00:01
OA Decompression.
00:03
So the OA junction is a very
important region to evaluate and treat,
if we find a
occipital atlanto dysfunction,
we want to try to disengage that by
utilizing an OAD compression technique.
00:16
So what we want to do here
is to try to place our finger on C1
and hold the C1 tubercle and allow the
occipital little condyles to slide back.
00:27
So, I'm going to find the inion,
I'm going to keep my finger curled,
pointing back up towards me,
and slide down till I find and
drop off the edge of the occiput.
00:37
And so the finger is aiming superiorly
and almost back up to the patient's nose.
00:42
And so there's a
lot of soft tissue
that you have
to kind of allow to soften up
until you get a sense of
being on the C1 tubercle.
00:51
To better expose C1, you could have the
patient dip their chin forward. Good.
00:55
And with the other hand you could gently
support that forward nodding of the head.
01:01
And so I'm paying attention
to my middle finger here
as it starts to advance
through the soft tissue
to contact the C1 tubercle.
01:09
And once I reach that point,
what it kind of feels like is
a tip of the pen on my finger
and you keep holding
it until that
sensation of that
bony tubricle disappears.
01:21
And when it disappears,
that's when the condyles
are sliding back, disengaging.
01:26
And so once you feel that area softening
and no longer feeling that firm
bony tubercle underneath your fingers,
you know that the occiput has
kind of slid back away from C1.
01:38
And then you could bring
the patient back and then recheck
to see if the OA junction
still has a somatic function present.
01:49
Occipital mastoid suture V Spread.
01:52
So our occipital mastoid suture, where
the occipital and temporal bones meet,
is a very important region to examine.
01:59
Remember, the jugular foramen
resides there,
and you have cranial nerves 9, 10, 11
that pass through there.
02:05
And also your venous
sinuses drain through there
to return from the, for blood to return
from the head back to the thorax.
02:13
So first we want to assess to see which
side feels a little bit more restricted.
02:19
You could perform a base spread to
see which side feels more restricted,
or you could kind of
feel the tissues around
the occipital mastoid suture and see
which area feels a little bit more
tender or restricted.
02:32
What we want to do is to get our fingers
on either side of the
occipital mastoid suture.
02:37
One finger is going to be
on the mastoid process
and the other finger is
going to support the occiput.
02:44
And so what we're going to do
is to provide a little bit of a
gentle spread with our fingers.
02:51
And so as you're spreading your fingers,
that's helping to spread the suture
and to decrease any
restriction in that area.
02:59
You could also try
to help improve
the spread there by creating a little bit
of a fluid wave from the opposite side.
03:07
So you could place
your hand on the head,
get a sense of
where the fluid wave
that you project from down here
will land on the opposite side.
03:19
And then when you find that you're going
to then project away from your top hand
to your hand on the
occipital mastoid suture.
03:27
So while I'm spreading, I'm also
creating a little bit of a pulsatile wave
with my top hand to try to help utilize
the fluid wave to help
open up that suture.
03:40
So once you feel the suture
release, then you come back,
reassess the region,
perform your base spread again,
just to see if this
technique was successful
in releasing the restriction
in that area.