CRANIAL TECHNIQUE OSTEOPATHIQUE

CRANIAL TECHNIQUE OSTEOPATHIQUE
PRESENTATION

INTRODUCTION p1 The life appears by the movement. Since the cell that we see under the microscope, to the animated bodies them also of a certain dynamism. These organic movements create in their turn various functions of the human body, the unit expressing our life. Each function is expressed on its organic level, by a movement which is clean for it. There is thus, for each structure, at every moment, a variable and different state. It is the same at the cranial level, whose plasticity is allowed by all. This unit is made up by the various bones of the vault and the base. And the sutures which connect them, present each one, of the particular movements, but with a synergy of the unit. The plasticity of the bones, united with these micro - movements constitute the dynamics of this system. Historically our predecessors had perceived it perfectly, since in many parts of the world, I met traditional practitioners who use more or less elaborate cranial techniques. But this is at the end of century XVIIIº, that in the U.S.A. and then in Europe, these techniques were explained, classified, improved and gradually codified. Like any articulation, that of skull must be free between the two parts which constitute it. In the contrary case, it then occurs a modification of its operation which can result in a deterioration in its dynamics. If it occurs an additional constraint, this articulation cannot then answer these new functional requirements, : the conditions with the installation of a pathology will be met, where this restriction of mobility appeared.

It is known that this barrier requires to be solicited by the function to appear.
From where the name of functional barrier. Posing his hands on skull, the therapist will perceive these barriers, which will enable him to then restore by its action a normal mobility where he had perceived this restriction of mobility. How does it perceive it? Simply with its five directions which is the most natural means for decoding the messages of abnormal operation of the human body. On the one hand, it sensitively records deteriorations of the function, which can be sometimes also visible and, on the other hand, it questions each articulation manually : examination of mobility, tests of tissue resistance, rebound at the end of the movement signing the state of conjunctive tissue, etc This manual approach renewed at the end of the processing will enable him to realize also of its effectiveness. The Greek philosopher Aristóteles “the man is intelligent because it has a hand”. The history of humanity also teaches us that in its evolution “l’homo habilis” (the man with tools) has preceded “l’homo sapiens” (the man who thinks). Let us draw the conclusions from them during practicing soft handling of which each one, appropriate to the cranial articular level considered, will involve the elimination thus of this functional barrier. Recovered lost freedom, the function will be restored where beforehand a functional deterioration, had allowed the installation of pathology. p2

BASIC PRINCIPLES p4 ANATOMY and BIOMECHANICS

BASIC FOR THE CRANIAL TECHNIQUE
p5 The training of the cranial techniques has like the anatomy basic which provides the structural substratum of it and biomechanics which then makes it possible to understand some operation. The control of these techniques then will be acquired thanks to a progressive proprioceptive refinement, so much with regard to the plasticity of the bones that of the sutural movements. These are two former qualities which will give the dynamics of the cranial mechanism.

THE PROPRIOCEPTION Like any direction, the proprioception is born from the receivers of tact, is transmitted to the cerebral zones which make the analysis of it, according to the elements beforehand perceived which are the only references. What thus requires a tactile education for any activity not carried on before. What is the case in cranial technique here, because the movements are only of a few microns.

PROPRIOCEPTION (continuation)
One cannot teach perception, because. it is not interpretable in words, It is personal and function of its reference frame, tactile for the touch. It is interpreted according to the state of the therapist. One can thus only make live an experiment. - It is that you teaches thanks to perception that you have some during the experiment. - This practice is thus the ideal way, personal, regularly developed, by each attentive expert with what occurs.

ANATOMY To understand cranial dynamics, made plasticity on the one hand, and micro-movements on the level of the sutures on the other hand, we must initially point out some elements of the cranial anatomy. Firstly that the cranial system is composed of three subsystems having a different dynamics, because of their embryologic origin and nonidentical histological constitution: 1º - the base of skull of cartilaginous origin. 2º - the vault of membranous origin. 3º - the face of the variable origins according to the bones.

The Base of the Skull p17 The base of skull, of cartilaginous origin is traversed by tension fields which show us its capacities of strength to the various constraints. In the same way they indicate the vectors of action to us of as our techniques. It is considered, in cranial dynamics, like the motive fluid of this one.

The Vault of the Skull It is membranous origin, which explains its greater flexibility, plasticity, and its little transmission of the constraints to the whole of the system. Therefore she is considered, like adaptation, inside the cranial mechanism. It especially consists of bone pairs.

THE FACE The Driving BASE The Adaptation VAULT The Expressive FACE
Unlike the two others subsystems which we have just seen, the face which is made up of many bones which are juxtaposed or intricate. Moreover they are: Not subjected to the reciprocal membrane of tension, Animated by a number impressing of small muscles, Not always subjected to the synergy of the whole of skull, And can be mobile, independently of the cranial rhythm which we will study front. For that it is considered, like the subsystem expressive of the cranial system. IN SHORT The Driving BASE The Adaptation VAULT The Expressive FACE

IN CONNECTION WITH CEREBRAL BLOOD CIRCULATION
p10 IN CONNECTION WITH CEREBRAL BLOOD CIRCULATION It seems important to us to initially point out the particular anatomy of the brain, since although representing less than 5% of the body weight its operation can require more than 20% of the totality of glucose and the oxygen, that brings to him this blood circulation. However, arterial circulation does not resemble that of the other bodies, according to Professor Lazorthes, world specialist on the matter. The brain does not have only one pedicle like the other internal organs, but blood is brought to him by 4 large arteries. Two internal carotids and the two vertebral arteries.

