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126 Cards in this Set
- Front
- Back
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How can neonates have asymmetric musculoskeletal mechanics?
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intrauterine forces
birth trauma |
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What are synchondroses?***
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cartilaginous connections of osseous components of the skull
(turn into bone before adult life) |
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When does the SBS ossifiy?
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8-18 years
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When does the sphenoid and temporal bones ossify?
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2 years
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When do the occipital bones ossify?
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7-9 years
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What does the Dural membrane do for cranial development?
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template for bones
transmits forces path for venous sinuses & CNs |
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What types of treatments are preferred in kids?
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indirect treatments
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What age should NOT get HVLA?***
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anyone under 6 years old
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What are the absolute contraindications for cervical HVLA?***
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Down syndrome
Rheumatoid arthritis (ODONTOID LIGAMENT susceptible to rupture) |
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What does the APGAR score look for?***
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Appearance
Pulse Grimace Activity Respiration (7-10 = normal); Done at 1 & 5min post-natal |
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What does a preference in standing on toes, or inflexibility of muscles indicate?
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pyramidal tract region injury
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What are the important developmental milestones of 1 month? ***
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Head: turns head side to side (prone); head flops back if unsupported
Extremities: flails arms around; hands within range of eyes, mouth Hands: tight fists |
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What are the important developmental milestones of 3 months? ***
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Head: lifts head when prone
Eyes: follows moving object with eyes Extremities: kicks legs Hands: loose hands Activity: grasp rattle |
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What are the importnat mile stones by 6 months? ******
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Head: sits up unsupported***
Extremities: reaches for objects Activity: shakes rattle, rolls over Language: single syllable words |
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What are the important mile stones by 12 months? ***
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Activity: Pincer grasp*** (picks up objects w/ thumb, finger)
drinks/feeds itself (finger food) knocks 2 blocks together |
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What are the important 2 year mile stones? ***
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Activity: walks (walked at 18mo), runs/stairs
Language: combines two words*** |
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What are the important 3 year mile stones? ***
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Activity: alternate feet walking, hopping
can draw self portrait knows parts of body ("pee by 3") |
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What happens to cranial MOLDING due to birth?
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this is alright, usually gets better
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What happens with cranial MOLDING after the first day of life?
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bone deformation with or without cranial base strain
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How do you treat PLAGIOCEPHALY?***
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Encourage tummy time***
Reassure parents OMT |
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What causes TORTICOLLIS? Somatic dysfunction (rotation, sidebending?) Complications? Management?
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Muscle imbalance: SCM , trap, or scalene: rotated & sidebent OPPOSITE
Malposition of head & neck (4-6wk) May cause plagiocephaly Tx: Neck stretching exercises |
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What cranial nerve dysfunction is common with TORTICOLLIS?
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CN XI
due to OCCIPUT & TEMPORAL bone problems |
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Before what gestational age is there a NON-NUTRITIVE suckling predominant?
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<32 weeks
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What gestational ages may have an immature sucking pattern?
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32-36 weeks
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What cranial nerve dysfunction is associated with problems with suckling?***
What OMT can you use to help with latching? |
CN XII (hypoglossal)
Occipital decompression/balancing*** |
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What does GERD look like in babies?
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excessive vomiting in spite of controlled feedings
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What is GERD in babies due to?
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vagus nerve (CN X) problem at base of skull (b/w occiput & temporal bone via jugular foramen)
thoracoadbominal diaphragm- esophagus motility and dysfunction |
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What somatic dysfunction can cause myopia, hyperopia, strabismus in kids?
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any kind of somatic dysfunction of the SPHENOID
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What is the mandibular drainage of GALBREATH used for?***
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URI's
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How is the mandibular drainage of GALBREATH used?***
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DIRECT soft tissue technique (myofascial release)
used to increase drainage of middle ear structures. gentle pumping of about 30 seconds per side (Gentle traction on proximal mandible) |
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What is the SINUS EFFLEURAGE used for?
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URIs (Allergic or Infective)
Repetitive DIRECT strokes (2-5min) of: frontal, nasal, maxillary, zygomatic +/- TMJ Facilitate lymphatic drainage toward jugulodigastric node anterior to TMJ, then distally to L&R lymphatic ducts. |
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What is the EAR PULL used to treat?
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Otitis Media
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What bone are you moving in the EAR PULL technique?
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TEMPORAL BONES
Balance fascia between PINNA & TRAGUS |
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What is the most common cause of PEDIATRIC PNEUMONIA?
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viral
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What thoracic levels do you evaluate for the LUNGS? (re: sympathetics, pneumonia) (parasympathetics?)
