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Pediatrics 3B > Pedia 3B - Applied Neurology - Primative Reflexes > Flashcards

Pedia 3B - Applied Neurology - Primative Reflexes Flashcards

0
Q 
Reflex: Palmar Grasp 
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A 
Reflex: Palmar Grasp 
Onset (AOG): 28w
Fully Developed: 32w
Duration/disappears: 2-3m
Elicitation: Dr finger in baby's palm
Normal: thumb locks onto finger tightly
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1
Q 
Reflex:  Plantar 
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Plantar
Onset (AOG): 11w
Fully Developed:
Duration/disappears: 7-9m
Elicitation: Stimulate Metatarsal arch of foot
Normal: Ball of foot drops and “grasps” w/feet; ready to cruise

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2
Q 
Reflex:  Rooting
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Rooting
Onset (AOG): 32w
Fully Developed: 36w
Duration/disappears: Less prominent after 1m
Elicitation: Stroke cheek
Normal: Infant turns toward stimulus and makes sucking motions

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3
Q 
Reflex: Moro  
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Moro
Onset (AOG): 28-32w
Fully Developed: 37w
Duration/disappears: 5-6m
Elicitation: Sudden drop of head (rel. to trunk
Normal: Abduction+Ext of arms+Legs flexed –> Abduction and flexion, flexed fists and flexed flegs

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4
Q 
Reflex:  Tonic Neck
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Tonic Neck
Onset (AOG): 35w
Fully Developed: 1m
Duration/disappears: 6-7m
Elicitation: Head of a relaxed child, laying on back, is rotated to side
Normal: “Fencer stance”
Arm faced extends straight away from body w/hand partially open
Arm on far side - flexed and fist clenched

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5
Q 
Reflex:  Placing/Stepping
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Placing/Stepping
Onset (AOG): 37w
Fully Developed:
Duration/disappears: 4-5m; pt can creep/crawl
Elicitation: Stimulate dorsum of foot against table edge
Normal: Stepping/walking movement

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6
Q 
Reflex: Parachute  
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Parachute
Onset (AOG): 4-9 (7-8?)
Fully Developed: 10-11
Duration/disappears: Masked by voluntary (Remains?)
Elicitation: Hold child upright and rotate body forward by hips (as if falling fwd)
Normal: Arms ext as if to break fall

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7
Q 
Reflex:  Landau  
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A 
Reflex:  Landau  
Onset (AOG): 9-10m
Fully Developed: 
Duration/disappears: Masked by voluntary action 
Elicitation: Hold in horizontal/prone position 
Normal: Superman pose 
Ext neck,head,arms 
Flex lower extremities
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9
Q 
Reflex:  Righting 
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Righting
Onset (AOG): 4-8m
Fully Developed:
Duration/disappears: Masked by voluntary
Elicitation: Supine, turn head to one side (sequential manner)
Normal: Rotates shoulder, trunk then pelvis