ARTERIES OF THE BASE OF THE BRAIN
p10

ARTERIAL CIRCULATION pp7,9

Arterial circulation. Internal sight
p9 Arterial circulation. Internal sight

PHYSIOLOGY OF CEREBRAL ARTERIAL CIRCULATION
“The distribution of the cerebral vessels to separate territories anastomosis imposes the concept of blood currents juxtaposed, and relatively autonomous, though heard well functional”. ( Professor Lazorthes )

Dependence between circulation and cranial mini-movement
The examination of the vascular prints left on the inner face of the bones of the skull (in the skull), in particular by the meningeal arteries, shows that their tree structure is done in range, opening towards the back lasting phylogenesis, in relation to occipital rotation on its transverse axis. It is the same of the venous prints as leave on the occipital one and the parietal ones, the higher longitudinal sines, the right and left sines right and sigmoid. As well as other vessels, morphologically less important. Experiments led to the United States of America established in the facts that the practice of the cranial osteopathic techniques increased cranial circulation, as well on the level of the arterial contribution as of the venous current.

VENOUS CIRCULATION pp12,13 We have that the prints of the venous sines on the face endocranial were important, with, links privileged on the level of the vault. It is important maintaining to also underline that these venous sinus restore this face endocranial, between the two layer of insertion of the external dura mater on these same bones. One then understands easily how much the mini movements of bones, joints to the sutural separation will instigate the venous sinus, which we point out it to you do not have a valve.

Endocranial Venous Circulation
p14

SPECIFIC ANATOMY The cranial sutures
pp18,19,20,21 Although you know all the anatomy of skull, there are elements specific to the cranial osteopathic technique which you are unaware of. In cranial technique, we attach an importance more particular to the suture, which are mini - surfaces slip allowing the changes in form of limps cranial as a whole. Indeed, these sutures are bevelled, that is to say on the level of the external table: They look at then towards outside is with depend on the internal table, looking towards the interior.

SPECIFIC ANATOMY Membranes of reciprocal tension
pp70, 71 As well the tent of the brain, as its scythe, the unit constituting a star with three regularly separated branches fits on the bones of the vault (occipital - temporal) that base (Sphenoid). They thus represent an internal system equilibrator as much as a system which distributes in a synergistic way, the constraints which the unit undergoes. We call them for that “Membranes of reciprocal tension”.

Anatomical elements of the sutures
p29 membrane of the reciprocal tension free nerve ending venous sinus artery external bevel internal bevel

Anatomy of the cranial articulation
pp28,29 Like shown joint diagram, it is made up by the same elements as any other articulation of the human body, whose elements are driven by forces, as well internal as external, and balanced permanently. It thus presents: - slip surfaces (bevelled and squamous sutures), of separation (notched sutures), juxtaposed (harmonic). - a periosteum of recovery - ligaments of recall, consisted by the bifurcation of the insertion of try and the forgery and their fixations on each sutural bank. - a free nerve ending in sutural space, like showed it in 1992 the study of the department of anatomy of the University of Michigan. - sutural arteries and veins - proprioceptors located at the sutural level. (Bunt - South Africa 1996),

Differencies of cranial sutures
p29 Differencies of cranial sutures

with all bevels of skull
p19 This figure shows you the unit of it. External bevels are illustrated in “hatched”, internal bevels in white. It is absolutely necessary to know them to understand the particular movement of each various bones of skull.

BEVELS and PIVOTS * You have notice on the preceding figure, that on the level of each suture it exists an inversion on the level of bevels, which indicates that a part moves contrary to the other. What means that between the two parts going in opposite direction, there is a pivot, that I show you on the parietal bone that I have in hand. When we meet two pivots by one line, we obtains an axis then. It is what I show you here on the former edge and the posterior edge of the parietal one. It is this axis which determines the movement that this bone carries out. As the skull resembles a ball overall, structure which has six degrees of freedom, the bones which are with the periphery will have possibilities of movement in the three plans of space. I.e. that they thus will have three axes of movement each one, although their displacement is major in a principal direction, there less in the others. Except the parietal ones which is made of a more flexible curved blade.

BEVELS, PIVOTS, AXIS OF MOVEMENT (Example: Temporal)
The lines link the 2 pivots located at the changes of bevels. They are the axes of movement.

THE BONE OF THE CENTRAL AND PERIPHERAL LINE
For the cranial motion study, we divide the constituent bones the skull, into two distinct unit. A - A central line, constituted by the odd bones of the median part of the base. Of back ahead: - occiput , - sphenoid - frontal ,- ethmoid, - vomer, mandible B – the peripheral bones , pairs , and which understands of back ahead, following bones: - parietals, - temporals, - maxillaries, - palatines, zygomatics, lacrymals, – nasals. This division is arbitrary, since the skull functions in synergy. But it makes it possible to better understand the biomechanical role of each element in the work of synergy of the unit.