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Sympathetics: T1-T5
Parasympathetics: OA junction |
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What is the normal tone on the bronchioles?***
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PNS dominant typically (Vagus N., CN X)
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What nerve affects bronchial smooth muscle ? (ASTHMA)
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Hyperactive Vagus N (CN X)
= Bronchospasm, obstruction, mucous production |
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What nerve signal is DIMINISHED in ASTHMA?
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SYMPATHETIC nerves
(especially T1-T5/6: paraspinal tissue texture changes) |
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What are the 3 main Asthma OMT treatments? What OMT balances parasympathetic and sympathetic nervous systems?
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Champans reflexes: Lung, sinus, adrenal glands
Lymphatic pump Cranial Sacral: CV4 Diaphragm release RIB RAISING: direct PNS=SNS balancing |
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What causes COLIC on infants? (What should you rule out?)***
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Compressed Hypoglossal and Vagus N's
R/O organic causes**: congenital megacolon, hypothyroidism, CF, Hirschsprung |
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What is the OMT for COLIC in infants?
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Rib raising
***Decompression of occipital condylar parts CV4 |
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Where is the problem if the baby has difficulty breathing?
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TEMPORAL BONES are not working in an integrated fashion
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Where is the problem if a baby cant suckle?***
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Compressed HYPOGLOSSAL N (CN XII) between CONDYLAR parts**:
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Whats the treatment for lack of suckling?**
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CONDYLAR DECOMPRESSION**: 1) 2 fingers on condyles, bring wrists/elbows together until tissue tension is balanced to decompress
then teach child to suckle on finger, then nipple |
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What is the problem if the baby spits up or vomits after feeding?
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Compressed VAGUS N (CN X) in Jugular Foramen
@ the occipital mastoid suture |
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How do you treat compressed Vagus N.? Where do is it compressed? ***
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SCS or V spread from long diagonal of head
CN X compressed at Jugular foramen |
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Where is the CHAPMAN'S point for the LIVER?
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Right 6th intercostal space
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Were is the CHAPMAN'S point for the PANCREAS?
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Right 8th intercostal space
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Where is the CHAPMAN'S point for the STOMACH ACID?
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Left 5th intercostal space
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Where is the CHAPMAN'S point for the STOMACH PERISTALSIS?
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Left 6th intercostal space
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What disease do you focus on for TODDLERS?
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Otitis Media
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What are the muscles and nerves of EYE MOVEMENT?
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AO3,
SO4, LR6 |
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What does the SUPERIOR OBLIQUE move the eye to?
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DOWN and out
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Where INFERIOR OBLIQUE turn the eye?
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UP and out
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What does the SUPERIOR RECTUS muscle turn the eye?***
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UP and IN (medial)***
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where does the INFERIOR RECTUS muscle turn the eye?***
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DOWN and IN (medial)***
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Where the LATERAL RECTUS muscle turn the eye?
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OUT
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What often causes trauma to the NASO-MAXILLA SUTURE?
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boys, right handed punches
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What causes ESTROPIA or STRABISMUS? Where is the damage?
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LATERAL RECTUS damage
in the CAVERNOUS SINUS |
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What is being used in the CRAWL development?
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IPSILATERAL arm and leg
(army/alligator) |
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What is being used in a CREEP?
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CONTRALATERAL arm and leg
(hands and knees crawl) |
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What is the focus of children 4-8?
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asthma
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What ages get acute low back pain?
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20-50 year old
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What are the high risk occupations for low back pain
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nursing
garbage collection warehouse airlines |
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What is the main traumatic cause of non-radicular low back pain?
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muscle or somatic dysfunction
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What is the presentation of Discogenic low back pain?
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acute onset
sharp/shooting dermatomal radiation worse with cough, sneeze, sitting better lying down |
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what is the most common cause of discogenic low back pain?
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irritation of a nerve root
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What is affected with discogenic low back pain?
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both sensory and then eventually motor
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What percent of bulging disks are asymptomatic?
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52%
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What is the most common type or location of a herniated nucleus pulposis?
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posterior lateral herniation, @ level L4-L5
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What is the main cause of spinal stenosis?
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degeneration and remodeling caused by normal aging
narrowing of the spinal canal |
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What are the symptoms of spinal stenosis
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bilateral, progressive pain that radiates to buttocks, thighs, legs.
Worse with standing/walking better in flexion |
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How are the signs of cluadication different than spinal stenosis?
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the pain improves with stopping ambulating
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What is spondylolysis?
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separation of the pars interarticularis of the vertebral arch
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Who gets spondylolysis?
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hyperextension injuries
seen in football linemen, and gymnasts |
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What is the pain of facet joint syndrome like?
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pain in the back, in the facet region with no radiation below the knee
pain gets better with activity (like osteoarthritis pain) |
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What is myofascial pain like?
