resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
February, 2003, Vol. 03, Issue 02
The Ligamentum Nuchae
By Neal Cross, PhD, NCTMB
In a recent article published in Clinical Anatomy,1 Dean and Richard clarified some of the anatomical detail of the upper cervical connective tissue elements.I think their results are exciting for anyone utilizing craniosacral techniques and/or treating cervicogenic headache.
The ligamentum nuchae is that well-developed portion of the supraspinous ligament in the cervical region. It runs from the external occipital protuberance along the tips of the spinous processes of the cervical vertebrae, to the tip of the spinous process of the vertebra prominens (usually C7). The supraspinous ligament can be considered the superficial continuation of the interspinous ligament. This latter ligament runs between the adjacent vertebrae extending from the base to the tip of each spinous process. The ligamentum nuchae is formed primarily from the aponeurotic attachments of the adjacent and subjacent musculature. From superficial to deep, these muscles are the trapezius; rhomboideus minor; splenius capitis; and the serratus posterior superior.
Dean and Richard found direct fibrous attachments between the ligamentum nuchae and the spinal dura - between the occiput and C1, and between C1 and C2. They found attachments to the ligamentum flavum and the spinal dura between C2 and C3. These were not as prominent as the attachments at superior levels. They did not find any direct connections between the spinal dura and the rectus capitis posterior minor (RCPM), as had been previously reported.2 However, they did find a connective tissue band that ran from the deep surface of the RCPM to the posterior atlanto-occipital membrane. This thin membrane runs from the posterior margin of the foramen magnum to the upper border of the posterior arch of C1.
It is interesting to note that although most of the cranial dura are innervated by the trigeminal nerve (CNV), the infratentorial portion (the portion inferior to the cerebellar tent) is innervated by upper cervical nerves. It is tempting to speculate how working the suboccipital soft tissue elements might have a positive impact on relieving cervicogenic headaches. We may be able to effect this end by using several different techniques, including craniosacral, Swedish and counterstrain, among others.
Of further interest for consideration would be to review the anatomy of the transition of the dura from the cranium to the vertebral canal. The cranial dura is comprised of two layers: the outer or endosteal layer, and the inner or meningeal layer. These two layers are contiguous throughout most of the cranial cavities, except where they part to allow for the formation of the dural sinuses. The outer layer also ends at its attachment around the foramen magnum. However, at this latter point, the inner layer continues through the foramen magnum to become the spinal dura. The periosteum of the vertebral canal is the equivalent of the outer layer of cranial dura.
In summary, we see several cervical elements associated with the cranial dura mater by their connection to the spinal dura. The ligamentum nuchae directly attaches to the spinal dura, as does the ligamentum flavum, to a lesser degree. The upper cervical nerves serve the sensory innervation of both the cervical spinal dura and the cranial dura in the posterior cranial fossa. These same nerves supply the sensory elements of the muscles of the deep back and skin over the back. Although the trapezius is innervated by the accessory nerve, its sensory innervation derives from the upper cervical nerves.
A therapist could spend quite some time on the back of a client's neck, and achieve results well-worth the time spent.
Click here for previous articles by Neal Cross, PhD, NCTMB.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.