathological)
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vertical strain (inf and sup)
Lateral Strains (right and left) SBS compression |
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What is a physiologic pattern?
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normal cranial motion
NOT from trauma |
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What is non-physio?
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Trauma, abnomral motion that distorts cranial mobility
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Can you have more than one strain pattern at a time?
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Yes!
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What does flexion feel like
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Occiput extends inferior and widens
greater wing of sphenoid moves inferior/wide (feels fatter and wider) |
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What is occuring in flexion?
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SBS rises superiorly
sphenoid/occiput rotate in opposite directions 2 parallel transverse axes |
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What is occuring in Extension?
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SBS move INFERIORLY
sphenoid and occiput rotate opposite 2 parallel transverse axes |
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What do you feel in extension?
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occiput moves superiorly and is thinner
greater wings more superior and get narrow (head feels thinner and longer) |
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Flexion SD
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extreme flexion with decreased extension (football head like Ernie)
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Extension SD
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extreme extension with decread flexion of SBS (skinny pencil head like Bert)
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What is occuring is SBS torsion?
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sphenoid and occiput rotate opposite
Anterior-Posterior (AP) axis |
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How do you name an SBS torsion?
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The Greater wing of the sphenoid that is Superior (higher)
Ex: R wing higher=R torsion feels like unscrewing a jar |
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What does SBS torsion feel like?
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a twisting motion of saggital plane
like unscrewing a jar: one hand moves toward you and the other away named for index finger that moves toward you (superior) |
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What is SBS Rotation/Sidebending?
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One AP axis and 2 parallel vertical axes
With AP, sphenoid and occiput rotate same direction Vertical is prependicular to the AP axis occiput and sphenoid go in opp directions opp sidebending causes a buldging on one side |
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How is SBS rotation/sidebending named?
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The side of convexity (rotation is toward the convex)
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What does SBS rotation/sidebending feel like?
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Feel a down and out sensation like cracking an egg
One side is flat and motionless, the other is fatter and bulges laterally and posterior Name for fat side |
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What occurs with SBS vertical strain?
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Sphenoid and occiput rotate same direction
parallel transverse axes the sphenoid shifts sup or inf to occiput |
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What causes vertical strain?
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A shearing force (like a ball to top of head)
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What do you feel with a vertical strain?
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You will opposite on palpation bc named for relative position to Sphenoid base to occiput
sup strain... sphenoid sup... fingers on wing go inf inf strain, base is inf.. fingers on wing go up |
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How do you name non-physiologic strain patterns?
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It is opposite of what you feel
so if you feel your fingers go up, you name it inferior |
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What does an inferior vertical strain feel like?
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index fingers move superior/towards you
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What does a superior vertical strain feel like?
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index fingers move down towards patients feet
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What occurs with a lateral strain?
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sphenoid and occiput rotate same direction
2 parallel vertical axes |
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What causes a lateral strain?
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shearing force just anterior or posterior to SBS
(bat nailing you on the side of the head) |
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What do you feel with a lateral strain?
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OPPOSITE MOTION
Ex: if pink shifts left, and index goes right=L lateral strain feels like a parallelogram head |
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How are lateral strains named?
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position of basi-sphenoid in relation ot basiocciput
R lateral strain: sphenoid base is R compard to occiput L lateral strain: sphenoid base is L " " |
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What occurs with SBS compression?
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sphenoid and occiput are forced together
Little or no motion at SBS |
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What causes SBS compression?
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a severe blow to head, fever, metabolic problem
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What does SBS compression feel like?
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No movement
or a "bag of worms" going in all directions or a different strain pattern everytime it goes into flexion |
