Term
| You find a somatic dysfunction at C3-C5 on a patient. The patient has a cough that won't go away. Being the awesome omtologist tht you are, you realize that this patients real problem is coming from somewhere else. |
|
Definition
The root of this persons problem is his JAW pain - because of his trigeminal n.
phrenic nerve (C3,4,5)
and Trigeminal N.: pain in any division of the trigeminal n. can refere to the mid and upper neck and generate somatic dysfunction. |
|
|
Term
| the tongue, palate, oropharynx and nasopharynx are all innervated by? |
|
Definition
|
|
Term
| Innervation of the EAR?? (3) |
|
Definition
1. Trigeminal via V3 (mandibular)
2. C2,C3 N roots of the cervical plexus
3. Vagus - via auricular branch supplies external acoustic meatus and a small area on the posteromedial surface of the auricle. |
|
|
Term
| T/F: chapman's points for the ENT are in the intercoastal spaces anteriorly |
|
Definition
| falseee, they areon the surface of the ribs or the clavicle |
|
|
Term
| where is the chapman point for laryngitis? |
|
Definition
anterior: upper surface of second rib - 2-3 inches from the sternum
posterior - over TP of C2 (between TP and SP) |
|
|
Term
| Nasal chapman points anterior and posterior ? |
|
Definition
anterior : first rib at the junction of the rib with the costal cartilage
posterior: anterior surface of TP of C2 |
|
|
Term
| Otitis Media chapman points? |
|
Definition
Anterior: upper edge of the clavicle where it crosses the first rib
posterior: upper edge of the tip of C1 TP |
|
|
Term
| Pharyngitis chapmans point? |
|
Definition
Anterior: anterior surface of the first rib 3/4inch
posterior: posterior aspect of the TP of C2 |
|
|
Term
|
Definition
anterior: surface of the second rib - 3.5 incles from the sternum
posterior: posterior surface of the TP of C2 |
|
|
Term
|
Definition
anterior: anterior surface of the 2nd costal cartilage, 3/4inches from the sternum
posterior: on the superior aspect of the TP of C2 |
|
|
Term
tonsilitis chapmans point?
anterior and posterior |
|
Definition
anterior: first intercostal space cose to the sternum (one segment above the heart point)
posterior: on the posterior surface of the TP of C1 |
|
|
Term
| a patient came in with eye pain and you suspect that this pain is generated by a myofascial trigger point. where are you going to go searching for a trigger point? |
|
Definition
1. orbicularis oris (duhh)
2. splenius cervicis
3. occipitalis
4. sternal division of the SCM
5. trapezius |
|
|
Term
| Patient's chief complaint = doc, i hear this high pitching ringing noise. you know that this is not because of an internal rotation of his temporal bone because you palpated his CRI and all is normal. so now you want to consider trigger points as the cause of his tinnitis. where you going to find em? |
|
Definition
1. deep portion of Masseter m.
2. clavicular division of SCM
3. Medial Pterygoid
4. Occipitalis
same for ear pain and diminished hearing |
|
|
Term
| nose pain ...wheres the trigger point? |
|
Definition
|
|
Term
| Otitis Media caused by a trigger point in ____ m |
|
Definition
| medial pterygoid. this is the trigger point for the eustachian tube |
|
|
Term
| patient has difficulty swallowing and complains of throat pain. all infectious causes, neoplastic causes, etc have been ruled out. she may have a trigger point in what two muscles that may be causing her symptoms? |
|
Definition
1. medial pterygoid
2. digastric |
|
|
Term
Students are complaining of nasal stuffiness because its flu season. but you realize that their nasal stuffiness is due to a trigger point in one of these three muscles. what are they?
ps. these are the same for maxillary sinus pain |
|
Definition
1. lateral pterygoid
2. masseter
3. sternal division of SCM ( also a trigger point for eye symptoms) |
|
|
Term
| external rotation of the temporal bone will produce which type of tinnitis? |
|
Definition
| low pitched roar (patent eustachian tube) |
|
|
Term
| Internal rotation of the temporal bone produces what type of tinnitis? |
|
Definition
| high pitched tinnitus (closed eustachian tube) and is often associated with chronic or recurrent otitis media |
|
|
Term
You have a patient who has chronic serous otitis media and you want to perform the galbreath technique on them. the traction applied in this technique impacts what muscle of mastication.?
this muscle's fascia is continuous with that of _______ muscle which allows for the pumping action on the eustachian tube. |
|
Definition
1. medial pterygoid muscle
2. tensor velli palatini m |
|
|
Term
| the sympathetics emanate from t1-t4 levels and are distributed to the ENT region via what system |
|
Definition
1 vertebral basilar arterial tree and carotid system!
