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D2 E1 Shea > Peds NEURO 1 - PE > Flashcards

Peds NEURO 1 - PE Flashcards

1
Q

Sx seen in 1st few months & DO NOT CHANGE over time

Congenital abnormalities or brain injury (cerebral palsy)

What type of sx?

A

STATIC

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2
Q

Sx due to degenerative disease or neoplasm

What type of sx?

A

Progressive

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3
Q

Epileptic or migraine syndromes

What type of sx?

A

INTERMITTENT

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4
Q

Bursts of symptoms followed by partial recovery

Vascular, demyelinating d/o

What type of Sx?

A

SALTATORY

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5
Q

What 6 components of the PE do you perform for pt with neuro sx?

A
  1. Hair, skin, teeth, nails
  2. Head circumference
  3. Fontanelles
  4. Ears, eyes
  5. Hands, feet
  6. Midline defects

“Has Harry Found Every Happy Moment?”

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6
Q

PE: Hair, skin, teeth, nails

_______&_______ have same embryonic origin

A

Brain & Skin have same embryonic origin

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7
Q

What do you monitor for during a head circumference check?

A

microcephaly/macrocephaly

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8
Q

T/F: You plot head circumference on a growth curve

A

TRUE

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9
Q

What does an accelerating pattern on a growth curve indicate?

A

possible hydrocephalus

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10
Q

What does a decelerating pattern on a growth curve for head circumference indicate?

A

possible degenerative neurologic d/o

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11
Q

Define craniosynostosis

A

abnormal shape of the skull due to premature suture closure

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12
Q

Is this a normal or abnormal fonatanelle?

+/- slightly depressed and pulsatile

may slightly bulge when crying, vomiting

A

NORMAL

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13
Q

Is this a normal or abnormal fonatanelle? Where would you see this PE finding?

contstant bulging

A

infection or inc. ICP

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14
Q

Age of anterior and posterior fontanelle closure?

A

anterior: 2 yrs
posterior: 2 mos

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15
Q

What are the following cranial nerves responsible for?

CN I

CN II

A

CN I: smell

CN II: pupillary light reflex, visual acuity

_**ALWAYS CHECK RED REFLEX**_

WILL BE ON TEST

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16
Q

What are the following cranial nerves responsible for?

CN III, IV, VI (3, 4, 6)

A

Following objects, fixating, oculocephalic reflex, EOMs

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17
Q

CN V?

A

Sucking/swallowing, light touch

18
Q

CN VII?

A

Observe face at rest, crying/blinking

19
Q

CN VIII

A

HEARING

20
Q

CN IX, X

A

gag reflex, sucking, salivation

21
Q

CN XI

A

posture, spontaneous movement

22
Q

CN XII

A

tongue movement

23
Q

What 2 things should you look for on the hands during PE?

A

single crease in down syndrome

polydactyly

24
Q

What 4 primitive reflexes must be present in normal child development?

A

Moro: startle reflex

Grasp: put finger in hand, will grasp around finger

Rooting: tactile stimulation around mouth- will search for stimulus

Tonic neck

“My grandchild runs too”

25
Q

When do primitive reflexes usually disappear?

A

4-6 mos = normal maturation

26
Q

Asymmetry of primitive reflexes may indicate What 2 possibilities?

A

focal brain or PNS lesions

27
Q

Origination & termination of upper motor neurons?

A

Origin: motor region of cerebral cortex or brainstem

Termination: brainstem & spinal cord

28
Q

Origination & termination of lower motor neurons?

A

Origin: brainstem & spinal cord

Termination: skeletal muscle fibers

29
Q

Flaccid paralysis

Decreased tone

Absent DTRs

Profound muscle atrophy

Fasciculations present

May have sensory disturbances

Sx of lower or upper motor lesion?

A

Lower motor neuron lesion

30
Q

Spastic paralysis

•Increased tone

Increased DTRs/+Babinski (in older children, normal in infants); usually with clonus

Minimal muscle atrophy/strength loss

Fasciculations absent

May have sensory disturbances

Sx of lower or upper motor lesion?

A

Upper motor neuron lesion

31
Q

The following midline defects may indicate which condition?

Tufts of hair, lipomas, dimpling

A

spina bifida

32
Q

What are the indications of normal strength in infants & toddlers?

What are abnormalities?

A

Infants: symmetrical movements in supine position

Toddlers: reach high, run, walk, hop, climb stairs

_________________________________________________

Abnormalities:

LMN lesions: weakness

UMN lesions: stiffness

33
Q

What are the normal passive & active movements seen in tone (in infants)?

What are abnormalities?

A

Passive: some resistance to stretch normal

Active: posture adopted when placed in particular position

_____________________________________________

Abnormalities:

LMN lesions: decreased passive tone

UMN lesions: increased passive tone

34
Q

What 3 components are part of the motor evaluation of the PE?

A

Gait

Cerebellar function/coordination

Reflexes

35
Q

What are the normal gait findings in infants & toddlers?

A

infants: crawling

toddler: wide-based & unsteady; gradually closes until 6yrs

36
Q

What are normal Cerebellar Function/Coordination findings?

A

Finger to nose, rapid alternating movements, heel to shin

Heel toe walking

Exchange objects

37
Q

What are normal reflex findings?

A

Can elicit DTRs at almost any age

Babinski reflex:

Neonates- variable response

Older children- toes down is normal after 18 months

38
Q

What are the PE findings during the sensory evaluation of infants?

A

Light touch vs. pinprick

Stimulation = withdrawal of limb

39
Q

What are the PE findings during the sensory evaluation of older children?

A

Proprioception/vibration

Graphesthesia

Stereognosis

2-point discrimination

40
Q
A

D2 E1 Shea (13 decks)

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