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COMP EXAM PREP > Pediatrics > Flashcards

Pediatrics Flashcards

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1
Q

APGAR Score

A

quick, standardized assessment tool used to evaluate a newborn’s physical condition immediately after birth

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2
Q

APGAR is an acronym based on 5 clinical signs:

A

Appearance (Color)
Pulse (Heart Rate)
Grimace (Reflex Irritability)
Activity (Muscle Tone)
Respiration (Breathing Effort)

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3
Q

Appearance

A

0: blue

1: blue extremities

2: no blue

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4
Q

Pulse

A

0: absent

1: <100 bpm

2: 100-140 bpm

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5
Q

Grimace

A

0: no response

1: grimace

2: cry or withdrawal

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6
Q

Activity

A

0: flaccid

1: some flexion

2: active motion extremities (kicking and punching)

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7
Q

Respiration

A

0: absent

1: weak cry, hypoventilation

2: strong cry (screaming)

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8
Q

APGAR score checked at:

A

1 minute
5 minutes

10 minutes (only if needed = abnormal score)

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9
Q

Reflexes before cortex

A

Primitive reflexes (e.g., rooting, Moro) appear before voluntary cortical control develops.

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10
Q

General before localized

A

Early movements are mass, whole-body responses before refined or isolated motions emerge.

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11
Q

Flexor tone before extensor tone

A

Infants are born with physiological flexion → extensor tone emerges as development progresses.

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12
Q

Extensor tone before flexor tone in upright/antigravity

A

When learning to move against gravity (e.g. head/trunk extension in prone), extensor strength develops before flexor control in these positions.

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13
Q

Cephalocaudal development

A

Motor control develops head to toe (e.g. head control → trunk → sitting → standing).

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14
Q

Proximal to distal

A

Core/trunk control develops before fine motor skills of the hands and feet (e.g. postural stability → grasp).

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15
Q

Gross motor before fine motor

A

Large movements (rolling, crawling, walking) develop before small, precise ones (pincer grasp, buttoning, writing).

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16
Q

milestones
month 3:

A

Prone on elbows

Can lift head in prone

Belly crawl (3-9 mo)

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17
Q

milestones
month 3-4:

A

Supine to sidelying

NOT fully rolling

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18
Q

milestones
month 5-6:

A

Prone to supine

Pull to sit without head lag

Sitting with UE support

Feet to mouth

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19
Q

milestones
month 6-7:

A

Supine to prone

Quadruped

Independent ring sitting

Transfers objects between hands

Trunk rotation in sitting

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20
Q

milestones
month 9-10:

A

Quadruped creeping

Cruises to sideways

Plantigrade, pulls to stand

Improving grasping skills, pincer, three
jaw chuck (10 mo)

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21
Q

milestones
month 10-15:

A

Begins to walk unassisted

Transitions in and out of squatting (10 mo)

Controls grasp AND release

Stacks two cubes

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22
Q

Creepy Crawly Baby

A

Crawling- army crawl, on belly: 3-5 months

Creeping- quadruped: ~6 months

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23
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 quadruped,
At 8, can’t wait to cruise (9).
Creep, cruise, and stand alone at 9,
Then walk and stack two cubes.

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24
Q

Integrated:

