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45 Cards in this Set
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- Back
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What are two signs of hypocalcemia?
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Trousseau's sign: adducted thumb, flexed fingers over it
Chvostek's sign: twitch of lips/nose when tapping on facial n. (at angle of mandible) |
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What is the imaging modality of choice to see the articulation of the TMJ?
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MRI
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Where do your 5 fingers go for vault hold?
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1 (thumb): off head
2 (index): greater wing 3: ant. to ear 4: post to ear 5: occiput |
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What are two positions that can be used to assess CRI?
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vault hold
frontal occipital hold |
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What are the 5 characteristics of CRI?
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rate
rhythm amplitude direction strength |
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In what direction do the sphenoid and occiput move during cranial flexion?
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sphenoid: anterior-inferior
occiput: posterior- inferior |
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In what direction do the sphenoid and occiput move during cranial extension?
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sphenoid: post-superior
occiput: ant-superior |
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Nutation of the sacrum occurs during what cycle of cranial motion?
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nutation: cranial extension
counternutation: flexion |
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Describe how BMT is used in cranial treatment.
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BMT: balanced membranous tension
indirect treatement Take tissues where they want to go to balance the contraction/relaxation of the membranes Hold until still point reached (b/w extremes of motion) using RTM |
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What forms the RTM?
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falx cerebri
tentorium cerebelli spinal dura |
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What type of strain pattern is associated with trauma and a parallelogram head?
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lateral strain
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You receive a blow to your left temple. What strain pattern might you experience?
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Right lateral strain
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You fell over and hit the back of your head. What strain pattern might you experience?
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superior vertical strain
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You ran into an open cabinet door in your kitchen. What strain pattern might you experience?
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inferior vertical strain
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What are some possible etiologies of SBS compression?
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birth (through birth canal)
hit windshield sacral dysfunction (fall on sacrum) |
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Torsional strain. Describe the following:
1. axis/axes of motion 2. planes of motion 3. landmark used for naming 4. direction of motion 5. palpatory findings |
1. AP axis
2. coronal plane 3. higher greater wing (L or R) 4. Sphenoid & occiput rotate in opposite directions 5. hands (1st/5th digits) rotate in opposite directions |
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SBR strain. Describe the following:
1. axis/axes of motion 2. planes of motion 3. landmark used for naming 4. direction of motion 5. palpatory findings |
1. one AP axis, 2 vertical axes
2. coronal plane, horizontal plane 3. which side is "down & out" (full side of head; L or R) 4. rotate same direction on AP, opposite on 2 transverse axes 5. one hand moves superior and fingers move closer, other hand does opposite |
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Lateral strain. Describe the following:
1. axis/axes of motion 2. planes of motion 3. landmark used for naming 4. direction of motion 5. palpatory findings |
1. 2 vertical axes
2. horizontal plane 3. Base of sphenoid in relation to base of ociput (R or L) 4. rotate same direction about 2 vertical directions 5. one hand rotates over the other (name for which one is on top) |
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Vertical strain. Describe the following:
1. axis/axes of motion 2. planes of motion 3. landmark used for naming 4. direction of motion 5. palpatory findings |
1. 2 transverse axes
2. sagittal plane 3. base of sphenoid in relation to base of occiput 4. rotate same direction about 2 axes 5. fingers of both hands pointing towards you (inf) or away (sup) |
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The CNS, CSF, & dural membranes make up the functional unit of the ?
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primary respiratory mechanism
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This is the palpable expresion of the PRM.
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CRI
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Describe the motion of paired cranial bones during cranial flexion and extension.
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Flexion: external rotation
Extension: internal rotation |
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Describe the motion, axis/axes, planes, and clinical manifestations of dysfunction of the parietal bones.
What technique addresses this bone? |
Motion: Flexion --> inf border moves lateral and sup border moves inf-medial
this increases the TRANSVERSE diameter Axis: AP plane: coronal CM: HA/ alteration of seizure threshold, localized pain Technique: parietal lift |
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Describe the motion, axis/axes, planes, and clinical manifestations of dysfunction of the frontal bones.
What technique may address this bone? |
Motion: Ext rotation --> inf-lateral angles move lateral and anterior (glabella moves posterior)
Axis: Dual AP axis Planes: coronal CM: HA, visual or smell disturbances Technique: Frontal lift |
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Describe the motion, axis/axes, planes, and clinical manifestations of dysfunction of the temporal bones.
What anatomic structures are associated w/ this bone? What technique may address this bone? |
Motion: Ext Rot --> sup border of petrous portion moves ant-lateral & slightly sup
Axis: oblique (jugular fossa to petrous apex) Plane: no etact plane CM: OM, tinnitus, hearing loss, dizziness, migraines Anatomic structures: middle ear, ICA, IJV, CN III-XI, muscle attachments Techniques: rocking the temporals |
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What cranial technique may be beneficial to a woman IN labor?
