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  1. Congenital Muscular Torticollis (CMT)
    • Describes the posture of the head and neck from unilateral shortening of the SCM
    • Causes the head to tilt to the ipsilateral side and rotate to the contralateral side
  2. Classifications
    • SCM: sternocleidomatoid - clinically palpable mass (extra collagen w/in the muscle)
    • MT: muscular - no palpable mass (no mass but decreased ROM)
    • POST: postural/positional - no tightness or mass but normal x-rays
    • Postnatal muscular torticollis: some induced subtypes
  3. Postnatal Muscular Torticollis
    • Environment
    • Plagiocephaly induced
    • Positional preference induced (inadequate length of injured muscle w/ growth & development)
    • CMT & other congenital birth problems (CP, Myelodysplasia, Downs)
  4. 4 Bands of the SCM
    Deep Band: Cleidomastoid

    Superficial Bands: Cleido-occipital, sterno-occipital, and sternomastoid

    • Bilateral flexion of head and neck
    • Unilateral ipislateral lateral flexion and contralateral rotation
  5. High Risk Characteristics
    • Palpable or observable mass
    • Cervical range limitations
    • Birth trauma
    • Body length > 51.3 +/- 1.49 cm
    • Facial asymmetry
    • Plagiocephaly
  6. Etiology & Pathophysiology: Predominant Theories
    • Birth trauma
    • Ischemic injury
    • Intrauterine compartment syndrome
  7. Compartment Syndrome
    • Position of head & neck in utero or during labor w/ delivery = forward flexion, lat bending and rotation
    • Causes compression of ipsilateral SCM and brachial plexus
    • Ischemia, reperfusion, edema and neurological injuries
  8. Fibrous Tumor (Fibroma)
    • Deposition of collagen & fibroblasts around individual muscle fibers and an absence of normal striated muscle
    • May appear between 14-21 days post birth and as late as 3 months
    • Disappears at 4-8 months
    • Severity related to size and amount of muscle atrophy
Card Set:
2014-03-08 00:33:48
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