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Ahmed OS4 Depression > [Lecture] OAT Pediatric [Nichols] > Flashcards

[Lecture] OAT Pediatric [Nichols] Flashcards

1
Q

Which treatment technique is generally unnecessary in young children?

A

HVLA

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2
Q

Which treatment technique may be difficult to perform in children due to decreased ability to follow directions?

A

Muscle energy

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3
Q

Which treatment techniques are useful in children regardless of age?

A

ART, MET, FPR, lymphatics, BLT, cranial

Indirect, may be able to use direct as they get older

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4
Q

Compression of the jugular foramen may cause dysfunction of tongue motion, resulting in ______ in kids. Which CNs?

A

Compression of the jugular foramen may cause dysfunction of tongue motion, resulting in poor suck in kids

CN 9, 12

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5
Q

Compression of the jugular foramen may cause dysfunction of intestinal peristalsis, resulting in ____, _____, and ________ in kids. Which CNs?

A

Compression of the jugular foramen may cause dysfunction of intestinal peristalsis, resulting in constipation, GERD, and contribute to colic in kids

CN 10

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6
Q

Compression of the jugular foramen may cause dysfunction of SCM/trapezius motion, resulting in ______ in kids. Which CN(s)?

A

Compression of the jugular foramen may cause dysfunction of SCM/trapezius motion, resulting in torticollis in kids

CN 11

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7
Q

Which spinal curvature is developed in infants? Which curvatures develop later?

A

C-Spine has slight lordosis, increases as baby supports own head

Thoracic kyphosis and lumbar lordosis develops later

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8
Q

When do the anterior fontanelles close?

A

12-36 mo

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9
Q

When do the posterior fontanelles close?

A

2-3 months

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10
Q

When do the sphenoid fontanelles close?

A

6 mo

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11
Q

When do the mastoid fontanelles close?

A

6-18 mo

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12
Q

Which cranial bone is most commonly dysfunctional in infants?

A

Occiput (compressed)

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13
Q

Dysfunction of which cranial bone affects the most cranial nerves?

A

Temporal

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14
Q

Infants have increased likelihood of otitis media if temporal bone is rotated how?

A

Internally rotated

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15
Q

Operative vaginal delivery cause palsies in which cranial nerves?

A

CN 6 - lateral rectus palsy

CN 7 - Facial palsy

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16
Q

Why might internal rotation of the temporal bone cause otitis media in children?

A

Eustachian tube is flatter in infants than adults

Rotation blocks drainage of tube => increased risk of infection

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17
Q

How can you tell synostosis from positional plagiocephaly on physical exam?

A

Synostosis - symmetrical forehead and eyes

Positional plagiocephaly - forehead protrudes on one side/parallelogram-shaped head

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18
Q

What is craniosynostosis?

A

Abnormal fusion of head sutures

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19
Q

What kind of cranial somatic dysfunction causes plagiocephaly?

A

Lateral strain

Parallelogram head

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20
Q

What positional head deformity is frequently associated with torticollis?

A

Plagiocephaly

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21
Q

What kind of cranial somatic dysfunction causes brachycephaly?

A

Vertical strain/Flexion strain

Head is wider than it is long, flat back of the head

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22
Q

What kind of cranial somatic dysfunction causes scaphocephaly?

A

Extension strain

Head is long and narrow

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23
Q

What CN may be irritated to cause torticollis? What muscle does this affect?

A

CN 11 (spinal accessory)

SCM - short and ropy

24
Q

Where would OMT be localized to treat torticollis?

A

OA region

Clavicles

Use MFR, BLT, MET, chapman’s points…etc

25
Q

How are most cranial somatic dysfunctions in infants treated?

A

Self-treated through crying and sucking

26
Q

3 techniques to use to treat cranial somatic dysfunction in infants?

A

Condylar decompression

Balanced membranous OR ligamentous tension

Venous sinus release

Indirect treatments!! Can also do MFR, suboccipital release, lymphatics

27
Q

Bone development in school-age children

Cranium?

Sinuses?

Epiphyseal plates?

A

Cranium - fully ossified

Sinuses - fully formed

Epiphyseal plates - Still developing, may develop length discrepancy => short leg syndrome/functional scoliosis

28
Q

School-age children have avg of _____ URIs per year

A

Avg 6-8 URIs a year

  • Risk from school, smoke exposure*
  • Do lymphatics, viscerosomatics*
29
Q

Which sinuses are present at birth?