(hope you guys can read dr e's slides better than i can. i hope i didnt mess anyone up) |
|
|
Term
| is a patient has decreased tissue turgor ...what would they have hyperparasympatheticotonia or hypersympatheticotonia or hyposympatheticotonia?? |
|
Definition
| hypersympatheticotonia - also vasoconstriction |
|
|
Term
| the visceral afferent fibers of the ENT region follow what sensory nerves back into the CNS |
|
Definition
1. trigeminal
2. glossopharyngeal
3. vagus
4. facial
5. occipital |
|
|
Term
| what are the symptoms of chronic hypersympatheticotonia?? |
|
Definition
1. thick viscous secretions
2. drying, cracking and breakdown of the mucosal barrier
3. predisposition to infection |
|
|
Term
| Manual or thermal stimulation of the trigeminal nerve can cause of type of sympatheticotonia? |
|
Definition
| hyper-sympatheticotonia with vasoconstriction |
|
|
Term
| the vasoconstriction in the hypersympatheticotonia that occurs with manual or thermal stimulation results in whaat? |
|
Definition
| the opening of the sinus ostia and allows the sinuses to drain |
|
|
Term
| T/F suboccipital traction or inhibition allows the sinus ostia to open as well and the sinuses to drain |
|
Definition
|
|
Term
| if you irritate the sphenopalatine ganglion what would happen? |
|
Definition
1. thinning of section and easier passage of sinus content through the ostia
2. eye to water |
|
|
Term
cranial somatic dysfunction can narrow ____ through which 85% of the venous blood leaving the head drains.
where is this anatomic struction located? |
|
Definition
1. jugular foramen - internal jugular vein exits through this thing.
2. jugular foramen is located in the petrobasilar suture, a continuation of the occipitomastoid suture |
|
|
Term
| when treating an ENT dysfunction, what treatment sequence?? |
|
Definition
1. tx thoracic, costal, cervical, and cranial dysfunction
2. open the thoracic inlet
3. apply thoracic pump, domin diaphragm
4. apply anterior cervical arches technique
5. apply cervical chain drainage
6. apply mandibular drainage
7. apply auricular drainage
8. apply reflexly mediated techniques (trigeminal stimulations, suboccipital pressure, sphenopalatine ganglion tx) |
|
|
Term
| most common reason for pediatric visits under 5 |
|
Definition
|
|
Term
| how do you treat pharyngitis with OMT |
|
Definition
lymphatic and splenic pump
compression of ventricle 4
anterior cervical fascia release
muscle energy |
|
|
Term
| You had a patient that experienced a blow to the frontal bone. the patient is experiencing ansomia, hyperosmia and dusgeusia. based on these symptoms, the cranial nerve that is irritated in this patient passes through what part of the head? |
|
Definition
the cribiform plate of the ethmoid bone (the nerve that is affected is CNI)
dyfunctions are due to ethmoid and bones that influence the ethmoid- frontals, sphenoid, nasals, vomer, and maxillae |
|
|
Term
| what cranial nerve passes through the optic foramen in the lesser wing of the sphenoid? |
|
Definition
|
|
Term
| what are symptoms?? when you have dysfunction of the sphenoid bone and the bones that articulate with the sphenoid?? |
|
Definition
| visual blurring; visual dimming; photophobia |
|
|
Term
| What are the bones that articulate with the sphenoid?? |
|
Definition
| occiput, parietal, temporal, frontal, ethmoid, zygoma, maxillae, and vomer |
|
|
Term
| what nerve courses over the FREE ANTERIOR border of the tendorium at the petrous apex? |
|
Definition
|
|
Term
| The oculomotor nerve can be affected when you have this dysfunction of the cranium. This dysfunction causes compression of the oculomotor nerve which can change the patient's vision significantly. |
|
Definition
| CN III is vulnerable to compression from EXTERNAL ROTATION OF THE TEMPORAL BONE in this location |
|
|
Term
| what nerve exits the skull via the superior orbital fissure between the greater and lesser wings of the sphenoid? |
|
Definition
| oculomotor n. (it passes through the cavernous sinus and then exits the skull via this.) |
|
|
Term
| patient has difficulty moving his eyes and complains of the tic. this may be a result of what dyfunction with relation to his oculomotor n.? |
|
Definition
| intraosseous dysfunction: sphenoid between the greater wing and the lesser wing. and any dysfunction that affects the sphenoid bone. |
|
|
Term
this cranial nerve pierces THROUGH the anterior border of the tentorium and then follows CN III??
a dysfunction in this area would cause what symptoms? |
|
Definition
trochlear
weakness of superior oblique muscle
diplopia
eye twitching |
|
|
Term
| what type of dysfunctions could cause a trochlear n. related symptoms? |
|
Definition
anything that TIGHTENS the tentorium.