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10
Q

Developmental Milestones: Gross

Runs

A

24m

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11
Q

Developmental Milestones: Gross

Walks upstairs w/assistance

A

18m

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12
Q

Developmental Milestones: Gross

Walks w/1 hand held

A

12m

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13
Q

Developmental Milestones: Gross

Pulls to stand

A

9m

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14
Q

Developmental Milestones: Gross

Sits momentarily

A

6m

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15
Q

Developmental Milestones: Gross

Supports weight on forearms

A

3m

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16
Q

Developmental Milestones: Fine Motor

Opens hands spontaneously

A

3m

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17
Q

Developmental Milestones: Fine Motor

Transfers objects

A

6m

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18
Q

Developmental Milestones: Fine Motor

Pincer grasp

A

9m

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19
Q

Developmental Milestones: Fine Motor

Releases object on command

A

12m

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20
Q

Developmental Milestones: Fine Motor

Feeds from a spoon

A

18m

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21
Q

Developmental Milestones: Fine Motor

Builds a tower of 6 blocks

A

24m

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22
Q

Developmental Milestones: Social skills

Smiles appropriately

A

3m

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23
Q

Developmental Milestones: Social skills

Social smile

A

2m

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24
Q

Developmental Milestones: Social skills

Shows likes/dislikes

A

6m

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25
Developmental Milestones: Social skills | Plays peek-a-boo & pat-a-cake
9m
26
Developmental Milestones: Social skills | Comes when called
12m
27
Developmental Milestones: Social skills | Mimics actions of others
18m
28
Developmental Milestones: Social skills | Plays with others
24m
29
Developmental Milestones: Language | Coos/Laughs
3m
30
Developmental Milestones: Language | Babbles
6m
31
Developmental Milestones: Language | Imitates sounds
9m
32
Developmental Milestones: Language | 1-2 meaningful words
12m
33
Developmental Milestones: Language | At least 6 words
18
34
Developmental Milestones: Language | 2-3 word sentences
24m
35
Head circumference growth in PRETERM
1st week: 0.5cm 2nd week: 0.5cm 3rd week: 0.75cm 4th week+: 1cm/week until 40th
36
Head circumference growth in TERM
34-35 @Birth 44cm @6m 47cm @1y
37
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Depth- Elevated disc (Phyiologic Cup Obliterated)
Papilledema | Papillitis
38
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Depth- Shallow
Optic Atrophy
39
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Edge: Blurred
Papilledema | Papillitis
40
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Edge: Very sharp
Optic Atrophy
41
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Vessels - Engorged
Papilledema | Papillitis
42
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Vessels - Narrow/Few
Optic Atrophy
43
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Color - No Venous pulse
Papilledema | Papillitis
44
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Color - Hyperemic
Papilledema | Papillitis
45
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Color - Hemorrhages
Papilledema | Papillitis
46
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Vision - Good (or enlarged blind spot)
Papilledema
47
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Vision - Poor (or loss of central)
Papillitis
48
Optic Fundus: Papilledema, Papillitis, Optic Atrophy: | Vision - Reduced
Optic Atrophy
49
Visual acuity in an infant
20/150
50
Visual acuity reaches adult level of 20/20 at
6m
51
Dazzle Reflex: Definition: Present: Note:
Involuntary avoidance response to a light shined in eyes Present in 28week old PRE-mature infants By 32w, eyes remain closed until light is removed
52
Blink Reflex: Definition: Present: Note:
Fxn'l vision Close when object moves to eye (-) in newborn (+) 3-4m (ALL by 1y/o, otherwise likely blind)
53
Turn eyes to sound by
7-8w
54
Turn head to sound by
3-4m
55
Weber Defective ear = Better ear =
Defective ear = Conductive HL | Better ear = Sensorineural HL
56
Rinne - should be (AC vs BC) - Bone > Air - Air > Bone
