OMM for Pediatrics

Question 1

What are the 3 osteopathic tenants?

Answer 1

1. Body is a unit: body + mind + spirit
2. Structure and function are reciprocally interrelated
3. Body is capable of self healing

Question 2

What treatment modality is rarely used especially in younger children? Why?

Answer 2

HVLA

– hypermobile joints

Question 3

With infants, their bones/joints are at maximum flexibility and are cartilaginous. What foramen is commonly compressed?

Answer 3

Jugular Foramen

Question 4

What cranial nerves exit the jugular foramen?

Answer 4

9, 10, 11

Question 5

What 2 sinuses exit the jugular foramen?

Answer 5

Inferior petrosal

Sigmoid

Question 6

What 2 muscles are innervated by CN 11 and thus can be dysfunctional if the jugular foramen is compressed?

Answer 6

SCM

Trapezius

Question 7

Where does CN 12 exit?

Answer 7

Hypoglossal canal

Question 8

List some possible signs of jugular foramen compression

Answer 8

• Poor suck
• GI upset
• Torticollis

Question 9

What is the most commonly dysfunctional cranial bone?

Answer 9

Occiput

Question 10

What cranial bone affects the most CN’s?

Answer 10

Temporal

Question 11

With infants, what type of OMM techniques are preferred?

Answer 11

Indirect

Question 12

With cranial dysfunctions in infants, what are 3 treatments?

Answer 12

Condylar decompression
BMT
Venous sinus release

Question 13

What is Craniosynostosis?

Answer 13

Cranial sutures fuse too early

Question 14

Craniosynostosis needs to be ruled out before OMM is performed on infants. What differentiates it from Plagiocephaly?

Answer 14

Forehead does NOT protrude

Question 15

What is Plagiocephaly?

Answer 15

Flat spot develops on 1 side of the head

Question 16

How will the head look with Plagiocephaly?

Answer 16

Parallelogram shaped head with a forehead protrusion

Question 17

What 2 things is Plagiocephaly associated with?

Answer 17

Torticollis

Lateral strain

Question 18

What is Brachycephaly? What strain pattern is it associated with?

Answer 18

Back of the head is flat; head is wide

– Associated with vertical/flexion strain

Question 19

What is Scaphocephaly? What strain pattern is it associated with?

Answer 19

Head is long and narrow

– Extension strain

Question 20

What is the most common dysfunction that causes Otitis Media?

Answer 20

Internally rotated Temporal bone

Question 21

What is the most common dysfunction that causes Otitis Media?

Answer 21

Internally rotated Temporal Bone

Question 22

What SNS levels correlate with Otitis Media?

Answer 22

T1 - T4

Question 23

Torticollis is from what CN dysfunction?

Answer 23

11

Question 24

In children the cranium is fully ossified, but what is still open?

Answer 24

Epiphyseal plates are still open –> growing pains with rapid growth

Question 25

URI's are common with children. What treatment modality is the best?

Answer 25

Lymphatics

Question 26

URI's are common with children. What treatment modality is the best?

Answer 26

Lymphatics

Question 27

With an URI, what is the SNS innervation?

Answer 27

T1 - T4

Question 28

If a child has URI symptoms for longer than 10 days, it initially improved but then worsened and has associated purulent discharge, what is the likely diagnosis?

Answer 28

Bacterial Sinusitis

Question 29

What OMM modality can be used for Bacterial Sinusitis too?

Answer 29

Lymphatics

Question 30

What is the SNS innervation for Asthma?

Answer 30

T1 - T7

Question 31

With children that have Asthma, diaphragm and rib dysfunctions are common. What specific type of rib dysfunctions?

Answer 31

Inhalation dysfunctions

Question 32

What OMM treatment can be used for Asthma?

Answer 32

Rib raising | --> SNS of T1 - T7

Question 33

What are the 2 PNS locations that are treatable with their corresponding nerves?

Answer 33

OA/AA = Vagus | S2 - S4 = Pelvic Splanchnic

Question 34

What does the PNS Vagus innervate?

Answer 34

Upper GI --> Transverse Colon

Question 35

What does the PNS pelvic splanchnics innervate?

Answer 35

Descending colon --> rectum

Question 36

If you increase the tone of the OA/AA or S2 - S4, what will occur?

Answer 36

Increased peristalsis (PNS)

Question 37

SNS celiac ganglion levels and what it innervates?

Answer 37

T5 - T9 = Upper GI --> duodenum

Question 38

SNS superior mesenteric ganglion levels and what it innervates?

Answer 38

T10 - T 11 = Middle GI --> splenic flexure

Question 39

SNS inferior mesenteric ganglion and what it innervates?

Answer 39

T12 - L2 = Splenic flexure --> rectum

Question 40

If you increase the tone of the SNS from T5 - L2, what will occur?

Answer 40

Decreased peristalsis

Question 41

If you are treating GERD, what levels of the PNS/SNS should you treat?

Answer 41

``` PNS = vagus at the OA SNS = celiac ganglion at the T5 - T9 ```

Question 42

With MSK complaints in children, what else should you evaluate besides the joint in question?

Answer 42

Joints above and below

Question 43

What are the SNS levels that correspond to Constipation?

Answer 43

T10 - L2 = superior and inferior mesenteric ganglion

Question 44

What treatment promotes the PNS for Constipation?

Answer 44

Sacral rock