OAT Peds Flashcards
red flags on history and exam
neck pain and fever
hip pain in obese child
HVLA is
rarely necessary in young children
relatively contraindicated in hypermobile joints
Very useful OMT
Articulatory, myofascial, FPR, lymphatic, BLT, and cranial
Common Infant Complaints
Colic GERD Constipation Torticollis Otitis media URI Croup Brachial plexus injury Cerebral Palsy club foot
Cardinal movements of labor
flexion
IR
Extension
ER
Foramen affected by labor
Juglar foramen - CNs IX, X, XI, inferior pertosal and sigmoid sinuses
Hypoglossal canal
CN IX
PSNS - parotid gland
motor - Ambiguus N.
somatosensory - Spinal Trigeminal N.
CN X
PSNS - vagal n.
Motor - ambiguus N.
Somatosensory - spinal trigeminal N.
CN XI
Spinal accessory
innervates the trapezius and sternocleidomastoid
CN XII
hypoglossal
innervates intrinsic and extrinsic muscles of the tongue
Compress of jugular foramen may cause dysfunction of
tongue motion (poor suck)- IX and XII Intestinal peristalsis (constipation, GERD, colic) - X SCM/Trapezius motion (torticollis)- XI
Infant spine
C-spine has slight lordosis which increases a baby can support head
thoracic kyphosis and lumbar lordosis have yet to develop
Anterior fontanelle closes at
12 - 36m
Posterior fontanelle closes at
2-3 m
sphenoid fontanelle closes at
6 m
mastoid fontanelle closes at
6-18 m
most common SD in infants
occiput
SD in infants that affects the most cranial ns
temporal
in infants, a internally rotated temporal bone increased likelihood of
otits media
operative vaginal delivery can cause
CN VI - lateral rectus palsy
CN VII - facial palsy
reason otitis media is more common in chidlren
eustachian tube flatter in infants
what needs to be ruled out or considered before OMM
craniosynostosis
Synostotic trigoncephaly
metopic suture fusion
synostotic scaphocephaly
sagittal suture fusion
synostotic brachycephaly
bicoronal suture fusion
synostotic posterior plagiocephaly
unilateral lambdoid suture fusion
synostotic anterior plagiocephaly
unicoronal suture fusion
deformational posterior plagiocephaly
all sutures open
positional plagiocephaly
plane of eyes is titled like plane of head
ear on flattened side more anterior
forehead protruding on the side of the flattening
unilateral bald spot
“parallelogram-shaped” head
frequently associated with torticollis and lateral strain
brachycephaly
head is wider than long
back of head is flat rather than curved
vertical strain or flexion strain
scaphocephaly
head is long and narrow
extension strain
torticollis due to irritation of
spinal accessory n. where it exits jugular foramen
OMM for torticollis
OA region
clavicles
how infants treat SD
crying and sucking
OMM for cranial SD
condylar decompression
BMT
venous sinus release
OMT in infants
indirect treatments preferred
Common childhood complaints
sinusitis URI Asthma GERD Constipation MSK compalints growing pains
Risk factors for URI
daycare and school
immunocompromised
smoke exposure
asthma/allergic rhinitis
OMT for URI
lymphatics - thoracic inlet
sympathetic T1-4
PSNS - CN VII(OA)
Bacterial sinusitis
URI sxs >10 days
sx imporve then worsen
OMT lymphatics
Sinuses present at birth
maxiallary and ethmoid
development of sphenoid sinus
4 yrs
development of frontal sinus
6 yr
OMT for Asthma
OA
accessory muscle or respiration
diaphragm
T1-12 and ribs
SD caused by asthma
inhalation rib SD
chapman’s point for sinuses
A: inferomedial clavicle, lateral to SC junction - nasal
superior second rib at midclavicular line - all
P: mastoid process
chapman’s point for larynx
A: superior second rib, just medial to sinuses CP
P: just lateral to SP of C2
Chapman’s point for pharynx
A: inferior first rib at sternocostal junction
P: lateral to SP of C2
Chapman’s point for tonsils
lateral manubrium
chapman’s point for middle ear
A: superior clavicle, about 2-3 cm lateral to SC junction
P: base of occiput at OA
OMT for sinusitis
sinus milking techniques
cranial lifts
OMT for OM
ear pull
glabreath
muncie technique
OMT for GERD
OA
T5-9
Diaphragm
Celiac ganglion
OMT for Constipation
OA
T10-L2
Superior and inferior mesenteric ganglia
sacrum
OMT for MSK
evaluate at least the joints above and below the joint in question
send pts home with exercises
OMT for cerebral palsy
treat what you find
common adolescent complaints
growing pains
back pain
joint pain
dysmenorrhea
viscerosomatics for SNS Upper GI
T5-9
ends at duodenum
viscerosomatics for SNS Middle GI
T10-11
ends at splenic flexure
viscerosomatics to SNS lower GI
T12-2
viscerosomatics for PSNS upper GI
OA, AA
ends at transverse colon
viscerosomatics for PSNS lower GI
pelvic splanchnic
CP for appendix
A: tip of 12th rib
P: TP of T11
CP for intestines
just below ASIS
CP for colon
along the IT band
CP for rectum
near inner thigh
