Venous Sinus Drainage: Venous sinus drainage
is a technique that we could utilize
to try to help improve venous flow away from
the head. What we want to do is
to place our fingers over the venous sinuses.
So, what we’re going to do is
we’re going to start by placing our fingers,
pinkies at the inion
and letting the rest of the fingers fall
midline, inferior to the inion.
We’re going to hold that position until
we feel a little bit of a softening,
or relaxing, or increased flow. Then we’re going to
address the transverse sinus.
So again, pinkies are still on the inion
but then we go across the nuchal line
where the transverse sinus would lie and again
holding it until we feel a release.
We’re going to project, add a little bit of anterior
projection for the straight sinus.
So remember, the straight sinus lies between
the superior and inferior sagittal sinuses.
We’re going to just project forward.
Either you could use your pinkies
or some people like to use their thumbs
right on the inion projecting forward,
almost towards the patient’s nose.
Then we’re going to address
the superior sagittal sinus. So, we’re going to
have our fingers kind of overlap
and walk one step at a time over superior
sagittal sinus. Then we’re going to finish
at the metopic suture on the frontal bone.
What we're going to do again
is make sure you find the landmark, find the inion,
and then pinkies on the inion
and letting the rest of your fingers
fall in line inferior to that.
Again, we’re going to hold that until we feel
release underneath our fingers here.
Once we feel release, we're going to then
move to the transverse sinus.
So, pinkies on the inion and our fingers are going to go
across now the nuchal line
and allowing the head to kind of just rest
on our fingers and allowing us
to get a sense of a softening underneath
our fingers. Once we feel release,
we’re going to go and focus on the straight
sinus. So now, I’m just focusing
on my pinkies aiming straight up to the nose.
You could also use your thumbs
and again, just a little bit of a pressure getting
a sense of a softening by the inion.
We’re going to find lambda and then from there,
do a little bit of a spread
across the sagittal suture. So, you're kind of taking
your thumbs and pushing laterally
to create some space and to soften up along
the sagittal suture. Then once you reached
the frontal bones, you’re going to line up
your fingers along the metopic suture
and apply a little bit of lateral spread
at the metopic suture.
Once you perform the technique,
you can go back and recheck.
A lot of times when you treat the venous sinuses,
that will also help to reduce
some tension along the dura. You can recheck
the vault or any other cranial hole
to see if there is improved flow and decreased
tension throughout the head.
Sinus Drainage Techniques: Our facial sinuses
sometimes could become clogged.
Patients have increased congestion.
Sometimes patients have sinusitis
where they have infection of the sinuses.
These techniques could help treat
the facial bones and allow for improved drainage.
So, make sure that you open up
the thoracic inlet first. What we're going to do
first are the different lifts
for the frontal, the nasion spread, and the maxilla
through the zygomatic lift.
So for the frontal lift, we're going to contact the
frontal bone. You want to make sure
you’re on the frontal bones with your fingers.
You could either use your
two-finger contact with your thumbs
crossing or you could use your
hypothenar eminences and perform
the frontal lift this way.
So, either contact is fine. You're going to
contact the frontal bone
and then provide a lift which is going to be
at a 45-degree angle towards you,
so a little bit more superior towards the ceiling
and also back towards the operator.
You're going to hold this. You're going to know
any sort of restriction or tension.
There might be a little bit more tightness
on one side versus the other
and just kind of meet that tension. Hold it.
When you feel a release,
then you could return and then reassess
by doing a little bit of a lift.
The nasion spread, we're going to
hold onto the frontal bone
and get on the nasal bones gently
with our fingers here.
Then we're going to spread our fingers apart.
So, we’re spreading nasion here
trying to get good mobility of the nasal
bones and making sure that
there's no restriction here. The same with all the lifts,
we’re going to just kind of hold
this until we feel a little bit more of a give
and freedom and then come back.
Then when you reapply the lift, that's how
you could reassess whether or not
there's still tension there. The last lift
for the sinus drainage technique
is the zygomatic lift. You want to find the zygoma
and you want to be anterior
to the temporal bones. You want to make sure
you're not too posterior on the arch here.
So, we’re going to get on the zygoma. Again,
the context could be with two fingers
on the zygoma or you could use your hypothenar
eminence or thenar eminence again
and just kind of bring your palms together
gently and lift up towards the ceiling
or use the two-finger contact here
with your thumbs touching.
Here, your lift is straight up towards the ceiling.
So, we're going to contact the zygoma.
Again, provide a gentle lift and hold this and see
if we could get a sense of
decreased tension. To promote lymphatic
drainage from the sinuses,
we could do a little bit of a pumping
and then effleurage.
So, we start with the frontal sinuses.
We place our thumbs over the eyebrows
and just gently pump the
frontal sinuses seven times.
Then after doing the gentle pump
seven times, we want to do
a gentle effleurage, sweeping our thumbs
across the frontal sinuses to the region
right in front of the ear. Again, we do
these motions for seven times.
After the frontal effleurage, we could
address the nasal sinuses.
So, for the nasal passageway,
what we're going to do
is we're going to take our thumbs and kind of
alternate our thumbs down the nose.
We're kind of going to push
on one side and then the other.
You don't want to get too far down
just so long the nasal bone is fine.
Then you kind of work your way down the nose.
After doing that seven times,
what we're going to do is then
address the maxillary sinus.
So, you're going to get your thumbs
on either side of the nose,
a little bit of gentle pressure seven times.
After pumping the sinuses seven times,
we're going to do effleurage starting next
to the nose and coming to the region
right anterior, inferior to the ear. So again,
seven times of gentle sweeping motion
with the thumb trying to improve lymphatic
drainage clearance from the sinuses.
Then finally, we improve drainage down the neck.
Usually, I'll turn the patient's head.
Remember, the sinuses will drain along
the lymph nodes along the neck.
So, we're going to take our thumb
and just gently perform effleurage
along the sternocleidomastoid, and again
seven times on one side
and then seven times on the other.
You just have to be careful.
You don't want to do this, really
patients that may have severe
lymphadenopathy or really swollen
lymph nodes. Patients with mono
may have really swollen and painful lymph nodes.
So, just be a little bit more wary
about performing this technique on the cervical spine
with too much pressure in those cases.
So, that's the sinus drainage technique. Again,
to summarize, we're going to do our lifts,
and then a little pumping and effleurage,
and then effleurage down the neck
making sure that the thoracic inlet has been
addressed and opened up to start.