Omm; 4.2.07; Pediatrics, Kek

Front 1

name the pediatric stages and the ages that correspond to each.

Back 1

Neonatal(up to 1month); Infant (1-12months); Child (1-13 yrs); adolescent (13-?) start of puberty to adulthood

Front 2

in regard to the birth history, what will put newborns at a higher risk for somatic dysfxn?

Back 2

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)

Front 3

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?

Back 3

cranial base somatic dysfunction

Front 4

when doing a structural observation and evaluation what is different compared to adults?

Back 4

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;

Front 5

what else do you check in the structural observation of children?

Back 5

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

Front 6

define internal and external rotation of the temporal bone.

Back 6

with an externally rotated temporal bone the mastoid is posteromedial (less prominent) and internal - the mastoid tip is anterolateral (more prominent)

Front 7

describe the skeleton a of a neonate.

Back 7

neonates have mostly cartilaginous articulations, bones are at maximal flexibility, and there is a minimal C-curve of the spine.

Front 8

what happens to the Cervical spine as the baby ages.

Back 8

as the child begins to hold up its own head, the spinal C-curve increases

Front 9

Describe the age and what skeletal component develops at sitting up, ambulation, long bone growth, and what happens up until 25yrs.

Back 9

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

Front 10

what allows the head of a neonate to go through the birth canal?

Back 10

the cranial bones are mainly cartilage that have small areas of ossification within them. this permits maximal compressibility

Front 11

how big is the cranium in a newborn and describe its growth in the 1st yr.

Back 11

initially the head is 50% of the body surface and it doubles in size during the 1st year of life

Front 12

the head of a child is __% of adult size at 6 yrs.

Back 12

90%

Front 13

name the restriction of intracranial membranous attachment that may occur during birth.

Back 13

corkscrew restriction- use OMT to reestablish NL cranial mechanics

Front 14

what is the most common site of SD and occurs in 88% of neonates?

Back 14

occiput - neonates self-correct by sucking and crying

Front 15

name the term that means "flat on one side of the head" and occurs in newborns and describe what it can cause.

Back 15

plagiocephaly - intracranial membranous strains, cranial nerve entrapments, CNS irritation and compression; difficulty with suckling (CNXII); excessive vomitting (CNX), colic (CNXI)

Front 16

What can cause impingement of CN IX, X, XI at the jugular foramen and XII at the hypoglossal forament?

Back 16

occiptal condylar compression

Front 17

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.

Back 17

CNVII (Facial nerve)

Front 18

what happens in a CN VI palsy?

Back 18

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

Front 19

if the newborn has a sphenobasilar synchondrosis dysfunction that affects the brainstem, what may happen?

Back 19

get apnea and bradycardia

Front 20

how do you treat an SBS in a newborn?

Back 20

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)

Front 21

in regard to the costal cage in peds, what 2 ways would they get Somatic Dysfxn?

Back 21

1) trauma; 2) muscle imbalance/spasm; 3) pathologies

Front 22

what kinds of things would you see in a costal cage dysfxn and name some pathologies that may cause rib dysfxn?

Back 22

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

Front 23

Name the treatment for the costal dysfunction, muscle spasm.

Back 23

inhibition, counter-strain (indirect method), and muscle energy

Front 24

Name other treatments for costal dysfunctions.

Back 24

Indirect OMT; HVLA (sitting/supine); relieve diaphragm motion restrictions

Front 25

If the child can breathe without pain, will the tenderness be gone?

Back 25

no. pt breathes without pain, the tenderness still remains

Front 26

In a torticollis describe the SCM, how is the head positioned?

Back 26

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)

Front 27

name acute, chronic and congenital problems that cause torticollis.

Back 27

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)

Front 28

how do you treat a torticollis?

Back 28

depends on the origin. indirect, then direct OMT; begin with Counterstrain -> then muscle energy; anti-inflammatories and muscle relaxants (24hrs later do OMT)

Front 29

What do you use to get a definitive dx of scoliosis?

Back 29

standing postural radiograph

Front 30

in scoliosis, the spinal process rotates ___ the concavity and the lumbar convexity goes ____ the short leg side.

Back 30

toward; toward

Front 31

how do you get a lumbosacral SD?

Back 31

fall, hyperextension, overuse with a preexisting problem like a short leg, scoliosis, spondyloysis/spondylolisthesis

Front 32

the affected side of a lumbosacral dysfxn will have a positive what test? how do you treat it?

Back 32

positive standing flexion test on affected side; treat with: 1) relax the muscle with counterstrain, soft tissue relaxation, trigger-point inhibition and ME

Front 33

an upper extremity dysfxn is most commonly due to what in children?

Back 33

trauma (birth= should dystocia; fractured clavicle; falling - sports)

Front 34

gallbladder dz will refer pain to where?

Back 34

right shoulder

Front 35

duodenal inflammation will refer pain to where?

Back 35

left shoulder

Front 36

how do you treat a clavicular fracture?

Back 36

immobilize for 3-4wks; do Spencer Techniques; and Counterstrain

Front 37

significant forces on the distal humerous may cause what fracture?

Back 37

elbow fracture - supracondylar fracture - above the elbow

Front 38

if a child has a long bone fracture called a spiral fracture, what is it from and what should you be aware of?

Back 38

torsion or twist fracture and think of possible abuse

Front 39

what OMT techniques do you use to treat wrist injuries?

Back 39

C/S, MFR, stretching exercises, and nocturnal splinting

Front 40

what OMT techniques do you use to treat jamming of the fingers or toes?

Back 40

Traction and rotation

Front 41

name the test that checks for a dislocated hip in neonates.

Back 41

Ortolani Test

Front 42

If the Ortolani Test is positive for hip dislocation, what is the treatment?

Back 42

place in a Pavlik harness and refer to orthopedic surgeon

Front 43

lower extremity pain may be referred pain from what?

Back 43

GI tract

Front 44

Describe the 3 Degrees of Ligamentous Injury.

Back 44

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

Front 45

in what position is the ankle more stable?

Back 45

dorsiflexion

Front 46

There are 3 types of ankle sprains. name them and what ligaments are involved.

Back 46

Type I: anterior talofibular ligament (most common); Type II: ATFL and calcaneofibular ligaments; Type III: ATFL, Calcaneofibular L and Posterior talofibular ligaments

Front 47

what is the difference in a sprain and a strain?

Back 47

sprains are ligamentous injuries. strains are muscular injuries

Front 48

what are the OMT treatments for ankle sprains?

Back 48

correct mortis in talus, correct ipsilateral fibular head, Correct T3 and Rib 3 (compensation); exercise prescription

Front 49

Name the respiratory infections that are more common in children.

Back 49

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)

Front 50

what is the most common cause of pediatric hospital admission?

Back 50

asthma

Front 51

what are the OMT treatments used for diarrhea and constipation?

Back 51

diarrhea: inhibitory pressure on T10-sacrum and correct lumbar SD; CONSTIPATION: Correct OA and AA and do fascial release