OPP- History and principles, OCMM Flashcards by Melanie Athens

“The arterial stream is , but the cerebrospinal fluid is in …..”

~ W.G. Sutherland, DO

supreme

command

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What are some important historical points about William Garner Sutherland, DO (WGS) 1873-1954- OCMM?

Observed a Beauchene skull
thought temporal and parietal bones resemled gills of fish
Started OCMM techniques
sphenoid bone beveled like gills of a fish

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Who quoted:

ʻBeveled, like the gills of a fish, indicating articular mobility for a respiratory mechanism.ʼ

William G. Sutherland, DO

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Other than William Sutherland, who was encourage by A.T. Still to study the circulation from the head through the spinal cord and its return

Favored radiographic study, followed by a single adjustment
was a neuropsychiatrist

Charlotte Weaver, DO

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What is the fundamental aspect of the classical cranial osteopathic model?

Primary respiratory mechanism

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Explan the meaning behind each of the words of:

Primary Respiratoy Mechanism

primary because precedes the thoracic respiration in importance

respiratory because of the exchange of gases and metabolites at the cellular level

mechanism because it is an integrated machine, each par working in relationship together

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The components of which mechanism are from the basis of an inherent rhythm that can be palpated on the skull and throughout the body?

Primary Respiratory Mechanism

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The primary respiratory mechanism is believed to occur dependently with/ independently of cardiac and respiratory activity and at a slightly slower/faster rhythm than pulmonary breathing

independently of

slower

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How many anatomic-physiologic components are involved with the primary respiratory mechanisms?

Phenomenon of osteopathic cranial manipulative medicine?

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What is the integration of anatomic structure and physiologic processes and can be palpated?

OCMM and primary respiratoy mechanism

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What are the 5 phenomenon of the osteopathic cranial manipulative medicine?

1) . Inherent Rhythmic Motility of the Brain and Spinal Cord
2. Fluctuation of the Cerebrospinal Fluid
3. Mobility of Intracranial and Intraspinal Membranes (Reciprocal Tension Membrane: RTM)
4. Articular Mobility of the Cranial Bones
5. Involuntary (Respiratory) Mobility of the Sacrum Between the Ilia

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The first phenomenon of osteopathic cranial manipulative medicine?

1). Inherent Rhythmic of the Brain and Spinal Cord

1). Inherent Rhythmic Motility of the Brain and Spinal Cord

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What is the difference between motility and mobility?

mobility= able to move something else, stays put (cilia, flagella)

motility= move independently

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Second PHENOMENA OF OSTEOPATHIC CRANIAL MANIPULATIVE MEDICINE

of the Cerebrospinal Fluid

Fluctuation of the Cerebrospinal Fluid

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the thirds PHENOMENON OF OSTEOPATHIC CRANIAL MANIPULATIVE MEDICINE

of Intracranial and Intraspinal Membranes (Reciprocal Tension Membrane: RTM)

(dural membranes)

Mobility of Intracranial and Intraspinal Membranes (Reciprocal Tension Membrane: RTM)

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4th PHENOMENON OF OSTEOPATHIC CRANIAL MANIPULATIVE MEDICINE:

Articular of the Cranial Bones

Articular Mobility of the Cranial Bones

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5th PHENOMENON OF OSTEOPATHIC CRANIAL MANIPULATIVE MEDICINE:

Involuntary (Respiratory) of the Sacrum Between the Ilia

Involuntary (Respiratory) Mobility of the Sacrum Between the Ilia

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Review the factors involved in cranial motion:

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1).The Inherent Motility of the Brain and Spinal Cord

Subtle, , pulse-wavelike movement
Shortens and thickens () and lengthens and thins ()
This may be a of the motion of embryologic development or a reflection of glymphatic drainage

slow

coils; uncoils

continuation

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How many phases involved with the Inherent Motility of the Brain and Spinal Cord, which is the first phenomena of the OCMM?

biphasic

Shortens and thickens (coils) and lengthens and thins (uncoils)

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2).Fluctuation of Cerebrospinal Fluid

CSF, produced by the , is inside and outside the CNS bathing it and protecting it.
Fluctuation: wavelike motion of fluid in a body cavity observed by or percussion.
In the PRM model as the CNS shortens and lengthens, the change shape and the CSF fluctuates.
This manifests a change throughout the body

choroid plexuses

palpation

ventricles

hydrodynamic

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How much CSF fluid is produced daily?

