1. Osteopathic Approach to the Pediatric Patient Flashcards
Birthing can compress what three nerves within the jugular foramen of infants?
CN 9, 10, 11
Birthing can compress what nerve within the hypoglossal canal?
CN XII
Compression of the occiput (most common SD in babies) may cause what symptoms?
Poor Tongue motion (CN 9, 12)
-Poor Suck
Intestinal Peristalsis issues (CN 10)
-Constipation, Colic, GERD
SCM/Trap Motion issues (CN 11)
-Torticollis
What cranial dysfunction increases likelihood of otitis media?
88% of infants had what cranial dysfunction?
Internally rotated temporal bone
Compression of occiput
When does the anterior fontanelle close?
12-36 months
When does the posterior fontonelle close?
2-3 months
When does the sphenoid fontanelle close?
6 months
When does the mastoid fontanelle close?
6-18 months
Direct or indirect for infants?
Indirect
What treatments are popular for infants?
BMT Condylar decompression BLT MFR to diaphragms Lymphatics
What treatment should be done for infants with poor suck if you only have a few minutes?
Suboccipital release (OA Decompression-Biomechanical) Condylar decompression (Biomechanical)
Can add venous sinus release (biomechanical) if you have more time
What condition in infants needs to be ruled out before OMM?
Craniosynostosis (premature suture fusion)
How is plagiocephaly shaped and what is it associated with
Parallelogram shaped and is associated with torticollis
(Flat Head Syndrome)
-lateral strain
Describe brachiocephaly and what strains (2) is it?
Head is wider than long
Back of head flat
Vertical strain or flexion strain
Describe scaphocephaly and what strain is it?
Long, narrow head
Extension strain
How do you treat plagiocephaly (time sparing)?
suboccipital release (Biomechanical) venous sinus release (Biomechanical) V-spread to tight sutures (Biomechanical)
Sympathetic and PSym to inner ear?
Sym: T1-T4
PSym: None
Treatment for otitis media
Lymphatic: Thoracic inlet release
Galbreath/periauricular drainage
+Rib raising (Sympathetic)
Upper thoracic soft tissue (Sympathetic) if time
What causes torticollis?
Spasm of sternocleidomastoid
-possibly due to irritation of CN 11 (Spinal Accessory Nerve) in jugular foramen
Treatment for torticollis
Thoracic inlet release (Biomechanical)
Suboccipital release to reduce CN 11 (Biomechanical)
Cervical soft tissue with SCM stretching (Biomechanical)
What Psym and Sym are targeted to treat URIs?
What is the Treatment?
Sym: T1-4 (lungs)
PSym: CN 7 (But cannot reach)
Release Thoracic Inlet (Lymphatic)
Treatment plan for URI/Sinusitis?
Thoracic inlet release (Lymphatic)
Galbreath technique (Lymphatic)
Rib raising/soft tissue (Sympathetic)
What type of dysfunction (inhalation or exhalation? is caused by asthma?
Inhalation
-asthma causes air trapping, so ribs will be raised
Treatment plan for lower respiratory complaint
Rib raising (Sympathetic) C3-5 treatment (Neurologic) Suboccipital release can break up mucus
Psym and Sym for upper GI
Middle GI?
Lower GI?
Psym: Vagus
Sym: T5-9 Celiac ganglion
Psym: Vagus
Sym: T10-11 Superior Mesenteric Ganglion
Psym: Pelvic Splanchnic (S2-S4)
Sym: T12-L2 Inferior Mesenteric Ganglion
Psym and Sym for middle GI
Psym: Vagus
Sym: T10-T11 Superior mesenteric ganglion
Psym and Sym for distal colon
Psym: S2-4
Sym: T12-L2 inferior mesenteric ganglion
Treatment plan for GERD
Suboccipital (OA release) (parasympathetic)
Celiac ganglion Release (sympathetic)
-if time, can do
Thoracic diaphragm release (sympathetic)
T5-9 (Sympathetic)
Treatment for Constipation
Sacral rock
T/L junction inhibitory pressure
Superior and inferior mesenteric ganglion release
4 Tenants of Osteopathic Medicine
1) Body is unit
2) STRUCTURE and FUNCTION are interrelated
3) Body capable of self REGULATION/HEALING AND HEALTH MAINTENANCE
4) RATIONAL TREATMENT is based upon and UNDERSTANDING and APPLICATION of the above
What are Common Infant Complaints
Colic, GERD, Constipation, Torticollis
