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Pediatrics Flashcards

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1
Q

APGAR: Appearance scores

A

0 = blue
1 = blue extremities
2 = no blue

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2
Q

APGAR: Pulse scores

A

0 = absent
1 = <100bpm
2 = 100-140bpm

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3
Q

APGAR: Grimace scores

A

0 = no response
1 = grimace
2 = cry/withdrawal

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4
Q

APGAR: Activity scores

A

0 = flaccid
1 = some flexion
2 = active motion

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5
Q

APGAR: Respiration scores

A

0 = absent
1 = weak cry/hypoventilation
2 = strong cry

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6
Q

When is APGAR checked?

A

-1min
-5mins
-10mins if needed (if normal score at 5min, no need to check again)

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7
Q

What is a normal APGAR score?

A

> /= 8/10

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8
Q

Interventions for abnormal APGAR scores

A

5-7 = blow-by oxygen
<6 = resuscitation
3-4 = bag mask ventilation

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9
Q

General rules of gross motor development:
a) reflexes before cortex
b) cortex before reflexes

A

a) reflexes before cortex

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10
Q

General rules of gross motor development:
a) localized before general responses
b) general before localized responses

A

b) general before localized responses

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11
Q

General rules of gross motor development: order of tone?

A

Gravity (supine): flexor before extensor
Antigravity (upright): extensor before flexor

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12
Q

General rules of gross motor development: order of body regions?

A

-Cephalic to caudal
-Proximal to distal

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13
Q

Key Milestones at month 3

A

-Prone on elbows
-Lift head in prone
-Belly crawl

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14
Q

Key Milestones at month 4

A

-Supine > sidelying

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15
Q

Key Milestones at months 5-6

A

-Prone > supine
-Pull to sit
-Sit w/ UE support
-Feet to mouth

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16
Q

Key Milestones at months 6-7

A

-Supine > prone
-Quadruped
-Ring sit
-Trunk rotation in sitting
-Transfer objects btwn hands

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17
Q

Key Milestones at months 9-10

A

-Quadruped creeping
-Cruising sideways
-Pull to stand
-Pincher grasp
-3 jaw chuck grasp (looks like ASL no)

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18
Q

Key Milestones at months 10-15

A

-Walking unassisted
-In/out of squat
-Controlled grasp & release
-Stacks 2 cubes

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19
Q

Flexor Withdrawal Reflex: stimulus, response, & when is it integrated?

A

Stimulus: noxious to sole of foot.
Response: toes ext, DF, LE flex.
Integrated: 2mo

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20
Q

Crossed Extension Reflex: stimulus, response, & when is it integrated?

A

Stimulus: noxious to ball of foot
Response: opposite (unstimulated) LE flexes, then adducts & extends.
Integrated: 2mo

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21
Q

Rooting Reflex: stimulus, response, & when is it integrated?

A

Stimulus: stroke cheek
Response: head turns toward direction of stimulus, mouth opens.
Integrated: 3mo

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22
Q

Traction Reflex: stimulus, response, & when is it integrated?

A

Stimulus: grasp arm & pull from supine > sit.
Response: total flexion of UE.
Integrated: 5mo

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23
Q

Asymmetric Tonic Neck Reflex (ATNR): stimulus, response, & when is it integrated?

A

Stimulus: rotate head to one side in supine.
Response: bow & arrow posture (flexion away from head turn, extension on side of head turn).
Integrated: 6mo

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24
Q

Palmar Grasp Reflex: stimulus, response, & when is it integrated?

