Clinical Aspects of Cranial osteopathy Flashcards
(93 cards)
1
Q
What are the reflexes that are more common in HENT?
A
Viscero-viscero reflexes
2
Q
Optic nerve goes through what foramen?
A
Optic canal
3
Q
V2 goes through what foramen? V3?
A
V2 = Foramen rotundum V3 = ovale
4
Q
VII goes through what foramen?
A
Internal acuostic meatus
5
Q
VIII goes through what foramen?
A
Internal acoustic meatus
6
Q
XII goes through what foramen?
A
Hypoglossal canal
7
Q
X goes through what foramen?
A
Jugular foramen
8
Q
XI goes through what foramen?
A
Jugular foramen
9
Q
III goes through what foramen?
A
Superior orbital fissues
10
Q
What are the CNs that run through the jugular foramen?
A
IX, X, and XI
11
Q
V1 goes through what foramen?
A
Superior orbital fissure
12
Q
IV goes through what foramen?
A
Superior orbital fissure
13
Q
VI goes through what foramen?
A
Superior orbital fissure
14
Q
What are the CNs that have a PNS component?
A
III
VII
IX
X
15
Q
Why do we need to know foramina for CNs?
A
CNs depart through the skull through foramen, which may be important if there is an abnormal growth of the foramen, or a disturbance in the bone
16
Q
Why is it important that the nerves that leave the head are covered in pia mater?
A
Any dysfunction of the dura may lead to a dysfunction of the nerves
17
Q
What is the difference between a stroke and bell’s palsy?
A
No forehead wrinkling with Bell’s palsy
18
Q
What are the s/sx of trigeminal neuralgia?
A
HA in the region of the eyebrows, sinuses, cheek
19
Q
Taste from the posterior 1/3 of the tongue is mediated via which CN?
A
IX
20
Q
What is the treatment for children with colic?
A
Decompression of the condylar parts to relieve CN X
21
Q
CN XI is affected with what congenital condition?
A
Torticollis
22
Q
What are the sympathetics for the head and neck?
A
T1-T4
23
Q
Vasoconstriction or dilation with PNS?
A
Vasoconstriction
24
Q
Thick or thin secretions with PNS?
A
Thick
25
What happens to lymphatic drainage with SNS?
Decreased drainage
26
What are the s/sx of increased SNS in the head?
- Tinnitus
- HA
- Dilation of the pupils
27
What are the ophthalmologic problems that can occur with SNS overstimulation in the head?
- Dilation of the pupils
| - Cataracts
28
What happens to the thyroid with increased SNS?
Increased secretions
29
Long term upper thoracic and cervical dysfunction with increased SNS is implicated in cataracts 2/2 what?
Congestion
30
SNS innervation causes thyroid gland secretions how?
Blood vessel constriction causes changes in the cells that secretion T4
31
What are the PNS effects on CN III? (2)
- pupil constriction
| - accommodation
32
What are the PNS effects on CN VII? (3)
- Lacrimal gland
- Mucosal glands
- Submandibular glands
33
What are the PNS effects on CN IX? (1)
Parotid secretions
34
What are the PNS effects on CN X? (2)
- Heart
| - Guts to 2/3 along transverse colon
35
Increased PNS causes what to secretions?
Thinning
36
What is ganglion that CN VII runs through?
Sphenopalatine (pterygopalatine) ganglia
37
What is sphenopalatine syndrome?
Redness/engorgement of the mucus membranes, tearing + retro orbital pain
38
What happens to asthma with sphenopalatine syndrome? Why?
Worsens d/t lowered resistance of the nasal mucosa to foreign protein and adequate conditioning of air
39
85% of the venous drainage from the head is through what?
Jugular foramen
40
What is the first sign of congestion in the head?
Fullness in the supraclavicular areas
41
Should you press on the lymph nodes with venous and lymphatic obstruction in the head
no--painful
42
Poor drainage from the head leads to what eye problems?
Glaucoma
43
Poor drainage from the head leads to what ear problems?
Meniere's disease
44
External rotation of the temporal bone = what tinnitus sound?
Low pitched roar
45
Internal rotation of the temporal bone = what tinnitus sound?
High pitched wine
46
What may cause otalgia in the head?
Dysfunction with the teeth, tongue, esophagus, tonsils , TMJ,
47
The temporal bones are being moved by what bone?
