paediatrics Flashcards
(84 cards)
1
Q
what are the pre- requisites of child development (Gross Motor Control)
A
- physiological flexion
- midline orientation
- reflexes
- mobility
- balance
- weightbearing
- coordination
- tone
- strength
2
Q
what is physiological flexion and its importance
A
- this is flexion at the hips, knees, ankles and rounded shoulders with hands close to the face
- if babies lack flexion they will remain in an extended position, which can hinder motor skills
3
Q
what happens if a baby does not have physiological flexion
A
without it a baby will not develop core muscles and will rely on surfaces for support
4
Q
what is midline orientation and its importance
A
- when a baby has symmetry (we want to promote symmetry)
- this allows babies to understand how to bring hands to midline which aids self-soothing via thumb sucking in stressful environments
5
Q
what is a stressful environment for a neonate
A
- being in hospital
- being away from the mother
- visual and audible noise
6
Q
what are some important reflexes
A
- rooting
- morrow
- suckling
- stepping
- reaching
- palmar and plantar grasp
- fencer response
7
Q
pre term babies have reduced muscle mass preventing them reaching _____________ __________
A
developmental milestones
8
Q
pre term babies would have breathing difficulty due to
A
- underdeveloped lungs
- reduced alveoli and surfactant
- cell walls being thicker than the normal 1cm which is optimum for gas exchange
9
Q
what are some factors that can impact development
A
- scoliosis, limb loss, hip dysplasia, insufficient tummy time
- muscular dystrophy, tone, prematurity
- recurrent chest infections, smoking, mould
- long hospital stays and neglect
10
Q
DHD stands for
A
developmental hip dysplasia
11
Q
is pain a factor of DHD in babies
A
no, babies don’t often feel pain caused by DHD
12
Q
how can you assess for DHD in babies
A
- assess ROM at the hips
- measure leg length
- lower limb tests : galeazzi (measuring femur leg length in crook lying), barlow (screens a dislocated hip by dislocating it) and ortalani (screens for an already dislocated hip by relocating it)
13
Q
what is the galeazzi sign
A
when there is a femur discrepancy in leg length
14
Q
what is the barlows test
A
this screens for a hip instability by dislocating the hip
15
Q
what is ortalanis test
A
this screens for an already dislocated hip by relocating the hip
16
Q
what is the latest age barlow and ortalani tests should be carried out
A
this is done on children under 3 months
17
Q
what are the two main types of positional talipes
A
- equinovarus
- calcaneovalgus
18
Q
what is the position of equinovarus talipes (foot)
A
plantarflexion and inversion
19
Q
what is the position of calcaneovagus talipes (foot)
A
dorsiflexion and eversion
20
Q
what is the most common orthopaedic condition in paeds
A
CTEV (congenital talipes equinovarus)
21
Q
what is pes cavus
A
pes cavus is a condition where a baby has an abnormal arch in the foot. babies are not supposed to have an arch developed at this point
22
Q
how does a vertcal talus present
A
this presents as a rocker bottom foot, where to sole of the foot is curved
23
Q
how is CTEV treated
A
initially treated with serial casting over the course of 6-8 weeks then boots and bars until the age of 5
24
Q
what is the outcome measure used for CTEV
A
the pirani score
25
what does a score of 0 on the pirani score indicate
0 = positional talipes
26
what factors does the pirani score asses
27
how many types does congenital muscular torticollis have
there are two types
28
what is type 1 torticollis
when it occurs during pregnancy due to foetal malposition
29
what is type 2 torticollis
when it occurs in early life due to perinatal trauma
30
what are some risk factors of torticollis and plagiocephaly
- neonatal stay
- unilateral stimulation
- Erbs palsy
- Dystonia
- resp issues
- visual/ vestibular issues
31
what is Erbs palsy
this is a condition that is caused by nerve damage during birth, causing paralysis of the arm
32
how is Erbs palsy treated
treated with exercises and typically recover within 6 months
33
what is Dystonia
this is a neurological movement disorder, people with this condition experience involuntary muscle spasms and contractions
34
dystonia can cause high tone leading to __(what condition)__
torticollis
35
as physios what can we look to assess in children
- assess independent movement of the baby and their response to stimulation
- assess AROM/ PROM in rotation and flexion
- baby's strength
- complete the plagiocephaly scale
36
what are some red flags to look for
- macrocephaly
- high/ low tone
- scoliosis
- lump on palpation
- facial deformity
37
what is macrocephaly
this is where the baby has a large head circumference and query if a condition had caused it
38
what is DCD
developmental coordination disorder
39
what was DCD (developmental coordination disorder) previously known as
dyspraxia
40
what is DCD (developmental coordination disorder)
its a neurodevelopmental coordinator disorder that causes children to have delays in advanced gross and fine motor skills
41
what can developmental coordination disorder lead to
- motor learning disabilities
- delays in executive function
- reduced academic performance
- effects on socialism
- possible joint laxity
42
developmental coordination disorder can be assossiated with two conditions. _______ and _________
autism and ADHD
43
what are key questions that should be asked in a subjective Hx taking
asking about:
- developmental milestones
- type of birth
- any complications at birth
- if the child regularly attends school
44
What assessment should be used for evaluating a child's movement?
