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OPP Lect 21

William G Sutherland Noted the beveles of the sutures that vary between the two different tables of a disarticulated skull. **wrote The Cranial Bowl.
5 components of Primary Respiratory Mechanism (PRM) 1.motility (inherent motion) of brain & spinal cord. 2.Fluctuation of CSF. 3.Mobility of the intracranial and intraspinal membranes. 4.Mobility of cranial bones. 5.Involuntary mobility of the sacrum b/w the ilium (flex/ext pattern).
Mobility Vs. Motility Mobility: passive secondary motion. Motility:inherent motion.
PRM Component 2: Fluctuation of CSF 1.Formed in choroid plexus, 2.circulates through the ventricles and over brain & spinal cord, 3.then to subarachnoid space via cisterna. 4.reabsorbed by arachnoid granules into sinuses of the dura.
PRM component 3: Mobility of Intracranial and Intraspinal membranes: 2 layers of dura 2 layers of dura: 1.Outer layer:periosteal covering that goes through the sutures and foramen. 2.Inner layer: covers the brain and spinal cord and forms the sinuses.
Falx cerebri Inner layer of dura seperating the right and left hemispheres of the cerebrum.
Tentorium Cerebelli Inner layer of dura seperating the cerebellum from the cerebrum.
Continuity of intracranial and intraspinal membranes: key attachments of inner dura layer As the inner dura layer entends inferiorly, it has strong attachments at: 1.Foramen Magnum. 2.Posterior dens. 3.Posterior aspect of the body of C2 & C3. 4.Posterior aspect of the body of S2.
Cranial Rhythmic Impulse (CRI) Palpation of cranial mobility. occurs at a rate of 10-14 per minute which is due to: 1.variation of ANS tone, 2.pulse pressure. **has good intraexaminer reliability.
Where is the origin of cranial motion? Sphenobasiliar synchondrosis. **movement is on a scale of 5
What occurs during CRI flexion 1.SBS rises superiorly. 2.Occiput expands inferiorly and widens. 3.Greater wings of sphenoid move inferiorly and widen. **feels fatter and wider. BURT
What occurs during CRI extension 1.SBS moves down inferiorly. 2.Occiput moves superiorly and gets thinner. 3.Greater wings of sphenoid move superiorly and get narrower. **feels thinner and longer. ERNIE
CRI rate Measured from wide to wide. Fast: >14. Slow: <10
CRI amplitude Normal: 4-5. Low: <4 **0: sphenobasilar compression.
What could cause a CRI asymmetry? 1.Cranial base strains. 2.Cranial bone restrictions. 3.Cranial membrane strains.
PRM component 5: Sacral motion is linked to cranial motion The sacrum base rises during extension, and falls during flexion when patient is supine. **restriction at sacrum affects the cranium, therefore need to check sacrum with headaches.
Entrainment CRI is a summation of different autonomic phenomenon. Waves upon waves. 1.Flexion: Ext rotation. 2.Extension: Int rotation.
3 different CRI holds 1.Vault hold (put the ear in between the V). 2.Fronto-occipital hold. 3.Posterior Temporal hold.
Asterion Just above the mastoid process. meeting of parietal, occiput, temporal bone.
Inion Promenence on the occiput
Pterion 4 cranial bones intersect: 1.temporal, 2.Parietal, 3.Frontal, 4.Sphenoid.
Lambdoidal suture b/w occiput and parietal
difference between CN VII Bell's palsy and stroke? with bell's palsy, wont be able to raise paralyzed side eyebrow.
contraindications for cranial 1.Intracranial bleed. 2.Skull or facial fractures. 3.Infections of the brain, dura meninges. 4.caution with seizures. 5.CNS cancer.
Created by: WeeG