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Flashcards in AK Cranial Faults Deck (22)
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1
Q

Cruciate Suture

A

Indications: TMJ involvement; failure to swallow with mouth partially open
Palpable Tenderness: tenderness at masseter BL,
mid-cervical over spinal intrinsics. May complain of decreased mouth opening or constant neck tightness. Tenderness over the suture in the area of involvement.
Therapy Localization: fingers placed on midline of the hard palate and PIM is tested for weakening.
Challenge Correction: separate and approximate for negation of positive TL. Correct in that direction (usually separation). Start at alveolar arch and proceed posteriorly and finally to anterior portion next to canines.
Special Muscle Tests: Richard Schroeder, DC - weak coracobrachialis BL is associated with need for approximation of suture. Upper portion of mid trap and lower portion of upper trap (place extended arms with palms rotated medially at a 45 degree angle and test by applying medial pressure as the patient attempts to adduct the arm) indicates need for separation of suture.

2
Q

Inspiration Assist

A

Indications: weak muscle strengthens on inspiration or a strong muscle weakens on expiration.
Palpable Tenderness: on the frontal bone along
mid-pupillary line.
Therapy Localization: occipital-temporal junction or the mastoid process.
Challenge: Gently, with 2-3 pounds pressure, push the mastoid anterior and check for strengthening of the weak indicator muscle. Vary the vector of force until maximal strengthening is achieved.
Correction: For 4-5 respirations, push the mastoid in the direction that achieved maximal strengthening of weak muscle with 2-3 pounds pressure during inspiration.
Sacral associated faults: a sacral inspiration assist fault is many times present with this fault pattern. It is corrected by anterior pressure on the lower 1/3 of the sacrum during inspiration.

Test for a weakening of the hamstrings. If one is found weak, have the patient inspire and test for strengthening. Correct as above, for 5-6 respirations using 5-6 pounds of pressure.

3
Q

Expiration Assist

A

Indications: a weak muscle strengthens on expiration or a PIM weakens on inspiration
Palpable Tenderness: on the frontal bone along the
mid-pupillary line.
Therapy Localization: at the occipital-temporal junction or the mastoid process.
Challenge: push the mastoid posteriorly and check for strengthening of a weak muscle. Find vector of force that causes maximal strengthening.
Correction: push mastoid posteriorly on expiration.
Special Muscle Tests:

4
Q

Sphenobasilar Inspiration

A

Indications: a weak muscle strengthens when air is forced in after full inspiration or when a PIM is weakened after forced expiration after full expiration.
Palpable Tenderness: many times there will be tenderness over the wing of sphenoid.
Therapy Localization: patient’s thumbs are placed on the hard palate on the cruciate suture.
Challenge: thumbs are placed as in TL and patient is asked to forcibly exhale or a separate challenge may be done at the mastoid and cruciate suture to find the optimal vector for correction.
Correction: contact is made on the cruciate suture with one hand and mastoid with the other. On inspiration the mastoids are pressed anteriorly while hard palate is pushed superiorly. Repeat 4-5 times.
Sacral Associated Fault: check for fixation between sacrum and coccyx that is corrected on inspiration. Correction would involve moving the sacral apex anteriorly while the coccyx is moved posteriorly.

4
Q

Temporal Bulge

A

Indications: a weak muscle strengthens on 1/2 breath in or pim weakens on 1/2 breath out.
Palpable Tenderness: tenseness is found along the parieto-temporal junction.
Therapy Localization: patient’s fingers are placed over the temporal bone.
Challenge: pressure is applied anteriorly and posteriorly as if to exaggerate the bulge. Find the vectors causing the greatest amount of weakening of a pim. Allow for possible torque of the temporal bone by challenging with one thumb superior as the other moves inferior.
Correction: contact the occipital bone near asterion and the frontal bone near pterion and attempt to exaggerate the bulging with the maximum force being applied during the middle of inspiration. No force is applied during expiration.
Sacral associated fault: a category I pelvic torque condition may exist in association with the temporal bulge.

