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)
Strengthening
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
false
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
Contusion/Laceration
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
C5-C7
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
in-toeing
W sitting
Tripping/falling
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
66%
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
(-5)-(-10)
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?
Clubfoot
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
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