Midline bones lab

Question 1

palpating sacral motion

Answer 1

pt supine; doc one side

ask pt to bend one or both knees

pt rotates torso towards physician allowing placement of docs caudal hand on sacrum

sacral hand: thenar + hypothenar eminence on ILAs of sacram and finger pads on sacral base

Question 2

coronal suture

Answer 2

transverse suture bw frontal and parietal bones

Question 3

parietosquamous suture

Answer 3

suture bw temporal and parietal bones

Question 4

lambdoidal suture

Answer 4

dense, fibrous connective tissue joint - connects the parietal bones with the occipital bone `

Question 5

pterion

Answer 5

region where the frontal, parietal, temporal, and sphenoid bones join together

Question 6

asterion

Answer 6

posterior end of the parietomastoid suture

Question 7

occipitomastoid suture

Answer 7

bw occipital bone and the mastoid portion of the temporal bone

Question 8

lambda

Answer 8

point of meeting of the sagittal and the lambdoid suture

Question 9

bregma

Answer 9

point of meeting of the sagittal and coronal suture

Question 10

when is it common to find sphenobasilar compression findings?

Answer 10

migraines

Question 11

Occipital condylar decompression indications:

Answer 11

poor infant feeding
infant colic
head and neck pain
post trauma to head and neck

Question 12

Occipital condyle decompression treatment:

Answer 12

contact as near to the foramen and condyles as possible (add slight OA flexion)

gently apply traction, then pull the occipital tissues in posterior and lateral direction

await slight occipital regional give in both directions (maybe 20-30s)

re-examine for efficacy

Question 13

how would you perform occipital condyle decompression in infants?

Answer 13

“V” spread technique

Question 14

Difference before age 7 vs adult

Answer 14

before age 7 treating the cartilaginous pre-ossification strains vs adults treating fascial strains

Question 15

CV4 compression treatment

Answer 15

aka still point induction

thenar eminences are inferior to superior nuchal line and MEDIAL to the patients OM sutures (*compression lateral to sutures may induce OM suture compression or ER of temporals)

gently encourage extension by leaning back (induces SUP and ANT force)

gently RESIST its inferior motion (FLEXION) by not reducing pressure (ratchet pattern)

motion will seemingly diminish to point where you question if it has disappeared (still point)

slowly release pressure and await CRI return (may take 1-2 mins)

Question 16

indications for CV4 compression tx

Answer 16

decreased CRI
URI
HA/migraine

Question 17

indications for SBS decompression

Answer 17

diminished CRI, mood disorders, cranial n. entrapment, URI/head congestino, pediatric development problems

Question 18

SBS decompression treatment

Answer 18

hold: frontoccipital or vault or can use post molars (direct)

indirect= BMT compression first, followed by release

direct= gently engage temporal bones to distract against the occiput–> PULL in ANTERIOR + slightly superior direction (not to level of barrier engagement; posterior molars may be used instead of frontal bone)

respiration or CRI may be used to augment movement–> await tissue release–> reassess CRI rate and amplitude

Question 19

Balanced Membranous tension is an ____technique

Answer 19

indirect cranial manipulative tx

Question 20

balanced membranous tension tx

Answer 20

identify asymmetry of cranial motion (membranes of brain)

gently exaggerate membranous asymmetry until sense of balance is noted (CRI will move or wiggle against your force but you should resist changing your force + position)

resist a return to CRI midpoint (neutral) until CRI stops at still point

gently release forces + return to CRI midpoint, monitoring for return of motion and symmetry

Question 21

indications for balanced membranous tension

Answer 21

asymmetrical or diminished CRI
cranial n. entrapment
sx related to dural strain or venous sinuses
HAs

Question 22

Direct cranial motion impulse correction tx:

Answer 22

aka Guiding, “ricochet,” LVLA lol

identify asymmetry of cranial motion

at CRI midpoint of motion bw flexion + extension, apply very gentle and brief force in corrective direction***

observe several cycles of flexion + extension to confirm return of ideal motion and symmetry of motion

repeat once or twice if necessary

(“little nudge its tricky but powerful)