This articulation is named Spheno-Basilar Symphysis (SBS).
THE BONE OF THE CENTRAL LINE: SPHENO-BASILAR SYMPHYSIS p40 In cranial technique, one gives an major importance to the articulation between the basilar apophysis of the occipital bone, located at his former part, and the posterior part of the sphenoid. This articulation is named Spheno-Basilar Symphysis (SBS). As you can notice it already, these two articular involved surfaces, on these two bones are irregular and rough, allowing a movement in successive drive partial and variable in cogwheel of part of a bone with the other.

Biomechanics of the cranial movement
p39 It is on the level of this spheno - basilar symphysis, that in cranial osteopathy, one considers that the cranial movement begins. We are now ready to study the characteristics of them.

Displacements of the two articular banks
Two articular surfaces (nonhyaline) of the cranial articulation, move, because of the layout of their slip surfaces, each one like a cogwheel in comparison with the other, in a system of gears.

BIOMECHANICS OF THE CRANIAL MOVEMENT
p39 BIOMECHANICS OF THE CRANIAL MOVEMENT The cranial movement is a movement which proceeds according to a cycle of two alternative phases, which are: - the flexion, which is achieved in the bones of the line of centers (odd bones) around their transverse axis, at the same time as the external rotation of the bones of the periphery (even bones) around an axis obliques which is specific to each one of them. We will study them then. It is the active phase of the movement. During this phase an expansion of the cranial mechanism occurs, which produces an opening of all the suture of skull. - the extension or phase of relaxation, phase during which the bones of the central line return to their position first, at the same time as the bones of the periphery carries out an internal rotation, each one around the axis which is clean for him: I.e. that they turn over to their initial position by using the potential energy accumulated by conjunctive tissue will intra and periarticular at the end of the final stage inflection, during the compression generated by the kinetic energy. It is the passive phase or phase of relaxation of the movement.

MOVEMENT OF FLEXION The active part of this movement (flexion - external rotation) is not uniform, but proceeds according to three phases: 1º - ascending phase, which enables us to perceive the beginning of the movement and to have perception of it. 2º - maximum unfolding. It is especially during this phase that the therapeutist will be able to influence and modify the movement. 3º - end of the movement. It is during this phase that the resistance of the conjunctive fabrics appears which with their elasticity and their plasticity slow down the movement, stores the potential energy which, restored causes the return to the neutral point of the unit.

Flexion Movement p41

Flexion Movement of the bone of the central line
pp40,41

Occipital Movement pp42,43 Its principal movement of flexion-extension (but it can like all the other bones, to move around a vertical axis or of an axis antero - Posterior) is carried out around a transverse axis located at the intersection of two secant plans during passing by stalemate the former edge of the foramen magnum and by the higher edge of its basilar apophysis.

Sphenoidal Movement pp44,45
Its principal movement occurs around a transverse axis, but in two successive phases: initially the body and mow large wings move in bottom and in front of the axis passing within the body sphenoid. Once this movement of the achieved body, the large wings continue theirs, always in bottom, ahead and outwards, around a second transverse axis passing between their roots.

Movement of Spheno-Basilar Synchondrosis
pp46,47 This articulation is regarded as the engine of the cranial movement, because it is of it that share its dynamics. Two elements in articular contact are located in contrary direction, like the gears of two cogwheels. It is this displacement which involves the other bones at the time of the cranial movement, its dynamics being increased by plasticity inherent in biological materials.

pp48,49 Frontal Movement In cranial technique the frontal bone is regarded as being formed of two parts. Indeed, in addition to the metopic suture gives to its convexity an additional plasticity between its two parts, the osseous blades located between the three pillars (two lateral and one central) confer they to him also an additional plasticity. The principal movement of the front-end processor is carried out especially around a central axis, bringing its edge postero - superior behind and in bottom, whereas the eyebrow arcades advance while being raised. But the elements underlined above form at the same time, a light depression of the metopic suture, as well as an antero-external rise the external orbital apophyses. This is supported, by the push ahead, in top and apart from the superior part of the large wing in its second time as we come to see it in the preceding slide.

Diagram of the movement of the frontal bone
p49

Ethmoidal Movement pp50,51 The ethmoide present of the tension fields which transform the horizontal forces into vertical forces and reciprocally. These movements are induced by the constraints which its central structure undergoes, whereas at the same time its side masses, under the action of the external rotation of maxillaries, take part in the expansion side of the face. Its transverse axis of rotation is located, on the upper part of the vertical blade. The flexion, around this axis, is induced by the part former of the sphenoid, which involves its posterior part in bottom and ahead, whereas its former part rises and moves back. This movement corresponds perfectly to that of the ethmoidal of the front-end processor in which the horizontal blade of the ethmoid is placed. It is it should be noted that as well the plasticity of the bone as the fronto-ethmoidal union, allows small lateral movements. They will allow small movements of adaptation and compensation.

