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Flashcards in Lectures 8-15 Deck (269)
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1

What part of the nervous system dominates the normal functioning of the lungs?

Parasympathetic

2

Persistent or unexpected coughing leads to what type of dysfx which complicates hemostasis?

Rib exhalation somatic rib dysfunctions

3

Pathophysiology of the pleura creates what structures?

Adhesions

4

What is dysfunctional about the receptors in the Hering-Breuer reflex?

They are unable to distinguish between fluid and air.

5

When the air sacs fill with fluid the Vagus. n sends a message to do what?

Decrease diaphragmatic excursion

6

What happens to the carotid body during this time?

It perceives the need for more O2 and sends signal to increase respiratory rate.

7

What is the ultimate result of the Hering-Breuer reflex?

Rapid, shallow breathing that can lead to loss of fluid.

8

What controls the sympathetics of the lungs?

T1-T6 (Parietal pleura may extend to T11)

9

What structures are stimulated by increased sympathetic tone and what does this lead to?

Stimulates bronchial glands, leading to increased numbers of Goblet cells and thick mucous secretions

10

Increased sympathetic tone does what to bronchiolar smooth muscle?

Relaxes it

11

What happens with prolonged sympathicotonia?

Vasoconstriction and hypoperfusion of the lung

12

What causes a Chapman point?

Increased sympathetic tone causes lymphatic stasis that is palpable as a tender myofascial, rubbery nodule. A primary visceral afferent produces a secondary myofascial tender point.

13

Do Chapman points radiate?

No

14

How do you manipulate a Chapman point?

With mild-moderate pressure in small circles; do this until modularity and tenderness dissipates

15

Where is the anterior Chapman point for the Bronchus?

2nd intercostal space near the sternum

16

Where is the anterior Chapman point for the Upper Lung?

3rd intercostal space near the sternum

17

Where is the anterior Chapman point for the Lower Lung?

4th intercostal space near the sternum

18

Where is the posterior Chapman point for the Bronchus?

In the soft tissue between spinous process of T2 and transverse process of T2

19

Where is the posterior Chapman point for the Upper Lung?

In the soft tissue between spinous process of T3 and transverse process of T4

20

Where is the posterior Chapman point for the Lower Lung?

In the soft tissue between spinous process of T4 and transverse process of T5

21

What is the parasympathetic nerve of the lung?

Vagus (CN X)

22

What do CN IX/X, and the carotid body control?

BP, CO2, and O2 regulation

23

What effect do the parasympathetics have on the bronchial cells?

Inhibition of bronchial cells decreases the number of Goblet cells and leads thinning of mucous

24

How do parasympathetics effect the bronchiolar smooth muscle?

Cause constriction

25

What can you evaluate to Dx parasympathetic function?

OA/AA

26

What occurs in an inhalation rib dysfunction?

Rib or group of ribs is “stuck up” and does not come down fully during exhalation. Rib space is narrow and wider below.

27

What is the key rib in an inhalation dysfunction?

Bottom rib (BITE)

28

What are the Sx of inhalation dysfunction?

Pain with exhalation and it may cause rapid, shallow breathing

29

What occurs in an exhalation dysfunction?

Rib or group of ribs is “stuck down” and unable to move up fully in inhalation. Rib spaces is wider, and narrower below.

30

What is the key rib of an exhalation dysfunction?

Top rib (BITE)

31

What are the Sx of an exhalation dysfunction?

Pain with inspiration

32

What comprises the functional thoracic inlet?

T1-4, ribs 1+2, manubrium, clavicles

33

Where is the drainage of the pleural sacs and lung tissues?

Pretracheal nodes——-> Right lymphatic duct

34

What is the innervation of the diaphragm?

C3,4,5 keep the diaphragm alive!

35

What creates negative intra-thoracic pressure?

Inhalation

36

What creates positive intra-thoracic pressure?

Exhalation

37

What structures pass through the diaphragm and where?

I 8 10 Eggs at Noon
IVC, T8; T10, Esophagus; Aorta T12

38

What structure opens in inhalation?

IVC

39

What structure closes in inhalation?

Esophagus

40

What muscles are you using when you treat with ME for the first rib?

