Midterm Flashcards
How can the approach to osteopathic treatment of children change based on age
Young children may need to be held by parent; warm hands, approach child condifdently
What treatment modalities are not used in children
HVLA (contraindicated in anyone with hyper mobile joints), ME may be difficult in young children
What treatments are used in children
Articulatory, myofascia, indirect, FPR, lymphatic, cranial
What are cranial treatments in infants and children useful for
Poor suckle, infant constipation, birth trauma (vomiting, excessive crying, poor suck)
Techniques to use: condylar decompression, BMT
What curvatures of the spine have yet to develop in infants
Thoracic kyphosis and lumbar lordosis
What cranial bone is most susceptible to SD in an infant
Occiput; CN XII and IX can lead to poor suck, CN X can lead to reflux, vomiting, and colic, CNXI can lead to colic, muscular dysfunction
What can temporal dysfunction in children cause
If internally rotated, increases risk of otitis media
What an forceps or vacuum delivery cause
CN VI: lateral rectus palsy
CN VII: facial palsy
How can you tell the diff btw synostosis and positional plagiocephaly
If ear on flattened side more post -> synostosis; if more ant -> positional plagiocephaly
If forehead protruding on side of flattening suggests positional
Unilateral bald spot suggests position
What is recommended for OMT in infants
Indirect treatments; BMT, BLT, condylar decompression, MFR to diaphragms, suboccipital release
What is the anterior Chapman’s point for intestines
Just below ASIS
What OMT can you do for ab complaints in children
Poor feeding: cranial, esp condylar decompression
- GERD: cranial, viscerosomatics T5-9, OA, AA
- constipation viscerosomatic (upper and lower GI), pelvic dysfunctions, mesenteric release
What is the parasympathetic treatment for the nose
Facial nerve
What are the respiratory Chapman’s points
- Nasal sinuses: anterior is inferomedial clavicle lateral to SC junction, superior second rib at MCL; posterior is mastoid process
- larynx: anterior is superior second rib medial to sinus; posterior is lateral to spinous process of C2
- pharynx: anterior is inferior first rib at sternocostal junction; posterior is lateral to spinous process of C2
- tonsils: anterior is lateral manubrium
- middle ear: anterior is superior clavicle lateral to SC junction; posterior is base of occiput at OA joint
What is the Muncie technique used to treat
Otitis media
What are the 5 model treatment or asthma
- neuro: Beta2 agonist
- immmune: ICS
- biomechanics: rib dysfunction
- behavioral: avoid triggers, use meds prior to exposure
- resp/circ: rib raise, lymph tx
What are the indications for abx for acute otitis media
Ear pain non responsive to analgesic meds, age <6 months, exclusive formula feeding, fever >102.2 or non responsive to anti-pyretics
What are the OMT techniques for otitis media
Sinus drainage, galbreath, submandibular walking, pre-post auricular drainage, cervical drainage, temporal pull, BMT
What are the effects of chronic MSK conditions on pregnancy
- scoliosis: more pain; increase risk of premature birth
- RA: improved sx
- Ankylosing spondylitis: aggravated by pregnancy due to increased stress on SI joints
What MSK changes occur during pregnancy
Ligamentous laxity, exaggerated lordosis of lower back, forward flexion of the neck, downward movement of shoulders, weakness and separation of ab mm, joint laxative of anterior and posterior longitudinal ligaments, widening and increased mobility of SI joints and pubic symphysis, anterior tilt of pelvis, compression of structures due to fluid retention
What is tensegrity
Property of skeleton structures that employ continuous tension members and discontinuous compression members in such a way that each member operates with maximum efficiency and economy
What causes an anterior pelvic tilt
Hypertonic quads, quadratus lumborum and iliopsoas
What causes a posterior pelvic tilt
Hypertonic iliopsoas and Piriformis
What are the risk factors for m imbalance and postural de compensation
Gravitational strain
Congenital (pelvic tilt, short leg syndrome, scoliosis)
Altered proprioceptive input (trauma, sedentary lifestyle, poor exercise technique, m weakness)
Stress
Hormonal
Nutritional
Aging
What is sherrington’s law
When a m receives a nerve impulse to contract, its antagonists receive an impulse to relax
What are the signs of lower crossed syndrome
Increased sacral flexion btw ilia; increased lumbar lordosis, increased flexion of hip and knee, hyper mobility in sagittal and coronal planes in L4-5 and L5-S1, sitting up from supine and forward bending are dysfunctional
What are the hypertonic and hypotonic mm in lower crossed syndrome
- hypertonic: iliopsoas, quadratus lumborum, tensor fascia lata, hamstrings, rectus femoris, Piriformis, adductors, gastrocnemius, soleus
- hypotonic: gluteals, abdominals, vastus medialis, anterior tibialis, peroneals
What are the sx of each of the spastic m groups in lower crossed syndrome
- iliopsoas: inability to st and straight; pain in groin
- QL: pain referral to groin and hip, exhalation rib 12 dysfunction, diaphragm restriction
- hamstrings: pain sitting or walking, pain disturbs sleep, pain referral to post thighs, limited straight leg raise
- Piriformis: pain down post thigh; pelvic floor dysfunction, dyspareunia
- adductors: pain referral to inguinal ligament, inner thigh and knee
- gastroc: nocturnal leg cramps
What are the sx of the inhibited m groups in low cross syndrome
- glut min: pain when rising from chair;
- glut med: pain with walking
- glut max: restlessness
- vastus medialis: buckling knee, weakness going upstairs; chondromalaccia patellae
- rectus abdominis: increased lordosis, constipation
- tibialis anterior: pain to great toe and anteromedial ankle; foot drag
What is the difference btw form and force closure
- form: properties of the surfaces of the joint; requires proper size and shape of articulating surface
- force: compression produced by body weight, m action, and ligament force