Oscar 2

Oscar 2

1. General

   • Shoulder Dystocia
     • Waiter's tip
       • C5, C5, C7 nerve dysfunction
     • Assisted Delivery
       • Risks
         • Previous Babies
         • Prolonged labour
         • Baby > 4 kg
       • Common Labour Complications
         • Breech
           • Feet first
           • Flip the baby manually form the outside
           • Chiropractor technique
           • During labour
         • Placenta Previa
           • Caesarian
           • Can know beforehand
         • Nuchal Chord
           • Provides nutrients and oxygen
           • If you have large umbilical chord
           • Large baby
           • Could have no effect
           • Common
     • OBPP
       • Stress on Brachial Plexus
       • Physio intervention is good
         • Not much research for conservative
         • 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
         • No unilateral bias
         • Always changing position
         • Potential splint
           • Hand
           • Wrist
       • Lying awkwardly
       • Trauma in uterus
       • Labour forces
   • Baby
   • No AROM in R arm
     • Reduced muscle tone
     • Decreased Moro in R arm
     • Good grasp
   • Movement in fingers

2. Biopsychosocial

   • Feelings
     • Threatened
     • Anxiety
       • Blame themselves
         • Counselling essential
     • Avoid sex
     • Can avoid medical care
     • Post traumatic stress disorder
     • Horror
     • Isolation
       • Post natal depression
   • Sue

3. Pathophysiology of Brachial Plexus Palsy

   • Neuropraxia
     • Myelin sheath
     • Schwann cell regeneration
   • Axonnotemesis
     • Axon and myelin sheath affected
       • Occurs at axon
       • Months to years recovery
         • Regeneration
       • Can't perform tests
       • degeneration
         • Empty tube
         • Can only regenerate once complete
   • Neurotmesis
     • Everything
       • No regain
         • Neuron fails to regenerate

4. Physical Exam

   • Reflexes
     • Suck Reflex
       • For breastfeeding
     • Rooting reflex
       • Finger in cheek
     • Grasp hold
       • 3/4 months
     • Tonic Neck
     • Neck turning reflex
       • Turn head
     • unsymmetrical refelx response
       • Nerve damage
         • Cookie tests
         • Hydrosis of fingers
         • Skin wrinkling
     • Moror
       • Abduction
       • 6 months
   • Difficult
   • Painful left to last
   • Too young to respond to toys
   • Observation
     • Skin abrasions

5. Milestones

   • 3 months
     • Respond to sound
     • Smiles
     • Head control
   • 6 months
     • Put objects in mouth
     • Roll over
     • Sit unsupported
   • 9 months
     • Crawl
   • 12 months
     • Baby can stand and cruise