A

Stimulus: pressure on palm.
Response: fingers flex.
Integrated: 6mo

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25
Moro Reflex: stimulus, response, & when is it integrated?
Stimulus: drop backward from sitting > supine. Response: UE extend & abduct, hands open. Then UE flex & adduct, arms cross over chest. Integrated: 6mo
26
Symmetric Tonic Labyrinth Reflex (TLR): stimulus, response, & when is it integrated?
Stimulus: prone or supine position. Response (Prone): increased flexor tone. Response (Supine): increased extensor tone. Integrated: 6mo
27
Positive Support Reflex: stimulus, response, & when is it integrated?
Stimulus: contact ball of foot in standing. Response: rigid extension of LEs. Integrated: 6mo
28
Plantar Grasp Reflex: stimulus, response, & when is it integrated?
Stimulus: pressure on ball of foot. Response: toes flex. Integrated: 9mo
29
Symmetric Tonic Neck Reflex (STNR): stimulus, response, & when is it integrated?
Stimulus: head flexion or extension in quadruped. Response (Flexion): UE flex, LE extend. Response (Extension): UE extend, LE flex. Integrated: 12mo
30
Startle Reflex: stimulus, response, & when is it integrated?
Stimulus: sudden loud noise Response: UE extend & abduct. Integrated: persists
31
Which reflex does not onset until 4-6mo after birth?
STNR
32
Plagiocephaly skull deformation
Ipsilateral: -Occipital flattening. -Frontal bossing (protruding). -Ear displaced anteriorly. Contralateral: -Occipital bossing.
33
Plagiocephaly treatment
Helmet
34
What does Left Plagiocephaly look like?
Left occipital flattening. Left frontal bossing. Right occipital bossing.
35
Torticollis presentation
Side bend toward Rotate away
36
How do Plagiocephaly & Torticollis relate?
Opposite sides. Left plagiocephaly = right torticollis.
37
Torticollis treatment
SCM stretching
38
Spastic Cerebral Palsy: definition & presentation
Velocity-dependent resistance to stretch. Synergy patterns. Contractures. Crouch gait. Toe walking.
39
Ataxic Cerebral Palsy: definition & presentation
Disorder of coordination, force, & timing; cerebellar involvement. Low tone. Tremor. Poor balance. Wide BOS. Nystagmus.
40
Dyskinetic Cerebral Palsy: definition & presentation
Slow, writhing movements; basal ganglia involved. Poor stability. Hand tremors. Fluctuating tone.
41
Cerebral Palsy GMFCS Level 1
Walks without restrictions. Some limitations w/ advanced motor skills.
42
Cerebral Palsy GMFCS Level 2
Walks without a device. Limitations with community ambulation (e.g., difficulty with stairs).
43
Cerebral Palsy GMFCS Level 3
Walks with a device. Limitations with community ambulation (may require manual WC).
44
Cerebral Palsy GMFCS Level 4
Mobility severely limited. Power WC for community.
45
Cerebral Palsy GMFCS Level 5
Mobility severely limited, even with assistive tech. Requires caregiver.
46
Down Syndrome definition
Trisomy 21 (extra chromosome 21)
47
What increases risk of Down Syndrome?
Geriatric pregnancy
48
Down Syndrome: precautions
Avoid forceful neck flexion & rotation (risk of subluxing AA joint). Avoid hyperextension of elbows & knees when WB (d/t hypotonia).
49
Down Syndrome: common sxs
Delayed milestones, especially running & jumping. Impaired postural control. Weak quads. Weak hip abductors.
50
Down Syndrome: treatments should ideally include...
Encourage WB - standing/walking activities. Exercises that address both gross & fine motor skills.
51
What is Dyspraxia & what condition is it commonly seen with?
Difficulty imitating movements. Autism.
52
Sensory Seeking definition
Hypo-reactive to sensory input.
53
Sensory Avoiding definition
Hyper-reactive to sensory input.
54
Duchenne Muscular Dystrophy definition
X-linked (boys only). Destruction of muscle cells. Pseudohypertrophy: fat & collagen fill muscles. Short lifespan, strength WILL decline.
55
Duchenne Muscular Dystrophy: key characteristic
Gower's Sign: puts hands on knees & "walks" up legs to stand upright.
56
Duchenne Muscular Dystrophy: treatments & precautions
-Focus on maintaining mobility for as long as possible & preventing contractures. -Strength will decline no matter what, so less focus on strengthening. -Do NOT over-fatigue!
57
Scheurrman Disease: definition & radiograph presentation
-Juvenile kyphosis. -Schmorl Nodes (wedging of thoracic vertebrae).
58
Scheurrman Disease: presentation
-Pain w/ thoracic extension. -Agg by standing or sitting for prolonged time. -Increased thoracic kyphosis. -Increased lumbar lordosis.
59
Scheurrman Disease: interventions
Stretch pecs Strengthen thoracic extensors Scapular stabilization
60
Nerve roots involved with Erb's Palsy
C5-6
61
Nerve roots involved with Klumpke's Palsy
C8-T1
62
Erb's Palsy: MOI
Stretch head downwards
63
Klumpke's Palsy: MOI
Stretch arm above head
64
Erb's Palsy: deformity & sxs
-Waiter's Tip deformity -Shoulder & elbow mm affected -Loss of abd & ER -Sensory loss of radial arm
65
Klumpke's Palsy: deformity & sxs
-Claw Hand deformity -Paralysis of hand intrinsics (non-functional hand) -Sensory loss of ulnar arm

NPTE (28 decks)

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