5 PRM anatomical-physiological elements?
- inherent motility of the brain and spinal cord
- fluctuation of CSF
- mobility of intracranial and intraspinal membranes
- articular mobility of cranial bones
- monbility of sacrum interdependent with motion of SBS
Indications for OCMM?
- stress
- after birth
- trauma
- dentistry/TMJD
- feeding difficulities infant
- plagiocephaly
- vertigo
- TBI/concussion
- orofacial pain
- sinusitis/otitis media
- tinnitus
- post CVA
- torticollis
Absolute contraindications to OCMM?
- Acute CVA or intracranial bleed
- Acute skull fracture
Relative contraindications to OCMM?
- hx of siezures
- coagulopathy
- Increased ICP
Where is CSF produced?
choroid plexus of 3rd and 4th ventricles
What is the driving push from CSF expansion called?
Cranial rhythmic impulse
What are the motion characteristics of the CRI and describe them?
- Rate
- 8-14
- Rhythm
- Amplitude
- SD will decrease this
- Direction
- normal should be linear and symmetric
- Strength
What is the reciprocal tension membrane?
- functioning unit that holds bones of the vault and base under a constant tension
- this is made by the tentorium cerebelli and the falx
- allows but limits motion and acts as a spring storing energy in flexion and releasing in extension
Where does the RTM attach?
- frontal
- sphenoid
- temporal
- occipital
Describe cranial flexion.
- SBS rises superiorly decreasing the angle btw the occiput and the sphenoid
- The head widens and decreases the AP diameter becoming more spherical
- inhalation (head fills like a balloon becoming spherical with cranial inhalation/flexion)
Describe cranial extension?
- SBS moves inferiorly increasing the distance btw the inferiro abgle of sphenoid and occiput
- Head gets tall and narrow (paired with exhalation)
- people die with exhalation, face elongates and cheekbones are prominent
- exhalation=extension
Where does the dura attach on the skull and sacrum?
- foramen magnum to the posterior body and disc of S2 in the spinal canal
What does sacral nutation pair with?
SBS extension
base moves anteroinferior and apex moves posterior
What does counternutation pair with?
- SBS flexion
- base moves posterosuperior and apex moves anterior
Where does CN1 travel?
Cribiform plate
wehre does CN 2 travel through?
optic canal
What travels through the superior oribtal fisssure?
- CN III
- CN IV
- CN VI
- CN V 1 (opthalmic)
What travels through foramen rotundum?
maxillary nerve
What travels through foramen ovale?
- mandibular nerve
- accessory meningeal artery
What travels through foramen spinosum?
- middle meningeal artery/vein
- meningeal branch of mandibular nerve
What travels through interior acoustic meatus?
- CN VII
- CN VIII
What travels through jugular foramen?
- CN IX
- CN X
- CN XI
What travels through foramen magnum?
- Medulla oblongata
- Meninges
- Vertebral arteries
- Spinal roots of accessory nerve
What kind of joint is the SBS?
- Hyaline cartilagenous junction- a synchondrosis