Anterior + Middle scalenes

41

What muscles are you using when you treat with ME of the second rib?

Posterior Scalene

42

What muscles are you using when you treat with ME Ribs 3-5?

Pectoralis minor

43

What muscles are you using when you treat with ME Ribs 6-9?

Serratus anterior

44

What muscles are you using when you treat with ME Ribs 10-11?

Latissimus dorsi

45

What muscles are you using when you treat with ME Rib 12?

Quadratus lumborum

46

What muscles of respiration become overused in pulmonary disease, producing Sx in the neck and back?

Accessory muscles

47

What syndrome is associated with breathing with your neck?

Thoracic OUTLET syndrome

48

What Sx can occur with breathing with your back?

Extreme fatigue

49

Pneumonia is highly associated with what kind of surgery?

Abdominal

50

What do you treat Pre-Op to prevent pneumonia?

C3-5 (aka Phrenic n.)

51

What do you treat Post-Op to prevent pneumonia?

Also C3-5 + rib raising

52

What are some situations in which HVLA may not be well tolerated?

Toxic tissues, viscerosomatic dysfunctions

53

What are the atypical ribs?

Anything with a 1 or 2: so, Rib 1, Rib 2, Rib 10, Ribs 11 + 12

54

Typical ribs contain 2 ______ articulations at the ________ joints.

Demifacets, Costovertebral

55


Typical ribs have _____ articulation with the transverse process but have ______ articulation(s) some the same vertebrae



one; two


56

What makes Rib 1 atypical?

It articulates only with T1 and has no rib angle.

57

What makes Rib 2 atypical?

Large tuberosity attaching to Serratus anterior

58

What makes Rib 10 atypical?

Not always considered to be atypical, but attaches only to T10

59

What makes Ribs 11 + 12 atypical?

Articulate only with the corresponding vertebra (i.e. Floating ribs)

60

What are the True Ribs?

Ribs 1-7

61

Where do the true ribs attach?

Directly or through chondral masses to the sternum

62

What are the False Ribs?

Ribs 8-12

63

Do the false ribs attach directly to the sternum?

No

64

What are the Floating Ribs?

Ribs 11 + 12

65

“The sympathetic nervous system is diffuse in distribution the and is the sole enervator of both the musculoskeletal and vasomotor systems. Therefore somatic dysfunction could impact on reflex patterns between both the musculoskeletal and autonomic nervous systems through the sympathetic intermediary, as well as the vasomotor system and could also become a common denominator in a wide variety of disease entities. The only way to alter sympathetic activity is osteopathic manipulative treatment.”

Who said this?

I.M. Korr

66

What is the primary motion of Rib 1?

50% Pump Handle Motion + 50% Bucket Handle Motion

67

What is the primary motion of Ribs 2-5?

Pump Handle

68

What ribs display primarily Bucket Handle Motion?

Ribs 6-10

69

What ribs display Caliper motion?

11 + 12

70

Pump Handle Motion of Ribs 1-5 increases what?

AP Chest diameter

71

What happens to Pump Handle ribs during inhalation?

Posterior angles moves inferiorly and anterior ends move superiorly around the transverse axis.

72

Where is Pump Handle Motion best palpated?

Mid-clavicular line

73

The axis of rotation is closer to what plane in pump handle motion?

Transverse plane

74

What muscles lift the chest for pump handle motion?

Ribs 3/4/5: Lifted by pec minor
Rib 2: Lifted by pec major
Posterior Scalene m

75

Bucket Handle motion increases what diameter and occurs around what axis?

Increases transverse chest diameter occurring around the AP axis

76

What occurs with bucket handle motion during inhalation?

Intercostal space widens and the rib moves laterally and superiorly.

77

What occurs with bucket handle motion during exhalation?

Intercostal space narrow and rib moves medially and inferiorly

78

Where is Bucket Handle Motion best palpated?

Mid- axillary line

79

The axis of rotation is closer to what plane in bucket handle motion?

Sagittal plane

80

What muscle lifts the chest in Bucket Handle motion?

Serratus anterior

81

How do Ribs 11 + 12 move during caliper motion?