The occiput movement
48
How do you treat otalgia?
Temporal rocking and VSD techniques
49
How do you treat tinnitus?
Temporal rocking
50
What is the SD that may cause eustachian tube dysfunction?
Internal rotation, torsion, or sidebending dysfunctions of the SBS, which leads to temporal bone dysfunctions
51
How do you treat OM?
Temporal rocking
52
What CN may cause OM?
CN X
53
What is the treatment for sinusitis? Why?
Frontal lift and intraocular techniques to address CN V (press on each part of CN V)
54
What is the treatment for pharyngitis? (3)
- Hyoid bone technique
- Submandibular drainage
- Effleurage of tissue
55
What is the effect of coughing in the elbow n the etiology of pharyngitis?
Torqueing of the neck fascia
56
What is the effect of SBS SDs with the endocrine system?
SBS restrictions can cause strains in the vasculature surrounding the pituitary and hypothalamus
57
How do you treat neural-endocrine problems?
Any SDs of the VSD
58
What is the most common, general, cause of HAs?
Vascular or other cause
59
What are the OMM causes of HAs? (3)
- Venous sinuses SDs
- Dura
- Dural arteries
60
What are the nerve roots that contribute to HA? (5)
```
V
VII
IX
X
C2-C3
```
61
True or false: a truly psychogenic cause of HA is rare
True
62
True or false: in the vast majority of cases, the physical exam of the head is WNL, including the OMM exam
False--OMM is always positive
63
What is Kernig's sign?
Flex the hip, can't extend at the knee
64
What is Brudzinski's sign?
Flexion of the neck causes flexion at the hips and knees
65
What are the s/sx of acute angle glaucoma?
Prominent eye pain, dilated pupils, narrow chamber
66
What are the three major recurrent HAs?
- Tension
- Migraine
- Cluster
67
What are the 2 types of migraines?
```
Classic = aura
Common = no aura
```
68
Caffeine is a vaso constrictor or dilator?
Constrictor
69
Tyramine in wine causes what effect on vessels?
Dilation
70
What are cluster HAs?
Neurogenic inflammation affecting the vascular plexus of the cavernous sinus
71
In whom are cluster HAs more common in?
20-40 aged men
72
What is the pain like with cluster headaches? (onset, intensity)
Explosive onset and very sharp in intensity
73
What is the associated syndrome with cluster HAs?
Horner's syndrome
74
Are tension HAs usually unilateral or bilateral?
bilateral
75
What are the characteristics of the pain with tension HAs?
Dull, achy pain/pressure
76
Is there an aura with tension HAs?
No
77
What are the associations with tension HAs?
Stress
Anxiety
Depression
78
What is the effect of physical activity on tension HAs?
Not worsened
79
C1 supplies motor innervation to what? How do you treat if these are involved?
Suboccipital triangle muscles
Treat OA
80
C2 and C3 provide sensory innervation to what?
Cranial vault, back of the head, and suboccipital pain
81
What are the areas that should be assess with HA 2/2 musculoskeletal pain
Upper cervs
| Suboccipital muscles
82
What are the borders of the suboccipital triangle?
- Rectus capitus posterior major
- Oblique capitis inferior
- Oblique capitis superior
83
What tender point should be treated with frontal or orbital HAs? Where is this, and how is it treated?
C1
| Posterior surface of the ramus of the jaw--rotate head away
84
What tender point should be treated with periorbital HAs? Where is this, and how is it treated?
C2
| Flex the spine and rotate away from the TP
85
What tender point should be treated with occipital HAs? Where is this, and how is it treated?
C4
| SARA
86
What is the blood supply to the dura and calvaria?
Middle meningeal artery
87
How does the sphenoid relate to the side of the HA?
Greater wing is low on the side of the HA (I/e/ left torsion)
88
HAs caused by temporal bone problems are usually due to what?
Internal rotation restriction
89
Which usually has more sinusitis, and which has more migraines: flexion or extension heads?
```
Flexion = sinusitis
Extension = migraines
```
90
What type of joint it the TMJ?
Diarthrodial joint
91
The mandible hands from what bones? What SDs, then, can cause problems with the TMJ?
- Mandible hangs from the temporals
| - Occiput
92
How is the Galbreath maneuver performed?
Effleurage from behind the ear, down into the neck
93
What is the ganglion that should(n't) be manipulated with throat s/sx?
Sphenopalatine
