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52 Cards in this Set

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  • Back
name the pediatric stages and the ages that correspond to each.
Neonatal(up to 1month); Infant (1-12months); Child (1-13 yrs); adolescent (13-?) start of puberty to adulthood
in regard to the birth history, what will put newborns at a higher risk for somatic dysfxn?
If they are: breech, transverse lie, face presentation; Cephalpelvic disproportion; firstborn infants, if the labor needed oxytocin, if it was a long or difficult labor, multiple births, post-term infants, premature, vacuum extraction, forceps (pretty much anything that's not normal)
If the infant has difficulty latching on to the nipple or learning to suck, cries excessively or is inconsolable, arches back repeating, throwing head back, and/or spits up or vomits excessively, what could these things indicate?
cranial base somatic dysfunction
when doing a structural observation and evaluation what is different compared to adults?
you do ROM regionally whereas in adults you do ROM segmentally. Also, there is no bony mastoid to use as a landmark for the SCM;
what else do you check in the structural observation of children?
check for symmetry or if one fingertip is posteromedial to the other; also check the temporal bone (for internal and external rotation) and check the sacrum for symmetry
define internal and external rotation of the temporal bone.
with an externally rotated temporal bone the mastoid is posteromedial (less prominent) and internal - the mastoid tip is anterolateral (more prominent)
describe the skeleton a of a neonate.
neonates have mostly cartilaginous articulations, bones are at maximal flexibility, and there is a minimal C-curve of the spine.
what happens to the Cervical spine as the baby ages.
as the child begins to hold up its own head, the spinal C-curve increases
Describe the age and what skeletal component develops at sitting up, ambulation, long bone growth, and what happens up until 25yrs.
A child starts sitting up at 8-9months and develops a thoracic kyphosis; child begins to ambulate at 13-60months and develops a lumbar lordosis; long bone growth develops in childhood and adolescence; the vertebral bodies continue ossification until 25yrs of age
what allows the head of a neonate to go through the birth canal?
the cranial bones are mainly cartilage that have small areas of ossification within them. this permits maximal compressibility
how big is the cranium in a newborn and describe its growth in the 1st yr.
initially the head is 50% of the body surface and it doubles in size during the 1st year of life
the head of a child is __% of adult size at 6 yrs.
name the restriction of intracranial membranous attachment that may occur during birth.
corkscrew restriction- use OMT to reestablish NL cranial mechanics
what is the most common site of SD and occurs in 88% of neonates?
occiput - neonates self-correct by sucking and crying
name the term that means "flat on one side of the head" and occurs in newborns and describe what it can cause.
plagiocephaly - intracranial membranous strains, cranial nerve entrapments, CNS irritation and compression; difficulty with suckling (CNXII); excessive vomitting (CNX), colic (CNXI)
What can cause impingement of CN IX, X, XI at the jugular foramen and XII at the hypoglossal forament?
occiptal condylar compression
if this nerve is damaged at birth will will cause flaccid paralysis of the face, loss of the nasolabial fold, and an eyelid that may not be able to close.
CNVII (Facial nerve)
what happens in a CN VI palsy?
abducens nerve control the lateral rectus muscle of the eye and the patient would not be able to move the eye laterally; may get nystagmus
if the newborn has a sphenobasilar synchondrosis dysfunction that affects the brainstem, what may happen?
get apnea and bradycardia
how do you treat an SBS in a newborn?
1)cranial OMT; 2)Rib raising helps to calm the sympathetic NS, improve breathing and move bodily fluids; 3)OA and condylar decompression; 4)sacral traction(using 2 fingers)
in regard to the costal cage in peds, what 2 ways would they get Somatic Dysfxn?
1) trauma; 2) muscle imbalance/spasm; 3) pathologies
what kinds of things would you see in a costal cage dysfxn and name some pathologies that may cause rib dysfxn?
non-rhythmic breathing, fractures would be rare (flexible, not ossified completely) however the posterior ribs have bony articulations and if fractured think abuse; children with Cystic fibrosis, asthma, scoliosis
Name the treatment for the costal dysfunction, muscle spasm.
inhibition, counter-strain (indirect method), and muscle energy
Name other treatments for costal dysfunctions.
