Test Part 3 - Dev Flashcards
Describe the process of a Falx release
a) how you would do it
(2 of 4 marks)
- Gently roll head side to side and lift head so 1 hand sits centrally under the occiput, curve of occiput sits in curve of palm, with the head well balanced so its not rolling to one side. Fingers pointing towards the sacrum and fingers extending into the soft tissue of the neck. Important that you can relax and the patient is comfortable.
- Move the chair so that your hand and arm under the occiput is in a straight line - if L hand under occiput move chair to right.
- Bring top hand through energy field towards frontal area. Heel of hand rests on crown or bregma, finger tips away from eyes.
Engage, check own fulcrums, level of physical contact, level of tissue contact and level of attention.
As engagement deepens, the hands respond to the energy field.
pg 224 CSIF
During the process of a Falx release
b) what you might feel in the patients CS system
(2 of 4 marks)
The Inherent treatment process;
As the energy field expresses its needs it may push or pull your hands, twist turn, into points of balanced tension and release back to neutral. And repeat.
Taking up the slack;
After a release, instead of returning to neutral as usual, one can take up the slack, which means taking up the slack of the softened and released tissues, and waiting until it draws into the next point of balanced tension, stillness and release. The slack can be taken in several times until the system lets you know it is complete, and wants to release out into neutral.
Craniosacral motion;
In flexion - frontal area arcs forward and down and occiput tucks under towards the neck - So the heels of the hands will be arcing away from each other during flexion and towards each other during extension.
Follow into extremes of motion;
When in a balanced neutral state, with CS motion in CSR or mid tide, see if system wants to draw more into flexion or extension. If unsure - ask the system. Useful to bring certain patterns into focus and address persistent patterns.
Subtle Integration;
Just sitting with neutral and seeing what else evolves in the system - giving space. Rhythmic cycles may stop as system deepens.
Reciprical tension membrane system;
Falx cerebri above and Falx Cerebelli below blend into the tentorium cerebelli at the straight sinus which affects the whole reciprocal tension membranes in other parts of the body, so may notice other transverse diaphragms relaxing or realigning because tentorium is being released through falx contact. Includes membranous attachments to C2, C3, S2 and coccyx so working at falx may feel repercussions all the way down the spine. Powerful for whole longitudinal membrane system.
CSIF Chapter 31.
Describe the process for the Mastoid Tip contact?
1) Gently roll head from side to side and lift the head
2) Place hands under back of head, fingers of one hand crossing fingers of the other to create a V shape and comfortably support the occiput, tips of fingers extending into upper neck.
3) pads (not tips) of thumbs on tips of the MASTOID PROCSSES.
4) Check levels of physical contact, attention and tissue connection.
5) Evolution of inherent treatment process - Engage, Allow, Follow, Stillness, Release, Reorganise
6) Rhythmic motion may surface as CSR or Mid Tide - follow into any extremes
7) Thumbs may feel the Mastoid processes drawing medially, follow this until it reaches balanced point of tension, stillness and release.
-) As the mastoid tips move medially, dont be tempted to think the heels of the hands move medially too, as this would compress the occiput, instead soften the heals of the hands laterally, and allow the occiput to expand too.
-) Feel system soften.
pg 199 CSIF
For what purposes is the mastoid tip contact useful?
Choose any - taken from book
-) stretching the tentorium and Impacting the straight sinus and whole reciprocal tension membrane system.
-) releasing OCCIPITO-MASTOID SUTURES - and Jugular Foramina.
-) JUGULAR FORAMEN - Spinal Accessory, Vagus and glossopharyngeal nerves and internal jugular vein.
-) HELPS RELEASE SUB-OCCIPITAL AREA - and structures associated with this region - venous drainage, arterial blood to brain, sympathetic nerve supply to head;
-) DRAINAGE OF EUSTACHIAN TUBE which runs along spheno-temporal suture
7) INTEGRATION OF WHOLE TEMPORAL/OCCIPITAL and CERVICAL REGION
8) CLEAR VANTAGE POINT FOR SPINE, dural tube and REST OF BODY.
