Pediatric Sinus Drainage OMT Module - PowerPoint PPT Presentation

Loading...

PPT – Pediatric Sinus Drainage OMT Module PowerPoint presentation | free to view - id: 20c745-ZDc1Z



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Pediatric Sinus Drainage OMT Module

Description:

Pediatric Sinus Drainage OMT Module – PowerPoint PPT presentation

Number of Views:335
Avg rating:3.0/5.0
Slides: 40
Provided by: bob4115
Category:
Tags: omt | drainage | module | pediatric | pou | sinus | sto

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Pediatric Sinus Drainage OMT Module


1
Pediatric Sinus Drainage OMT Module
  • American College of Osteopathic Pediatricians
  • Robert Hostoffer, DO,FACOP, FAAP

edited by Eric Hegybeli, DO, FACOP
2
Background
Andrew Taylor Still, was born in Virginia in
1828, the son of a Methodist minister and
physician. At an early age, Still decided to
follow in his father's footsteps as a physician.
After studying medicine and serving an
apprenticeship under his father, Still became a
licensed M.D. in the state of Missouri. Later, in
the early 1860's, he completed additional
coursework at the College of Physicians and
Surgeons in Kansas City, Missouri. He went on to
serve as a surgeon in the Union Army during the
Civil War.
3
Background
  • After the Civil War and following the death of
    three of his children from spinal meningitis in
    1864, Still concluded that the orthodox medical
    practices of his day were frequently ineffective,
    and sometimes harmful. He devoted the next ten
    years of his life to studying the human body and
    finding better ways to treat disease.

4
Background
  • His research and clinical observations led him to
    believe that the musculoskeletal system played a
    vital role in health and disease and that the
    body contained all of the elements needed to
    maintain health, if properly stimulated. Still
    believed that by correcting problems in the
    body's structure, through the use of manual
    techniques now known as osteopathic manipulative
    treatment, the body's ability to function and to
    heal itself could be greatly improved. He also
    promoted the idea of preventive medicine and
    endorsed the philosophy that physicians should
    focus on treating the whole patient, rather than
    just the disease.
  • http//www.aacom.org/OM/history.html

5
Toddler and Children OMT
6
Review Sinus Anatomy
7
Review Anatomy of Ear
8
Respiratory System Otitis Media
  • Goals Considerations
  • Encourage proper Eustachian tube mechanics
  • Tube positioning
  • Promote drainage of the middle ear via lymphatic
    channels
  • Central drainage
  • Acute Otitis Media (AOM)
  • The use of osteopathic manipulative treatment as
    adjuvant therapy in children with recurrent acute
    otitis media. Mills MV, Henley CE, Barnes LL,
    Carreiro JE, Degenhardt BF. Arch Pediatr Adolesc
    Med. 2003 Sep157(9)861-6.

9
Eustachian tube difference
10
Hands-On Approach Treating Otitis Media
  • Treatment Options
  • Thoracic Muscular Assessment and Treatment
  • Thoracic Inlet/Outlet Release (emphasizing the
    right side, which drains the entire head and
    neck)
  • Occipitoatlantal (OA) Release
  • Rib Raising (T1-4)
  • Chapmans Points
  • Auricular Drainage Technique
  • Mandibular Drainage of Galbreath
  • Miller Thoracic Pump
  • Contraindications Rib fracture and dislocation,
    malignancy of lymphatic system
  • Relative Contraindications Decreased cough
    reflex

11
Respiratory System Pharyngitis
  • Goals Considerations
  • Improve venous and lymphatic drainage
  • Promote arterial blood flow
  • Normalize cranial and spinal nerve afferents and
    efferents affecting function of the throat
  • Relieve pain
  • It is important to note that most of the
    cranial nerves which innervate the pharynx pass
    through the suboccipital area

12
Hands-On Approach Treating Pharyngitis
  • Treatment Options
  • Cervical Thoracic Muscular Assessment and
    Treatment
  • Thoracic Inlet/Outlet Release
  • OA Release
  • Rib Raising (T1-4)
  • Chapmans Points
  • Cervical Chain Drainage
  • Miller Thoracic Pump
  • Contraindications Rib fracture and dislocation,
    malignancy of lymphatic system
  • Relative Contraindications Decreased cough
    reflex

13
Hands-on Sinus Drainage Techniques
14
Sinus Effleurage
  • To effleurage is to move in a stroking massage
    movement to move lymphatic fluids. Excessive
    mucus production, and decrease of cilliary
    motility can all be modified using effleurage.
    Effleurage will promote lymphatic drainage in
    both allergic or infective pathology. Effleurage
    of the anterior cervical chain towards each
    lymphatic duct and ultimately the heart will
    eventually promote health.