Diagram of ethmoidal movement
p51

pp52,53 The movement of Vomer Lamellar bone, whose oblique tension fields in bottom and ahead, balance on the one hand the vertical forces, and on the other hand literally in bottom the bimaxillary vault. This double role obliges it to adapt constantly in torsion, this double constraint. Its transverse axis is located, in its central part, between the most marked tension fields. Its movement of flexion is induced by the lower part of the body of the sphenoid, i.e. that its upper part moves in bottom and ahead, whereas its lower part goes in bottom and behind. What corresponds perfectly to the described movements share the palatine apophyses of the maxillaries and by the horizontal blades of the palatine ones.

Diagram of the movement of Vomer
p53

Movement of the peripheral bone : Cranial Vault
It is formed: I - the pair bones of membranous origin like parietal bones , II - the pair bones (Temporals) and impair bones (Occipital, Frontal, Sphenoid) of mixed origins : - membranes by their squamous part, - cartilaginous by their basilar part. Its curved and plastic general aspect, with the well marked tension fields gives him its flexible resistance. Its accommodating dynamics results, in addition to the effect of its plasticity, of the important movements permitted by sutures of the various type (notched, bevelled, by juxtaposition, etc….) which allows between them these mini - displacements. Located at the periphery of the cranial cavity, these bones present all of the axes of movement having different obliquenesses We will speak - to simplify the demonstration - about only one axis of movement, knowing pertinently that at each moment of the same movement, its axis being differently directed, and that these successive axes will describe in space a particular figure for each one of them, called cardioid. p55

Biomechanical characteristics of the Vault
pp55,56 The coronal, lambdoidal, occipito-temporal sutures, present on their course of the changes of bevels, who form the pivots around of which will be held the movements of each bone of the vault. Indeed, these pivots succeed two to two determined axes of the movements of parietal and their articulations as well with the front-end processor as the occipital one. The movements of the even bones of the periphery proceeding around oblique axes, each one in varied plans, constitute, at the time of their phase of expansion, which one calls external rotation. Their phase of relaxation or the opposite movement constitutes internal rotation then. Let us see one by one, the dynamics of each one.

Biomechanics of the temporal bones
pp58,59 Biomechanics of the temporal bones The axis of the temporal bone passes - roughly by the petrous pyramid, and like this one, described a cardioid during its general movement. Nevertheless this bone, presents six pivots, joined together in two groups of three, which form two almost perpendicular secant plans then. Thanks to those it will carry out, according to the particular drawing of the various types of sutures, of the small movements particular to the level of each pivot, who will allow on the one hand to have a discriminative movement, and on the other hand to adapt this one to the small losses of mobility being able to exist that and there. Their perception - that we have focusing - will be the diagnostic key which will involve the choice of the specific techniques which will restore the movement general of the temporal one. Let us examine initially, the movement complete general of the temporal bone, which understands four sequences well distinctly (cf. drawing herewith) starting from its neutral point: lowering, external rotation, extreme rotation, internal rotation.

Diagram of Temporal Movement

Movement of three pivots of Temporal base
pp60,61 Movement of three pivots of Temporal base Petro-Basilar Pivot : Articular involved surfaces are grooves, convex at the base of occipital (full rail), and convex (hollow rail) on the petrous part which is articulated with it. Its axis is transverse. It produced there a movement of slip, which allows the widening of skull. Petro-Jugular Pivot Two articular surfaces form the internal part of the posterior torn hole. There would exist, according to certain anatomists, sometimes a small meniscus. The movement is carried out around two transverse axes (external rotation) and vertical (time rotation on the level of occipital) and anti - time on the level of the temporal one. Spheno-Petrous Pivot It is a movement of circumduction of the sphenoid around clinoid insertion of the spheno-petrous ligament (ligament de Grüber). This movement allows to balance the structures of the cavernous sinus and the torn anterior hole.

Movement of the three pivots of Temporal vault
pp60,61 Condylo–Squamo–Mastoidal Pivot : Located between the occipital bone, and the posterior part of mastoid, on the level of its change of bevel (supero - internal, and infero - external). The temporal one carries out an external rotation movement on its transverse axis, at the same time as this former pivot, around a vertical axis, while separating from the occipital one. Hinge-Mastoid Pivot (H.M.) : Between the parietal one, and the temporal one, on the level of the small change of internal - external - internal bevel, squamous edge of temporal (entomion). This small setback in external bevel within a general internal bevel on the squamous edge of temporal, induced movement in veiled wheel, which makes it possible the axis of the bone to drop and increase then its external rotation. We call this as it is extreme rotation Spheno-squamous Pivot. Between the edge posterior of the large wing of the sphenoid and the former edge of the squamous temporal, with the change of bevel of these two bones with their lower edges. The sphenoid is driven on its three axes.

Parietal Movement pp64,65 Its 2 coronal and lambdoidal sutures comprise each one, two bevels, one side which is internal, the other medial which is external. With the change of bevels of each suture the point pivot is. The 2 points pivots of the coronal and lambdoidal sutures, succeed, determine the axis of movement of each of the two parietal ones. On the level of the squamous sutures with the temporal one, the parietal present one on the major part of this one an external bevel, except in the very small zone of the H.M pivot. Or it is reversed., i.e. internal.