9) CONDTIONS - ear infections; tinnitus; headaches from poor venous drainage, colic, nausea, respiratory or digestive issues
-) Diagnosing and impacting emotions via the emotional transverse diaphragms.
-) ENGAGING WITH WHOLE SYSTEM - so whole system will respond
pg 199 CSIF
What are the nerve root origins of the Sciatic Nerve?
1 mark
L45, S123
Notes; Longest and largest nerve in body
Nerve roots travel in the lumbar sacral plexus and then form the sciatic nerve which exits the pelvis through the Greater Sciatica Foramen, and sometimes travels through the belly of Piriformis.
-> down posterior thigh
-> divides above the knee
-> to form Tibial and Common Peroneal nerve
-> Tibial nerve travels in posterior of lower leg and whole of foot
-> Common Peroneal nerve anterior and anterior and lateral of lower leg and medial foot.
pg 363 CSIF
What are the symptoms of sciatica?
2 marks
pain (stabbing, burning or shooting), tingling, numb or weakness
in
bottom, back of leg, foot and/or toes.
Notes; https://www.nhs.uk/conditions/sciatica/
Can cause foot drop (L5)
What are the causes of sciatica? ( NOT TEST QUESTION SO SKIP IF WISH)
L5 is principle site of outflow for sciatic nerve
L5 - significant mechanical pivotal area - carries whole weight of vertebral column above; accommodates twists, turns and bends;
Angle between L5 and S1 is acute and vulnerable
Piriformis muscle sits above Greater Sciatica Foramen - if piriformis spasms, causes sciatic symptoms
Causes - spinal stenosis; degenerative discs; sacro-iliac joint dysfunction - L5 sits on top of SI joint; pregnancy; scar tissue; spinal tumour; inflammation of spine. Falls compressing spine.
What is the Superior Cervical Sympathetic Ganglion?
1 mark of 3
Uppermost ganglion or junction box of the sympathetic chain.
It is the pathway and junction of synapse for sympathetic supply to the head and eyes.
pg 374 CSIF
Where is the Superior Cervical Sympathetic Ganglion located?
1 mark of 3
C1 to C4, at side of neck bilaterally.
Note, the bony attachments to the membrane are at C2 and C3.
pg 374 CSIF
What is the Superior Cervical Sympathetic Ganglions function and significance?
1 mark of 3
It function is the pathway and junction of synapse for sympathetic supply from T1/T2 to the head and eyes with vital functions for face and head, including pupil dilation and blood vessel constriction. Overstimulation of the SCSG can cause not only issue to these functions but throughout the sympathetic nervous system as a whole. Located in the suboccipital region adds to its significance.
pg 142,374 CSIF
Note; full pathway is; Hypothalamus sends pre-ganglionic fibres down spinal cord which emerge T1/T2 of sympathetic chain.
Travels up through inferior, middle and synapses at superior cervical sympathetic ganglion. Post ganglionic fibres contributes to carotid plexus.
Travels via carotid canal as carotid nerve (with carotid artery) - up through cavernous sinus to be distributed in cranium.
Name 5 sympathetic functions and 5 parasympathic differences?
P - Pupils constrict - Parasympathetic fibres from Oculo-motor nerve
S - Pupils dilate - sympathetic fibres from sympathetic chain emerging from T1/T2 via SCSG as carotid nerve to head.
P - Increases stomach peristalsis and secretions - vagus
S - Decreases stomach peristalsis and secretions - T6 to T10
P - Saliva production increases - parasympathetic fibres from Facial and Glossopharyngeal nerve.
S - Saliva production decreases - arterial constriction from T1, T2.
P - Increase in urinary output - kidney/vagus, bladder/Pelvic Splanchnic Nerves S2-4
S - Decrease in urinary output - T10 to L2
P - neurons are cholinergic: acetylcholine
S - neurons are mostly adrenergic: epinephrine / norepinephrine
P - Rest and digest
S - Fight-or-flight
P - Decreases heart rate - vagus
S - Increases contraction, heart rate - T1-5
P - Bronchial tubes constrict - vagus
S - Bronchial tubes dilate - via T2 to T6
P - Muscles relax
S - Muscles contract
The parasympathetic nervous system general function is the body’s rest-and-digest response.