Both move posteriorly and laterally
Rib 11 moves slightly superior and Rib 12 moves slightly inferior

82

How do Ribs 11 + 12 move during exhalation?

Anterior and medially

83

What muscles attach cervical vertebrae to the 1st rib?

Anterior and middle scalenes

84

What structure emerges between the anterior and middle scalenes?

The brachial plexus

85

What structure attaches the 1st rib to the clavicle?

Costoclavicular ligament

86

What are the attachments of the diaphragm?

Xiphoid/Sternum
Ribs 6-12
Anterolateral surface f T12-L3

87

What is the origin of the serratus anterior?

Anterior surface of the medial border of the scapula

88

What is the insertion of the serratus anterior?

Superior lateral surface of Ribs 2-8

89

What is the action of the serratus anterior?

Protracts the scapula and holds it against the thoracic wall

90

What is the innervation of the serratus anterior?

Long thoracic nerve (C5-C7)

91

What are the muscles of Forced Inhalation?

SCM, Scalenes, Serratus anterior m.

92

What innervates the SCM?

CN XI (Spinal Accessory n.)

93

What part of the chest does the SCM move?

Manubrium of the sternum/ Lateral 1/3 of clavicle

94

What innervates the scalenes?

Ventral rami of C3-C8

95

What is the main muscle of forced expiration?

Rectus abdominus

96

What is the innervation of the rectus abdominus?

Lower 6 thoracic and first lumbar segmental nerves

97

What is Plagiocephaly?

Asymmetrical and twisted condition of the head, resulting from irregular closure of the cranial sutures

98

What is the anterior fontanelle?

It is the junction of the frontal + parietal bones at the intersection of the metopic, coronal, and sagittal sutures

99

When does the anterior fontanelle close?

@ 20 months

100

What is the posterior fontanelle?

The junction of the lambdoid and sagittal sutures

101

When does the posterior fontanelle close?

@ 3 months

102

What is Craniosynostosis?

Premature closure of the fontanelles

103

Increased venous congestions leads to what condition?

Cephaligia

104

85% of the venous drainage of the head is via the ___________ veins located in the ________ foramina between the occipital and temporal bones.

Jugular; jugular

105

Dilated pupils, photophobia, and narrow angle glaucoma are all condition that are related to increased sympathetic tone where?

T1-T4

106

A constricted pupil is due to what nerve?

CN III, parasympathetic response

107

Where does CN III synapse?

Ciliary ganglion; (goes to ciliary muscle)

108

What are some of the causes of nystagmus?

Can be congenital, secondary to vision loss, medication, MS, etc.

109

What nerves are compressed to elicit nystagmus?

CN III, IV, VI near tentorium

110

Is conjunctivitis usually bacterial or viral?

Viral

111

Conductive hearing loss can be secondary to what dysfunction?

Dysfunction of the Eustachian tube

112

What is the sympathetic innervation of the lungs?

T2-T7

113

What is the parasympathetic innervation of the lungs?

Vagus n

114

Increased sympathetic tone will do what to nasal secretions?

Thicken them

115

What is the first sign of lymphatic congestion?

Supraclavicular fullness

116

A “Plugged Ear” is secondary to what type of infection?

Nasopharyngeal infection

117

What are the Sx of Sphenopalatine syndrome (aka Pterygopalatine syndrome)?

Red, engorged mucous membranes, photophobia, tearing and pain behind the eye, nose, neck, ear, and temple

118

What the is cause of Sphenopalatine syndrome?

Irritation/somatic dysfunction of the sphenopalatine ganglion.

119

What is the route of parasympathetic innervation to the lacrimal gland + nasopharyngeal mucosa?

Innervation travels via CN VII, synapses in the sphenopalatine ganglion

120

How do you Tx somatic dysfunction of the sphenopalatine ganglion and what is the result of Tx?

Stimulation of the Sphenopalatine ganglion; results in tearing and thinning of secretion

121

What are some of the clinical effects of autonomic dysfunction?

Vasomotor congestion, secretions, nutritive functions, immune response, visual disturbances, hearing disturbances, vertigo, dizziness, light-headedness, and pain

122

What are some of the Sx associated with increased sympathetic activity?

