Neuro Peds

Define Plagiocephaly?
when is peak prevelance

flattening of the head; 4 months best to intervene at 3 months

Define Torticollis

Head tilted in lateral flexion toward the affected Sternocleidomastoid muscle

Muscle asymmetry is emphasized with what condition

Torticollis and plagiocephaly

Torticollis will present with what imapirments

Motor development
Postural control
(Crawling may present with one side of arms/legs to lift off floor due to the constant tilt of head )
Vestibular system
Visual system
Somatosensory system

Treatment for toricollis/plagiocephaly will include and emphasis what

Stretches (important to correct muscle imbalance)
Balance/Righting Reactions
Gross Motor Skills
(Belly time(important to correct muscle imbalance))

Occurs during childbirth when after the baby's head delivers the anterior part of the baby's shoulder gets stuck on mother's pubis bone with the baby not delivering easily

Shoulder Dystocia

True or false: BPI always occurs if they baby is born with shoulder dystocia


A factor influencing a babys chances of being born with BPI is what

a high birth weight (>9lbs)

Clavicle fracture (10%)
Humerus fracture (4%)
Brachial Plexus Injury
Birth Asphyxia; are consequences of what condition

Consequences of shoulder dystocia

affects nerve roots C7/C8/T1 with elbow flexed and forearm supinated

Klumpke Palsy

Does Klumpke palsy or Erbs palsy affect Lower nerve roots?

Klumpke palsy

List the affected nerves of Erbs Palsy


Brachial Plexus injury is often caused by what

Most injuries are caused by stretching of nerves; traction, stretch, over stretch or avulsion (tearing of nerve severe)

What are the two conditions that could cause in-toeing

Femoral anteversion or tibial torsion

What age does femoral anteversion peak?

2 years

what age is femoral anteversion most apparant?

5-6 years old

when an infant is born how much anteversion do they have? at what age does this become a "normal" angle?

40 degrees; at age 8 should be 12-15 degrees

W sitting
Running with inward swing are symptoms of what

Femoral anteversion

What condition is seen distally at the knee?

tibial torsion

Affect males and females equally, bilaterally _______% of time


What age is Tibial Torsion seen?

2-3 years

what other congenital disorders are seen with tibial torsion

Associated with Developmental Hip Dysplasia and Cerebral Palsy

in relation to tibial torsion: Derotational osteotomy of inward rotation > ______ degrees

35 degrees

The child's foot bends inward from the midfoot down to toes, ankle remains neutral alignment describes what condition

Metatarsus Adductus

Rarely an outward twist on femur but usually a positional deformity where hip external rotators are tight and hip rotates excessive describes what condition

Femoral Retroversion

What is typically the underlying issue of Femoral Retroversion?

Excessively tight hip muscles especially external rotators

What are other biomechanical imbalances are seen with femoral retroversion? (3)

Associated with late walkers, and flat feet (pes planus),
Lower tone also associated

The distal portion of knee bends outward while proximal portion goes inward describes what condition?

Genu Valgum

Typical newborns present with what shape of the knees? what age should this resolve?

Genu Varum; 1.5-2 years

What is a typical presentation of the knee at 2.5-4 years of age?

Genu Valgum

Bowing of lower leg in relation to thigh describes what presentation at the knees?

Genu Varum

Normal IR/Er for child? (4& up)

IR 10-45
ER 45-70

Average Genu Valgum for adults


Which motion would show the largest decrease ROM as a child ages?

External rotation of the hip

Excessive pronation
You want to look up the kinetic chain describes what condition

Pes Planus

Congenital foot deformity
Heel points downward while foot turns inward describes what congenital disorder?


Serial casting within days of birth
(Until 2-3 years)
Heel Cord tenotomy to release muscle
Ponsetti method used by orthopedic surgeons
Several years of stretching and bracing
Severe clubfeet require invasive surgical correction; describes typical treatmen


Clubfoot affects girls or boys more often? unilaterally or bilaterally?

boys; 50 % bilateral

Growth disorder of the tibia causing lower leg to angle inward describes what disease

Blount's Disease

T/F Blounts disease is not a progressive disease?

false; it is a severely progressive disease

Instability or looseness of hip joint present after birth and Severity ranges from ligamentous laxity that allows subluxing to a complete dislocation describes what disorder

Development Hip Dysplasia

Highly genetic and reliant on family history

Development Hip Dysplasia

what are some common symptoms of hip dysplasia?

Involved side may be shorter or turned outward due to dislocation
Hip/thigh/buttock skin folds may be uneven
Space between legs may be wider
Decreased hip ABD PROM
Waddle gait/sway back

Pavlik Harness is used for what disease and accomplishes what

This allow femoral head to sit solidly in acetabulum and facilitate rounding of femoral head; hip dysplasia

Babies with torticollis should also be ruled out for what condition?

Development of hip dysplasia