1. temporal external rotation
2. sphenoid or occipital dysfunction |
|
|
Term
| T/F: Disorders in the Lesser/Greater Wing of sphenoid, ethmoid bone, maxillae, zygomatic bones can result in disorders of conjugate gaze |
|
Definition
|
|
Term
| Pt presents with ocular pain, conjunctival injection and swelling. You suspect orbital venous congestion. Your patient asks you to describe anatomically how this is a possible cause of her pain. what will you say? |
|
Definition
| most everything from your eye drains into the ophthalmic vein which exits the orbit via the optic foramen and emptyies into the cavernous sinus. so any dysfunction of the sphenoid bone will cause a narrowing of your optic foramen which will cause your opthalmic vein to malfunction |
|
|
Term
| How does the Trigeminal n. course through/over/under the tentorium in your head? |
|
Definition
| trigeminal n. courses OVER the petrous ridge and benight the anterior border of the tentorium |
|
|
Term
| the three branches that supply the face are |
|
Definition
supraorbital
infraorbital
and mandibular |
|
|
Term
| sinus pain without any sinus disease can be attributed to |
|
Definition
|
|
Term
| describe the course of the supraorbital n (V1) through the orbit and out of the orbit? |
|
Definition
| V-1 -- enters the orbit through the superior orbital fissure and then courses across the roof of the orbit and exits the orbit through the supraorbital notch/foramen |
|
|
Term
| which branch of the trigeminal is susceptible to dysfunctions of the frontal and sphenoid bone only |
|
Definition
supraorbital n.
why? the superior orbital fissure is in between the greater and lesser wings of the sphenoid |
|
|
Term
| The infraorbital fissure is mainly related to what two bones of the orbit? |
|
Definition
| the lower edge of the greater wing of the sphenoid and the orbital surface of the maxillae. |
|
|
Term
this cranial n. enters the orbit via the inferior orbital fissure and runs below the eye, partially in an open groove and partially through the maxilla.
Dysfunctions if what two bones will result in pain along the nerve discribed above |
|
Definition
1. nerve = infraorbital (V2)
2. dysfunctions in sphenoid and maxillae |
|
|
Term
| the mandibular n. emerges through ______ foramen and passes between what two muscles to then enter the ____ canal of the mandible. |
|
Definition
| the mandibular nerve emerges through the FORAMEN OVALE and passes through the TENSOR VELLI PALINTINI AND LATERAL PTERYGOID MUSCLES and then Enters the ALVEOLAR CANAL of the mandible |
|
|
Term
| the mandibular n. is vulnerable to dysfunctions in what three bones |
|
Definition
sphenoid
temporal and
mandible
* temporal and mandible have to do with TMJ dysfunction in adults
*Kids - could be because of intraosseous dysfunctions |
|
|
Term
| pt just had a dental extraction done, she describes her lower molars being extracted on the left side. her chart states that her chief complaint is she is pain on her face. before you even enter the room, your OMM skills allow you to suspect to find what two physical findings. |
|
Definition
1. neuralgia on the opposite side!
2. internal rotation of the temporal bone. |
|
|
Term
| pain pattern with an upper tooth extraction will be |
|
Definition
| trigeminal neuralgia on the same side |
|
|
Term
| you have a newborn that will not latch onto the nipple, has been crying excessively and is colicy. nothing seems to be making this baby calm down so as last resort you dig deep in your omm knowledge and remember that birth injuries could often produce such symptoms. where might you find dysfunctions that you can fix with omt? |
|
Definition
1. sphenobasilar dysfunction
2. compression of the condylar parts
3. occiput |
|
|
Term
| where does the hypoglossal n. exit the skull ? compression of this nerve will cause ?? ? |
|
Definition
just anterolateral to the occipital condyle
compression causes tongue dysfunction |
|
|
Term
| T?F?: in a study they found that by doing decompressiong of condylar parts on an infant with colic, their crying time was cut in 1/2, sleeping time increased and parents didnt have to hold and rock their infants as much for them to fall asleep. |
|
Definition
|
|
Term
The location of the jugular foramem =
what cranial n. exits through this foramen |
|
Definition
in the sutureee between the petrous portion of the temporal bone and the occipital condyle
vagus |
|
|
Term
| so if i irritate the suture between my petrous portion of my temporal bone and my occipital condyle, what might happen to me?? |
|
Definition
| hyperparasympatheticotonia: too much rest and digest stuff -- lower heart rate, irritable bowels, miosis. |
|
|
Term
| in children if you cause a severe compression of the vagus n. what division of the autonomic n. system dominates? |
|
Definition
|
|
Term
| you have a patient who feels very congested and you palpate his sinuses and find that the emissary veins are congested. this might be due to and impingement where? |
|
Definition
| impingement of the internal jugular vein through the jugular foramen might have cause this general cerebral congestion with over distention of accessory circulatins (batson's veins, emissary veins) and a wide range of cerebral cervical, facial and other symptoms. |
|
|
Term
| what all does the jugular foramen carry? |
|
Definition
venous drainage through the internal jugular vein
glossopharyngeal n.
