OMM Midterm Fall Quarter Year 2

William G. Sutherland. AKA "Bare Bones Bill"
The temporal - sphenoidal suture reminded him of the "gills of a fish".

Indirect: very light touch, more fluid and energy focus
Direct: slightly heavier touch: more articular and dural membranous focus

John Upledger. He copyrighted the term Craniosacral Therapy. (DO's now use Cranial Osteopathy)

1. Sutherland Cranial Teaching Foundation
2. Cranial Academy
3. Osteopathic Center for children
4. Osteopathic Medical Schools

1. The body is a dynamic unit of function.
2. Structure and function are reciprocally interrelated.
3.The body has a inherent therapeutic potency.
4.Treatment plan is based on the application of the above principles.

1. Inherent Mobility of CNS tissue/cells
2. Articular Mobility of the cranial bones
3. Mobility of the Dural Membranes (esp falx and tentorium)
4. Mobility of the CSF
5.Mobility of Sacrum in response to Occiput

Reciprocal Tension Membrane.
it is elastic and tensile

Pia - adherent to brain and spinal cord
Arachnoid - contains CSF
Dura - toughest, external layer continuous with periosteum of craneum, internal layer - sinusus

Straight Sinus. They move over "sutherland's fulcrum" which is the pivot point around which all motion in the RTM occurs.

Anterior Superior Pole
Anterior Inferior Pole
Lateral Pole
Posterior Pole
Sacral Pole

falx attaches crista galli of ethmoid and frontal crest

tentorium attaches to anterior and posterior clinoid processes of sella turcica

tentorium attaches to the petrous ridgeof the temporal bone and transverse ridge of the occiput

internal occipital protuberance

Dura exits formane magnum and attaches to C2 and hangs loosely until it attaches to S2 sacral segment

SBS - sphenobasial synchondrosis
formed by sphenoid and occiput

Rises
Flexion
CounterNutation

Descends
Extension
Nutation

FLEX
External Rot

EXTEND
Interal Rot

bones move away from midline
bones move toward midline

Rate (flexion plus extension, normally 10-14)
Amplituate
Vitality

CN 9,10,11 and IJV
CN 12

CN 9, 10, 11, 12. Plays a role in migraine cephalgia

Flexion/Extension

Body, greater and lesser wings, two inferior projections, L & R Pterygoid processes

13!

membrane
cartilage

Sella turcica

base of sphenoid rises
greater wings move anterior and laterally
pterygoids move perioterioly and inferolaterally
body expands laterally

alter sense of smell
contains CN I

affecs vision
contains CN II and ophtalmic artery

contains 3,4,6,5(1), and superior opthalmic vein. get vision problems

disturbances in hormonal function because of pituatary gland and if theres a injury to optic chaism get probelsm in vision

contains 3,4,6,5 (1) as well as tendinous ring of ZIN - origin for extraocular mucular attachements

V2 - movements of the jaw

contains V2

contains V3

meningeal branches of V3 and middle meningeal artery

1. Large hematopoetic source
2. protect pelvic organs
3. posture
4. Part of cranial mechanism

level of S2; craniosacral motion and respiratory motion

second sacral body; sacro-ilial motion - SEATED FLEXION TEST

S3; ilio sacral - STANDING FLEXION TEST

rotation in sagittal place

rotation in coronal plane - sidebending

combination of sidebening and roatation

SOMATIC DYSFXN

TEMPORAL BONES

3,4,6,
7,8,
9,10,11

6.
frontal bone functionally regarded as two bones because it has a life long resilience.

glabella goes posterior
ILAs move lat and inferior and anterior

glabella goes anterior and ILAs narrow

small bony island trapped within a suture

PARIETALS

become shorter and wider
taller and narrower

tic douloureux

bells palsy

tinnitus, vertigo, hearing loss

1. dry mouth, altered taste
2. cardiac/lung/gi problems and h/a
3. dysfxn of trap or SCM
4. dysphagia slurred speech

know it!!

