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CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
November, 2008, Vol. 08, Issue 11
The Pressurestat Model Explains the Craniosacral Rhythm
By John Rollinson, D. Eu, CST-D; guest author for John Upledger, DO, OMM
The Pressurestat Model illustrates the mechanism behind the circulation of cerebrospinal fluid through the semi-closed, hydraulic craniosacral system.Originally defined by Dr. John Upledger and a team of researchers at Michigan State University in the 1970s, the model explains the palpable, rhythmic expansion and contraction of the craniosacral system.
The brain and spinal cord are surrounded by cerebrospinal fluid (CSF). This fluid transports nutrients, hormones and peptides. It removes metabolic waste and toxic substances. It serves as a shock absorber, floating the brain to counteract gravity. It even influences respiration and cerebral blood flow, among its many functions. Given all this, it's easy to see how essential it is for CSF to flow unimpaired. If an area of brain tissue is even partially deprived of optimal CSF motion and flow, that area will be forced into some degree of functional compromise.1
Cerebrospinal fluid is held within the dural membrane that surrounds the brain and spinal cord. This tough, watertight sac takes the shape of the interior of the cranium and intervertebral canal. Though dura mater doesn't stretch much, this fluid container is flexible and allows for CSF pressure changes. When pressure increases, the dural membrane expands, and the bones of the cranium and sacrum move along with it. When pressure decreases, the reverse occurs.
This filling of the craniosacral system is known as flexion, and the emptying is known as extension. During flexion, the head becomes wider transversely and shorter in its anterior-posterior dimension. The whole body externally rotates and widens. After flexion, this motion passes through a neutral zone on its way into extension, during which the head narrows and elongates and the whole body internally rotates.
Under normal circumstances, the craniosacral system proceeds cyclically through flexion and extension at a rate of about six to 12 cycles per minute. We can feel this rhythm at various places on the body because "this whole-body response is probably due to the pumping effect of the cerebrospinal fluid upon the motor system ... which causes a rhythmical tonification and detonification of the myofascial system in response to rhythmically fluctuating nerve signals."2
Tracing the Flow of Cerebrospinal Fluid Through the Craniosacral System
So, we have a hydraulic system that surrounds the brain and spinal cord. To understand how it is semi-closed, we must first understand how CSF enters and leaves the system. Within the ventricles of the brain, you'll find a capillary network - the choroid plexus - that produces CSF. In essence, blood circulating through the choroid plexus is "turned into" CSF, which then enters the craniosacral system.
The choroid plexus has stretch- and compression-sensing receptors within the saggital suture of the cranium. As CSF is added to the craniosacral system and its volume increases, the dural container expands, spreading the bones of the head. The parietal bones then move apart and spread the saggital suture. When this happens, the whole neuromechanism signals the choroid plexus to stop or greatly reduce the production of CSF. As the fluid drains from the system, the dura and cranium shrink and the parietals come together, compressing the saggital suture. The pressure-sensing nerve endings connected to the choroid plexus then send a signal to resume CSF production and the cycle repeats.
Normally, the system seems to operate on a cycle of about six seconds; CSF is produced for about three seconds and then production ceases for about three seconds. This creates the rhythmical rise and fall of fluid pressure within the system.
From the lateral ventricles, CSF enters the third ventricle via the foramina of Monro, then the fourth ventricle via the cerebral aqueduct. The CSF then enters the subarachnoid space and the central canal of the spinal cord via the foramina of Luschka and of Magendie, where it joins the CSF that is already bathing the brain and spinal cord, and all neural tissue enclosed by the dura mater. The fluid then circulates down and around the spinal cord and up and around the brain.
Cerebrospinal fluid passes out of the semi-closed hydraulic system via folds - called arachnoid granulation bodies or arachnoid villae - of the arachnoid layer of the cranial meninges that project through the inner layer of dura mater into the venous sinuses of the brain.3 CSF is reabsorbed into the venous blood through these arachnoid villae, which are primarily in the saggital venous sinous.
Although the rate of reabsorption is fairly constant, it seems to be regulated (think of a car idling) by a cluster of arachnoid granulation bodies found at the anterior end of the straight sinus. From its position at the "crossroads" of the intracranial membranes, this cluster can become aware of any tension within the membrane system and may regulate the outflow of CSF accordingly.
To summarize in a different way, the craniosacral system is like a leaking toilet with the tank cracked into pieces and lined with a giant exam glove (which is the dural membrane). The float-switch in the toilet tank is the saggital suture, which causes an inflow whenever enough water/CSF leaks away down the drain (sinuses).
Generating Whole-Body Effects
The craniosacral system is intimately related to the nervous, musculoskeletal, vascular, lymphatic, endocrine and respiratory systems. Just as abnormalities in the structure or function of any of these systems can influence the craniosacral system, abnormalities in or injuries to the structure or function of the craniosacral system can have profound and deleterious effects on the development or function of the nervous system, especially the brain.4
There are also ways in which the craniosacral system directly influences important, ongoing physiological processes. For instance, the continuing rhythmical movement of the system may serve to "milk" the pituitary gland and affect the neuroendocrine system. The rhythmic motion may also be an important stimulus for the development of the brain. Similarly, the motion around the skull sutures may pump the newly formed red blood cells out of the flat bones of the skull and into the general circulation.5
Of course, any abnormality of the craniosacral system could impact the body or any of its parts through the central nervous system. Any deficiency in circulation of CSF could affect brain and nerve functioning. Any restriction of nerves passing out of the craniosacral system due to restrictions in the cranial sutures or membranes may affect their end organs. Thanks to the Pressurestat Model, we can see why.
Click here for previous articles by John Upledger, DO, OMM.
John Rollinson practices full-time in Northampton, Mass., and at several school clinics in the area. You can contact him at www.rosetrust.org.
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