vagus n
and spinal accessory n |
|
|
Term
| which cranial n orginates from the cervical spinal chord levels of c1-c8 |
|
Definition
|
|
Term
| how does the spinal accessory n course? |
|
Definition
enters the cranium via the foramen magnum and exits via the jugular foramen
* its vulnerable to distortion of the shape of the foramen magnum by interosseous dysfunction of the occiput and as it passes through the foramenn magnum |
|
|
Term
| You have a patient with an acute asthma attack and you perform a CV4 technique and are able to give him some relief. what physical signs might you see on a patient who has asthma? |
|
Definition
| severe extension head with high arched palate creating a nasal obstruction and mouth breathing |
|
|
Term
what n causes this?
a floppy baby that can't hold its head up at the appropriate age |
|
Definition
|
|
Term
| hyperparasympatheticotonia causes bronchoconstrictions or bronchodialation? |
|
Definition
|
|
Term
| where does your auditory apparatus live? |
|
Definition
| in the petrous portion of your temporal bone |
|
|
Term
| an external rotation of the temporal bone causes?? |
|
Definition
| the eustachian tube to OPEN and creates a low pitched roaring tinnitus (similar to holding a conch shell to your ears) |
|
|
Term
| internal rotation of the temporal bone causes what? |
|
Definition
| the eustachian tube to close and creates a high pitched hum or buz |
|
|
Term
| patient has vertigo and you think its because of a cranial somatic dysfunction. what might you find when palpating his cri ? |
|
Definition
| temporal bone internally rotated and the other externally rotated |
|
|
Term
| describe the relationship between chronic serous otitis media and the temporal bone |
|
Definition
| fixed internal rotation of the temporal bone causes the eustachian tube to stay closed and results in chronic serous otitis media |
|
|
Term
| fixed external rotation of the temporal bone results in a chronically open eustachian tube which causes what? |
|
Definition
| it causes retrograde transit of food particles and liquids into the middle ear and resultant recurrent acute otitis media |
|
|
Term
| infants delivered via forceps often have -- |
|
Definition
| internally rotated temporal bones therefore more common to see serous otitis media with this kids |
|
|
Term
| a child with serous otitis media due to internally rotated temporal bones should respond to treatment in |
|
Definition
| only two treatments should be necessary to correct the problem |
|
|
Term
| impairment of the jugular foramen and its venous drainage causes what type of headache |
|
Definition
|
|
Term
| headaches can also be associated with sympathetic fibers carried via the arterial system. two arteries involved are |
|
Definition
carotids (via carotid canal located in the petrous portion of the temporal bone..makes a right angle turn within the temporal bone)
vertebrals (carries sympathetics to the posterior fossa region; enters cranium via foramen magnum) |
|
|
Term
| what kind of cranial dysfunction do you see with a person suffering from epilepsy? |
|
Definition
| internal rotation of the parietal bones with a mid-saggital ridge |
|
|
Term
| T?F? Infantile seizures respond to cranial manipulation and it is an indication |
|
Definition
| FALSEEE - do not respond to cranial manipulation and it is NOT indicated! |
|
|
Term
| T?F? cerebral palsy is caused by cranial somatic dysfunction |
|
Definition
|
|
Term
| how should you treat achild with cerebral palsy in whom you found a cranial somatic dysfunction |
|
Definition
do a trial treatment
if no improvements after about three months of weekly treatment, there will never be any improvements. please discontinue the treatment |
|
|
Term
| when should you treat a patient with cranial somatic dysfunction due to a trauma (post concussion) |
|
Definition
| ASAP - as closer to the time of trauma as possible |
|
|
Term
| what bones can you see dysfunctions in ..in a sinusitis patient |
|
Definition
ethmoid
maxillae
vomer
sphenoid
zygoma
temporalis
frontal
palantines |
|
|
Term
| with relation to a stroke, when is cranial treatment contraindicated |
|
Definition
1. first three weeks post stroke (due to the risk of lowering the intracranial pressure and promoting further bleeding in the brain)
2. all acute cerebral bleeds and infarcts |
|
|
Term
| indications for the application of osteopathy in the cranial field |
|
Definition
presence of somatic cranial dysfunction
absence of contraindications
presence of symptoms which may respond to cranial approach |
|
|
