Flashcards in Pediatric Chiro Eval Deck (42)
What is a reverse fencer?
Invert infant - relax tension on one leg and watch child's head turn to that side
What is a positive fencer?
Infant considered restricted or twitches turning to one side compared to other
Suggests subluxation between atlas-axis or atlas-occ on that side
If an infant arches backwards during a fencer what may this be a sign of?
What MUST you check before performing the fencer on an infant?
Hip stability (orthani's)
True or false; if the landau's response is present in an infant reverse fencer is no longer a viable test
true (landau is when infant is suspended prone when head looks up so do the feet - if the head looks down the feet go down)
What is the acetabular pump part of the reverse fencer? How do you interpret findings?
Infant supine - apply pressure along shaft of femur - the "spongy" side consider side of atlas laterality (if they're even consider occ)
True or false; infants have a normal flexed tone and legs are commonly in "frog leg" position
What is KISS? What are the 2 types?
KISS = Kinematic imbalances due to suboccipital stress
KISS 1: Fixed lateroflexion
KISS 2: Fixed retroversion (hyperextension during sleep)
Signs & symptoms of KISS
Torticollis, scoliosis, plagiocephaly (flat spot on baby's head)
Frequent vomitting, dysphagia, colic with excessive crying
What is KISS induced Dyspraxia and Dysgnosia (KIDD)?
Syndrome related to KISS that has been associated with:
Slow development of fine and gross motor skills
Poor posture and equilibrium
Delayed language development
Essentially neurological complications related to KISS
What is the normal "evolution" from bowlegs to knock-knees to normal valgus knees
2 years = bowleg
3 years = Knock knees (extreme valgus)
5 years = normal valgus
True or false; typical causes of Toe-out during a prone leg check would include: EX ilium, tibial torsion, femoral anteversion, weak psoas or glute max, cerebral palsy
false; all of those would cause Toe-IN
Common causes of toe-out during prone leg check
Hypertonicity of psoas or glut. max
True or false; placing patient prone during instrumentation can be helpful with infants and children
How many degrees F does it take for an atlas reading to be considered significant clinically
True or false; during lateral bend at C1-Occ area small children differ from adults or older children in that their atlas moves up toward your finger - contrast adults or older children atlas moves under occiput during lateral flexion
What motion should be assessed first from C2-L5 on infants
P-A motion (segments not always rotated)
True or false; when infants lay prone and turn head ipsilateral SI motion may appear restricted
When would you use a reverse fencer?
Infants under 6 months
Restricted occ. glide bilaterally; both condyles are restricted in flexion are motion findings with what listing?
Restricted occ glide, and lateral flexion with pain over ipsilateral nuchal line, "High ear" are findings with what listing?
True or false; you should palpate atlas laterality in a seated or upright position
Where do infants tend to hold their head relative to atlas subluxation
Opposite (example: ASR would hold head to left)
Note: Breastfed infants may be irritable/feed poorly on breast that requires them to lie with subluxated side down
What response can be triggered by a C1 adjustment
Moro (commonly causes infant to cry)
True or false; extension will be restricted at C2 on P, PLS/PRS, or ESL/ESR listings
true all have restricted extension (note ESL/ESR not toggle listing - with no uncinates yet they segment can move that way relative to C3)
True or false; during a PLS/PRS listing at C2 pain will be felt on ipsilateral articular pillar
False; pain will be felt both at lateral inferior tip of spinous and OPPOSITE articular pillar (side of body rotation)
Pain will be felt at the lateral/inferior tip of spinous on ESL/ESR listings at C2. Where else would infant feel pain?
Ipsilateral articular pillar (contrast opposite articular pillar in PLS/PRS)
In a P listing at C2 where would pain be felt in an infant
over spinous and both lamina
When do unicnates typically begin to develop?