EACH PARIETAL PART LOCATION
pp64,65 EACH PARIETAL PART LOCATION The movement of parietal can thus be summarized thus. During external rotation (synchronous of the flexion of the odd bones): the antero-internal angle and the side part of the coronal suture precedented and expressed. the medial part of the coronal suture is depressed and moved back, like it does bregma. The interparietal suture is depressed, moved back, and its two banks separate, especially on its posterior part. Lambda is inserted and separated its two banks. parietal (whereas the occipital part moves back) The lambdoidal suture is inserted, and separates in its medial part, but advances, while expressing itself in its lateral part. Its temporal suture is exteriorized (open).

The drawing of the parietal bones

MOVEMENTS OF THE FACIAL BONES
pp66,67 Sphenoid, temporal and the front bone transmits their movement to the maxillary which, under their joint action, transfers this dynamics to all the bones which are articulated with it, i.e. all the other bones from the face. It is the moment of the sutural opening. Whereas the frontal slope is accentuated, the whole of the face widens, swells. The eyes open. The mandible unobtrusive while dropping. The schema here after you indicate the general movement of each facial bone. We will specify the distinct characteristics of them, by a specific study of each one of them.

DIAGRAM OF GLOBAL MOVEMENT OF FACIAL BONES
p67

Movement of maxillo-palatino-vomerian complex
pp68,69 This unit, as we wrote, receives any wave of dispersion coming from the direct cranial shocks, because of convergence in its centre of the tension fields of cranial architecture. After longtime, by Felizet, Benninghoff, etc... pillars and beams and its continuum in the dural membrane, is well described by Arbuckle. We know as this unit, by its dynamic flexibility, must answer the intrinsic possibilities of its osseous environment, i.e. with the mechanical constraints as well of the front-end processor as of the sphenoid. It will have to thus be able to adapt these situations by the following movements : torsion spheno-maxillary, shearing spheno-maxillary, disimpaction spheno-maxillary at the same time as : latero-flexion fronto-maxillary, separation fronto-maxillary, or shearing antero-posterior fronto-maxillary.

Diagram of movement of maxillo-palatino-vomerian unit

The maxillary movement
pp70,71 The maxillary movement Its axis of external-internal rotation is carried out around an oblique axis, passing by the frontal apophysis in top, and by the angle antero - external (either the node) of the tuberosity of the maxillary in bottom. Synchronous with the flexion of the sphenoid, the maxillary moves as if it were suspended with its frontal apophysis. It thus will occupy a more frontal plan, whereas its suture inter maxillary drops, moves behind and that the bone seems to separate from its counterpart subsequently. The posterior edge of the rising apophysis moves laterally, so that it is located in a plan more coronal and its anterior face drives antero-laterally. It should be noted that the palatine apophysis of the maxillary carries out a movement parallel and identical to that of the parietal bone corresponding. At the time of the flexion the two maxillary give to the vault of the palate a more Romance form to the Gothic warhead which represents their form during the extension.

Diagram of the maxillary movement
p71

The movement of the palatine
pp72,73 The movement of the palatine Its constitution shows perfectly its biomechanical role within the cranial movement. Formed by two flexible orthogonal plans which meet, while forming a tension field antero - posterior reinforced, it will give flexibility where the cranial system transform the vertical forces into vertical forces and vice versa. Its movement, follows on the one hand the movement of the apophyses pterygoid against which its pyramidal apophysis presses, and in addition moves back while following the movement induced by the palatine apophysis of the maxillary, on which presses its former edge. Moreover, it will compensate for by flexibility of its vertical plan the slightly oblique movement behind and apart from the apophyses pterygoid.

Diagram of the palatine movement

Movement of Zygomatic pp74,75
Of dense structure and resistance, it is articulated with the maxillary, the front-end processor and the temporal one Its axis of oblique movement, goes from a point located slightly under the glabellar one at the gonion, i.e. that at the time of the flexion, the zygoma, rolls antero-laterally, involving its edge orbítal outside, widening the diameter of the orbit. Its frontal apophysis follows the external orbital apophysis, ahead and outside, whereas its temporal apophysis moves infero - laterally.

Nasal Bone Movement pp74,75 Articulated with the spine nasal of the front-end processor, it will follow the movements of them. Its axis, goes from its higher edge to its lower edge, through the body obliquely in bottom, ahead and outwards. Its movement at the time of the flexion makes it turn around this axis, its central part is depressed whereas her periphery is raised, while being expressed.

Lacrymal Bone Movement
pp74,75 mobility of right lacrymal mobility Size of a nail, this lamellate bone downwards carries out a small movement, before and outside, which increases very slightly the concavity of its inner face.

Mandibular Movement p77 Suspended part of the articulation Temporo - Mandibular, this bone is dependent on temporal by its lateral ligaments, and mandibular stylus, like by its meniscus. Its movement will thus follow that of the temporal part with which it is most intimate, i.e. its mandibular fossa. We know that in external rotation, this part of the temporal one which is located under its axis of rotation, drops, moves back, and goes slightly outside. It will be movement that will achieve the mandible, which moreover will tend to widen, because of the possibilities structural still existing on the level of its symphysis menton.

