19-Pediatrics Flashcards
What reflexes are present at birth?
- Blink reflex
- Rooting reflex
- Normal suck reflex
- Grasp reflex
- Moro reflex
What is the Rooting reflex?How is it elicited?
When the cheek is brushed or stroked, a newborn infant turns the head in the direction where the cheek near the corner of the mouth is brushed in preparation to find food . This reaction serves to help a newborn find food
What does the Moro reflex demonstrate? How to perform the test?
(aka STARTLE reflex) symmetry and overall vigor ; To elicit this reflex, the infant is held in the supine position with the head supported by the examiner’s hand and the head is then suddenly allowed to drop. In response, the infant will abduct and extend the arms, open the hands, and then adduct the arms and flex the elbows. A bilaterally absent Moro reflex indicates brain injury (e.g., birth asphyxia, intracranial hemorrhage). A unilaterally absent Moro reflex indicates ipsilateral brachial plexus injury or ipsilateral clavicle fracture
What does the absence of the moro reflex in one arm indicate?
a fractured humerus
brachial nerve palsy
or fractured clavicle
What does the absence of the moro reflex in one leg indicate?
lower spinal injury
myelomeningocele
avulsion of the cord
dislocated hip
what does a hyperactive moro reflex indicate?
tetany or CNS infection
when should moro reflex disappear?
by the 5th month
when should the babinski reflex disappear?
age 1-2 years
what is a positive babinski test in a bay?
dorsiflexing of the hallux; spreading of the lesser digits (Normal babinski should be down-going toes in adults)
Developmental milestone age for crawling?
age: 3-5 months
Developmental milestone age for creeps?
age: 7-9 months
Developmental milestone age for standing?
age: 9-14 months
Developmental milestone age for cruising?
age: 9-12 months
Developmental milestone age for walking?
average is 13 months (between 7-18 months)
at what age range is the flatfoot normal until?
until age 6-7 years
*calcaneal eversion should reduce approx. 1 deg per year
what is the most commonly encountered congenital deformity?
congenital calcaneovalgus (FLEXIBLE deformity) (dorsal surface of the foot is in contact with the anterior surface of the lower leg) *this is correctable with gradual and persistent casting
what is the congenital rigid flatfoot called?
convex pes planovalgus (vertical talus)
what is the radiographic hallmark of convex pes planovalgus?
dorsal dislocation of the navicular on the talar head and neck
(in congenital calcaneovalgus, the navicular is lateral to the talus)
what is the most common complication seen with correction of juvenile bunion?
shortening of the 1st metatarsal as a result of growth interruption of the physis from base wedge osteotomies of epiphysiodesis
what age do the sesamoids appear?
age 12
what age does the growth plates close in the leg/foot?
age 15-17
which bones ossify before birth?
calcaneus, talus
what is the last bone to ossify before birth?
cuboid
“cute boy at birth”
what is Kohler’s disease?
osteochondritis of the navicular bone
