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OPP 13

Terms in this set (94)

Retina anterior point
Lateral superior humerous
Retina posterior point
mastoid
Neck anterior point
medial superior humerous
Neck posterior point
TP C3-7
Cerebellum anterior point
tip coracoid process
Cerebellum posterior point
Superior to C1 TP
middle ear anterior point
Medial superior clavicle
middle ear posterior point
TP C1
Sinus anterior point
medial inferior clacicle
Sinus posterior point
C2 articular pillar
Pharynx anterior point
superior lateral edge manubrium
Pharynx posterior point
C2 articular pillar
Tonsils anterior point
Middle lateral edge of manubrium
Tonsils posterior point
C2 articular pillar
Tongue anterior point
Medial 2nd rib
Tongue posterior point
C2 articular pillar
Esophagus, Thyroid, Heart, Bronchus anterior point
Medial 2nd inter coastal space
Esophagus, Thyroid, Heart, Bronchus posterior point
T2 TP
What direction do you push for AC1 TP, what location is it, what position?
-lateral to medial
-on C1 TP midway between ramus of mandible and mastoid process
-SARA
What direction do you push for AC1 Mandible, what location, what position?
-posterior to anterior
-Posterior surface of ramus
-SARA
What direction do you push and where do you find A2-6, 8?
-anterior to posterior
-corresponding TP
-FSARA
Alt position for AC3?
ESARA
What direction do you push for AC7 , what location, what position?
-superior to inferior
-Clavicular insertion of SCM 2-3 cm lateral of proximal clavicle
-FSTAR
What direction do you push for AC8 , what location, what position?
-superomedial to inferolateral
-sternal insertion of SCM
FSARA
Where is PC1 inion and what position?
-1 cm lateral and inferior to inion
-FSTAR
Where is PC1 Occiput and what position?
3-4 cm lateral to midline in muscle mass
-E WITH SARA AS NEEDED
Where is PC2 and what position?
medial: on C2 spinous process or just lateral
lateral: 2 cm lateral to midline below occiput muscle mass
E WITH SARA AS NEEDED
Where is PC3-7 and what position?
Midline or inferolateral SP of C2-6
(NOTE PC3=C2 AND SO ON)
ESARA
-PC3 might require flexion
-pure midline points might just need extension
Where is PC8 and what position?
Medial: midline or inferolateral aspect of C7
lateral: posterior TP anterior to trapezius muscle belly
-ESARA
Mesenchyme that is compressed become________ or ______ while mesenchyme that is stretched becomes _________ or ______
-cartilage or basicranium
-membrane (dura) or neocranium
What is CRI?
Cranial ryhthmic impulse, 8-14 cpm normal
5 phenomena of PRM
1) motility of brain and spinal cord
2) fluctuation of CSF
3) mobility of membranes in CNS
4) articular mobility of cranial bones
5) involuntary mobility of sacrum between ilia
What two bones make up the cranial base
Spehnoid and occiput
Axes of motion for flexion, extension and vertical strain
two parallel transverse axes
Paired bones ____ in flexion and ____ in extension
Externally rotate and internally rotate
Steps in sacral BLT
-monitor L5
-grasp both ASIS and add medial compression to gap SI joints
-medial compression by approximating fingers and forearm until motion is felt at SI
where do you put your fingers in the vault hold?
