Chapter 40: Cranial remolding orthoses Flashcards
What are the greek words of plagiocephaly?
Plagio: Oblique
Cephalo: head
The pathogenesis of carnial deformities arise from what three causes?
Abnormalities in brain shape or development
Abnormalities in bone or suture development
Prenatal and postnatal deforming forces.
What are some conditions that result in abnormalities in brain shape or development?
Microcephaly
Macrocephaly
Utero cerbrovascular accident.
What does carniosynostosis involve?
Premature fusion of one or more cranial sutures, and genetic disorders such as Apert syndrome and Crouzon syndrome
Cranial deformities often begin with what?
Restrictive in utero environments, such as multiple births, a large fetus, first pregnancies, or sustained abnormal positioning secondary to conditions such as oligohydramnios, breeching positioning, or early descent into the maternal pelvis.
Who are extremely susceptible to cranial deformation?
Premature infants due to the increased plastsicity of the underdeveloped cranial structures.
What is the suggested sleeping position of the baby?
Supine because it reduces sudden infant death syndrome but cause more deformity to the head.
What is a common variable in plagiocephaly?
Torticollis
When a cranial remolding help suggested?
first 3 month after birth.
What is deformational plagiocephaly?
Asymmetry of the neurocranium and viscerocranium Unilateral occipital flattening Ipsilateral anterior ear progression Ipsilateral forehead bossing Contralateral forehead depression contralateral occipital bossing fascial asymmetry Congenital muscular torticollis
What is deformational brachycephaly?
Disproportion of the neurocranium and viscerocranium Bilateral occipital flattening bilateral forehead bossing increased heigh of cranial vault associated weakness of neck musculature
What is deformational scaphocephaly?
Disproportion of the neurocranium and viscerocranium Bilateral parietal flattening Anterior forehead bossing Posterior occipital bossing associated weakness of neck musculature.
What age can cranial remolding helmet be used?
3 to 18 months.
What is the average cranial width desired compared to cranial length?
78%
patients with deformational brachycephaly have an increased what?
Cephalic index
Infants with deformational scaphocephaly have a lower what?
Cephalic index.
Deformational plagiocephaly have what type of cephalic index?
Slightly increased.
What are the average values of the cephalic indices?
Males 16 days to 6 months: 73.7
Males 6-12 months: 78.0
Females 16 days to 6 months: 73.3
Females 6-12 months: 78.5
What degree of difference from the normal cephalic indices indicates deformity?
greater than 3.5%
Where is the cranial circumference measured?
Taken at the equator
Where is the cranial width measured?
Euryon to Euryon
Where is the cranial length measured?
Glabella to opisthocranion
Where is the cranial vault, right and left measured?
Frontozygomaticus to contralateral euryon
Where is the orbitotragial depth (upper face), right and left measured?
Exocanthion to tragion
Where is the cranial base (lower face) measured?
Subnasion to tragion
What is the equation for cephalic index?
CI= Cranial width/Cranial length
What is the equation for cranial vault asymmetry
CVA= cranial vault (R) - Cranial vault (L)
What is the equation for cranial vault asymmetry index
CVAI= [Cranial vault (R) -Cranial vault (L)]/ Cranial vault (R)
What is the equation for orbitotragial depth asymmetry?
OTDA= orbitotragial depth (R) - orbitotragial depth (L)
What is the equation for cranial base asymmetry?
CBA= cranial base (R) - Cranial base (L)
What is the recommended age for treatment with a cranial remolding helmet
4-8 months.