A

When the reflex disappears to allow for normal development

cortex can take over

good = want this to happen -> voluntary control

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25
Persistent:
A reflex that has not integrated and indicative of central nervous system (CNS) dysfunction
26
Flexor Withdrawal Reflex:
onset: 28 weeks gestation integrated: 1-2 months stimulus: Noxious stimulus (pinprick) to sole of foot response: Toes extend, foot dorsiflexes, LE flexes uncontrollably
27
Crossed Extension Reflex:
onset: 28 weeks gestation integrated: 1-2 months stimulus: Noxious stimulus to ball of foot of LE fixed in extension response: Opposite LE flexes, then adducts and extends
28
Rooting Reflex:
onset: 28 weeks gestation integrated: 3 months stimulus: Stroking the side of baby’s cheek response: Head turns toward stimulus and mouth opens
29
Traction Reflex:
onset: 28 weeks’ gestation integrated: 2-5 months stimulus: Grasp forearm and pull up from supine into sitting position response: Grasp and total flexion of the UE
30
Asymmetrical Tonic Neck (ATNR) Reflex:
onset: birth integrated: 4-6 months stimulus: Rotation of the head to one side response: Flexion of skull limbs, extension of the jaw limbs, “bow and arrow” posture
31
Palmar Grasp Reflex:
onset: birth integrated: 4-6 months stimulus: Maintained pressure to palm of hand response: Maintained flexion of fingers
32
Moro Reflex:
onset: 28 weeks gestation integrated: 5-6 months stimulus: Drop patient backward from sitting position response: Extension, abduction of UEs, hand opening and crying followed by flexion, adduction of arms across chest
33
Symmetrical Tonic Labyrinthine (TLR / STLR) Reflex:
onset: birth integrated: 6 months stimulus: Prone or supine position response: Prone: Increased flexor tone of all limbs Supine: Increased extensor tone of all limbs
34
Positive Supporting Reflex:
onset: birth integrated: 6 months stimulus: Contact to the ball of the foot in upright standing position response: Rigid extension (co contraction) of the LEs
35
Plantar Grasp Reflex:
onset: 28 weeks gestation integrated: 9 months stimulus: Maintained pressure to ball of foot under toes response: Maintained flexion of toes
36
Symmetrical Tonic Neck (STNR) Reflex:
onset: 4-6 months integrated: 8-12 months stimulus: Flexion or extension of the head response: Head flexion: Flexion of UEs, extension of LEs Head extension: Extension of UEs, flexion of LEs
37
Startle Reflex:
onset: birth integrated: persists stimulus: Sudden loud or harsh noise response: Sudden extension or abduction of UEs, crying
38
Reflex Integration 1-2 month:
flexor withdraw crossed extension flex + extend
39
Reflex Integration 3 month:
rooting
40
Reflex Integration 2-5 month:
traction
41
Reflex Integration 6 month:
PAMS TP palmar ATNR moro sucking TLR postural support
42
Reflex Integration 9 month:
plantar grasp
43
Reflex Integration 12 month:
BS babinski STNR
44
Plagiocephaly
Results from prolonged asymmetrical pressure on the premature skull Creates a parallelogram shape when viewed from the vertex Assess c/s ROM and strength, educate parents on positioning, exercises, helmet and tummy time
45
Plagiocephaly Flattening vs bossing
Occipitoparietal flattening and contralateral occipital bossing Ipsilateral frontal bossing and anterior displacement of the ear
46
Occipital flattening is on ___ side, and Occipital bossing is on ___ side
SAME OPP
47
Plagiocephaly and ___occur on OPP sides!
torticollis
48
Classification of CP is according to movement disorders:
spastic ataxia dyskinetic
49
Spastic CP:
Velocity dependent resistance of a muscle to stretch ̶Synergy patterns, contractures, crouched gait, toe walking increased tone hypertonic: gastroc hip flexor knee flexor adductor
50
Ataxia CP:
Disorder of coordination, force, and timing, associated with cerebellar involvement ̶Low tone, tremor, poor balance, wide base of support, nystagmus decreased tone
51
Dyskinetic CP:
Disorder of basal ganglia, characterized by involuntary movements that are slow and writhing ̶Poor stability, hand tremor, fluctuating tone, hypo becomes hyper athetosis poor movement
52
Gross Motor Classification of CP
5 levels Think of Level I = most independent Level V = most dependent Focus on mobility and assistance needs when differentiating levels
53
Gross Motor Classification for Cerebral Palsy level 1
Patient will walk without restrictions but will have limitations in more advanced gross motor skills. no problem with ADLs
54
Gross Motor Classification for Cerebral Palsy level 2
Patient will walk without assistive device with limitations in walking outdoors and in the community.
55
Gross Motor Classification for Cerebral Palsy level 3
Patient will walk without assistive device with limitations in walking outdoors and in the community. AD>WC
56
Gross Motor Classification for Cerebral Palsy level 4
Patient self mobility will be severely limited; children are transported or use power mobility outdoors and in the community. WC>AD
57
Gross Motor Classification for Cerebral Palsy level 5
Patient self mobility will be severely limited, even with the use of assistive technology, requires caregiver.
58
Down’s Syndrome
Results from presence of full or partial extra copy of the 21st chromosome; trisomy 21 Increased risk with increased age of the mother Forceful neck flexion and rotation activities should be limited due to laxity of odontoid ligament and potential for a subluxation of atlanto-axial joint = hypermoblity!! Encourage motor function and avoid hyperextension of the elbows and knees during weight bearing activities
59
Symptoms of Down’s 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
60
Autism Spectrum Disorder
Social/communication skill limitations, especially non-verbal skills Repetitive behaviors (routines, highly focused interest, spinning of hands) Sensory processing issues Difficulty developing relationships Dyspraxia (inability to imitate movement)
61
Autism Spectrum Disorder Sensory processing issues:
Hypo-reactive -> sensory seeking Hyper-reactive -> sensory avoiding
62
Interventions for Autism Spectrum Disorder
* Controlled, multi-sensory input * Give specific information * Behavioral interventions (e.g., Social) * Encouraging motor development * Coordination * Visual supports (lines on floor for gait) * Using first, then (or sequencing) * Consistency
63
Duchenne Muscular Dystrophy
* X-linked recessive, inherited by boys * Dystrophin gene missing – destruction of muscles’ cells * Causes pseudohypertrophy (collagen and adipose tissue) (calves appear bigger)
64
Duchenne Muscular Dystrophy examination:
Strength, ROM, Functional testing, skeletal alignment, respiratory function, assess need for adaptive equipment
65
Duchenne Muscular Dystrophy PT interventions:
* Maintain mobility as long as possible * Maintain joint ROM with active/passive * DO NOT OVER FATIGUE
66
Gower's Sign
quad weakness!! using hands to push on legs to stand hands lock knees into extension
67
Scheuermann Disease Examination:
more common in boys * Schmorl’s Nodes (end plate crack) and angled/wedged thoracic spine = front side vertebrae shorter than back * Pain with thoracic extension and rotation * Aggravation with long periods of standing/sitting or physical activity * Increased thoracic kyphosis & lumbar lordotic curve
68
Scheuermann Disease PT interventions:
The Schroth Method: stretch pecs strengthen thoracic extensors and scapular stabilizers
69
Erb’s Palsy:
nerve roots: C5-6 MOI: Stretching head downward loss of movements: Loss of abduction and lateral rotation of the shoulder deformity: Waiter’s tip deformity
70
Klumpke’s Palsy:
nerve roots: C8-T1 MOI: Stretching of arm overhead loss of movements: Paralysis of the intrinsic of the hand deformity: Claw hand

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