Beryl Arbuckle's Cranial

67 Pages·2011·3.78 MB·English

Beryl Arbuckle’s
CCrraanniiaall
“CCoonnttrroovveerrssyy iinn
Thought”
BBy
Kenneth Lossing D.O.
1
WW..GG.. SSuutthheerrllaanndd DD..OO..
• One morning in 1899,
while still a student in
Kirksville, on his way to
ccllaassss, tthhee iiddeeaa ffoorr
cranial mobility came
ffrroomm vviieewwiinngg DDrr. SSttiillll’ss
Beauchene
disarticulated skull in the
North Hall.
With Thinking Fingers, A. 2
Sutherland
TThhee FFiirrsstt TThhoouugghhtt
• “As I stood looking and thinking in the channel
of Dr. Still’s philosophy, my attention was
ccaalllleedd ttoo tthhee bbeevveelleedd aarrttiiccuullaarr ssuurrffaacceess ooff tthhee
sphenoid bone. Suddenly there came a
tthhoouugghhtt;; II ccaallll iitt aa gguuiiddiinngg tthhoouugghhtt-bbeevveelleedd lliikkee
the gills of a fish, indicating articular mobility
for a respiratory mechanism” W.G. Sutherland
With Thinking Fingers, A. 3
Sutherland
Mobilityy
• “MMoobbiilliittyy iiss tthhee ssttaattee ooff bbeeiinngg iinn mmoottiioonn..
• In physics, motion is a change in position of an
objject with resppect to time.
• Motion is typically described in terms of
velocityy,, acceleration,, dispplacement,, time and
speed”.
• Mobility, for some reason, is not defined in our
Osteopathic Glossary.
From Wikipedia, the free encyclopedia 4
MMoottiilliittyy
• “Motility is a biological term which refers to
tthhee aabbiilliittyy ttoo mmoovvee ssppoonnttaanneeoouussllyy aanndd aaccttiivveellyy,
consuming energy in the process”.
•• AAggaaiinn, tthhiiss tteerrmm iiss aabbsseenntt ffrroomm oouurr OOsstteeooppaatthhiicc
glossary
• SSoo, tthhee bbrraaiinn aanndd fflluuiiddss mmoovvee wwiitthh mmoottiilliittyy, aanndd
the container, the skull, needs to be able to
accommodate to this, and thoracic resppiration.
From Wikipedia, the free 5
encyclopedia
Articular Mobility
• ““AArttiicullar mobbiilliitty occurs iin tthhe bbasiillar
area, and that of the facial bones; such
basilar mobility being accommodated
througgh comppensatoryy exppansile and
contractile service at the vault sutures”
•• SSoo, tthhee qquueessttiioonn iiss:: IIss tthhee mmoobbiilliittyy
responsive to primary respiration, or
tthhoraciic respiirattiion, or bbotthh?? IItt’’s a
question of distance and distensabilty.
The Cranial Bowl, 1939, W.G. 6
Sutherland
MMeennttaall PPiiccttuurree
• “The formation of a “mental picture”
ooff tthhee aarrttiiccuullaarr ssuurrffaacceess ooff tthhee
cranial and facial bones, is the first
necessity for recognizing the fact of
cranial articular mobilityy”.
• “The picture should be like that of a
wwaattcchhmmaakkeerr”
• So, we need to know the whole
thing!
The Cranial Bowl, 1939, W.G. 7
Sutherland
SSoo,, wwhhaatt iiss “nnoorrmmaall” mmoobbiilliittyy??
• In his first book, “the Cranial Bowl”, published
iin 11993399, SSutthherllandd usedd ““posiittiion”” andd
“motion testing” to diagnose the bones and
ssuuttuurreess ooff tthhee sskkuullll.
• The treatment techniques he describes are
nneeaarrllyy aallll “ddiirreecctt tteecchhnniiqquueess”.
• So he spent nearly 40 years doing direct !
•• HHee aallssoo ssppeeaakkss aabboouutt ssuuttuurreess tthhaatt aarree
“locked”, in that they do not move when
motion tested.
The Cranial Bowl, W.G. 8
Sutherland
WWhhyy iiss tthhiiss iimmppoorrttaanntt ??
• We know babies skulls are like a water
bballlloon, easy tto ddefform, andd tthhey spriing bbackk.
• Most of our patient’s skulls are somewhere
bbettween a bbaskkettbballll, andd a bbowlliing bballll.
• Could he have possibly meant that an adult
sskkuullll ccoouulldd bbee nneeaarrllyy aass ffrreeeellyy mmoovveeaabbllee aass aann
infant skull?
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The current biomechanical
tteerrmmiinnoollooggy : VViissccoo-eellaassttiicciitty ooff
Sutures
• SStiiffffness: tensiille fforce//chhange iin llengthh
• Ultimate stress: tensile force at suture
rruuppttuurree//ccrroossss sseeccttiioonnaall aarreeaa
• “Sutures demonstrate classical viscoelastic
behavior. During the elastic phase, they
eelloonnggaatteedd aapppprrooxx 11 uumm ffoorr eevveerryy 11gg ooff ffoorrccee
104 N/m. The ultimate tensile stress was approx
4 MN/m2. The estimated mean elastic
moddullus was 1100 megapiixells””.
• “The Load-Displacement Characteristics of
NNeeoonnaattaall RRaatt SSuuttuurreess” TThhee CClleefftt PPaallaattee-
Craniofacial Journal. Vol.37, McLaughlin
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