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OS4 exam 1 > Peds > Flashcards

Peds Flashcards

1
Q

Primary flexion curves of thoracic and pelvis caused by

A

Flexion position of embryo

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2
Q

Extension curves in cervical and lumbar regions due to

A

Functional muscle development (erector spinae muslces)

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3
Q

Spinal cords ends where?
24 fetal weeks?
At birth?
Adult?

A

S1
L3
L1

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4
Q

What do ribs begin as? What happens later? Diaphragm insertion?

A

Ribs begin as cartilage and are horizontal in infants
Progress towards bucket/pump handle as child grows
Diaphragm inserts horizontally on inner surface of ribs in infant instead of obliquely as in adults

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5
Q

Infants have anterior, posterior, 2 mastoid, and 2 sphenoid fontanels. Posterior closes when? ANterior closes when?

A

Posterior by 2 months

Anterior by 2 years

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6
Q

Describe flexion of basicranium

A

30 degrees in infants
51 in adults
basicranial flexion relates supralaryngeal space

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7
Q

Describe temporal changes, specifically petrous portion

A

At birth, temporal bone in 3 parts
Petrous portion houses acoustical vestibular organ
Growth: rotates external auditory meatus into sagittal plane. Tips Eustachian tube from horizontal position to oblique angle
Most cranial nerves pass through this bone: CN3-11

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8
Q

What is a common cause of cranial dysfunction in infants? Most susceptible ?

A

Birth trauma
Head accommodates to pelvic outlet during birth
Occiput most susceptible

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9
Q

CN VI and CN VII may be injured during forceps delivery. Results?

A 
CNVI = lateral rectus palsy, nystagmus
CNVII = facial palsy, smooth forehead, inability to fully close eye
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10
Q

CNs 9-12 may be impinged by occipital bone dysfunction. Results?

A 
Jugular foramen (9-11)
CN9 = poor sucking
CN10 = excessive vomiting/spitting up
CN11 = colic, poor sucking, often affected by occiptal-temporal bone dysfunction

Hypoglossal canal
CN12 = poor sucking due to infant’s difficulty moving tongue = cannot suckle properly

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11
Q

What is associated with increased incidence of otitis media? Why? How to diagnose?

A

Internal rotation of temporal bone
Impairment of middle ear drainage due to Eustachian tube blockage
Cradle occiput in hands and gently place tips of index fingers on mastoid portion/attachment of SCM muscle. If one side is more prominent, then there is internal rotation

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12
Q

What happens in toddlers (1-4 years)?

A

Ossification increases

Some bones become fused

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13
Q

What happens in school age children?

A

Cranium fully ossified
Epiphyseal plates still open
Rapid growth taking place in long bones = growing pains
May develop leg length discrepancy = short leg syndrome or functional scoliosis

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14
Q

Describe the 3 types of growth areas

A

Epiphyseal growth plate
Proximal/distal end of bone
Made of hyaline cartilage

Epiphysis/articular surface
Made ofhylaine cartilage

Apophysis
Area of cartilaginous growth at insertion of tendon
Made of fibrocartilage
Creates bony tubercles like tibial tubercle or AIIS
Apophysitis, avulsion fractures more common in peds because of unossified apophysis

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15
Q

What are hyaline and fibrocartilage more vulnerable to?

A 
Hyaline = loading and compression
Fibrocartilage = tensile forces and shearing
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16
Q

Describe Wollf’s law

A

Mechanical stressors will affect tissue differentiation and growth characteristics of MSK tissues
Normal compression stimulates growth (condrogenesis and epiphyseal plate growth)
Affect collagen synthesis = increase tissue strength and ability to absorb energy
Excessive compression = osteogenesis decreased epiphyseal growth
MSK most vulnerable to mechanical forces during periods of growth

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17
Q

Describe scoliosis

A

Abnormal lateral curvature of spine in sagittal plane
Females undergo more rapid progression of curvature
Most common etiology is idiopathic

18
Q

What happens in adolescents

A

Epiphyseal plates closing/closed
Innominates fuse by age 20
Sacrum fuses in late adolescence
Athletes particularly susceptible to somatic dysfunction
Watch out for hypermobility = HVLA contraindicated

19
Q

Cranial treatments in infants/children are highly useful in poor suckle, infant constipation, birth trauma, vomiting, excessive crying, etc.
What techniques do you use?

A

Condylar decompression

Balanced membranous tension

20
Q

Parasympathetic tx for
upper GI, SI, and ascending/transverse colon?
Descending colon, sigmoid, rectum?
Increased tone leads to what?

A

Vagus (OA, AA)
Pelvic splanchnic (S2-4)
Increased peristalsis

21
Q

Sympathetic treatment for
Upper GI (stomach, liver, gallbladder, spleen, portions of pancreas and duodenum)?
Middle GI (ligament of Treitz to splenic flexure)?
Lower GI (splenic flexure to rectum)?
Increased tone leads to what?

A

T5-9
T10-11
T12-L2
Decreased peristalsis

22
Q

CP for appendix?

A 
Anterior = tip of 12th rib
Posterior = TP of R T11
23
Q

CP for intestines (peristalsis)?

A

Anterior = just below ASIS

24
Q

CP for colon?

A

Along IT Band

25
Q

CP for rectum

A

Anterior = just below lesser trochanter of femur

26
Q

Tx for GERD?

A

Cranial, esp infants

Viscerosomatics = OA, AA, T5-9

27
Q

Tx for constipation?

A

At viscerosomatic level
Pelvic (innominate/sacral) dysfunction
Mesenteric release

28
Q

OMT for respiratory?

A

Viscerosomatics
Sympathetic head and neck T1-4
Para: nose = CN7, OA and AA = vagus

29
Q

CP for nasal sinuses

A

Anterior = inferomedial clavile, lateral to SC junction (nasal sinuses), superior second rib at midclavicular line (all sinuses)

Posterior = bottom edge of C1 pillar

30
Q

CP for Larynx

A 
Anterior = superior second rib, just medial to sinus CP
Posterior = just lateral to spinous process of C2 (larynx, pharynx, tongue, all sinuses)
31
Q

CP for pharynx

A 
Anterior = inferior 1st rib at SC junction
Posterior = just lateral to spinous process of C2
32
Q

CP for tonsils

A

Anterior = lateral manubrium

33
Q

CP for middle ear

A 
Anterior = superior clavicle, 2-3cm lateral to SC joint
Posterior = base of occiput at OA joint
34
Q 
OMT for gynecologic complaints
Sympathetic:
Uterus
Ovaries
Uterine/fallopian tubes

Para?

A

T9-L2
T10-11, ipsilateral
T10-L2, ipsilateral

S2-4 (pelvic splanchnic nerves)

35
Q

CP for uterus

A 
Anterior = superior edge of inferior pubic ramus
Posterior = transverse process of L5/lateral sacral base b/l
36
Q

CP for ovaries

A 
Anterior  = superior pubic ramus, 2 cm lateral to pubic symphysis
Posterior = lateral body of T10
37
Q

CP for vagina/uterus/broad ligament

A

Posterior = just lateral to sacral base

38
Q

CP for vagina/clitoris

A

Posterior = medial thigh just inferior to ischial tuberosities

39
Q

CP for fallopian tubes

A

Posterior = PSIS, posterior femoral head

40
Q

OMT for dysmenorrhea

A

Treat thoracic, lumbar, pelvic dysfunctions
OA/AA for associated catamenial HA
MFR to abdominal wall and uterus

OS4 exam 1 (3 decks)

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