Thick secretions with cough/irritation; dilation of pupils and photophobia; clouding of the lens; vasoconstriction; dry and cracked mucous membranes (pharyngitis); and secondary infections

123

What are some of the Sx of increased parasympathetic activity?

Increased clear, thin, watery secretions of glands; irritation of tissues; pupillary constriction and vision disturbance

124

What anatomical changes can affect autonomic output?

Cranial nerve entrapments + TMJ syndrome

125

What nerves are affected in cranial nerve entrapment?

CN III, IV, VI

126

What do these nerves pass under?

Petrosphenoidal ligament formed by the tentorum cerebelli

127

Entrapment of nerves in the petrasphenoidal ligament leads to what?

Increased dural strain

128

What are the SX of Cranial Nerve Entrapment?

Blurred vision, diplopia, nystagmus, eye fatigue, headache

129

What nerve is closest to the dura and is most likely affected?

CN VI

130

If CN IV is affected, what is the result?

Medial Strabismus

131

What is the first step of the general treatment plan for HEENT?

Treat the thoracic inlet (1st ribs and stellate ganglion, cervicothoracic)

132

Treatment of what region of the thoracics is most effective for HEENT?

T1-T4

133

What is the main goal of rib raising?

To normalize the sympathetic ganglia

134

What is the main goal of treating rib dysfunction?

To improve respiration and enhance drainage

135

What is the result of releasing the diaphragm?

Enhances respirations

136

When you treat L1 + L2, what are you really treating?

The diaphragmatic attachments

137

Frank Chapman initially described his points (in the 1920s) as _________ __________ that blocks lymphatic drainage.

Gangliform contraction

138

Who wrote “An Endocrine Interpretation of Chapman’s reflexes” in 1937?

Charles Owens DO and Ada Chapman DO

139

What syndrome did Owens coin?

PTAS: Pelvis-Thyroid-Adrenal Syndrome

140

What is the official Hendryx definition of a Chapman reflex?

A system of reflex points that present as predictable anterior and posterior fascial tissue texture abnormalities (plaque-like changes or stringiness of the involved tissues) assumed to be reflections of visceral dysfunctions or pathology. Used by Chapman and described by Owens

141

Where are Chapman points located?

Located deep to skin, subcutaneous tissue in deep fascia or on periosteum

142

We know that Chapman points are paired on both the anterior and posterior surfaces. Which points are usually more tender?

Anterior points

143

Describe a Chapman point.

Nodular: small (2-3 mm), smooth, firm, discrete, and move slightly

144

Does the pain radiate in a Chapman point?

No

145

Where are the VS Reflexes of the Upper Respiratory Tract (i.e. Head, Neck and Bronchi) located?

T1-T4

146

Where are the Cardiopulmonary (i.e. Heart, Lungs, Trachea, and Bronchi) VS reflexes located?

T1-T6

147

What are the VS Reflexes T5-T9 on the Left?

Stomach (L) and Duodenum

148

What are the VS Reflexes T5-T9 on the right?

Liver and Gallbladder

149

What are the VS Reflexes T7 on the Right and on the Left?

R: Pancreas
L: Spleen

150

Where are the VS Reflexes for the Right side of the colon located?

T10-11

151

Where are the VS Reflexes for the left side of the colon located?

T12-L2

152

Where is the VS Reflex for the appendix?

T12

153

What is the first step in treatment using Chapman points?

Normalize the pelvis

154

How long do you typically treat a Chapman point?

20-60 seconds

155

What treatment methods seem to correlate with the meridian acupuncture points?

Chapman points (60%)
Travell Trigger Points (70%)
Jones Counterstrain (80%)

156

How many tender points must a fibromyalgia pt experience in order to make a definitive Dx?

11/18 or more

157

What is the definition of a primary Key Lesion?

The somatic dysfunction that maintains a total pattern of dysfunction, including other secondary dysfunctions

158

What are some examples of those other secondary dysfunctions?

They can be somatic, visceral, mental, emotional, spiritual, or energetic

159

What is the definition of a secondary Key Lesion?

Somatic dysfunction arising either from mechanical or neurophysiologic responses subsequent to or as a consequence of other physiologies

160

What are 3 ways to find Key Lesions?