A

Maxillary

Ethmoid

30
Q

Around what age do sinuses typically reach their adult size?

A

12-15, teen years

31
Q

What is the typical course that Bacterial sinusitis takes?

A

URI sx >10 days =>

Sx improve, then worsen =>

Fever/purulent discharge >3 days w/ facial tenderness/HA

Tx with lymphatics (galbreath, ear circles)

32
Q

What division of the autonomic nervous system do you want to focus on when treating an asthma attack in children?

A

Sympathetic

Focus on C3-5 (diaphragm), T2-7 sympathetic innervation

T1-12 and accompanying ribs and diaphragm

Can also use for PNA treatment

33
Q

What did the 2005 asthma study show regarding using rib raising, MET, and MFR in pediatric patients?

A

Increased peak flow by 7-19 l/m

34
Q

Chapman’s points Anterior/Posterior

Nasal sinuses

A

Anterior: inferomedial clavicle, lateral to SC junction (nasal sinuses), 2nd sup rib at midclavicular line (all sinuses)

Posterior: Mastoid process

35
Q

Chapman’s points Anterior/Posterior

Larynx

A

Anterior: Superior 2nd rib, just medial to the sinus chapman’s point

Posterior: Just lateral to SP of C2 (larynx, pharynx, tongue, all sinuses)

36
Q

Chapman’s points Anterior/Posterior

Pharynx

A

Anterior: Inferior 1st rib at sternocostal jxn

Posterior: just lateral to SP of C2 (larynx, pharynx, tongue, all sinuses)

37
Q

Chapman’s points Anterior/Posterior

Tonsils

A

Just Anterior!!

Lateral manubrium

38
Q

Chapman’s points Anterior/Posterior

Middle Ear

A

Anterior: Superior clavicle, about 2-3 cm lateral to SC jxn

Posterior: Base of occiput at OA joint

39
Q

What do you always do when doing lymphatic techniques?

A

Always open the thoracic duct 1st

40
Q

What OMT might you want to do on a kid with rhinosinusitis?

A

Sinus milking techniques

Cranial lifts

41
Q

OMT for GERD in kids/Adolescents includes what levels/structures?

A

OA (parasympathetic)

T5-9 (sympathetic)

Diaphragm

Celiac ganglion (parasympathetic)

42
Q

OMT to treat constipation in kids/adolescents might include what levels/structures?

A

OA (parasympathetic)

T10-L2 (sympathetic)

Superior and Inferior Mesenteric ganglia

Sacrum (Sacral rock)

43
Q

For musculoskeletal complaints in children, what joints must be evaluated?

A

AT LEAST the joints above and below the joint in question

44
Q

What did the 2008 JAOA study find in relation to OMT and children with cerebral palsy?

A

Statistically significant improvements in Gross Motor Function Measurement and Functional Independence Measure for Children

45
Q

Bone fusion in adolescents

Epiphyseal plates?

Innominates?

Sacrum?

A

Epiphyseal plates - Closing by adolescence

Innominates - fuse by age 20

Sacrum - Fuses in late adolescence

46
Q

What population of adolescents is particularly susceptible to somatic dysfunction?

A

Athletes

Watch out for hypermobility

47
Q

What does the USPSTF recommend for scoliosis screening?

A

USPSTF found that screening asymptomatic individuals did not identify significant dz better than screening only when clinically indicated

48
Q

What does the American Academy of Pediatric guidelines recommend for scoliosis screening?

A

They do not support recommendation against screening (they like screening)

49
Q

What effect does increased parasympathetic tone have on peristalsis?

A

Increased

50
Q

What effect does increased sympathetic tone have on peristalsis?

A

Decreased

51
Q

Chapman’s Points Anterior/Posterior

Appendix

A

Anterior: Tip of 12th rib

Posterior: Transverse process of T11

52
Q

Chapman’s Points

Intestines

A

Just below ASIS

53
Q

Chapman’s Points

Colon

A

Along IT band

54
Q

Chapman’s Points

Rectum

A

Near inner thigh

55
Q

In pediatric patients, treating the whole patient requires recognition of what?

A

The family unit

Ahmed OS4 Depression (10 decks)

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