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diffuse, focal.
worse with rest relieved by warmth stiff |
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What does L1-L2 motor do?
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psoas
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What does L3 motor do?
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quadriceps
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What does L4 motor do?
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tibialis anterior
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What does L5 motor do?
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extensor hallicus longus
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What so S1 motor do?
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gastrocnemius
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What does patellar DTR test?
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L4
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What does achilles DTR test?
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S1
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What does a positive straight leg raise test look for?
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nerve root irritation
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What does a patricks test look for?
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hip pathology
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What does the thomas test look for?
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tight hip flexor
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motion for L on L forward sacral torsion?
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axis side down,
rotate chest to table (forward) legs off table, have them raise ankles to ceiling |
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Motion for R on L sacral torsion?
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axis side down
rotate back to table only superior leg off table* have them raise upper leg to ceiling |
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What is the position for a unilateral sacral extension treatment?
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abduct leg on side of extension
sphinx position- in order to flex the sacrum push that beast back into place |
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for treating sacrum- abduct those legs !
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do it!
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position for UPL5 counterstain?
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extend hip
Adduct hip external rotation |
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position for LPL5 counterstrain?
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flex hip
adduct (off side of table) pull opposite ilium up |
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Glute medius counterstain?
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extend and ABduct thigh
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What is Naegls rule?
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to determine estimated date of delivery=
one week to FDLMP, minus 3 months (in the next year, of course...) |
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What is the age of fundal height of pubic symphysis?
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12 weeks
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waht is the age of fundal heigh at umbilicus?
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20 weeks
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What does each CM above pubic symphsis equal (past 20 weeks)
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about one extra week
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How soon do women feel fetal movement?
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20 weeks primigravidas
15 weeks for multigravidas |
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How often should fetal movements be?
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10 per 12 hours
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What does the corpus luteum secret to allow for ligament laxity ?
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relaxin
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how do the innominates move in pregnancy?
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these externally rotate
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What are the risk factors for pregnancy low back pain?
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multiparity
old prior low back pain or trauma |
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Why do pregnant ladies get feet edema?
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vena cava compression
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How much fluid do women gain when pregnant?
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6.5 liters
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What are the viscerosomatic reflexes for uterus and bladder?
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T10-L1
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What are the viscerosomatic reflexes for ovary and fallopian tubes?
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T9-T10
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What are the viscerosomatic reflexes for parasympathetics
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S2-S4
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Treatment for Dysmenorrhea?
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OMT to thoracolumbar dysfunction to improve homeostasis
or pressure over sacrum |
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What are the vertebral levels for morning sickness?
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C2, T5-T9
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What treatment is used to decrease the severity of dysmenorrhea?
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sacral inhibition
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What is the ischeial tuberosity spread used to treat?
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urinary incontience
hemorrhoids pelvic pain shyness |
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What is the position for visceral treamtent of bladder
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listening hand directly on skin
hand that applies force above it |
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What does throacolumbar stimulation treat? at what levels?
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improves quality of contractions in uterine dystocia or long labor
T12-L2 |
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What is the preferred treatment position for pregnant people?
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Left lateral recumbent (IVC is on the right, dont squish it)
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For inguinal ligament counter stain, where do you stand?
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opposite of TP, leg on table
flex pts legs up adduct and wrap around TP |
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Strain pattern of plagiocephaly***
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OA & SBS
LATERAL strain: parallelogram & OA rotation toward flat side |
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List some causes of pediatric somatic dysfunction
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RAPID GROWTH, Intrauterine forces/positioning, Birth trauma, Developmental milestones, weight-bearing mechanics, childhood trauma or injury
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Caput succedaneum v. Cephalohematoma***
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Caput succedaneum: fluid under skin/soft tissue
Cephalohematoma: fluid under PERIOSTEUM |
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4 basic osteopathic principles
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1) Body is a unit of function
2) Structure & Function are interrelated 3) Body has capacity for self-healing & restoring homeostasis 4) Rational treatment is based on the application of the above principles |
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Chapman's point: Middle ear
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Ant: Superior medial clavicle (where rib 1 dives)
Post: Posterior occipital condyles |
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An unopposed normal L medial rectus (AR3) with a dysfunctional left lateral rectus (LR6) leads to esotropia on...which side?
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Left
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Chapman points (HEENT): Eye
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Anterior: Anterior-Lateral Humerus
Posterior: Posterior mastoid process |
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Chapman point (HEENT): Ear
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Superior clavicle (MCL)
Inion (greater occipital protuberance) |
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Chapman Nose/Sinus
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1st ICS (MCL)
Post-lat OA |
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Chapman Throat
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1st ICS (lateral to sternum)
Post-lat AA |