Through H + P; listening/observing; appropriate evaluation

161

What are the 3 headache classifications?

Migraine (with or without aura); Tension-type, Cluster

162

What is the most important factor in Dx of a headache etiology?

Take a good H + P

163

Name some other types of headache etiologies:

Vascular disorders
Infection
Brain tumor
Idiopathic cranial HTN
Concussive
Drug seeking/Withdrawl
Spinal low pressure
Chronic daily headache
Chiari malformation
Acute hydrocephalus
Metabolic disorders
Neuralgias
Medications
Glaucoma

164

What is the most prevalent type of primary headache in the general population?

Tension-Type Headache, mostly the infrequent episodic subtype (less than once/month)

165

What plays a critical role in the pathogenesis of TTH?

Heightened sensitivity of the pain pathways in the CNS and PNS

166

What type of condition is associated with the intensity and frequency of TTH attacks?

Pericranial muscle tenderness

167

How do you Tx a TTH?

Pharmacologic (NSAIDS, m. relaxants, antidepressants)
Sleep hygiene
Exercise/PT
Psychological counseling
Relaxation techniques

168

What is the theories regarding the pathophysiology of Cluster headaches?

Extracerebral vasodilation
Neuronal dysfunction
Trigeminovascular system
Hypothalamus involvement
PNS and SNS dys fyx

169

How do you Tx Cluster headache?

O2 Therapy
Pharmacologically

170

What OMT can you perform for a cluster headache?

Same as for Migraine:
Cranial, C1-C3, Upper thoracics, 1st rib, lymph + thoracic inlet
ALSO: SPG release

171

Define Bell palsy.

A unilateral lower motor neuron facial paralysis resulting from dysfx of CN VII

172

What is the etiology of Bell palsy?

Possibly viral infection or cold air exposure, psychological distress

173

What is the natural history of Bell palsy?

Often self-limiting

174

What are some Tx options for Bell palsy?

Protect the eye
Prednisone +/- antivirals
Psychological support

175

Inflammation of CN VII at the location of the ______ _______ is responsible for Bell palsy.

Stylomastoid foramen

176

What type of cranial somatic dysfunction is typically seen with Bell palsy?

Internally rotated temporal bone

177

How can you correct somatic dysfunction in Bell palsy?

Using indirect or direct action cranial techniques

178

What Sx do you see with TMJ Dysfunction?

Pain over TMJ radiating to the ear; clicking, popping, locking of jaw when opening/closing; deviation of jaw to one side with opening

179

What structures make up the TMJ?

It is formed by the head of the mandible + mandibular fossa of the temporal bone as well as the fibrous capsule and ligaments

180

What occurs when the mouth opens?

The head of the mandible + articular disc move anteriorly relative to the temporal bone. The opposite occurs when the mouth closes.

181

When the mouth opens, the head of the mandible rotates about a ______________ axis on the inferior surface of the articular disc.

Transverse

182

What occurs when the jaw protrudes?

Head of mandible glide anteriorly and articular discs move posteriorly. The opposite occurs with retraction of the jaw.

183

When the mouth closes, the head of the mandible rotates _________ direction on the transverse axis.

Opposite

184

Who is the father of cranial osteopathy?

William Garner Sutherland, DO

185

“Beveled, like the gills of a fish, and indicating an articular mobile mechanism for respiration”
_______ ________ ________

William Garner Sutherland

186

What are the 5 tenants that comprise the Primary Respiratory Mechanism?

Inherent mobility of the brain and spinal cord
Fluctuation of the CSF
Mobility of the intracranial and intraspinal membrane (reciprocal membrane tension)
Articular mobility of the cranial bones
Involuntary mobility of the sacrum between the ilia

187

What does PRM maintain?

Maintains an inherent, rhythmic, automatic, involuntary “life and motion” cycle of mobility and motility expressed by every cell and all the fluids in the body

188

Brain and spinal cord have a subtle, inherent slow pulse-wave like motion described as having ________ ________, which ma have a rhythmic nature

Biphasic cycle

189

What happens in the flexion phase?

CNS shortens and thickens

190

What happens in the extension phase?