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CV4
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Describe the parietal lift technique
(objective, positions, contact points, movements) |
Objective: restore motion of parietals
Positions: pt supine, doc at the head Contact: modified vault (more sup), thubs interocked above sagittal suture Movement: gap/distract parietals cphalad maintain until change in motion use EQUAL pressure in both hands |
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Describe the frontal lift technique
(objective, positions, contact points, movements) |
Objective: free inferior aspects of bone from the coronal suture
Positions: pt supine, doc at pt head Contact: interlace fingers, hypothenar eminences are placed on lateral angles of frontal bone; heel of hand in front of coronal suture Movement: constant pressure medially against frontal eminences; raise frontal bone anteriorly (uni/bilateral); follow ext rotation and gently release |
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Describe unilateral and bilateral contact points for the five finger temporal hold.
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Pt supine
Doc at head of table Middle finger: in ext aud meatus thumb & index: grip zygomatic arch ring & pinky: ant & post to mastoid process Unilateral: opposite hand cradles occiptal squama medial to OM suture |
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Describe the "rocking the temporals" technique
(objective, positions, contact points, movements) |
Objective: Tx CN IX, X, XI entrapment, jugular vein compression, restricted temporo-occipital articulation, & tinnitis
Positions: pt supine, doc at head of table Contact: five finger hold OR palms support head, thumbs behind ears in front of mastoid process Movement: START at free side of motion (not through barrier), rock temporals alternating b/w ext/int rotation (asynchronous) through several cycles feel CSF fluctuation to become free slowly bring temporals back to balance point (DON'T leave asynchronous) |
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Describe the V-Spread technique.
(objective, positions, contact points, movements) |
Objective: tx compression of a suture (OM often used)
position: pt supine, doc at head contact: two fingers along suture line spreading apart. two fingers on contralateral (most distant) side of head pushing toward suture. wait for still point or release of tissues |
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Describe the CV4 technique.
(objectives, positions, contact points, movements) |
Objectives: compress 4th ventricle to stimulate inherent therapeutic force of body
Positions: pt. supine, doc at head of table Contact: thenar eminences on occipital squama (not the OM suture!) Movements: push ant-medial on extension, resist flexion wait for still point.... stop & hold until CRI returns |
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When observing the face during TMJ evaluation, what things should you note? (contours of face, teeth)
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Divide face into thirds: should be equal and symmetrical
Bite of teeth: Class 1: 1st molars normal, irregularities elsewhere Class 2: lower 1st molar posterior to upper (overbite) Class 3: lower 1st ant (underbite) |
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What muscles clench the jaw?
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masseter
temporalis medial pterygoid |
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What muscles bilaterally protract the jaw?
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medial & lateral pterygoids
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What muscles depress the jaw against mild resistance?
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diagstric and suprahyoid
(DG says lateral pterygoids) |
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What musles move the jaw laterally (and forward)?
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medial/lateral pterygoids on contralateral side
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How can you palpate the medial pterygoids?
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use glove to feel lateral to the molars (runs vertically right underneath the masseter)
use 2-3 lbs of pressure |
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What is the normal distance a pt should be able to open their mouth?
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3-6 cm
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Describe active motion testing of the TMJ.
(contact points, motions, deviations) |
Palpate anterior to tragus w/ pt supine
Pt. slowly opens mouth: C-shape --> unilateral deviates TOWARDS side of dysfunction first, then comes back towards center S-shape: bilateral dysfunction Have pt move mandible lat and medial, retract, and protrude |
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What treatment may address a C-shape deviation?
Describe this treatment. |
ME: treats all muscles that move the TMJ
Pt. supine, open mouth slightly Palm of hand contact body of mandible on side of deviation Push laterally toward barrier.... the rest is ME lingo |
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What treatment may address an S-shaped deviation?
Describe this treatment. |
Isometric exercises done by the pt.
Warm towels over TMJ for 10-15 minutes pt resists their own motions (20-30 seconds Do sets of 10, twice a day |
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Describe bilateral and unilateral stretching of facial muscles around the mandible.
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Bilateral: pt supine; contact angles of mandible, strecth caudally
Unilateral: Pt supine w/ head turned AWAY from dysfunction (doc at head of table); stabilize head w/ one hand, other grasps mandible caudad stretch |
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How can you stretch out tight pterygoid fascia?
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Pterygoid fascial stretch:
Pt. supine, doc at head, gloved hand Place finger along upper molars slide finger posterior until you engage the fascia induce a SUPERIOR-LATERAL force wait for tissue release (tearing may result due to indirect stim of the sphenopalatine ganglion) |
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Pt. presents with severe unilateral jaw pain on the right side. You suspect an anterior disc in the TMJ. Describe reduction of the anterior disc.
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Objective: pin condyle on disc, reduce w/ motion of mandible
Pt. supine Grasp (R) mandible 4/5th fingers on posterior ramus 2/3rd fingers on body Other hand: palm contacts other side (L) ---> body of mandible Motions: 4/5 lift anterior 2/3 lift cephalad opposite hand forces mandible medial (towards dysfunction side) |
