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OPP Lect 26

OPP Lect 26 Pediatric Indications of OCF

Most frequent Overall diagnosis seen from 0-11 months 1.Torticollis. 2.Skull/face deformity. 3.Otitis media. **opposite in ages 1-4yrs.
With adults, trauma leads to dural strains causing what 3 symptoms? How does this differ in Infants? 1.Intracranial congestion. 2.Dural Pain Patterns. 3.Entrapment neuropathy. **this is the same in infants which will lead to crying.
What additional symptom can infants get from trauma that adults cant? DEFORMITY from bony molding. **still growing, Inc risk with TWINS!
Besides being susceptible to deformity, what other major difference exists in infants' skull? They have many bony PARTS of cranial base bones which will be complete bones in adults. 1.Occiput: 4. 2.Sphenoid: 3. 3.Temporal: 2. **these can be compressed much more easily leading to entrapment neuropathies.
Benign positional plagiocephaly Flat R occiput is 2X more likely to appear. Will see Occular & dental problems, Learning disorders. **can be prevented by sleeping on back and TUMMY TIME (1hr).
Are twins at higher risk of Benign positional nonsynostotic plagiocephaly? YES
What type of SBS strain can lead to R occiput Benign Positional Plagiocephaly? R Lateral Strain **side of occipital flattening is the side of the lateral strain.
What must you rule out before treating benign positional plagiocephally? synostotic plagiocephaly
Treatment for Mild/moderate benign positional plagiocephally? 1.Active counterpositioning. 2.Supervised tummy time. 3.OMT. 4.Infant Massage. 5.Helmets (need to use before 12 months). **Observation: if not better by 3 months, wont get better.
What neuropathies are you likely to see in children due to the boney PARTS of the cranial base? 1.IX. 2.X. 3.XI: Torticollis 4.XII. **9,10,12: GERD, Cholic, and suckling.
What type of babies are more susceptible to Torticollis? Larger Babies.
Treatment for Torticollis 1.Positioning (have child look towards affected side). 2.Stretching & PT. 3.OMT (occipital decompression to prevent jugular foramen release of CN XI). 4.Surgery. **AND TUMMY TIME
What is the "Rule of 3's" and what does it apply to? COLIC: Baby will cry for 3hrs/day at least 3days/wk around 3PM. **Causes: Entrapment neuropathy IX,X,XII. Pull of cervical muscles against cranial base. PNS overstimulation.
What is the OMT treatment for Colic? 1.Occipital Decompression. 2.MFR of abdominal valves & plexi. **teach parents.
Otitis Media can be caused by 1.Immaturity. 2.Allergies. 3.Structural (Angle). 4.Somatic dysfunction (Cranial base strain). **DO NOT feed child on their back, formula will go to middle ear via eustachian tubes.
Treatments for Otitis Media 1.Prevention (vaccines, environmental factors). 2.OMT: Gallbreath Mandibular technique which will inc drainage.
Summarize the main treatment for Plagiocephaly, Torticollis, Colic, and Otitis Media. 1.Plagiocephaly: refer for osteopathy in the cranial field. 2.Torticollis: occipital decompression, MFR SCM muscle. 3.Colic: occipital decompression, MFR abdomen. 4.Otitis media – Steele/Carreiro OMM protocol, Galbreath mandibular drainage for at home.
What SD is causing Torticollis Occipitomastoid compression. **entrapment of CN XI
Created by: WeeG