Final Practical Techniques Flashcards
(68 cards)
Vault Hold
Little finger: lateral angles of occiput Ring Finger: Mastoid Middle finger: zygomatic process of temporal Index finger: greater wing of sphenoid Thumbs: frontal bone Palms: parietal eminence
Fronto-occipital hold
Thumb and middle fingers on lateral angles of frontal bone with cephalad hand
Caudad hand cups occiput
Temporal Hold
interlace fingers and cradle occiput with thenar eminences along mastoid process
Relationship between breathing and motion of temporal bones
Inhalation–flexion=external rotation=internal motion of mastoids
Exhalation–extension=internal rotation= lateral motion of mastoid
Frontal lift
Goal: internally rotate and lift ant. frontal bone to disengage from articulations and improve motion
Position: Interlace fingers above head, hypothenar eminences on lateral angles of frontal, apply medial pressure while lifting ant. until a release is felt
Parietal lift
Finger pads on inferior border of parietal bones, thumbs crossed above head. Induce internal rotation and cephalad traction until release is felt.
Temporal bone release (bilateral and synchronous)
Useful for otitis media, TMJD, vertigo, dizziness, tinnitus
Temporal hold
Encourage synchronous motion of the mastoid by following external rotation with pressure, and releasing to allow for internal rotation of the temporal bone. Continue until symmetrical motion or a still point is reached. This is a rocking type motion.
Describe torsion strain and hand placement
Vault hold, hands rotate opposite each other, side of higher sphenoid is side name
Sidebending-Rotation strain pattern
Named for side that is fuller and more caudad
Sidebending is the fullness, rotation is the movement caudad
Vertical strain
Shear at SBS in vertical direction
Named for direction of the Sphenoid in relation to occiput
Vertical would involve rotating both hands forward
Inferior is rotating both hands backward toward you
Lateral strain
Parallelogram motion of hands
Fingers to the right indicate a left lateral strain
Which strains can be considered physiologic?
Torsion & Sidebending-Rotation
SBS compression
Feels like a bowling ball head
May have alternating sup/inf strain motion
CV4 Technique
Naturally, weight of the head causes lateral angles of occiput to move medially and the center portion moves post adding tension to the tentorium cerebelli.
Treatment compresses the 4th ventricle and induces extension and internal rotation throughout the cranium.
Place one hand over the other with thenar eminences parallel. Support head on thenar over the lateral angles of the occiput but medial to the occipito-mastoid suture. Hold until the CRI fades and then comes back. CRI should come back with greater amplitude. Be sure to encourage extension and not flexion.
BMT
Balanced Membranous Tension
In vault hold, asses motion to find a restriction. Take to a neutral point and hold until tension releases. Allow CRI to return and follow a few cycles to assess motion.
Repeat for torsion, sidebending rotation, vertical and lateral strains
There are 5 treatment options as well:
1) Direct–engage barrier with a force
2) Disengagement–separate two surfaces
3) Indirect–exaggerate strain where likes to go
4) Molding–direct action to re-form bone
5) Fluid techniques like CV4 and V-Spread
5 elements of primary respiratory mechanism
1) Inherent motility of brain and spinal cord
2) Fluctuation of CSF
3) Mobility of intracranial and intraspinal membranes
4) Mobility of cranial bones
5) Involuntary motion of sacrum between ilia
V-Spread
Does not change the CRI, but directs fluid movement to a compressed suture.
Place index and middle fingers on opposite sides of compressed suture and spread. Place fingers from other hand on opposite side of head and introduce a fluid wave from that side of the head towards the compressed suture.
Traditional sacral hold
Caudal hand between legs, fingers on sacral base
Cephalad hand cups L5 OR spans ASIS’s
Patient extends fully legs
Alternative sacral hold
Patient keeps knees and hips bent
Caudal hand comes in from side, but still important to keep forearm midline and parallel to table edge
Lumbo-sacral decompression
Use alternative or traditional holds
Put sacrum in flexion to disengage, then into extension with inferior traction and hold until release. Then recheck CRI amplitude and motion and the inferior spring of the sacrum from the Lumbar.
Sacroiliac decompression
Traditional or alternative hold with cephalad hand spanning ASIS’s.
Disengage by approximating ASIS’s which allows flexion of sacrum. At same time, take sacrum into extension and hols until release.
Venous sinus drainage technique
Support Inion with finger pads–>Confluence of sinuses
Same 1-2cm below Inion–>Occipital sinus
Occ. condyles at foramen magnum with V of fingers
Superior nuchal line–>Transverse sinuses
Sup nuchal with thumbs on lambda–>Straight sinus
Thumbs push apart sagittal suture–>superior sagittal sinus
Fingers and thumb on metopic suture–>sup sag sinus
SBS Decompression using BMT
Vault hold, resist flexion, encourage extension until still point. Lift sphenoid ant until dural unwinding felt. Then release sphenoid slowly and reassess the motion of the cranium.
OA Still Technique
Place in position of ease, apply compression, take to barrier.
Remember to recheck.