MOVEMENT OF THE MEMBRANES OF RECIPROCAL TENSION
pp78,79 We will limit our study of the tension, transverse partition separating the cranial volume in two stages, and of the forgery, partition medio - sagital, separating the two cerebral hemispheres, with their purely biomechanical role. Indeed, their lateral insertions are divided into two layers anchoring each one, either with a sutural bank, or with the lip of an osseous gutter which shelters a venous sinus..In addition their medial insertions form, on the level of the right sine, a point of balance, a fulcrum flexible and variable, which makes that the whole of these membranes creates an internal system equilibrator for the structure of cranium, where the tension fields of this one are continued with that one by unifying them and by distributing the efforts undergone by the whole of the system. The diagrams of the next pages, show these tension fields, which can become lines of stress, as well as the displacement of the tension as well as scythe at the time of the movement of flexion of the cranial mechanism.

DIAGRAM OF THE MEMBRANES OF RECIPROCAL TENSION
pp80,81 Fiber of stress of the dura mater according to B.E. Arbuckle

MOVEMENT OF THE MEMBRANES OF RECIPROCAL TENSION

CRANIAL ADAPTIVE MODES

GENESIS OF THE CRANIAL ADAPTATION
pp83,84 GENESIS OF THE CRANIAL ADAPTATION The human being does not preserve all its life its potential of functional freedom. Gradually the age comes to deteriorate of it the structure which generates it. Hypermobile points, even fixed settle that and there, because of certain postural attitudes, of abnormal operations, small traumas, gestures imperfectly carried out, muscular tensions and/or fascial, which is born of its emotional reactions in front of the events. This loss of partial freedom will create restrictions of local operation that and there, of the muscular and facial tensions, more or less permanent which makes affect its diagram of general operation at the same time as to mark it of a special character in its gestural expression. It is a biological law, which the human being seeks to express the best possible life which is in him, whatever the acquired restrictions, by printed typical diagrams which maintain operation with the maximum of it remaining possibilities.

GENESIS OF THE CRANIAL ADAPTATION. TORSION
pp84,85 As we showed in addition, the first stage of this adaptation will be done in torsion, because this position enables him to preserve the totality of its potential of operation, even will increase it temporarily, for two reasons. Initially because the continuum fascial which crosses our body, enables us to grow ourselves and to unroll us starting from a point fixes (ground) while keeping our balance. The example of the person who stretches herself in torsion to go to unscrew an electric bulb that it touched very right before the famous good. Then, because this position allows us to store by this movement an energy (potential energy) that the body will restore in the form of kinetic energy by leaving this position. The examples make abundance in the sport : preparatory torsion with the reverse with the tennis or the recovery of stolen to football, etc… The body understood it well. It tries to prevent the fall, will try to control it while seeking by and in its torsion an additional kinetic energy. TORSION IS THE FIRST STAGE OF OUR ADAPTATION.

GENESIS OF THE CRANIAL ADAPTATION. Rotation / Lateral Flexion
pp84,85 But if it proves to be insufficient, the body will increase its internal stress, by creating itself a fixed point from which will be born a new balance from which it is then ready to take up its duty. Unfortunately it will be also accompanied by a functional limitation, the most limited possible. Always the same biological law of functional survival. The skull, to the image any other subsystem of the human being, will follow the same laws. It will be put successively initially in torsion to continue to function quasi normally. But if that proves to be insufficient, it will then create this less mobile zone of accommodation. This one can also settle following a trauma whose wave of dispersion exceeded the possibilities of the cranial system, it will be an adaptation in Rotation - Flexion - Lateral. This cranial zone by losing part of its biomechanical potential, in parallel produce a constraint on endocranial circulation with like consequence a deterioration of the sugar and oxygen contribution whose brain is fond of delicacies. Always the same biological law, our being adopts the best solution for its operation, in term of permanence and survival.

GENESIS OF THE CRANIAL ADAPTATION. other adaptations
pp86,87 Other adaptations can occur, but they make following constraints which have occurred during the time native, postnatal, or very early in the life, and are not field of the general adaptation of the system. We find them in certain small children, teenagers or adults. We will detail the most frequent diagrams here of them. They are at the level of spheno - basilar synchondrosis (SBS). The principal ones are: * Horizontal displacements, * Vertical displacements, * Compressive stresses

ADAPTATION: THE CRANIUM IN TORSION
pp86.87 ADAPTATION: THE CRANIUM IN TORSION At the time of the movement of flexion, the bones of the central line, carry out each one a movement around their transverse axis, whereas those of the periphery using the oblique axes which are clean for them, are put in external rotation. Because of its central position, Spheno-Basilar Synchondrosis (SBS) sees converging all the sutures of the base in its direction, like as much rays. One understands easily that a blocking on one or more sutures of the base modifies this movement of flexion - external rotation, around this new fixed point. It creates for itself a hinge, which constrained the cranial unit to use an additional axis to carry out its movement. This new axis antero - posterior implies that the movement is also made in torsion, i.e. that parts former and posterior of skull move in direction opposite one of the other. Who is more the plastic deformation of skull reveals an additional component passive, tiny, around the vertical axes, in opposite direction. We qualify this torsion of right-hand side or left according to the side of the large most raised wing, in the direction of the vertex (and very slightly turned towards the opposite side).