Index: on greater wing of the sphenoid
Middle: anterior to the EAM
Fourth: posterior to the ear, on mastoid if possible
Fifth: on occiput
Thumbs: meet over junction of coronal and sagittal sutures
motion of fingers in flexion
fingers move away and spread apart
motion of fingers in extension
fingers move towards and together
describe brain and spinal cord changes in flexion
-brain shorter in AP diameter and wider laterally
-spinal cord shorter and thicker
describe brain and spinal cord changes in extension
-brain shorter in AP diameter and wider laterally
-spinal cord shorter and thicker
Physiologic strain patterns
Torsions and sidebending rotation
Pathologic strain pattern
vertical strain and lateral strain and SBS compression
axis for torsion
single AP axis
fingers right torsion
right index up left index down
axes for sidebending and rotation
two parallel vertical axes one ap
fingers right sidebending and rotation
right hand flex left hand extend
axes for vertical strain
two parallel transverse axes
superior strain fingers
both index fingers on top
inferior strain fingers
pinky fingers on top
axes of lateral strain
two parallel vertical axes
fingers of left lateral strain
index fingers to the right pinky to the left
Fronto-occipital hold
hold the ducking bones
SBS decompression
-Fronto-occipital hold
-distract sphenoid and stabilize occiput to avoid extension of OA
-BLT
Membrane internally becomes the ___ and externally becomes the ___
dura and periosteum
serrated sutures
sagittal and lambdoidal and coronal
Squamous Suture
Temporoparietal suture
Harmonic or Plane suture
irregular surface of two bones meet
-lacrimoethmoidal suture
Gomphosis "peg and socket"
teeth, spehnoid great wing and body
venous sinus drainage steps 1-4
1) fingers on superior nuchal line for transverse sinus
2) finger on inion for confluence of sinus
3)fingers lined on side of midline below inion to suboccipital tissues for occipital sinus
4) from lamba two crossed thumbs gently spread to drain superior sagittal sinus
frontal bone starts as paired bones and fuses at the ___ suture by 6 yoa
metopic
paired cranial bones
parietal and temporal
v-spread technique
-index and middle fingers on one hand on either side of a suture and gently spread or traction
-fingers on contralateral side of suture being treated and apply gentle pressure to cause fluid wave
Parietal lift
hands on parietal, cross thumbs but not on vertex
-gentle traction
Sympathetic innervation
T1-6, right to SA left to AV and both deep to respective cardiac plexus
Parasympathetic inervation
Vagus, right SA and left AV
Heaviest concentration of cardiac nociception
T4
MI facilitation is found where on the left and right?
T1-2 left, T2-3 on right
texture changes from posterior and inferior wall infarction are found ___
upper cervical region
HTN patient dysfunction is:
C6 T2 T6 'stitch'
where should you focus treatment for arrhythmias?
-C2, where the superior cervical ganglia is located
-left pec major trigger point
-T1-6
-Rib raising
-NO LYMPH PUMPS
BLT is performed on the OA to affect what nerve?
vagus
BLT of OA
- middle finger on opisthion ( midpoint of posterior foramen magnum)
-index and ring finger on occipital condyles
-other hand middle finger above C2 SP
-pt looks at feet and tuck chin to larynx
-Dr should feel C1, balance it
contents of thoracic inlet
Viscera, vascular, nerves, connective tissue (sibson's fascia)
How does the thoracic inlet affect blood and lymph flow? (2)
1) effects pressure gradient of thoracoabdominopelvic cylinder
2) inpingement of vascular through aperture
How do you Dx the 1st rib?
nfraclavicular parasternal asymmetry for rotation and costotransversearea of T1on the posterosuperioraspect for sidebending
CCP for thoracic inlet?
Sidebent right rotated right
Thoracic inlet treatment? (Tx more significant dysfunction first if needing two steps)
-sidebending only: high rib side, thrust to angle of louis
-rotation only : ease of rotation rib side, thrust to axilla
-both: high rib side, through to ASIS
Which cervical vertebrae are atypical?
C1, C2, C7
atlas facets are orientated?
medially
axis facets are orientated?
horizontally
other cervical orientation?
BUM
uncinate processes create___?
uncovertebral joints of Joints of Luschka
Ligament of nuchae is an extension of__?
interspinous ligament
anterior occipito-atlantal ligament extends from__?
anterior longitudianl ligament
posterior occipito-atlantal ligament extends from___?
ligament of flavum
PIERCED BY NERVES AND VERTEBRAL ARTERY
what keeps the ondontoid ligament in place?
transverse ligament
what is anterior scalene syndrome?
brachial plexus entrapment between anterior and medial scalene or cervical rib
chin deviates to the left in flexion, which condyle is dysfunctional?
right won't go posterior
chin deviates left in extension, which condyle is dysfunctional?
left won't go anterior
Muscle energy OA
look to toes if extending them
FPR
Indirect and passive
-specific dysfunctions maintained by short restrictors
-superficial large muscles for tissue texture changes
-okay for acute pain and after trauma
Steps of FPR
-neutral
-force (compression/torsion)
-move into ease
-release
Steps of Still Technique
-place in position of ease
-introduce force vector
-move tissue smoothly from position of ease through position of restriction
-passively move back to neutral and rescreen
-Work C2 down
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