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Second Developmental Exam > Adolescence & Scoliosis > Flashcards

Adolescence & Scoliosis Flashcards

1
Q

What ages are considered Adolescence? Which are young adulthood?

A

Adolescence= 11 to 18 yrs while Young Adulthood= 18- 22/25 years

In contrast to Erik’s where Adolescence is 12-19 (identity vs confusion)

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2
Q

When does the adolescent period begin and end?

A

Begins with sexual maturity and ends with cessation of growth

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3
Q

What is Pre-adolescence marked by and when does it occur in females and males?

A

Marked by rapid physical growth and development of secondary sex characteristics

Females: 8-10 yrs
Males: 9-11 yrs

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4
Q

Puberty occurs due to….

A

Gonadal hormone changes

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5
Q

Puberty ends with the onset of menses. What are the sex differences?

A

Females: menarche at 12-13 yrs
Males: production of sperm

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6
Q

What are the 4 major changes in puberty

A
  1. Development of primary sex characteristics (sex organs)
  2. Development of secondary sex characteristics (hair, hips, voice change, etc)
  3. Rapid physical growth (height and weight)—PTs need to be careful
  4. Changes in body proportions
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7
Q

Factors that affect timing of puberty

A

Genetics, stress, SES, environmental toxins, nutrition/diet/exercise, amount of body fat/body weight, and chronic illness

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8
Q

What are differences that can be expected in female athlete puberty?

A
  1. delayed menarche
  2. menstruation irregularities
    - first ovulatory cycle occurs after menarche
    - pubertal maturation: establishment of cyclic ovarian function
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9
Q

What is the phase in development with the most rapid growth? What is the second?

A

Prenatal; puberty

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10
Q

What is the order of growth spurt?

A

Feet —> legs —> trunk

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11
Q

When is the typical growth spurt for females and males?

A

Female: 12-14
Male:14-15

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12
Q

When are females and males typically done growing?

A

Female: 16-17
Male: 18-20

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13
Q

What is the expected amount of gain in height and weight for males and females during puberty?

A

Height:
Female: 2-8 in
Male: 4-2 in

Weight:
Female and Male: 15-65

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14
Q

What are changes in body proportions that occur in puberty? Adolescence?

A

Puberty:
1. Nose reaches adult size first
2. Hands and feet reach adult size before arms and legs
3. LE become longer than trunk
4. Bones grow faster than muscles —> motor awkwardness

Adolescence:
1. Growth slows down
2. Body proportions are similar to adults
3. Permits adolescents to stabilize the organization of different muscular patters —> improved coordination

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15
Q

When is skeletal maturity achieved?

A

When the epiphyseal plates close

(Begins in childhood with cranial bones (2 yrs) and vertebral arches (1 yr) and lumbar spine (6 yrs))

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16
Q

What are features of bone that is immature through much of adolescence? How can you indicate when it is mature?

A

More porous, thick periosteum, unstable phases

compare ossification amount on x-rays with standards

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17
Q

Muscle mass increases before the body grows, and there is an increase in muscle size, strength, and endurance during adolescence. Muscle mass increase is directly related to what? When is adult muscle diameter reached?

A

Increase in strength; early teens (12-15 yrs)

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18
Q

While strength increases linearly with age from childhood through adolescence, what is the sex differences that occurs during puberty?

A

Females level off after 15 while Males accelerate between 13-20 years

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19
Q

What is the Cardiopulmonary system like at rest vs during acute exercise in adolescence?

A

At rest:
Pulse rate: 60-90 bpm
RR: 16-24 breaths/min
Increase in heart size and blood volume
Increase weight and volume of lungs

During acute exercise:
HR is higher during submax and max exercise
Stroke volume is lower
Adjusted for mass, Cardiac output is higher in children and teens
BP is lower at rest

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20
Q

How is temperature regulation different in adolescents?

A

Greater SA:body mass ratio —> produce more metabolic heat/mass unit during PA
+ lower sweating capacity (fewer sweat glands)

Therefore, at risk for heat-related injuries at high temps & increased heat loss risk at low temps

21
Q

Social antagonism develops in puberty. What is it?

A

Need for privacy, resent supervision and directions, struggle for independence, wish to be free from restrictions/parental controls

22
Q

Psychosocial development of young teens (13-14 yrs)

A

Most self-centered, seem from their POV
Value peer opinions with the stereotypical adolescent preoccupations

23
Q

Psychosocial development of middle teens (15-16 years)

A

Better at compromising, more tolerant of others’ views
Think more independently and make more of own decisions
Risk-taking behaviors (with focus on the present and denial of consequences)
Dating begins around 15-16 yrs

24
Q

Psychosocial development of late teens (17-18 yrs)

A

Develop a sense of seriousness
Ends when they take on adult work roles, marry, or become parents

25
Q

Cognitive Development of 11-14 years olds

A

Increasingly capable of thinking hypothetically, applying formal logic, and using abstract concepts
- more relative
- more self-reflective
- capable of considering an extended time perspective

26
Q

Perceived ______ from parents and peers is associated with adolescent self-esteem

A

Support

27
Q

Stats about sexuality in adolescence

A

48% have had sexual intercourse by end of high school
57% condom use

28
Q

What increases the risk of injury in adolescent athletes?

