Lecture 3 Atypical

Question 1

What muscles are affected by torticollis?

Answer 1

SCM, Scalene, Trap, Levator Scap

Question 2

Can atypical development start out as typical?

Answer 2

Yes

Question 3

When many components from normal development are missing, babies learn to compensate, these compensations lead to __________

Answer 3

pathologies that cause atypical movement postures and patterns

Question 4

If a child is toe walking, what do you need to know in their history? (Some questions are the same as any other atypical development question)

Answer 4

Has this happened before?

What is their developmental history?

note: new toe walking is a red flag for neurological changes

Question 5

Idiopathic toe walking is toe walking beyond _______

Answer 5

24 months

or intermittent toe walking beyond 36 months

Question 6

Delays in what domains are associated with idiopathic toe walking?

Answer 6

Language and sensory

Question 7

Does a child with torticollis have atypical muscle tone?

Answer 7

Usually no, unless the torticollis is caused by the CNS

Question 8

What is the key indicator in the examination for how we will treat toe walking

Answer 8

PROM measurements and muscle tone

Question 9

How much does eye dominance, hand dominance, and leg dominance correlate?

Answer 9

they aren’t directly related but significantly associated

Question 10

When is eye dominance established?

Answer 10

emerges 3-4 years, by 6 it is typically established

Question 11

When is hand dominance established

Answer 11

emerges 3-4 , by the age of 4-6 hand dominance is usually established

Question 12

When is leg dominance established

Answer 12

emerges around 3 years, by 6 years it is typically established

Question 13

how can you test a child’s eye dominance

Answer 13

ask them to look through something

Question 14

Patterns of an immature motor system

Answer 14

Loss of dynamic balance

Falling after finishing motor task

inability to control force

inability to maintain rhythm

inappropriate motor planning

lack or decreased transverse plane movement

Question 15

How do we assess pain in an infant?

Answer 15

FLACC observation scale

Face Legs Activity Cry Consolability

Question 16

The wong baker pain scale is approved for use in kids how old?

Answer 16

3-10

Question 17

At what age is the verbal analog scale suggested to use for pain

Answer 17

10+

Question 18

What are the two general types of diagnoses of atypical development

Answer 18

MSK

and

Neuromuscular

Question 19

What do we need to rule out when assessing torticollis?

Answer 19

non-muscular torticollis must be ruled out

Question 20

What can be potential causes of non-muscular torticollis?

Answer 20

Cervical rib

cataract

brachial plexus injury

posterior fossa tumor

Question 21

Right torticollis has what 2 components at the neck?

Answer 21

Right lateral flexion and Left rotation

(named for the side of the flexion)

Question 22

Asymmetries of ___ to ___ degrees in hip _______ may indicate hip dysplasia

Answer 22

5-10 degrees

hip abduction

Question 23

What is plagiocephaly?

Answer 23

Misshapen skull

Question 24

at what age is prognosis for torticollis considered better for conservative treatment

Answer 24

before the age of 1

Question 25

What is the key to a conservative treatment of torticollis?

Answer 25

comprehensive home program

Question 26

what is typically perscribed to help with plagiocephaly at what age does the cranial orthosis no longer work?

Answer 26

cranial orthosis 18 months

Question 27

the posterior fontanelle closes by _________ the anterior fontanelle closed by ___________-

Answer 27

1-2 months 7-18 months

Question 28

9 specific health factors to know for infants with torticollis

Answer 28

Age of initial visit age of symptom onset pregnancy history delivery history head/posture preference family history of CMT other known or suspected medical conditions developmental milestones

Question 29

Torticollis patients must be screened for

Answer 29

hip dysplasia and spine/vertebral asymmetry pain and discomfort at rest and during passive/active movement skin integrity and symmetry of neck and hip skin folds Palpate SCM Craniofacial assymetries Head/skull shape

Question 30

What is the most consistent clinical sign of hip dysplagia in neonates

Answer 30

hip abduction limitation or asymmetry

Question 31

What is a Pavlik Harness At what age can it be used

Answer 31

Harness used to help fix DDH by holding hip in proper position * restricts hip extension and adduction up to 3 months

Question 32

For babies 3-6 months, what are the options for DDH

Answer 32

brief 3 week trial of Pavlik harness, if not successful they receive closed reduction and spica cast

Question 33

For dislocated hips dx'd between 6-18 months of age, ____ is usually required

Answer 33

Surgical tx.

Question 34

Dx of hip dislocation in a child at the age of ___________ is generally considered to be mandated for an open reduction surgery to fix DDH

Answer 34

2 years or older

Question 35

Older children with continuing acetabular dysplasia may benefit from ____________

Answer 35

pelvic osteotomy

Question 36

Club foot is associated with what gait deviation

Answer 36

early heel rise (theyre stuck in plantarflexion)

Question 37

T or F: At no point should Internal rotation be typical in gait

Answer 37

true

Question 38

The Barlow and orlotani test are typically done until what age?

Answer 38

6 months

Question 39

The pavlik harness holds a baby in what position What movements does it restrict

Answer 39

Flexion and abduction Restricts adduction and extension