500 ml

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How often is the CSF fluid replaced daily?

2-4X daily

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How much CSF fluid usually at one time?

150 ml

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Which 4 places and by what structure produces CSF?

70% lateral, 3rd, 4th ventricles 30% formed as CNS extracellular fluid moves into the subarachnoid space

Describe the path of the CSF?

lateral ventricle 3rd ventricle cerebral aquecuct 4th ventricle cisterna magna subarachnoid space arachnoid villi large sagittal venous sinus and other venous sinuses

The CSF exits the 4th ventricle @

(1) midline via the foramen of Magendie (2) lateral foramina of Luschka enters the cisterna magna

Where is the cisterna magna located?

behind medulla and under cerebellum

The cisterna magna, which is behind the medulla and beneath the cerebellum, is continuous with what?

subarachnoid space that surrounds the brain and spinal cord

What are some Fluctuating Waveforms Within the Body?

Cardiac depolarization ⧫ Respiration ⧫ Peristalsis ⧫ Lymphatic ⧫ Glymphatic (cranial lymphatics) ⧫ CRI/PRM

perivascular tunnels formed on astroglial cells that promotes elimination of proteins and metabolites from the CNS

glymphatic system

As the brain lacks evidence of lymphatic circulation, what is the theory of how the brain clears extracellular proteins?

glymphatic system

How is it theorized how solutes from the brain iterstitium move from the parenchyma to the CSF?

glymphatic system

A substantial portion of subarachnoid cycles through the brain interstitial space.

CSF

As concerning the glymphatic system, CSF enters the parenchyma along spaces that surround penetrating arteries and that brain interstitial fluid is cleared along drainage pathways.

paravascular paravenous

As concerning the glymphatic system, Clearance through paravenous flow may also regulate extracellular levels of proteins involved with conditions, its impairment perhaps contributing to the misaccumulation of soluble proteins.

neurodegenerative

Outer layer of dura lines cranial cavity forming covering for inner aspect of the bones

periosteal

What Extends through sutures of the skull to become periosteum on the outer surface of the skull?

Dura mater

The Inner layer of dura covers brain & spinal cord & has reduplications, what are they? ⧫ Falx cerebri ⧫ Tentorium cerebri ⧫ Falx cerebelli

⧫ Falx cerebri ⧫ Tentorium cerebelli ⧫ Falx cerebelli

Where do all the dural folds originate?

along the straight sinus

The dura mater surround,support and the CNS

protect

The dura mater (intracranial and intraspinal membranes) extend down through the foramen magnuma nd are firmly attached at which 2 vertebra?

C2 and S2.

What is the dural connection of the meninges to the sacrum and is often called the core link?

reciprocal tension membrane

Which model of how the body works fits well with the reciprocal tenstion membrane?

tensegrity model

The cranial bones allow for a **minimal/maximal** amount of motion at the sutures

minimal

As concerning the articular mobility of the cranial bones, the 4th phenomena of the OCMM, what May be a protective mechanism to avoid brainstem herniation?

The cranial bones allow for a minimal amount of motion at the sutures.

What are the edges of the newborn bones like in the cranium?

smooth

During development, they interdigitate with the movement of the CNS. What does interdigate mean?

become serrated

What creates the sutures between the cranial bones?

growth and motion

What allows for a minimal amount of motion as well as provides protection for the brain?

the edges develop sutures between them.

With growth and motion, the edges develop sutures between them. ⧫ This allows for a minimal amount of motion as well as provides protection for the brain. ⧫ This movement contributes to a homeostatic mechanism: cranial

compliance.