DIAGRAM OF TORSION p89

CRANIUM IN ROTATION / LATERAL FLEXION
pp92,93 When the constraint exceeds at the cranial level the possibilities of torsion, that involves a diagram different of adaptation which will give a new possibility of dispersion, by adding an additional compensation in the third dimension of space. But to be established it creates on the other hand, a zone of functional restriction. It is the lateral rotation flexion, which is characterized by a movement of: - flexion around the transverse axes, - of lateral slope of all skull on a side around a antero-posterior axis. - of rotation, in opposed direction, of the halves former and posterior, around two vertical axes passing by the body of the sphenoid and the occipital one. It is named by the side of the opening of the symphysis spheno - basilar (SBS).

DIAGRAM OF ROTATION LATERAL FLEXION
p93 Horizontal.

DIAGRAM OF ROTATION LATERAL FLEXION
p95 Three parts

ADAPTATION : LATERAL DISPLACEMENT
pp106,107 ADAPTATION : LATERAL DISPLACEMENT Just as the other diagrams as we have just seen, that of lateral displacement is established very early during the cranial development, and under pressure exceeding its capacities of adaptation (flexibility and plasticity). But in this case, this constraint is lateral. The anterior and posterior parts of skull, on the level of the bones of the line of centers of the base move in the same direction, at the time of the phase of expansion: the sphenoid and the bones which are moved by it turn around a vertical axis passing by its body, the occipital one and its satellites move in the same direction, around an axis passing by its body. What seems to open the spheno-basilar synchondrosis (SBS) on the side opposed within the meaning of torsion, It is this side which gives its name to this displacement. During the tests of evaluation, as in the preceding cases, if the cranial mechanism is free, it must be able to adapt to this movement induced by the fingers of the practitioner.

DIAGRAM OF LATERAL DISPLACEMENT

vascular and nervous pathway Bevel
ALGORYTHME CRÂNIEN vascular and nervous pathway Bevel Pivot Movement

CRANIAL TECHNIQUE p111 PATHOMECANIQUE

THE LESION of CRANIAL OSTEOPATHY
Tissue changes, induced either by biomechanical disturbances, or by the not compensated variations of vascularization or of hormonal information that it conveys to their target, and/or of nervous information, result in an accepted loss, causes deterioration of its plasticity and its normal elasticity. What changes the tissue dynamics of fabrics conjunctive, then creating a fixed point in its centre. It is this new fixed point which constitutes the osteopathic lesion. We insist on the fact that “not fixes” does not mean “not motionless”, but not fixes compared to specific intrinsic dynamics to each tissue, i.e. an operation decreased compared to its normal driving possibilities.

PHYSICAL CHARACTERISTICS OF LESION OSTEOPATHY
- Tissue Change of state: Less plasticity. Less elasticity, - Decreased Mobility, - Loss of the final elasticity of the movement, with articular stop “Net”. (abrupt, without any flexibility). - Pain expressing the tissue suffering (especially when one touches there) - Each bone having at least two articulations, this change will be transmitted at least to two articulations, which will generate on the level of this second articulation, an articular synchronization.

OSTEOPATHY DIAGNOSIS We see immediately that these four characteristics will give us the signs of the lesion osteopathic, completely accessible to our hands: Tissue change, Reduced mobility, with abrupt stop at the end of the normal movement. Pain (when it is touched) Synchronization. It is obvious that the access osteopathic of the cranial field will follow the same process imperatively: even diagnostic approach, even search of the objective physical signs signing the lesion, and finally, even rationalization relating to the choice of the therapeutic techniques.

DIAGNOSTIC PROCESS p114 In four distinct stages.
1º - tissue Test of resistance (evaluates the change of State or of nature). 2º - active Test evaluating the flexibility at the end of the movement. 3º - Palpation of the faded zones tissue (large, hard and painful when one touches there). 4º - Tests of the proximal articulations, to measure the assignment of it It is obvious that the cranial access osteopathic of the fields will follow here also the same diagnostic approach, same search of the physical signs objective which sign the lesion, and then same rationalization at the time of the decision of the election of the choice of therapeutic technique.

THERAPEUTIC DEDUCTION
Establishment of a therapeutic protocol. With the specific techniques best adapted according to this evaluation. - And for each technique, the definition of its methods: Contact point, Direction of the gestural application, gestural Method, privileging: The speed, The strength, Moment of the greatest action, When to let itself slow down.

Of the lesion at the diagnosis
p116 Of the lesion at the diagnosis Osteopathic lesion Alteration of mobility Pain in touch Synchronization Tissue change (plasticity and elasticity) Less elasticity (rebound) Resistant test Tissue palpation zone Active proximal articulation test Osteopathic Diagnosis

THE REDUCTION OF THE CRANIAL LESION (I)
p117 THE REDUCTION OF THE CRANIAL LESION (I) Once perceived the lesional barrier, we evaluate its characteristics of them. What then enables us to choose his mode of suitable reduction. Three possibilities are offered then to us: 1 - To be located against the barrier, to rest against this one, without increasing the force of support, and to wait for its own release. It is the technique of induction. 2 - Our gesture penetrates little by little in the lesion (that we represent in the shape of a triangle of operation weakened within the range of the articular movement), the gestural reiteration creating thanks to its dynamics, a resolution partial of the amplitude of the triangle of weakened operation, is a progressive retreat of this barrier. It is a technique of progressive reduction.