A
  1. Sport specialization (neuromuscular control improvs when adolescence play multiple sports
  2. Rapid growth spurts and change in body proportions (decreased coordination)
  3. Increased training volume (training several hrs each week and year round)
29
Q

What is RED-S? And what are the PT implications?

A

RED-S= relative energy deficiency in sport
- insufficient caloric intake and/or excessive energy expenditure leading to inadequate energy to support the body’s physiological functions

PT implications:
1. Decreased muscular strength and endurance performance
2. Chronic fatigue
3. Bone loss —> increased risk of stress fractures
4. Psychological stress, depression, and anxiety

30
Q

What is an ACL injury? What are PT implications?

A

ACL (anterior cruciate ligament) resists anterior translation of ulna and injury is typically use to rapid change in direction or during non-contact situations (landing from a jump, quick twisting motion)
- more common in female athletes

PT implications:
- In pediatrics, ACL commonly occurs with fracture of growth plate (close at 13-15 for females and 15-17 for males)
- increased risk of osteoarthritis later in life

31
Q

What does rehab look like for ACL injuries?

A

Early on: ROM and mobility
Gradually progress to strengthening, endurance, & neuromuscular training (hamstrings & gluteals)
Later on: sports-specific activities

32
Q

ATNR that continues past 9 months can lead to…

A

Poor eye tracking, difficult crossing visual midline, difficulty learning to read/tell time/left-right confusion, and could case spinal deformities

33
Q

What are the tests for ATNR?

A

Test 1:
Have patient stand facing therapist with arms and hands straight out in front of them and have the patient hold that position and turn their head to the side

Look for: patient should be able to move their head only and look for elbows bending or shoulder turning towards the direction of the head turn

Test 2: have the person quadruped with their head straight out looking at the floor and have them look to one side while keeping their neck and arms straight

Look for: elbows bending and body shifting from side to side

34
Q

How do you test if patient has STNR reflex?

A
  1. Have the patient get down in quadruped and have their neck straight with their body slightly forward enough to put weight on their hands.
  2. Ask the patient to lower head (chin to chest) for 7 seconds.
  3. Then, raise their head up towards their back
  4. Repeat 3 times

Look for: back trying to arch up, arms bending, body weight shifting toward their legs when head goes up

35
Q

How do you test if patient has STNR reflex?

A
  1. Have the patient get down in quadruped and have their neck straight with their body slightly forward enough to put weight on their hands.
  2. Ask the patient to lower head (chin to chest) for 7 seconds.
  3. Then, raise their head up towards their back
  4. Repeat 3 times

Look for: back trying to arch up, arms bending, body weight shifting toward their legs when head goes up

36
Q

STNR that hasn’t integrated after 11 months can lead to..

A

Poor posture,
poor hand-eye coordination,
poor focusing difficulties,
difficulty sitting still in a desk, learning to swim, and any sports that involve a ball

37
Q

How to determine dominant hand, eye, and leg?

A

Dominant Hand: writing/catching a ball (emerge around 3 but by 5 it should be established)

Dominant Eye: small triangle with object and take turn closing 1 eye (emerge around 3 yrs)
— typically correlates with hand dominance

Dominant Leg: tell by standing on 1 leg, kick ball, or hop (may not have clear one that is stronger & coordinated)

38
Q

What is scoliosis?

A

Lateral curve of the spine

39
Q

What are the main types of Scoliosis?

A

Structural: 3D with spine rotating and curving to side (typically spinal deformity, Cerebral Palsy, etc.)
Nonstructural: 2D with side-to-side curve (caused by variety of factors)

40
Q

What is Idiopathic Adolescent Scoliosis (AIS)?

A

Pediatric; suddenly have it

41
Q

What plane(s) of motion does scoliosis affect?

A

Transverse and coronal

42
Q

What bony and body landmarks does a practitioner look at and compare when examining a patient for scoliosis?

A

Adam’s forward bend test (rib hump)
Shoulders
Ears
Hips
Arm/trunk gap

43
Q

When should AIS be screened for?

A

Typically middle school
Females: 10-12
Males: 13-14

44
Q

When should a patient be referred to a pediatrician for scoliosis?

A

Cobb angle> 10 degrees

45
Q

Naming Conventions for scoliosis

A
  1. Region (lumbar/thoracic)
  2. Peak/convex side (left/right)
  3. If multiple, named after bigger
46
Q

Factors that influence plan on care for AIS

A

Compliance, severity, riser sign (skeletal maturity), age, sex

47
Q

PT plan for AIS

A

Strengthen long side and stretch short side

48
Q

When is orthotic intervention typically referred for patient with scoliosis?

A

Children with curves between 25-45 degrees

49
Q

When is surgical intervention typically considered for scoliosis?

A

45-50+ degrees if adolescent and orthotics aren’t working

Second Developmental Exam (5 decks)

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