Head and Neck conditions

Question 1

What is plagiocephaly?

Answer 1

One side of occiput is flattened

Question 2

What is brachycephaly?

Answer 2

Wide-shaped head

Question 3

What is scaphocephaly?

Answer 3

Long shaped head - common for premature babies

Question 4

Cranial Index

Answer 4

Proportion between width and length of head

(Lateral Dimension/anteroposterior dimension) x 100

Question 5

Cranial index of normal head

Answer 5

75-80%

Question 6

Cranial index of brachycephaly

Answer 6

95%

Question 7

Cranial index of scaphocephaly

Answer 7

60%

Question 8

Cranial Vault Asymmetry Index

Answer 8

Important for plagiocephaly
From midpoint of forehead to opposite occiput
[(Diagonal A - Diagonal B)/ Diagonal A] x 100

Question 9

Risk factors for plagiocephaly

Answer 9

Pregnancy and birth
- intra-uterine constraint 
- multiple births
- assisted delivery - vacuum pull
Infant factors
- first born, male, premature
- long supine sleeps 
Parent positioning 
- long total supine time
- lack of sidelying when awake
- lack of prone when awake

Question 10

Infant positioning

Answer 10

Reduce total supine lying - promote side lying and prone during awake times
Monitor longest sleep time at 6 weeks - promote proactive passive head repositioning
Monitor AHO when awake and asleep - promote active head repositioning through play

Question 11

Positional Plagiocephaly Prevention

Answer 11

ABC
Active baby
Balance handling
Corrective strategies

Question 12

Active Baby

Answer 12

Position baby in different play positions on their tummy, their side or carry them upright
Encourage your baby to hold their own head up and turn head and body in your directions

Question 13

Balanced handling

Answer 13

Carry your baby on both sides and different positions

Position your baby so that they need to turn their head in both directions to look at things around them

Question 14

Corrective Strategies

Answer 14

Encourage baby to turn their head to non-preferred side when playing
Turn your baby’s head to their non-preferred side when asleep

Question 15

Torticollis

Answer 15

Wry neck
Tightness or contracture of unilateral SCM
Causes same side lateral flexion, contralateral rotation and making a nod - flexion (SCM)

Question 16

Torticollis assessment

Answer 16

Assess postural alignment from anterior, posterior and side views
Assess active ROM and passive ROM

Question 17

Torticollis treatment

Answer 17

Parent education
- active facilitation into limited ROM
- positioning to encourage movement into limited ROM
- carrying position to encourage lengthening of contracture
Active exercises to lengthen neck musculature - SCM
Passive rotation and lateral flexion holds 3-5 secs