pinky -lateral angeles of occiput
ring - mastoid process of temporal bone
middle - acoustic meatus of zygomatic process of temporal
index - greater wing of sphenoid
thumbs - on frontal bones parallel to each other and palms on parietal eminence

H/a, sinusitis, non-emergent head trauma, birth trauma, infant plagiocephaly, chronic illness

H/a infant plagiocephaly, compression strain patterns

otitis media, TMJD, tinnitus, vertigo, dizziness

Transverse at S2

A-P
nasion through body of sphenoid to the opisthion

Secondary to a blow where one side of the sphenoid is affected.
Sphenoid and occiput rotate in opposite directions (temporal follows occiput)

The side on which the greater wing of sphenoid is superior
(like two wheels rotating in opposite directions)

greater wing of sphenoid high and occiput is low on the left.
left temporal bone is in relative external rotation

sphenoid and occiput move in oppsite directions around vertical axis and same direction around AP axis
ex. in L sidebending rotation - right sidebending and convexity to left

side of convexity.
ex. left means right sidebeding with left roatation
ex: left hand feels fuller "more head" than right hand

Sphenoid and occiput rotate in same direction around their respective transverse axis. when one is in flexion the other is in extension

occiput in extension, sphenoid flexion
occiput in flexion, sphenoid extension

1. sidebending ( named for convexity)
2. torsions (named for high side of greater wing)

sphenoid and occiput rotation in same direction. ex of left : base of sphenoid moves to the left and base of occiput moves to the right
head looks like parallelogram

choroid plexus

lateral entricles
foramen of Monro
thrid ventricle
cerebral aqueduct
fourth ventricle
foramen of magendie and foramen of lushka
subarachnoid space
to bath the brain, spinal cord and cauda equina

arachnoid villi

suport and buffer for cns
carries secretions of hypothalamus
secretory fxn
controsl brains chemical environemnt

still point. this is a point of relase that allows for resetting of an electrical potential and can be considered a point of balance.

patient has something in body that needs to be expelled.
reduce edema.
ifection
venous congestion
febrile
toxicity
restore balance
CT disease
stimulate newborn
stimulate productice cough

epiletpic seizures
encephalitis
sometimes pregnancy

any paired bones and the sacrum

1, 2, 3.

1, 2, 3.

patient has something in body that needs to be expelled.
reduce edema.
ifection
venous congestion
febrile
toxicity
restore balance
CT disease
stimulate newborn
stimulate productice cough

epiletpic seizures
encephalitis
sometimes pregnancy

any paired bones and the sacrum

1, 2, 3.

1, 2, 3.

Left pinky finger goes toward patients feet and left index finger goes toward physician.
Right pinky finger goes toward physician and right index finger goes toward patients feet.

Right forefinger and little finger are closer together and held closer to the physician. The left forefinger and little finge are further apart and held away from the physician.

Forefingers move antero-inferiorly and little finger move postero-superiorly

Parallelogram. The forefingers move to the right and the pinky fingers move to the left.

Medial to the occipito mastoid suture and not on the suture.

Extension.

Balanced membranous tension (BMT)

Focus suture restrictrion/compression.

Paralysis of CN IV rarely occurs alone but with CN III as well.

Sigmoid sinus.

Jugular foramen.

H/A, sinusitis, allergies, congestive disorder, complex restricted mechanism, sphenobasilar compression, sinus congestion, first choice of treatment in a new patient.

Recent trauma, infection, elevated intracranial pressure, cerebral edema, recent stroke, recent neurosurgery, congenital malformation, any abnormal finding not thought to be somatic dysfxn.

Confluence of sinuses

Occipital sinus.

Decompression of condylar parts – opening of jugular foramen and foramen magnum

Transverse sinus and straight sinus.

Superior and inferior sagittal sinus.

Superior and inferior sagittal sinus.