The sympathetic nervous system (SNS) general action is to mobilize the body’s fight-or-flight response.
Function
P - Control the body’s response while at rest.
S - Control the body’s response during perceived threat.
Originates in
P - Craniosacral outflow; S234 and Cranial nerves III, VII, IX, and X
S - Thoracolumbar outflow; T1 - L2
Why is an understanding of the anatomy of the nervous system, in terms of both SPINAL outflow and distribution, potentially useful in diagnosis and treatment in CS therapy? Give 2 examples, one somatic and one autonomic.
3 marks
It’s valuable to understand the relationship between the dural/vertebral levels and the areas and dysfunctions of the body (organs, muscles, limbs) it supplies from those levels.
Also, fascial restrictions anywhere along the nerve pathway caused by trauma, inflammation, repetitive use, tension etc.
Also, the reciprocity of the whole system, in which restrictions maybe reflected distant from their source.
Examples of peripheral nerves and their spinal outflow, distribution and restrictions;
Somatic; Sciatic Nerve - originates in SPINAL root origin L45, S123. So pain in posterior thigh, lower leg, foot or toes may originate anywhere along its path, e.g. exit of the spinal cord at L4-S3, perhaps as it pierces the dura, note dura stops at S2. Or where the nerve leaves the pelvis at the greater sciatic foramen next to or within piriformis, or as it passes in the popliteal fossa at the back of the knee. Or as it passes through tense calf muscles thru the posterior of the lower leg.
Autonomic; Asthma, the sympathetic nervous supply to the lungs is from vertebral levels T2-T6, which is invariably tight with patients with asthma.
Ulnar Nerve - originates in SPINAL root origin the C78. T1. Neurological symptoms - numbness; pins and needles; pain in the little and ring finger - may originate in the fascia of the lower neck (Brachial plexus).
How might you identify emotional characteristics in a patient through the CS process?
4 marks
Observation; Symptoms; Case history; Palpation;
Observation; demeanour, posture, manner, behaviour, breathing, facial expression, body language, pace of speech, level of eye contact.
Symptoms; all conditions and symptoms have psycho-emotional and a physical component. E.g. traumatic injuries, asthma, IBS, teeth grinding.
Case history; not just what is said but how it is said. Timing of stress with disease, work pressure, family issues, traumas. However, case history is often unreliable, as the patient seldom reveals full story.
Palpation; 100% reliable. Patterns of trauma and emotional masking are all palpable. Palpable as a QUALITY in the system, tense, agitated, controlled, open, held in shock frozen. Quality of tissue, fascia, SNS, breathing, responsiveness of system.
Key areas are Sympathetic plexi, diaphragm, suboccipital area, shoulders, neck, jaw, throat, viscera.
There are also common emotional visceral associations; Liver/anger, Gall bladder/control, kidneys/fear, heart/grief, lungs/anxiousness, stomach/insecurity.
Understand emotions can be very different at different levels due to suppression, masking, and circumstances. CSI can engage with all these levels.
Chap 55 CSIF
Give 4 ways which personal development can be helpful as a CS therapist?
4 marks
The state of the practitioner is the most important element of the CSI process. A practitioners genuine calm, quiet, presence can be be continuously improved by personal development. Personal Development can;
-Clear the clutter from your own system
-Address past traumas and tensions
-Clear out prejudices and preconceptions
-Maintain a constant state of grounding, centring and balance.
Knowing your own fulcrums and what triggers them, becoming more self aware.
Knowing what is the patients and what is the therapists ‘stuff’.
Knowing about transference, counter-transference and projection how that can unfold in the treatment.
Enables effective self care during and outside of treatments.
Being able to hold the space no matter what comes up in the treatment.
Chap 56 CSIF
Name 8 factors in fascial unwinding?
4 marks
Practitioner letting go
Patient letting go - articulation and breathing
Engagement
Allowing, not imposing
Containment, elastic tension
Still points - balanced tension
overview - connection between the local detail and the Whole person.
your own Body use and body awareness
Continuity - within the process and own movements
pg 319 CSIF
Punch Paces WBC