CNS lengthens and thins

191

What causes fluctuation of the CSF?

Pressure gradients produced by production and release of the CSF into the cranial cavity by the choroid plexus in the ventricles, and drainage of CSF into the venous system and lymphatics

192

Inherent motility of the brain and spinal cord will cause movement of the ______ ______.

Dural membranes

193

What is the “Sutherland “fulcrum”

Junction of the falx and tentorum at the common origin: Straight sinus
A balancing point or fulcrum located along the straight sinus where falx cerebri joins tentorium cerebelli
Provides balancing point from which membranes can shift in response to motion induced by primary respiratory mechanism

194

Cranial and spinal nerves may be affected by what changes?

Changes in dural tension

195

What is the Reciprocal Tension Membrane?

It is the core link between the cranium and sacrum

196

What is a suture?

Sutures are joints that allow for a minimal amount of motion while still providing protection for the brain

197

Cranial dura is continuous with spinal dura which has a firm attachment where?

To the posterior superior aspect of the second sacral segment

198

The sacrum rocks between the ilia on the __________ ________ _______ through the articular pillar of the second sacral segment.

superior transverse axis

199

What is the movement of the sacrum in flexion?

Posterior and superior

200

What is the movement of the sacrum in extension?

Anterior and inferior

201

What is the keystone of all cranial movement?

SBS: Sphenobasilar synchodrosis. The angle of the SBS defines the Flexion and Extension phases.

202

The basiocciput and basisphenoid move ___________ during flexion.

Superiorly

203

How many cycles/minute is typical motion?

8-14 cycles/min

204

What are some things that will diminish the amplitude of a flexion/extension cycle?

Age, stress, psychiatric illness, infection, chronic poisoning

205

What are some things that will increase the amplitude of a flexion/extension cycle?

Exercise, fever, OMT

206

__________ bones flex and extend as defined by the SBS

Midline

207

What is the motion of paired bones?

Internal and external rotation

208

Do the sacrum and occiput move in the same or different direction(s) due to RTM?

SAME

209

Temporal motion is driven by what?

The Occiput

210

Facial bone motion is driven by what?

The Sphenoid

211

What bones are considered midline structures?

Occiput + sphenoid; ethmoid + vomer; sacrum

212

What bones are considered paired structures?

Parietals, temporals, frontal (yeah, I know, I don’t like it either); most facial bones, innominates, UE + LE

213

In flexion, there is an increase in _______ diameter and a decrease in _________ diameter.

Transverse; anteroposterior

214

In flexion, rotation of the sphenoid is __________.

Anterior

215

How does the basiocciput move during flexion?

Anterosuperiorly

216

How does the foramen magnum move during flexion?

Superiorly

217

How does the sacral base move during flexion?

Posteriorly and superiorly

218

An “Ernie” head is in what?

Flexion

219

A “Burt” head is in what?

Extension

220

What are the 4 physiological strains?

Flexion, extension, torsion, sidebending rotation

221

What are the three pathological strains?

Superior + Inferior Vertical, Right and Left Lateral, SBS compression

222

What is the goal of cranial osteopathy?

To balance membranous tension

223

Who benefits from indirect action (aka exaggeration) techniques?

Ages 5 through adult

224

What is a contraindication to the indirect action technique?

Trauma

225

Who benefits from direct action (aka disengagement) techniques?

Young children

226

When is it appropriate to use a disengagement technique?

In cases of trauma or overriding sutures

227

What are the 2 absolute contraindications to treatment with cranial osteopathic techniques?

Intracranial bleed or increased intracranial pressure
Skull fracture

228

What type of motion does the serrate (sawtooth) suture have?

Rocking motion

229

What type of motion does the squamous (scale-like) suture have?

Gliding motion

230

What type of motion does the harmonic (edge to edge) suture allow?

Allows shearing

231

This suture allows for a combination motion.

Squamoserrate

232

Define CRI

Cranial Rhythmic Impulse: A palpable rhythmic fluctuation believed to be synchronous with PRM

233

Where is CRI palpated?

Cranium and sacrum

234

What type of axis is the craniosacral axis?

Superior transverse axis through S2 segment

235

What is the motion of the sacrum?