Movement Assessment Battery for Children (Movement ABC)
This assessment helps identify movement difficulties in children.
45
What should be done with the results of the Movement ABC?
Results should be interpreted and the child should be referred to a paediatrician for diagnosis
This ensures proper medical evaluation and potential intervention.
46
what is joint laxity
describes an unstable joint as it can PASSIVELY move beyond normal limits, particularly during glides
47
what is joint hypermobility
this describes the increased ROM of a joint beyond normal range, and it is a full body connective tissue disorder
48
What tool is used to measure joint extension?
Goniometer
49
How is joint hypermobility classified?
- Generalized joint hypermobility
- Peripheral joint hypermobility
- Localized joint hypermobility
50
What is generalized joint hypermobility?
Joint hypermobility present in many different joints throughout the body.
51
What is peripheral joint hypermobility?
Joint hypermobility limited to the hands and feet.
52
What is localized joint hypermobility?
Joint hypermobility in a single joint or group of joints in the same area.
53
What scale is used to assess generalized joint hypermobility?
Beighton Score.
54
How many points is the Beighton Score based on?
9-point scale.
55
What joints are assessed in the Beighton Score?
1. Base of the right 5th (pinky) finger
2. Base of the left 5th (pinky) finger
3. Base of the right thumb
4. Base of the left thumb
5. Right elbow
6. Left elbow
7. Right knee
8. Left knee
9. Lower spine
56
What is a positive Beighton score for adults?
Greater than or equal to 5/9 points.
57
What is a positive Beighton score for children before puberty?
Greater than or equal to 6/9 points.
58
What is a positive Beighton score for adults over age 50?
Greater than or equal to 4/9 points.
59
60
What occurs when joints are not just hypermobile but also unstable?
Joint instability occurs when the bones of a joint aren’t held in place securely.
61
What can joint instability lead to?
Joint instability can lead to:
- Joint subluxations
- Dislocations
- Sprains
- Other injuries
62
What types of pain can joint instability cause?
Joint instability can cause both acute and chronic pain.
63
How does joint instability affect daily life?
It can interfere with ADLs and make doing them harder
64
What are hypermobility spectrum disorders (HSD)?
Connective tissue disorders that cause joint hypermobility, instability, injury, and pain.
65
What symptoms are often associated with HSD?
Symptoms include:
- Fatigue
- Headaches
- GI problems
- Autonomic dysfunction
66
True or False: HSD only causes joint-related issues.
False
HSD can also lead to various other symptoms such as fatigue and gastrointestinal problems.
67
Fill in the blank: HSD can lead to joint ______, instability, injury, and pain.
[hypermobility]
68
HSD (Hypermobility Spectrum Disorder) is classified as a __________ ___________ disorder ?
Connective tissue disorders.
69
children with T21 have reduced tone where
they have reduced tone in the core, head and neck along with joint laxity
70
True or False: CT21 patients have different milestone trajectories
true
71
fill the gap:
babies with this condition can experience __________ pain due to early intervention for illnesses
chronic
72
True or False: toddlers cannot localise pain
true
73
what is JIA
juvenile idiopathic arthritis
74
what is the cause of JIA
the cause is unknown (idiopathic), however factors such as genetic and environmental play a role and lead to an abnormal immune response
75
how much more common is JIA in girls than boys
girls are twice is likely to get JIA
76
how is JIA diagnosed
- looking for stiffness
- pain
- swelling going on for 6 weeks
- elevated CRP
77
what are the symptoms of JIA
- pain
- swelling
- decreased ROM
- fever
- rashes
- delayed growth
- difficulty walking
78
myalgic encephalomyelitis (ME) is also known as
chronic fatigue syndrome (CFS)
79
what are the most common symptoms of chronic fatigue syndrome (CFS)
- extreme tiredness - feeling tired all the time
- sleeping problems, insomnia or the feeling of exhaustion or stiffness when waking up
- problems with thinking, concentration and memory (brain fog)
- exacerbated symptoms after physical or mental activity, requiring sometimes weeks to recover (post exertional malaise)
80
what is the cause of chronic fatigue syndrome (CFS)
the cause is unknown
81
Is there a specific test for ME/CFS?
No, there is no specific test
82
True or False: ME/CFS can be diagnosed with a standard laboratory test.
False
83
treatment of ME (Myalgic encephalomyelitis) / CFS include:
- energy management
- medicine to control pain and sleep symptoms
- cognitive behavioural therapy (CBT), works by changing how a person thinks and behaves
84
