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B & L > OPP > Flashcards

OPP Flashcards

1
Q

Most frequent diagnosis among 0-11 months

A

Congenital muscular torticollis

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2
Q

Most frequent diagnosis 1-4 years

A

Otitis media

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3
Q

Plagiocephaly

A

Abnormal head shape when viewed from above

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4
Q

Synostotic plagiocephaly (craniosynostosis)

A

due to premature closure of one or more cranial sutures

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5
Q

Nonsynostotic plagiocephaly (deformational or benign positional)

A

due to external forces causing deformation

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6
Q

Prenatal cranial pressure

A
  • Uterine compression or constraint

- Multiple gestation

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7
Q

Postnatal cranial pressure

A

Prolonged time in the same position

  • Sleeping with head always turned to same side
  • Sitting in a car seat with head to same side
  • Bottle fed in the same position as opposed to changing sides with breast feeding
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8
Q

Risk factors for plagiocephaly

A
  • Male sex
  • Firstborn child
  • Multiple gestation
  • Developmental delay
  • Supine sleep position from birth to 6 weeks
  • Bottle feeding only (previous slide explanation)
  • Tummy time <60 minutes/day
  • Same position for prolonged time
  • Co-morbid torticollis
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9
Q

Long-term sequelae of plagiocephaly

A
  • Learning disorder
  • Stabismus
  • Difficulty in fitting glasses
  • TMJ
  • Orthodontia
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10
Q

What cranial strain is associated with benign positional plagiocephaly?

A

Lateral strain

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11
Q

Treatment of plagiocephaly

A
  • Rule out synostosis
  • Observation (if doesn’t resolve w/i 2-3 years, probably won’t)
  • Identify and remove source of prolonged external pressure on head
  • Active counter positioning
  • Alternate side of head at nap time
  • Alternate sides for bottle feeding
  • Supervised tummy time 1 hr/day
  • OMT
  • infant massage
  • orthoses (by 6 months of age, no later than 12)
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12
Q

Plagiocephaly protocol

A

-Eval and treat SBS w/occipital condylar decompression
-Eval and treat sutures with V-spread or lifts
-Eval and treat cranial strain pattern
-Mold the head
-Eval/treat the rest (torticollis, thoracic inlet,
abdomen, lumbar spine)

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13
Q

Congenital muscular torticollis

A
  • SB towards weak SCM/scalenes
  • chin rotated opposite
  • most common form
  • males more common
  • associated with plagiocephaly and facial asymmetry
  • constrained intrauterine position (multiple gestation)
  • increased birth weight or length
  • breech
  • difficult birth (vacuum or forceps-assisted)
  • birth injury including shoulder dystocia
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14
Q

Ocular torticollis

A

Postural torticollis adapted to compensate for visual disturbance such as strabismus

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15
Q

Neurogenic torticollis

A

Tumor in the cranial posterior fossa or brainstem

Syringomyelia or Arnold-Chari malformation

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16
Q

Benign paroxysmal torticollis of infancy (spastic torticollis)

A

> Recurrent episodes lasting a few hours to a few days, commonly accompanied by

  • Vomiting, irritability, or drowsiness
  • Pediatric migraine or vestibular dysfunction (may switch sides)
17
Q

Otitis media caused by

A
  • Immaturity
  • Allergies
  • Structural (Eustachian tube more horizontal in infant)
  • SD (cranial base strains can lead to impaired Eustachian tube drainage)
18
Q

OMT protocol for middle ear effusion

A
  • Balanced ligamentous tension (BLT) to SI joints
  • MFR to thoracolumbar junction & abdominal diaphragm
  • MFR or BLT of rib cage
  • MFR C/T (thoracic inlet)
  • BLT of cervical area
  • Suboccipital release
  • Venous sinus drainage technique
  • Occipital decompression
  • SBS decompression
19
Q

Galbreath mandibular drainage contraindicated in…

A

TMJ dysfunction

20
Q

Colic

A

Rule of 3’s “cry 3 hours/day at least 3 days/week around 3 PM”

21
Q

Proposed causes of colic

A
  • Entrapment neuropathy of CN IX, X and XII from cranial base strains
  • Carreiro: pull of cervical muscles against cranial base and upper cervical spine causing pain
  • Pottenger: parasympathetic overstimulation causing constriction and secondarily, to dilation.
22
Q

OMT for colic

A
  • Occipital decompression (CN IX, X, XII)

- MFR of abdominal valves and plexi

23
Q

Feeding disorders and GERD proposed cause

A

entrapment neuropathy of CN IX, X and XII from cranial base strains

24
Q

Feeding disorders and GERD treatment

A
  • Occipital decompression (CN IX, X, XII)

- MFR of abdominal valves & plexi

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