1. Osteopathic Approach to the Pediatric Patient

Question 1

Birthing can compress what three nerves within the jugular foramen of infants?

Answer 1

CN IX, X, XI

Question 2

Birthing can compress what nerve within the hypoglossal canal?

Answer 2

CN XII

Question 3

Compression of the occiput (most common SD in babies) may cause what symptoms?

Answer 3

Poor Tongue motion (CN IX, XII)

Intestinal Peristalsis issues (CN X)
-Constipation, Colic, GERD

Scap/Trap Motion issues (CN XI)

Question 4

What cranial dysfuntion increases likelihood of otitis media?

Answer 4

Internally rotated temporal bone

Question 5

When does the anterior fontanelle close?

Answer 5

12-36 months

Question 6

When does the posterior fontonelle close?

Answer 6

2-3 months

Question 7

When does the sphenoid fontanelle close?

Answer 7

6 months

Question 8

When does the mastoid fontanelle close?

Answer 8

6-18 months

Question 9

Direct or indirect for infants?

Answer 9

Indirect

Question 10

What treatments are popular for infants?

Answer 10

BMT
Condylar decompression
BLT
MFR to diaphragms
Lymphatics

Question 11

What treatment should be done for infants with poor suck if you only have a few minutes?

Answer 11

Suboccipital release and condylar decompression

Can add venous sinus release if you have more time

Question 12

What condition in infants needs to be ruled out before OMM?

Answer 12

Craniosynostosis

Question 13

How is plagiocephaly shaped and what is it associated with

Answer 13

Parallelogram shaped and is associated with torticollis

-lateral strain

Question 14

Describe brachiocephaly and what strains (2) is it?

Answer 14

Head is wider than long with back of head flat

Vertical strain or flexion strain

Question 15

Describe scaphocephaly and what strain is it?

Answer 15

Long, narrow head

Extension strain

Question 16

How do you treat plagiocephaly (time sparing)?

Answer 16

suboccipital release,
venous sinus release, and
V-spread to tight sutures

Question 17

Sympathetic and PSym to inner ear?

Answer 17

Sym: T1-T4
PSym: None

Question 18

Treatment for otitis media

Answer 18

Lymphatic: Thoracic inlet release and Galbreath/periauricular drainage
+Rib raising and upper thoracic soft tissue if time

Question 19

What causes torticollis?

Answer 19

Spasm of sternocleidomastoid

-possibly due to irritation of CNXI in jugular foramen

Question 20

Treatment for torticollis

Answer 20

Thoracic inlet release, suboccipital release to reduce CNXI, and possible cervical soft tissue with SCM stretching

Question 21

What Psym and Sym are targeted to treat URIs?

Answer 21

Sym: T1-4 (lungs)
PSym: none

Question 22

Treatment plan for URI/Sinusitis?

Answer 22

Thoracic inlet release, galbreath technique, and rib raising/soft tissue

Question 23

What type of dysfunction (inhalation or exhalation? is caused by asthma?

Answer 23

Inhalation

-asthma causes air trapping, so ribs will be raised

Question 24

Treatment plan for lower respiratory complaint

Answer 24

Rib raising,
C3-5 treatment, and
suboccipital release can break up mucus

Question 25

Psym and Sym for upper GI

Answer 25

Psym: Vagus
Sym: T5-9 Celiac ganglion

Question 26

Psym and Sym for middle GI

Answer 26

Psym: Vagus
Sym: T10-T11 Superior mesenteric ganglion

Question 27

Psym and Sym for distal colon

Answer 27

Psym: S2-4
Sym: T12-L2 inferior mesenteric ganglion

Question 28

Treatment plan for GERD

Answer 28

OA release and Celiac ganglion release

-if time, can do thoracic diaphragm release and T5-9

Question 29

Treatment for Constipation

Answer 29

Sacral rock
T/L junction inhibitory pressure
Superior and inferior mesenteric ganglion release