Oscar 2

Oscar 2

General
1. Shoulder Dystocia
  1. Waiter's tip
    1. C5, C5, C7 nerve dysfunction
  2. Assisted Delivery
    1. Risks
      1. Previous Babies
      2. Prolonged labour
      3. Baby > 4 kg
    2. Common Labour Complications
      1. Breech
        Feet first
        Flip the baby manually form the outside
        Chiropractor technique
        During labour
      2. Placenta Previa
        Caesarian
        Can know beforehand
      3. Nuchal Chord
        Provides nutrients and oxygen
        If you have large umbilical chord
        Large baby
        Could have no effect
        Common
  3. OBPP
    1. Stress on Brachial Plexus
    2. Physio intervention is good
      1. Not much research for conservative
      2. Motor training
        Head position
        Stimulate Child
        Head control
        Facial position
        Active range
        Across and against gravity
        Passive range
        Normal movements for babies
        Education of parents
        Only to R1
      3. No unilateral bias
      4. Always changing position
      5. Potential splint
        Hand
        Wrist
    3. Lying awkwardly
    4. Trauma in uterus
    5. Labour forces
2. Baby
3. No AROM in R arm
  1. Reduced muscle tone
  2. Decreased Moro in R arm
  3. Good grasp
4. Movement in fingers
Biopsychosocial
1. Feelings
  1. Threatened
  2. Anxiety
    1. Blame themselves
      1. Counselling essential
  3. Avoid sex
  4. Can avoid medical care
  5. Post traumatic stress disorder
  6. Horror
  7. Isolation
    1. Post natal depression
2. Sue
Pathophysiology of Brachial Plexus Palsy
1. Neuropraxia
  1. Myelin sheath
  2. Schwann cell regeneration
2. Axonnotemesis
  1. Axon and myelin sheath affected
    1. Occurs at axon
    2. Months to years recovery
      1. Regeneration
    3. Can't perform tests
    4. degeneration
      1. Empty tube
      2. Can only regenerate once complete
3. Neurotmesis
  1. Everything
    1. No regain
      1. Neuron fails to regenerate
Physical Exam
1. Reflexes
  1. Suck Reflex
    1. For breastfeeding
  2. Rooting reflex
    1. Finger in cheek
  3. Grasp hold
    1. 3/4 months
  4. Tonic Neck
  5. Neck turning reflex
    1. Turn head
  6. unsymmetrical refelx response
    1. Nerve damage
      1. Cookie tests
      2. Hydrosis of fingers
      3. Skin wrinkling
  7. Moror
    1. Abduction
    2. 6 months
2. Difficult
3. Painful left to last
4. Too young to respond to toys
5. Observation
  1. Skin abrasions
Milestones
1. 3 months
  1. Respond to sound
  2. Smiles
  3. Head control
2. 6 months
  1. Put objects in mouth
  2. Roll over
  3. Sit unsupported
3. 9 months
  1. Crawl
4. 12 months
  1. Baby can stand and cruise

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	Created by MariaE almost 9 years ago