The cranial bones have grown and developed in such a way to allow for a amount of motion at the sutures.

minimal

The sacrum moves in response to the inherent of the CNS, to the fluctuation of the CSF and the pull of the dural membranes.

motility

The motion of the sacrum in response to the inherent motility of the CNS, is called?

nutation= nodding forward countermountain= coming backwards

Where does nutation and counternutation of the sacrum occur?

superior transverse axis at S2 called the respiratory axis

Occurs around the superior transverse axis at S2 called the respiratory axis and is **independent/dependent** of postural motion of the sacrum between L5 and the ilia

independent

What is the sacral motion with cranial extension?

nutation (nodding forward)

What is the sacral motion iwth cranial flexion?

counternutaion (coming backwards) of the sacrum

The primary respiratort mechanism has 2 phases of motion:

FLEXION (Inhalation) AND EXTENSION (exhalation)

The main driving force for the primary respiratory mechanism is driven by the?

sphenoid and occiput

As regarding the PRM The sphenoid and occiput flex and extend (single bones) * Spending an amount of time in each phase * Moving an amplitude in each phase

equal equal

Which bones of the body respond to cranial motion?

all

During the flexion phase, how do paired and single bones move?

* Paired bones externally rotate * Single bones move into flexion

During the extension phase of the PRM, how do paired and single bones move?

* Paired bones externally rotate * Single bones move into flexion

Where and what is the sphenobasilar synchodrosis?

the junction where the base of the sphenoid and the base of the occiput articulate

How is cranial motion named?

Review and memorize the following chart:

What is A palpable, rhythmic fluctuation believed to be synchronous with the primary respiratory mechanism.?

Cranial Rhythmic Impulse CRI

CRI may be palpated as a motion of expansion and retraction of the cranium with a frequency of cycles/minute (This is an average number, based on many different studies)

10-14

The mechanical power inherent in the cerebrospinal fluid as a body liquid, which is not compressible and which is contained within the articulated cranium. The hydrodynamic relationship with the rest of the body automatically extends this inherent power throughout the organism and makes it available for use in diagnosis and treatment when the mechanism is understood. What is this concept?

potency

What is The fundamental principle in the functioning of the PRM?

potency the amplitude, how well we feel the CRI

What are 3 things one can do to increase the rate and quality of the PRM?

it increases potency and is more easily palpated

What are 6 things that can decrease rate and quality of the PRM?

the potency is decreased and less palpated

What are the 5 methods of balancing membranous tension?

* Exaggeration * Direct action * Disengagement * Opposite physiologic motion * Molding

What does it mean to balance membranous tension?

it means to improve mobility at the recriprocal tension membrane influence mechanism through structure that we can palpate

What are some infections that can be treated with OCMM?

* Otitis Media * Sinusitis * Bell’s Palsy

What 4 causes of pain can be treated with OCMM?

* Tension Headache * Migraine Headache * Jaw Pain/TMJ * Other pain

What are some common head and neck conditions that can be treated with OCMM?

* Vertigo * Trigeminal neuralgia * Tinnitus * Cranial neuropathy/ Nerve entrapment

What kinds of trauma can be treated with OCMM?

* Birth trauma * Concussion * MVA

What are some common pediatric conditions that can be treated with OCMM?

* Thumb-sucking * Colic * Poor feeding/latch * Plagiocephaly * Torticollis

OCMM can normalize nerve function, including all cranial and spinal nerves, as well as the nervous system

autonomic

One goal of treatment is to counteract stress-producing factors by normalizing function of the cerebrum, thalamus, hypothalamus, and body

pituitary

Where can OCMM eliminate statis in the body?

arterial, venous, and lymphatic channels that can include sinuses and ventricles

Review the goals of treatment for OCMM

* Normalizing nerve function, including all cranial and spinal nerves, as well as the autonomic nervous system * Counteracting stress-producing factors by normalizing function of the cerebrum, thalamus, hypothalamus, and pituitary body * Eliminating circulatory stasis by normalizing arterial, venous, and lymphatic channels * Normalizing CSF fluctuation * Releasing membranous tension * Correcting or resolving cranial articular strains • Modifying gross structural patterns

OPP- History and principles, OCMM Flashcards

(85 cards)