Flexion + Extension

236

What do the paired bones do during flexion?

Externally rotate (Ernie head, and Ernie is an extrovert)

237

What do the paired bones do during extension?

Internally rotate (Burt head and he’s an introvert)

238

What is the axis of a torsion?

AP

239

Do the sphenoid and occiput rotate in the SAME or OPPOSITE directions in a torsion?

Opposite

240

How do you name a torsion?

Named for the side of the higher great wing of the sphenoid (either a L or R torsion)

241

What are the axes for sidebending/rotation?

Two parallel vertical and one AP

242

Sphenoid and occiput rotate ___________ directions about the vertical axes and ________ direction about the side of the AP axis.

Opposite; same

243

How do you name side-bending/rotation?

Named for the side of the convexity

244

What are the axes of a lateral strain?

2 parallel ; one through the sphenoid and one through the foramen magnum

245

In a lateral strain, sphenoid and occiput rotate in the _______ direction.

Same

246

How do you name a lateral strain?

Named according to the location of the base of the sphenoid

247

What are the axes of a vertical strain/shear?

2 parallel transverse axes

248

In a shear, sphenoid and occiput rotate in the ______ direction.

Same

249

What cranial impingement disorders arise from a dysfunction of CN X?

GI, respiratory, cardiac arrhythmias, colic, nausea/vomiting

250

What cranial impingement disorders arise from a dysfunction of CN IX,X?

Torticollis (SCM dysfxn), upper trap spasm, weakness (XI)

251

What cranial impingement disorders arise from a dysfunction of CN IX, X, XII?

Sucking/swallowing problems in infants

252

Name the 4 parts of the occiput at birth.

Base, squama, 2 condylar parts

253

At what age do the occipital part ossify?

Age 3

254

What is the Tx for failure to suckle?

Condylar decompression and release temporal

255

List the full Sx of Bell palsy.

Facial m. paralysis (CN VII), chorda tympani dysfx leads to loss of taste on anterior 2/3 of tongue, hyperacusis due to paralyzed stapedius m.

256

How do you Tx Bell palsy with OMT?

Tx temporal, sphenoid, occipital bones, and stylomastoid foramen somatic dysfunctions

257

Compression of what nerve will cause tinnitus?

CN VIII

258

What is the OMT Tx for tinnitus?

Tx of temporal, sphenoid, occipital bone and SCM

259

What are the sympathetic pre-ganglionic collateral ganglia?

T5-9: Greater
T10-11: Lesser
T12: Least Splanchnic
L1-L2: Lumbar splanchnic

260

The celiac ganglion sends post-ganglionic fibers to what structures?

Distal esophagus, stomach, liver, gallbladder, spleen, some pancreas, proximal duodenum (aka Foregut)

261

The superior mesenteric ganglion sends post-ganglionic fibers to what structures?

Some pancreas, duodenum, jejunum, ileum, ascending colon, proximal 2/3 of transverse colon (aka midgut) ; adrenals, gonads, kidneys upper 1/2 of ureters

262

The inferior mesenteric ganglion sends post-ganglionic fibers to what structures?

Distal 1/3 transverse colon, descending colon, sigmoid colon, rectum (Hindgut) lower 1/2 of ureter, bladder, genitalia

263

The thoracic duct pierces what structure two times?

Simpson's fascia

264

What is the order of ventricular flow?

1. Lateral ventricle
2. Foramen of Monroe
3. 3rd ventricle
4. Cerebral aqueduct of sylvius
5. 4th ventricle
6. Foramen of Magendie

265

What major structure of the brain regulated respiration and where is it located?

Medulla; located in the fourth ventricle

266

What is a big, bad contraindication to Tx with CV-4?

Pregnancy: Stimulation of ptosin can induce early labor
Also acute CVA, malignant HTN, skull fracture, and aneurysm

267

What ages is otitis media common?

occurs in 20% of infants between 6 mo- 6 years

268

Why are ear infections more common in children?

Eustachian tube is narrower, shorter, and more horizontal, making the movement of fluid and air difficult

269

What is the OMT Tx for otitis media?

Temporal bone, eustachian tubes, and somatic dysfunction of pharynx