- AC > BC - - Normal or - - Sensorineural HL - AC < BC = Conductive HL
57
Muscle stretch: | Jaw Jerk
CN V
58
Muscle stretch: | Biceps
C5-6 | Also in Brachio-radialis
59
Muscle stretch: | Triceps
C6-8
60
Muscle stretch: | Brachio-radialis
C5-6 | Also in Biceps
61
Muscle stretch: | Patellar:
L2-L4
62
Muscle stretch: | Ankle
S1-2
63
Muscle stretch: | Asking patient to contract a muscle you are not testing
Jendrassik Maneuver
64
Superficial Reflexes: How/What | Umbilical migration test (Beevor's)
Stroke quadrants of abdomen towards umbilicus --> Umbilicus moves towards orgin of stimulus Tests for injury between T10-T12
65
Superficial Reflexes: How/What | Cremasteric Reflex
L1-L2 | Stroke inner thigh towards testicle --> ipislateral testicle moves upward
66
Superficial Reflexes: How/What | Anal pucker
S4-5 | Pricking the skin around anus --> Quick twitch-like constriction of sphincter
67
Superficial Reflexes: How/What | Ext Toe Sign -
Pyramidal tract function | - Normal up to 2 years old ("up to 2 1/2")
68
Superficial Reflexes: How/What | Chaddock
Extensor toe sign - lateral side of foot
69
Superficial Reflexes: How/What | Schaeffer
Ext toe sign - Squeeze hard on achillies
70
Superficial Reflexes: How/What | Oppenheim
Ext toe sign - Squeeze calf muscles
71
Superficial Reflexes: How/What | Bing
Ext toe sign - multiple light pinpricks on dorso-lateral surface of foot
72
Abnormal movements: Incessant, random, moderately quick movements "Milkmaids"
Chorea
73
Abnormal movements: | Slow, writhing movements of fingers or extremities
Athetosis
74
Abnormal movements: | Prolonged, strong contraction + relaxation of agonists and antagonists
Dystonia
75
Abnormal movements: | Quick, stereotyped movements of face, tongue or extremities
Tics
76
Abnormal movements: | Hand turns to palm outward as arms are raised over head
Pronator sign
77
Abnormal movements: | Child should maintain flexed legs at right angles at knee
Barre sign
78
Reflex: Plantar Onset (AOG): Fully Dev: Duration/Disappears:
Reflex: Plantar Onset (AOG): 11 Fully Dev: Duration/Disappears: 7-9m
79
Reflex: Palmar Onset (AOG): Fully Dev: Duration/Disappears:
Reflex: Palmar Onset (AOG): 28w Fully Dev: 32w Duration/Disappears: 2-3m
80
Reflex: Rooting Onset (AOG): Fully Dev: Duration/Disappears:
Reflex: Rooting Onset (AOG): 32w Fully Dev: 36w Duration/Disappears: Less prominent after 1m
81
Reflex: Moro Onset (AOG): Fully Dev: Duration/Disappears:
Reflex: Moro Onset (AOG): 28-32w Fully Dev: 37w Duration/Disappears: 5-6m (?)
82
Reflex: Tonic Neck Onset (AOG): Fully Dev: Duration/Disappears:
Reflex: Tonic neck Onset (AOG): 35 Fully Dev: 1m Duration/Disappears: 6-7m
83
Reflex: Placing/Stepping Onset (AOG): Fully Dev: Duration/Disappears:
Reflex: 37w Onset (AOG): Fully Dev: Duration/Disappears: 4-5m; Pt can creep and crawl
84
Reflex: Parachute Onset (AOG): Fully Dev: Duration/Disappears:
Reflex: Parachute Onset (AOG): 7-8m Fully Dev: 10-11m Duration/Disappears: Persists throughout life
85
Reflex: Landau "Superman" Onset (AOG): Fully Dev: Duration/Disappears:
Reflex: Landau "Superman" Onset (AOG): 9-10m Fully Dev: Duration/Disappears: Covered up by voluntary
86
Reflex: Parachute Onset (AOG): Fully Dev: Duration/Disappears:
Reflex: Parachute Onset (AOG): 4-9m Fully Dev: Duration/Disappears: Covered up by voluntary
87
Reflex: Righting Onset (AOG): Fully Dev: Duration/Disappears:
Reflex: Righting Onset (AOG): 4-8m Fully Dev: Duration/Disappears: Covered up by voluntary
88
Sensory Examination: Level of Involvement | Back of head
C2
89
Sensory Examination: Level of Involvement | Shoulders
C4
90
Sensory Examination: Level of Involvement | Thumbs
C6
91
Sensory Examination: Level of Involvement | Nipple line
T4
92
Sensory Examination: Level of Involvement | Umbilicus
T10
93
Sensory Examination: Level of Involvement | Inguinal sign
L1
94
Sensory Examination: Level of Involvement | Big toe
L5
95
Sensory Examination: Level of Involvement | Small toe
S1
96
Sensory Examination: Level of Involvement | Posterior thigh
S2
97
Meningeal signs: (+) Resistanceto flexion (-) Resistance to extension Inflammation in dura
Nuchal rigidity/catch | Protective reflex prevents stretching/lengthening
98
Meningeal signs: Bent-knee Straight-knee-leg raising test Neck bends to prevent stretching
Kernig
99
Meningeal signs: | ADduction and flexion of legs as you attempt to flex the kneck --> ?
Brudzinski --> knees go up to prevent stretching
100
Scarf sign tests
If elbow passes midline --> HYPO-tonia

Pediatrics 3B (12 decks)

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