Ultimate Cranial OMM Mega Review: CV4, SBS Mechanics, Strain Patterns, Sacral Motion & Vault Hold – Complete COMLEX Questions Complete with Verified A+ Graded Rationales Latest Updated 2026

Ultimate Cranial OMM Mega Review: CV4, SBS Mechanics, Strain Patterns, Sacral Motion & Vault Hold – Complete COMLEX Questions Complete with Verified A+ Graded Rationales Latest Updated 2026 Compression of 4th Ventricle (CV4) • Craniosacral mechanism is held towards the position it assumes during exhalation phase • Contact is on Occipital squama, not sutures or mastoid. • Steady deep compression to "deepen the saucer" of the occipital squama. • Patient can cooperate by holding breath in prolonged exhalation. Compression of 4th Ventricle (CV4) • Can be thought of as a "lymphatic pump" for the CSF and all body fluids. • Believed to increase the amplitude of the CRI CV4 (CV4 Compression Technique) Thenar eminences contact medial to Occipito-mastoid sutures Frontal Lift Parietal Lift 1) Motility of CNS 2) Fluctuation of CSF 3) Mobility of intracranial / intraspinal membranes (reciprocal tension) 4) Articular mobility of cranial bones 5) Involuntary motion of sacrum between ilia 5 Components to Model: Cranial Concept Falx attaches to cristi galli of ethmoid and to the frontal crest Describe the pole of attachment? Anterior- Superior Pole Tentorium attaches to anterior and posterior clinoid process of the sella turcica Describe the pole of attachment? Anterior-Inferior Pole Tentorium attaches to the petrous ridge of the temporal bone and the transverse ridge of the occiput Describe the pole of attachment? Lateral Poles The interal occipital protuberance Describe the pole of attachment? Posterior Pole Dura exits the foramen magnum attaches to C2 and C3 and then hangs down and attaches to S2 Describe the pole of attachment? Sacral Pole Superior Transverse Sacral Axis (S2) Sacral axis for involuntary cranial motion is at the _______________________________ Superior Transverse Sacral Axis (S2) Involuntary motion of the sacrum between the ilia occurs around what axis? Flexion or Extension Motion of midline bones Transverse Axis Midline bones flex or extend around what axis? AP Axis Paired bones internally or externally rotate around what axis? Internal or External Rotation Motions of paired cranial bones Midline bones: Flex Paired bones: Externally rotate Describe movements of midline and paired bones during FLEXION phase Midline bones: extend Paired bones: Internally rotate Describe movements of midline and paired bones during EXTENSION phase Flexes (expands) During the inhalation phase, the SBS ________________ Extends (contracts) During the exhalation phase, the SBS ________________ Transverse Axis Flexion and Extension at the SBS occur because of motion around what axis? 2 How many transverse axes are there? 1 How many AP Axes? 2 How many Vertical Axes?