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Early development > Child development > Flashcards

Child development Flashcards

1
Q

What are the 4 parts of the embryo in the dorsal view at 4 weeks

A

Future forebrain (prosencephalon)

Future midbrain (mesencephalon)

Future hindbrain (rhombencephalon)

Future spinal cord

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2
Q

Using the side view at 4 weeks of life, what are the 3 flexures

A

Cephalic

Pontine

Cervical

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3
Q

At 5 weeks, what can be seen

A

Fore - telencephalon and diencephalon

Mid

Hind - pons and medulla

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4
Q

What can you see at 8 weeks

A

Hemispheres and ventricles 3 and 4 developing

Cerebellum developing

Aqueduct developing

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5
Q

What do you see at term

A

Fully developed:

Cortex
Ventricular system
Aqueduct
Cerebellum
Pons
Medulla

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6
Q

What is the grey matter in the anterior section of the cord responsible for

A

Motor neurones

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7
Q

Where do the nerves in the pyramidal tract supply

A

They supply the sacral, lumbar, thoracic and cervical nerves in the lateral corticospinal tract

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8
Q

What are the extrapyramidal tracts responsible for

A

Co-ordination of lumens
Regulation of posture and balance

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9
Q

Components of the reflex arc

A

Starts with a sensory receptor responding to a stimulus by producing a generator or receptor potential

Moves across dorsal part of spine through the sensory neurones (axon conducts impulses from receptor to integrating centre)

Connects to interneuron and integrating centre (one or more regions within the CNS that relay impulses from sensory to motor neurones)

Then through motor neurones (axon that conducts impulses from integrating centre to effector)

Effector (muscle or gland that responds to motor nerve impulses)

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10
Q

Primitive reflex - moro reflex?

A

Extension, abduction and adduction

28-32 weeks gestation

Should disappear between 3-6 months or could be a sign of impaired development if it doesn’t

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11
Q

Standing primitive reflex?

A

Present at 3 months

Extension of lower extremities
Hip[s are slightly flexed and somewhat behind shoulder
Head free to turn

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12
Q

Grasp primitive reflex?

A

When object placed in palm of new-born hand, fingers grasp very tightly

Stroke on the lateral side of the fingers will open them again

Reflexes are replaced between 6-9months with voluntary movement of hand as part of fine motor development

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13
Q

Protective reflexes / parachute reflexes

A

Developed between 6-9 months
When baby placed in forward tilting position, protects themselves with stretched arms

Also occurs when baby is placed on side ; sideway parachute reflex

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14
Q

What is development

A

Global impression of a child encompassing: growth, increase in understanding, acquisition of new skills and more sophisticated responses and behavior
Endows child with increasingly complex skills in order to function in society

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15
Q

What are the 4 domains of developmental assessment

A

Gross motor skills - position, head lag, sitting, walking and running

Fine motor skills - use of hands, grasp and fine pincer, bricks, crayon and puzzles

Speech and language skills - vocalization, words, understanding and imaginative play

Social skills - social interaction, stranger reaction, eating skills and dressing

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16
Q

What should the posture of a new born be like

A

Limited flexed, symmetrical posture lying down
Marked head lag on pulling up due immaturity of neck muscles

17
Q

How does a baby sit between 6 -8 weeks

A

Sits without support:

6: Round back
8: Straight back

18
Q

How does vision and fine motor change from 6 weeks to 4 months

A

Follows moving object or face by turning head

Reaches out for toys

19
Q

How does a baby’s grip change form 6 months to 8 months

A

Palmar grasp , inferior grasp - using whole hand

Transfers toys from one hand to another

20
Q

How does a babys grip change from 10months to 17 months

A

Mature pincer grip

Makes mark with crayon

21
Q

How does a newborns hearing compare to a 3-4month year old

A

Startles to loud noises

Vocalises alone or when spoken to, coos and laughs

22
Q

Normal motor development:
Pushes up on arms
Holds head up

A

Unable to lift head or push up on arms
Stiff extended legs
Pushing back with head
Constantly fisted hand and stiff leg on one side
Difficulty moving out of this position

23
Q

Sits with support
Holds head up
Rounded back

A

Unable to lift head
Floppy trunk
Stiff arms, extended legs

Arms flexed and held back
Stiff, crossed legs

24
Q

Sits without support
Arms free to reach and grasp

A

Rounded back
Por use of arms for play
Stiff legs, pointed toes

Poor head control
Difficulty getting arms forward
Arches back – stiff legs

Poor ability to lift head and back
Will not take weight on legs

25
Q

Pulls to stand

A

Not interested in weight bearing
Difficulty in pulling to stand
Stiff legs, pointed toes

Cannot crawl on hands and knees
May use only one side of body to move

26
Q

Independent standing or walking

A

Holds arm or both arms stiffly and bent
Excessive tiptoe gait

Sits with weight to one side
Uses predominantly one hand for play
One leg may be stiff

27
Q

What is the healthy child programme

A

Screening,
General examination and immunisation,
Health education /promotion

28
Q

Screening?

A

Hbopathy, rhesus, infection

US scan dating and nuchal (down syndrome)

US scan detailed

New-born bloodspot, hearing and physical

Physical examination

Vision

29
Q

Child health reviews

A

Birth visit

10-14 day visit

6-8 week review

first year review

two year review

30
Q

How to evaluate a child for abnormal development

A

History
Parental concern
Birth history
Family history

PMHX
Developmental history
Current skills

Examination
Developmental assessment, + general and neurological examinationa

Investigations – as appropriate

31
Q

How to approach a developmental assessment

A

Ask, observe and task

Need to assess
Milestones proceeding age
Expected milestones for age
Next important milestones

32
Q

What factors can influence developmental dealy

A

Ill health

Lack of physical / or psychological stimuli

Sensory / motor impairment

Reduced inherent potential

33
Q

What are the types of developomental delay

A

Global (all 4 domains)

Specific - language / motor / sensory / cognitive

34
Q

What are causes of global delay

A

Chromosomal abnormalities
e.g. Down’s syndrome, Fragile X

Metabolic
e.g. hypothyroidism, inborn errors of metabolism

Antenatal and perinatal factors
Infections, drugs, toxins, anoxia, trauma, folate def

Environmental-social issues

Chronic illness

35
Q

What are causes of motor delay

A

Cerebral palsy
Global delay eg Down’s syndrome
Congenital dislocation hip
Social deprivation
Muscular dystrophy-Duchenne’s
Neural tube defects: spina bifida
Hydrocephalus

36
Q

What are causes of language delay

A

Hearing loss
Learning disability
Autistic spectrum disorder
Lack of stimulation
Impaired comprehension of language
-Developmental dysphasia
Impaired speech production
-stammer, dysarthria

37
Q

What are commonly used assessment tools

A

Standardised tests „

Schedule of Growing Skills (II) „

Griffiths developmental scale „

Bailey developmental scale „

Denver developmental screening tests

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Early development (2 decks)

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