5
Q

SphenobasilarExpiration

A

Indications: a weak muscle strengthens when additional air is forced out after full expiration or a PIM weakens after forcing more air in after a full inspiration.
Palpable Tenderness: many times there is tenderness over the wing of sphenoid.
Therapy Localization: the patient’s thumbs are placed on the hard palate on the cruciate suture.
Challenge: thumbs are placed as in the TL position and patient is asked to forcibly inhale. Alternatively, a separate challenge man be done with one hand at the mastoid and one behind the central incisors to find the optimum vector for correction.
Correction: contact is made posterior to the central incisors and on the anterior margins of the mastoids. During expiration, the incisors are pulled anteriorly and the mastoids are pushed posteriorly. Repeat 4-5 times.
Sacral associated faults: check for fixation between the sacrum and the coccyx that is corrected on expiration. Correction involves moving the sacral apex posterior while the coccyx is move anterior.

6
Q

Parietal Decent

A

Indications: a weak muscle strengthens when 1/2 breath is let out or a pim weakens when 1/2 breath is inspired.
Palpable Tenderness: Tenderness is localized to an area superior to the ear on the temporal bone.
Therapy Localization: one hand touches the anterior scalene and the other on the parietal bone on the same side.
Challenge: lift the parietal bone, separating its junction with the temporal bone and test for a change in muscle strength.
Correction: use thumbs or heel of hand to protect sagittal suture by bracing the opposite parietal bone and pull the parietal bone superiorly, separating and raising it from the temporal bone on expiration with the maximum force applied during mid-breath.
Pelvic associated fault: many times a category I pelvic torque condition exists in association with the parietal descent.

7
Q

Glabella

A

Indications: breathing through either the nose or the mouth weakens a strong muscle. This is almost always found on oral respiration. Nasal findings are usually associated with trauma to the nose or surrounding structures.
Palpable Tenderness: none
Therapy Localization: one hand contacts the Glabella and the other the eop.
Challenge: pressure against the Glabella and the eop strengthens a weak associated muscle.
Correction: with one hand on the Glabella and the other on the eop, a force is applied with the type of breathing, oral or nasal, that did not cause weakness. After repeating 4-5 times, contact is also made to the upper 3 cervical vertebrae and they are pressed inferiorly while compression of the skull occurs, 4-5 times.
Special Muscle Tests:

8
Q

Interosseous (Universal)

A

Indications: a strong muscle is made weak by breathing in through one nostril.
Palpable Tenderness:
Therapy Localization: both hands are placed on the squamous portion of the occipital bone and a strong muscle is tested for weakening.
Challenge: with the patient prone, press one mastoid inferiorly and the other superiorly and the. Test for weakening of a strong muscle. If weakness doesn’t occur, reverse the direction of force and retest.
Correction: this is accomplished in the opposite direction that made the muscle weak on challenge. Contact is made simultaneously to the mastoids bilaterally and to both sides of the occiput. The contacts are then rotated in the appropriate direction, clockwise or counterclockwise, for 4-5 respirations.
Special Muscle Tests:

9
Q

Sagittal Suture

A

Indications:weakness of the rectus abdominus.
Palpable Tenderness:
TL: the fingers are placed over the sutures and a muscle is tested for change in strength.
Challenge: the suture can be approximated or separated.
Correction: forceful traction is applied to separate or close the suture during any phase of respiration.
Special Muscle tests:

10
Q

Lambdoidal Suture

A

Indications: weakness of the SCM may indicate jamming of this suture ipsilaterally. This fault is common in whiplash injuries.
TL: the fingers are placed over the suture and a muscle is tested for a change.
Challenge: the suture can be approximated or separated.
Correction: forceful traction with the fingers is applied to separate or close the suture during any phase of respiration. Correct in the direction opposite to that which weakened a pim.
Special Muscle Tests:

11
Q

Zygomatic Suture

A

Indications: this fault is usually associated with ileocecal valve problems. Local skull trauma, TMJ imbalances and chronic protein deficiencies can relate to this fault.
TL: fingers are placed over each of the 3 zygomatic sutures and a muscle is tested for change in strength.
Challenge: the sutures can be approximated or separated.
Correction: forceful traction with the fingers is applied to separate or approximate the suture during any phase of respiration. Correct in the direction opposite to that which weakened a pim.
Special Muscle Tests:

12
Q

Squamosal Suture

A

Indications: pain or discomfort on the side of the skull.
TL: the fingers are placed over the suture and a strong muscle is tested for weakening.
Challenge: the suture can be approximated or separated. A pim is tested for weakening and then a patient is asked to inspire or expire to see which phase of respiration restrenghthens muscle.
Correction: pressure is applied with fingers to either approximate or separate the suture, depending on the challenge direction and phase of respiration that negated challenge.
Special Muscle Tests:

13
Q

Cruciate Suture

A

TL: fingers are placed on the midline of the hard palate and pim is tested for weakness.
Challenge: separate or approximate for negation of TL.
Correction: correct in the direction that challenged (usually separation).
Special Muscle Tests:

14
Q

Naso-sphenoid Fault

A

A chronic finding that occurs with sphenobasilar faults. Goodheart found that this was associated with pituitary problems.