15
Positioning
  • The patient is supine. With repetitive strokes,
    the thumbs are brought across the frontal
    maxillary sinuses from medial to lateral
    finishing at a point near the ear lobes. The
    thumbs should be used to milk the lymphatic fluid
    down the anterior aspect of the
    sternocleidomastoid muscle belly along the
    anterior cervical lymphatic chain towards the
    heart. Repeat this technique for complete
    drainage.

16
(No Transcript)
17
Demonstrate the procedure on patient in front of
director
18
(No Transcript)
19
Demonstrate the procedure on patient in front of
director
20
(No Transcript)
21
Demonstrate the procedure on patient in front of
director
22
Demonstrate the procedure on patient in front of
director
23
Mandibular Drainage of Galbreath
  • A passive soft tissue technique is used to induce
    jaw motion to create increased drainage of middle
    ear and tonsillar areas via the eustachian tube
    and lymphatics. This technique can be used for
    chronic otitis media.

24
Positioning
  • The patient is supine and the dcotor is behind
    patient, while stabilizing the head and placing
    traction on the mandible. With a pumping
    action, the fascia of the eustachian tube via
    the mandible is brought anteriorly and medially
    across the face a short distance, multiple times
    on each side of the head. The procedure is done
    for 30 seconds on each side for up to three times
    a day.

25
(No Transcript)
26
Demonstrate the procedure on patient in front of
director
27
Ear Pull Technique
  • A gentle bilateral ear pull will help mobilize
    the underlying fascia and the temporal bones. The
    physician will notice that one side may be less
    mobile and may require longer to feel a release.
    The side that is more medial often correlates
    with an internally rotated temporal bone.

28
Positioning
  • The patient is supine. The doctor is behind the
    patient. A gentle force is applied to the
    bilateral pinnae until the pinnae becomes more
    mobile. The earpull is helpful in infants but may
    not be useful in children that are moving around.

29
(No Transcript)
30
Demonstrate the procedure on patient in front of
director
31
Chapmans Reflexes
  • Discovered by Frank Chapman, D.O.,
  • Chapman's Reflexes are painful palpated points
    located all over the body.
  • These reflexes are clinically useful in three
    principal ways
  • 1) for diagnosis,
  • 2) for influencing the motion of fluids, mostly
    lymph, and
  • 3) for influencing visceral (organ) function
    through the nervous system.

32
Innervation Table
33
Print out the answer sheet to use with the
following questions.
34
Circle the correct answer and review with
director
  • Question1 A, B, C, D, E.
  • Question2 A, B, C, D, E.
  • Question3 A, B, C, D, E.

35
Post Test
  • A 2 day old male is seen in the newborn nursery
    for initial examination. The nurses note that the
    newborn is having difficulty nursing and latching
    onto mothers nipple. Which procedure would be
    the most appropriate for this patient
  • A. Ear pull tugging
  • B. Mandibular Drainage of Galbreath
  • C. Occipital release
  • D. Sinus Effleurage
  • E. Maxillary release

36
  • A 2 year old male presents for chronic otitis
    media with effusions. At the present visit he has
    no active infection but as bilateral effusions.
    Which procedure would be most appropriate
  • A. Occipital-temporal release
  • B. Cervical HVLA
  • C. Mandibular Drainage of Galbreath
  • D. Cranio-sacral maneuvers
  • E. Sinus Effleurage

37
  • A 18 year old female presents to your office with
    pressure and pain over the face. The patient is
    afebrile without evidence of infection. These
    symptoms have been present for 2 years and
    worsens with change of seasons. The most
    appropriate osteopathic treatment would be
  • A. Mandibular drainage of Galbreath
  • B. Ear pull tugging
  • C. Sinus Effleurage
  • D. HVLA to the thorax
  • E. Occipital release

38
Certificate of Completion
  • I, _________________________, successfully
    completed the Pediatric OMT Module on __ __ 20__
  • Signatures
  • Pediatric Resident ____________________
  • Pediatric Residency Director____________
  • ( Please print and give to program director.)

39
Congratulations
About PowerShow.com