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pediatric Flashcards

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1
Q

APGAR score of 0

A

Appearance: blue
Pulse; absent
Grimace: no réponse
activity (muscle tone): flaccid
respiration: absent

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2
Q

APGAR scoring of 1

A

Appearance: blue exteremities
Pulse: <100bpm
Grimace: grimace
Activity: some flexion
Respiration: weak cry, hypoventilation

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3
Q

APGAR scoring of 2

A

Appearance: no blue
Pulse: >100 bpm
Grimace: cry or withdrawal
Activity: active motion extremities
Respiration: strong cry

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4
Q

gross motor development

A

reflexes before cortex
general before localized responses
flexor tone before extensor tone
antigravity/upright: extensor tone before flexor tone
cephalic before caudal
proximal to distal
gross motor before fine motor

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5
Q

PEDs milestones - month 3

A

prone on elbows
can lift head in prone
belly crawl (3-9m)

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6
Q

PEDS milestones - months 3-4

A

supine to sidelying

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7
Q

PEDs milestones months 5-6

A

prone to supine
pull to sit without head lag
sitting with UE support
feet to mouth

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8
Q

PEDs milestone - months 6-7

A

supine to prone
quadruped
independent ring sitting
transfers objects between hands
trunk rotation in sitting

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9
Q

PEDs milestons - months 9-10

A

quadruped creeping
cruises to sideways
plantigrade, pulls to stand
improving grasping skills, pincer, three jaw chuck (10m)

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10
Q

PEDs milestones - months 10-15

A

begins to walk unassisted
transitions in and out of squatting (10m)
controls grasp AND release
stacks 2 cubes

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11
Q

crawling

A

army crawl, on belly

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12
Q

creeping

A

quadreped

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13
Q

a poem to PEDS warriors

A

3 I lift my head
4 lay on my side
5 prone to supine
and at 6 I sit upright
7 quadreped
at 8 can’t wait to cruise (9)
creep, cruise, and stand alone at 9,
then walk and stack 2 cubes

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14
Q

integrated

A

when the reflex disappears to allow for normal development

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15
Q

persistent

A

a reflex that has not integrated and indicative of CNS dysfunction

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16
Q

flexor withdrawal reflex - stimulus and response

A

onset - 28 weeks gestation
integrated - 1-2 months

stimuli - noxious stimulus (pinprick) to sole of foot
response - toes extend, foot DF, LE flexes uncontrollably

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17
Q

crossed extension reflex

A

onset - 28 weeks of gestation
integrated - 1-2 months

noxious stimulus to ball of foot of LE fixed in ext
respond - oppose LE flexes, then adducts and extends

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18
Q

rooting reflex

A

onset - 28 weeks of gestation
integrated - 3 months

stroking the side of the baby’s cheek

response - head turns toward stimulus and mouth opens

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19
Q

traction reflex

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A

onset - 28 weeks of gestation
integrated - 2-5 months

grasp forearm and pull up from supine into sitting position

response - grasp and total flexion of the UE

20
Q

assymetrical tonic neck reflex(ATNR)

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A

onset - birth
integrated - 4-6 months

rotation of the head to one side

response - flexion of skull limbs, extension of the jaw limbs, “bow and arrow” posture

21
Q

palmar grasp reflex

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A

onset - birth
integrated - 4-6 months

maintained pressure to palm of hand

response - maintained flexion of fingers

22
Q

moro reflex

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A

onset - 28 weeks of gestation
integrated - 5-6 months

drop pt backward from sitting position
response - extension, ABD of UEs, hand opening and crying followed by flexion, ADD of arms across stretch

23
Q

symmetrical tonic labyrinthine reflex (TLR/STLR)

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A

onset: birth
integrated: 6 months

prone or supine
prone - increased flexor tone of all limbs
supine: increased extensor tone of all limbs

24
Q

positive supporting reflex

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A

onset: birth
integrated: 6months

contact to the ball of the foot in upright standing
response - rigid extension (concentration) of the LEs

25
plantar grasp reflex
onset - 28 weeks of gestation integrated - 9 months maintained pressure to ball of foot under toes response - maintained flexion of toes
26
symmetrical tonic neck reflex (STNR)
onset - 4-6 m integrated - 8-12 m flexion or extension of the head head flexion: flexion of UEs, ext of LEs head ext: ext of UEs, flexion of LEs
27
plagiocephaly
Occipital flattening is on the SAME side, and Occipital bossing is on OPP side results from prolonged asymmetrical pressure on the premature skull creates a parallelogram shape when viewed from the vertex ipsilateral frontal bossing and anterior displacement of the ear assess c/s ROM and strength, educate parents on positioning, exercises, helmet and tummy time
28
spastic CP
velocity dependent resistance of a muscle to stretch synergy patterns, contractures, crunched gait, toe walking
29
ataxia CP
disorder of coordination, force, and timing, associated with cerebellar development low tone, tenor, poor balance, wide BOS, nystagmus
30
dyskinetic CP
disorder of basal ganglia, characterized by involuntary movements that are slow and writhing poor stability, hand tremor, fluctuating tone, hypo becomes hyper
31
level 1 CP
patient will walk without restrictions but will have limitation in more advanced gross motor skills
32
level 2 CP
pt will walk without AD with limitation in walking outdoors and in community
33
level 3 CP
pt will walk with AD with limitations in walking outdoors and community
34
level 4 CP
pt self mobility will be severely limited; children are transported or use power mobility outdoors and in community
35
level 5 CP
pt self mobility will be severely limited even with use of AD required caregiver
36
down syndrome
results from presence of full or partial extra copy of 21st chromomsome; trisomy 21 increased risk with increased age of mother forceful neck flexion and rotation activities should be limited due to laxity of odontoid ligament and potential for a subluxation of Atlanta-axial joint encourage motor function and avoid hyperextension of elbows and knees during WB activities
37
symptoms of Down Syndrome
hypotonia, ligamentous laxity delayed motor milestones (running and jumping most delayed) deficits in memory and expressive language impairments in postural control and coordination decreased quadriceps and hip abductor strength inefficient movement strategies due to hypotonia
38
autism spectrum disorder
social/communication skill limitations, especially nonverbal skills repetitive behaviors sensory processing issues difficulty developing relationships hypo-reactive or hyper-reactive to sensory input - sensory seeking or avoiding dyspraxia (inability to imitate movement)
39
interventions for ASD
controlled, multi-sensory input give specific info behavioral interventions encouraging motor development coordination visual supports (lines on floor for gait) using first, then or sequencing consistency
40
DMD
x-linked recessive, inherited by boys dystrophin gene missing - destruction of muscle cells causes pseudo hypertrophy (collagen and adipose tissue)
41
DMD exam
strength, ROM, functional testing, skeletal alignment, respiratory function, assess need for AD
42
DMD interventions
maintain mobility as long as possible maintain joint ROM with active/passive do not OVER FATIGUE
43
Scheuermann Disease exam
schmorl's nodes and angles/wedged thoracic spine pain with thoracic extension and rotation aggravation with long periods of standing/sitting or physical activity
44
Scheuermann Disease interventions
the Schroth method, stretch pecs, strengthen thoracic extensors and scapular stabilizers
45
Erb's Palsy
C5-C6 MOI: stretching head downward loss of movement: loss of ABD and lateral rotation of shoulder deformity: waiters tip deformity
46
Klumpke's Palsy
C8-T1 MOI: stretching of arm overhead loss of movements: paralysis of the instrinsic of hand deformity: claw hand
47

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