Intro to Peds OMT

Question 1

{{BLANK}} is the most common reason for children ≤5 yo to visit the doctor

Answer 1

OM

Question 2

Does OMT help with OM recurrence?

Answer 2

Yes, 62% of pediatric patients who received 3 weekly OMT sessions after an episode of AOM did not have recurrence of AOM S/Sx

Question 3

What is the galbreath technique?

Answer 3

• Used to Tx AOM
• Hold head w/ one hand & w/ Tx hand pull jaw outward (hold above the angle of the mandible) & have patient keep their jaw open & loose
• Pull jaw out & hold it for 3-5 secs, repeat 3 times

Question 4

What nerve innervates the SCM?

This can be dysfunctional in torticollis

Answer 4

CN XI (Accessory)

Question 5

What is true regarding initiation of treatment for torticollis?

Answer 5

• Start ASAP
• If you wait until after 1 mo it will prolong the amount of PT required by ~6 months
• Infants are more cooperative < 2 mo

Question 6

{{BLANK}} is a term used to describe flattening of the cranium

Answer 6

Plagiocephaly

Question 7

What is important regarding the prevention of plagiocephaly?

Answer 7

• Limit time baby rests in positioning devices (e.g., car seat)
• AAP recommends babies sleep on their back
• AAP recommends supervised tummy time when awake

Question 8

{{BLANK}} results from premature fusion of one or more cranial sutures

Answer 8

Craniosynostosis

Question 9

Premature fusion seen in craniosynostosis restricts the growth of the skull {{BLANK}} to the affected suture

Answer 9

Perpendicular

Question 10

By what age is the annular ligament more resistant to tear or displacement?

Answer 10

5 yo

Question 11

What position is the radial head most likely in during displacement seen in Nursemaid’s elbow?

Answer 11

• Forearm pronated
• Elbow in extension

Question 12

What position do kids usually hold their arm in after suffering from radial head distraction?

Answer 12

flexed w/ forearm pronted (forearm against belly)

Question 13

When do you order imaging for radial head syndrome?

Answer 13

• < 5 yo: Age < 6 mo w/o Hx of arm trauma; Severe trauma; Swelling beyond radial head; Focal bony tenderness; Bony deformity; Inability to reduce displacement
• ≥5 yo: uncommon so order

Question 14

What is the hyperpronation technique for fixing RHS?

Answer 14

• Place one hand on elbow, stabilize arm, place thumb on radial head applying pressure
• Other hand hyperpronates hand
• May hear click

Question 15

What is the supination/flexion method for fixing RHS?

Answer 15

• Support elbow w/ one hand, put pressure against radial head with thumb
• Hold distal forearm w/ other hand, apply traction & fully supinate forearm then fully flex elbow w/ smooth motion
• May hear/feel a click

Question 16

What is the difference between acute versus subacute rhinosinusitis?

Answer 16

• Acute: Resolves < 30 days
• Subacute: Resolves between 30-90 days

Question 17

How do you Tx rhinosinusitis?

Answer 17

Stroke sinuses 3-5 times

Each sinus & area of face (3 areas traditionally)

Question 18

Ankle sprains most commonly occur after ankle {{BLANK}}

Answer 18

Ankle inversion

Question 19

When is an ankle film needed?

Answer 19

• Pain in malleolar zone plus one of the following:
• bone tenderness at medial or lateral malleolus; inability to bear weight immediately & at ED

Question 20

When do you order a foot film?

Answer 20

• Pain in midfoot plus any of following:
• Bone tenderness base of 5th metatarsal; Bone tenderness at navicular bone; inability to bear weight immediately or at ED

Question 21

What is the preferred OMT for HA?

Answer 21

Suboccipital tension release

Question 22

What techniques are useful in treating asthma patients with OMT?

Answer 22

• rib raising
• MFR

Question 23

The parietal bones should override everything (post-childbirth) except for?

Answer 23

temporal bones at the squamous sutures

Question 24

The parietal bones override the frontal bones at the {{BLANK}} suture

Answer 24

Coronal

Question 25

The **parietal** bones override the **occipital** bones at the {{BLANK}} sutures

Answer 25

lambdoid

Question 26

The **parietal** bones override each other at the {{BLANK}} suture

Answer 26

sagittal

Question 27

Molding should resolve within approx. {{BLANK}} days post-delivery

Answer 27

2-days | Faster if breast fed

Question 28

What CNs are transmitted through the **jugular foramen**?

Answer 28

IX, X, XI

Question 29

The **hypoglossal canal** transmits?

Answer 29

XII

Question 30

The {{BLANK}} nerve provides sensation to the posterior 1/3rd of tongue

Answer 30

Glossopharyngeal (IX)

Question 31

The {{BLANK}} nerve is visceral sensory to the pharynx & larynx

Answer 31

Vagus (X) | lesion can lead to reduced peristalsis & reflux

Question 32

B/L damage to the {{BLANK}} can lead to arching which is frequently seen in reflux

Answer 32

XI

Question 33

The **eustachian tube** forms between the {{BLANK}} and {{BLANK}} of the **temporal bone**

Answer 33

Between the petrous & squamous portions

Question 34

The **superior orbital fissure** transmits?

Answer 34

III, IV, V1, VI | Can lead to strabismus, seen in lateral strains & condylar compression

Question 35

The **Foramen ovale** transmits the {{BLANK}} nerve which innervates muscles of mastication

Answer 35

V3 (mandibular)

Question 36

The **foramen rotundum** transmits the {{BLANK}} which provides sensation to the upper lip, teeth, gums, and palate

Answer 36

V2 (maxillary)

Question 37

How do you Dx **torsion**?

Answer 37

Side w/ greater wing of sphenoid (e.g., left or right)

Question 38

How do you name **sidebending rotation**?

Answer 38

Side of convexity (side that moves inferiorly)

Question 39

How do you name a **lateral strain**?

Answer 39

Direction in which sphenoid base moves (e.g., left or right)

Question 40

How do you name a **vertical strain**?

Answer 40

Which sphenoid base moves (e.g., superior or inferior)