THE REDUCTION OF THE CRANIAL LESION (II)
p117 THE REDUCTION OF THE CRANIAL LESION (II) 3 - The thrust. Gestural acceleration in contact with the barrier, surprises this one and, its elimination by its own dissolution causes some. It is certain that in this last case, the gestural choice which makes it possible to vary as well the mass as the velocity, allows a perfect adequacy the tissue on which one acts, as on their state. We always carry out this gestural choice, in perfect agreement with another criterion, that of the nervous organization maintaining the lesion. It is there that for us one of the important differences between structural lesion and functional lesion is located.

THE REDUCTION OF THE CRANIAL LESION (III)
induction progressive reduction osteopathic lesion

APPLICATION TO THE CRANIAL LESION (I)
The cranial articulation such as we defined it before, like its outlined biomechanics the next pages, show us the identity of the operation of the cranial system with the other body articular systems. We then understand easily osteopathic adequacy with the model, like its lesional similarity. The approach of the expert osteopath will be thus identical. Its diagnostic step consisting with the identification of the accused systems, their lesions, to collect the physical signs of them, that its reasoning will then enable him to classify, to treat on a hierarchical basis. It will be able to then choose the therapeutic sequence as well as it will implement, than the techniques which it will practice according to qualities of the barrier and accused tissue.

APPLICATION TO THE CRANIAL LESION (II)
Within this framework, a major knowledge of the anatomy will be one of the essential bases leading to the diagnostic step. It is it which allows according to the complaints, of the functional and tissue changes, to attach the physical signs, either with the interested subsystem, or to understand some in the direction etymologic of the term, the implication of the regulating subsystems located remotely. Of course, biomechanics is the other theoretical base more than essential. It gives a direction, an explanation so that our hands perceive, and as well allows us to induce a test evaluating its dysfunction, that an impulse qualifying the quality of the barrier, even its insufficiency.

APPLICATION TO THE CRANIAL LESION (III)
The lesional characteristics are identical: - Tissue Change, with reduction in its plasticity given by the change of final rebound, whereas its elasticity appears in the neutral phase of the movement at the time of the return to the neutral point. - Less Mobility, - Tissue Pain sometimes, - Articular Synchronization, being able to modify the usual relation with the other bones. And their diagnosis will be made by it by the usual method. - Tissue Palpation of the suture, - Tissue Resistance, which will qualify and quantify the barrier (final rebound) - active Test at the functional level. - Tests using the movements of cranial adaptation, which underline the restrictions sutures.

p119 CRANIAL TECHNIQUE THERAPEUTIC TOOLS

ATTITUDE OF THE THERAPEUTIST IN CRANIAL TECHNIQUE
The expert should not present any fixed point to the level of his hands at the time of the reception of the head of the patient, so that the cranial movement of this last of anything is not changed or is limited by this contact. This total freedom of skull in the hands of the expert, removing the usual interface between patient and expert, at least will make it possible this last to have a possibility of perception, wide until its abdominal center. In order to be unified with its patient, and to perceive the totality of the movements of it, it will gum any possible interface between him and its patient, creating a different interface of action, moved away from the relational center(feet on the ground, sitting on the chair, back of the hand against the coating of the table, etc…).

CONCEPT OF INTERFACE p122 The wind meets the sail to make it possible the boat to advance. It is on this level that it transmits its energy to him. Each interface requires an absolute intimacy of contact, of inter - penetration, for a faithful transmission of energy in a perfectly proportioned action. Energy is the wave, at the same time as it prints its force and its movement to it. In the therapeutic action, the hand of the practitioner is melted in an intimate way with the segment which it will animate, transmitting to him the energy produced by its movement. The practitioner not to break this union between his/her hand and the skull of the patient, will create an interface between him/her and the table of processing. In other words, between the back of its hand and the surface of contact on which it is driven. The error would be to create this interface between the palm of the hand and the skull which it animates: energy would be dispersed there partly. In order to avoid it, the practitioner increases very slightly the contact of his hand against the table, which indirectly perfect the unit created between the palm of its hand and skull of the patient.

DIAGRAM OF THE CONCEPT OF INTERFACE
pp123, 124 DIAGRAM OF THE CONCEPT OF INTERFACE

CONCEPT OF FULCRUM pp124, 125 We conceive it with the wide direction that gives him the Héritage dictionary of “point of balance, equilibrium, position, element or action through which, around which, or by the means of which, of the vital potentials are tested”, so much our action joins together all these aspects of them. The therapist will create a new pressure point, exactly with the interface of the energy which he provides and of the structure that he wants to animate, making it possible to focus of it the action with precision there or it wishes either to appreciate the existence of a functional freedom or not, or to help it later to be recreated. In order to act that on tissue interested, its contact will be placed at the adequate depth, by using as well the density and the presence of its hand, that by prolonging its perception at the adequate level.

CRANIAL TECHNIQUE OSTEOPATHIQUE

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