After using a two hand TL, with one hand on the Glabella and one to various organs to isolate problem, use a respiratory challenge to isolate type of cranial fault.

Usually will be a sphenobasilar fault.

Next, palpate the squamosal suture for tenderness or challenge the fault. Place thumb in upper medial border of the orbit and press toward the opposite sphenoid bone. Test pim for weakening.

If pim weakens, perform correction for cranial fault while patient contacts, with their thumbs, the upper medial border of the orbit. The patient presses toward the opposite sphenoid while the doctor performs the original cranial correction.

15
Q

Internal Frontal Fault

A

Indications: anterior neck flexor weakness may indicate this fault. There will be a nares imbalance with the larger on the side of internal rotation of the frontal bone, and the orbit will be smaller.
Palpable tenderness: over the supraorbital notch.
TL: fingers are placed either over the frontal bone or over the maxilla, inferior to the orbit of the eye.
Challenge: pressure is applied to the maxillary bone, inferior to the malar surface of the zygomatic bone. This pressure is applied nasally.
Correction: pressure is applied against the hard palate at the junction of the last premolar and the first molar, on the side of internal rotation. Pressure is applied as to roll superior and laterally against the palate. Repeat 5-6 times.

Check for a high sphenoid by examine the eyeball. The high sphenoid is on the side of the protruding eye. On that side, slide your fingers along the lateral margins of the molars until you reach the pterygoid muscle pocket, lateral and superior to the last molar tooth. This area will be very painful. Press inferiorly. Follow this by pressing the opposite pterygoid pocket superiorly and laterally.

16
Q

External Frontal

A

Indications: anterior neck flexor weakness may indicate this fault.
Palpable tenderness: at the superciliary arch on the side of external rotation and zygomatic malar arch on the opposite side.
TL: fingers are placed either over the frontal bone or over the maxilla, inferior to the orbit.
Challenge: the central incisor are pulled causally and an indicator muscle is tested.
Correction: on the side opposite to the external rotation, place your fingers in the hard palate, medial to the last molars. Pressure is applied cephalad and posterior (the exact vector of correction may be determined by finding the direction of pressure that will alleviate palpatory pain over the eyeball). This pressure is applied until the palpable soreness is relieved at the superciliary arch and the malar surface of the zygomatic. Your finger is then placed in the pterygoid pocket on the side of external rotation. Pressure is applied cephalad and medial for 20 seconds.

17
Q

Hologramic Breath Cessation

A

Research from Fryman, Michael and Retzlaff has shown that the skull is moving between 10-14 cycles per minute. This is unrelated to heart rate or to respiration. The cranial dura consists of two layers. The cranial section of the dura is divided into the falx cerebri, tentorium cerebelli and falx cerebelli and diaphragma sella. When chronic stress has been applied to the dura from either cranial/dental stress or due to chronic spinal imbalances, these attachments become tender on heir external surface.
TL to the sutures while holding breath for more than 10 seconds and test for weakening of sartorius or gracilis.
Procedure:
1. Test sartorius or gracilis and make sure is strong-if not correct.
2. Test against breath cessation-should stay strong regardless of inspiration or expiration.
3. Test again against breath cessation while the patient TLs to any of the cranial sutures. Wait 10 seconds and test for weakening of muscle.
4. Palpate the skull for tender points where dura attaches. Treat all tender areas using strain counterstrain technique (apply pressure through the skull at varying angles until pain is relieved).
5. Retest for tenderness after the technique. Retest against breath cessation and TL.
6. TL the lambdoidal suture and the ipsilateral SI joint. If weakness is found, tap the suture and SI for 40-60 seconds.
7. TL to the B&E points and tap those that are indicated.

18
Q

Epicranius or Occipito-frontalis muscle

A
Origin:
Insertion: 
Function:
Challenge:
Cranial:
19
Q

Temporoparietalis muscle

A
Origin:
Insertion: 
Function:
Challenge:
Cranial:
20
Q

Auricularis muscle

A
Origin:
Insertion: 
Function:
Challenge:
Cranial:
21
Q

Procerus

A
Origin:
Insertion: 
Function:
Challenge:
Cranial: