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FINAL Review

FINAL Review. Where should I spend most of my time?. Ground Rules. This review is not all-inclusive You are still responsible for: Extra notes, comments added in class to clarify a concept, etc…. The FINAL is Cumulative.

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FINAL Review

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  1. FINAL Review Where should I spend most of my time?

  2. Ground Rules • This review is not all-inclusive You are still responsible for: • Extra notes, comments added in class to clarify a concept, etc…

  3. The FINAL is Cumulative • The primary emphasis will be on the last unit covered including lab materials (Hip Dysplasia & Pediatric Chiropractic) • There will also be questions relating to: • Adjusting During Pregnancy • Webster’s

  4. Basics… • “Flexed” tone • Symmetry • Expected posture • Infant: kyphosis (until they can sit) • Toddler: lumbar lordosis, belly

  5. Milestones

  6. Newborn • Pes planus • Tibial torsion • Metatarsus adductus If persists… Fetal positioning

  7. For each age group/body region/etc…

  8. Congenital Hip Dysplasia • What is it? • dysplasia, subluxation, dislocation • How do you evaluate for it? • Management? <6 months vs. >6months

  9. For each condition… • What is it? • How do you evaluate for it? • Expected resolution? Treatment? Eg. Pes planus -flat foot -weightbearing/not -should resolve by 3 years

  10. Genu valgum • What is it? • How do you evaluate for it? • Expected resolution? Treatment?

  11. Nursemaid’s Elbow • What is it? • How do you evaluate for it? • Expected resolution? Treatment?

  12. Make lists… • Muscular dystrophy • Genetic • Degeneration of muscle • Progressive weakness • Muscle atrophy • Pseudohypertrophy • fatty infiltrates • Gower’s sign *Please make sure to include “management”

  13. CN II, III, IV, VI Blink reflex Doll’s eye V Rooting Sucking VII Facial expressions VIII Acoustic blink Doll’s eye IX,X Swallow, gag XII Suck, swallow Tongue midline Infant cranial nerve exam PediNeurologic Exam available through w3.palmer.edu/oneill

  14. Automatisms • Most disappear by 6 months • Replaced with more advanced skills • Babinski (up to 2 years) • Fencer’s (peak at 2-4 months)

  15. Automatisms aka Primitive Reflexes • Know how to elicit them • What do you expect to see? • What info can the test give you? • Clavicle fracture • Cranial nerves • Etc. PediNeurologic Exam available through w3.palmer.edu/oneill

  16. Neuro exam – Child • Cranial nerves • Necessary adaptations? • DTRs • Soft signs • What’s normal, what’s not • Should all be gone by 10 yoa

  17. Things that jump out: • Meningitis • Nuchal rigidity is not seen until 6-9 months • Seizures • 75% of new cases develop during childhood and adolescence • Rett syndrome • Girls 6-18 months • Hands

  18. Common Conditions Be able to recognize/diagnose • Meningitis (infant vs. child) • Encephalitis • SOL/Intracranial Tumors • Cerebral Palsy • Etc.

  19. Chiropractic Assessment • Reverse fencer • Determine a listing? Occ/C1 • Atlas • Reverse fencer • Atlas fossa • Leg checks • Sacrum? Pelvis?

  20. Things that cause “toe in” • Tibial torsion • Femoral anteversion • Reverse tailor sitting • Metatarsus adductus • Talipes • Ex ilium • Muscle patterns…

  21. Pediatric Adjusting • Pediatric Variants… Considerations • Minimize excessive ROM and Force • Much smaller – specific CP

  22. Fysh – Suggested Adaptations • OCC • C1 • C2-C7 • Limit rotation to 25-30 degrees, then laterally bend? • Thoracic • No anterior adjusting until 3 yoa (Why?) • L1-3 • L4-5 • SI Side posture >1 year Facet alignment

  23. Peds Chiro Lab Handout • “Infant will tend to hold their head… when subluxated” - how would this affect breastfeeding? • Be able to determine the best “listing” to adjust based on findings given (similar to the last quiz) • Interpret Reverse Fencer, taut & tender findings associated with potential listings, etc. • Modifications - CP, PP, etc.

  24. Pediatric Radiology • Normal Anatomy • Normal variants • Pseudospread • Psuedosubluxation • ADI • Etc. • Salter-Harris • Films: documenting abuse • DISCITIS

  25. Chiropractic Management of Common Conditions • Make sure to be familiar with S&S and diagnosis, as well as management for: • Asthma • Colic • Enuresis • Otitis • Erb’s Palsy • Torticollis • Plagiocephaly • Headaches in kids • Back Pain in kids • KNOW THE 7 WARNING SIGNS *you’ll want to make a list outlining important features of each and key management concepts for each

  26. Pos. Head Deformity Synostosis Plagiocephaly

  27. Autism • Prevalence • Cause? • Associated behaviors, signs • Diagnosis • Etc. • vs. Aspergers

  28. SIDS • What is it? • Risk factors • Recommendations

  29. Adjusting in Pregnancy Understand … • Biomechanical changes • Hormonal influences • Variations in Work-Up • Instrumentation, motion palp, etc. • Modifications necessary • SuD? Knee chest? Side posture?

  30. Webster’s Technique • What is it? • When is it used? Part I – Part II – Reasons why fetus might not turn…

  31. External Cephalic Version • When is it done? • Success rate? • Risks? • What tests are involved? Why is each done?

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