Indirect OMT; HVLA (sitting/supine); relieve diaphragm motion restrictions
If the child can breathe without pain, will the tenderness be gone?
no. pt breathes without pain, the tenderness still remains
In a torticollis describe the SCM, how is the head positioned?
torticollis is a shortening/contracture of the SCM; the head will tilt toward and rotate away from the SCM (the irritation of the XI nerve may affect the jugular foramen)
name acute, chronic and congenital problems that cause torticollis.
acute: trauma (cervical ver. dislocation), lymph node that is irritating the CNXI, or tumor of the SCord); CHRONIC: long standing OA dysfxn with lateral strain (may of had h/o shoulder dystocia at birth or a cervical malformation)
how do you treat a torticollis?
depends on the origin. indirect, then direct OMT; begin with Counterstrain -> then muscle energy; anti-inflammatories and muscle relaxants (24hrs later do OMT)
What do you use to get a definitive dx of scoliosis?
standing postural radiograph
in scoliosis, the spinal process rotates ___ the concavity and the lumbar convexity goes ____ the short leg side.
toward; toward
how do you get a lumbosacral SD?
fall, hyperextension, overuse with a preexisting problem like a short leg, scoliosis, spondyloysis/spondylolisthesis
the affected side of a lumbosacral dysfxn will have a positive what test? how do you treat it?
positive standing flexion test on affected side; treat with: 1) relax the muscle with counterstrain, soft tissue relaxation, trigger-point inhibition and ME
an upper extremity dysfxn is most commonly due to what in children?
trauma (birth= should dystocia; fractured clavicle; falling - sports)
gallbladder dz will refer pain to where?
right shoulder
duodenal inflammation will refer pain to where?
left shoulder
how do you treat a clavicular fracture?
immobilize for 3-4wks; do Spencer Techniques; and Counterstrain
significant forces on the distal humerous may cause what fracture?
elbow fracture - supracondylar fracture - above the elbow
if a child has a long bone fracture called a spiral fracture, what is it from and what should you be aware of?
torsion or twist fracture and think of possible abuse
what OMT techniques do you use to treat wrist injuries?
C/S, MFR, stretching exercises, and nocturnal splinting
what OMT techniques do you use to treat jamming of the fingers or toes?
Traction and rotation
name the test that checks for a dislocated hip in neonates.
Ortolani Test
If the Ortolani Test is positive for hip dislocation, what is the treatment?
place in a Pavlik harness and refer to orthopedic surgeon
lower extremity pain may be referred pain from what?
GI tract
Describe the 3 Degrees of Ligamentous Injury.
1st degree Ligament injury: no tear, good strength, no laxity (mild pain, swelling); 2nd DEGREE: partial tear, decreased strength, mild-moderate laxity; 3rd DEGREE: complete tear, no strength, severe laxity
in what position is the ankle more stable?
There are 3 types of ankle sprains. name them and what ligaments are involved.
Type I: anterior talofibular ligament (most common); Type II: ATFL and calcaneofibular ligaments; Type III: ATFL, Calcaneofibular L and Posterior talofibular ligaments
what is the difference in a sprain and a strain?
sprains are ligamentous injuries. strains are muscular injuries
what are the OMT treatments for ankle sprains?
correct mortis in talus, correct ipsilateral fibular head, Correct T3 and Rib 3 (compensation); exercise prescription
Name the respiratory infections that are more common in children.
1) Otitis media (most commonly caused by strep. pneumo) and is the most common reason for peds visit in pts<5yrsold; 2)Pharygitis (MC: rhinovirus; adenovirus, Group A (strep pyogenes); 3) Croup (parainfluenza virus); 4) Bronchiolitis (viral of lower RT in children <2yrs)
what is the most common cause of pediatric hospital admission?
what are the OMT treatments used for diarrhea and constipation?
diarrhea: inhibitory pressure on T10-sacrum and correct lumbar SD; CONSTIPATION: Correct OA and AA and do fascial release