class 6: peds Flashcards

1
Q

what is APGAR Score

A

a clinical assessment that evaluates a newborn’s health shortly after birth

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2
Q

what are the 5 categories of the APGAR score

A

apperence

pulse

grimace

activity

respiration

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3
Q

appearance - 0

A

blue

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4
Q

appearance - 1

A

blue extremities

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5
Q

appearance - 2

A

no blue

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6
Q

pulse - 0

A

absent

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7
Q

pulse - 1

A

<100

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8
Q

pulse - 2

A

100 -140

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9
Q

grimace - 0

A

no response

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10
Q

grimace - 1

A

grimace

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11
Q

grimace - 2

A

cry or withdrawal

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12
Q

activity (muscle tone) - 0

A

flaccid

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13
Q

activity (muscle tone) - 1

A

some flexion

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14
Q

activity (muscle tone) - 2

A

active motion in the muscles

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15
Q

respiration - 0

A

absent

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16
Q

respiration - 1

A

cry
hypoventilationn

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17
Q

respiration - 2

A

strong cry

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18
Q

when is APGAR checked

A

1 min

no normal - 5 mins

not normal - 10 min

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19
Q

Month 3

A

● Prone on elbows
● Can lift head in prone
● Belly crawl (3-9 mo)

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20
Q

what is normal on APGAR

A

8-10

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21
Q

Months 3 - 4

A

● Supine to sidelying

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22
Q

Months 5 - 6

A

● Prone to supine

● Pull to sit without head lag
● Sitting with UE support
● Feet to mouth

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23
Q

Months 6 - 7

A

● Supine to prone
● Quadruped
● Independent ring
sitting
● Transfers objects
between hands
● Trunk rotation in
sitting

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24
Q

Months 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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25
Q

Months 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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26
Q

Crawling

A

army crawl, on belly

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27
Q

Creeping-

A

quadruped

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28
Q

poem for children

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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29
Q

Integrated:

A

When the reflex disappears to allow for normal development

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30
Q

Persistent:

A

A reflex that has not integrated and indicative of central nervous
system (CNS) dysfunction

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31
Q

onset of flexor withdrawl

A

28 weeks gestation

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32
Q

what is the stimulus for flexor withdrawl

A

Noxious stimulus (pinprick) to
sole of foot

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33
Q

integrated of flexor withdrawl

A

1-2 months

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34
Q

what is the normal response to flexor withdrawl

A

Toes extend, foot dorsiflexes, LE
flexes uncontrollably

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35
Q

onset of Crossed Extension

A

28 weeks gestation

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36
Q

intrgration of Crossed Extension

A

1-2 months

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37
Q

Crossed Extension stimulation

A

Noxious stimulus to ball of foot
of LE fixed in extension

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38
Q

onset Rooting

A

28 weeks gestation

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38
Q

Crossed Extension response

A

Opposite LE flexes, then adducts
and extends

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39
Q

intregrated rooting

A

3 months

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40
Q

rooting stimulus

A

Stroking the side of baby’s
cheek

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41
Q

rooting response

A

Head turns toward stimulus and
mouth opens

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42
Q

Traction onset

A

28 weeks’ gestation

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43
Q

Traction intregration

A

2-5 months

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44
Q

traction stimulus

A

Grasp forearm and pull up from
supine into sitting position

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45
Q

traction response

A

Grasp and total flexion of the UE

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46
Q

what is onset of Asymmetrical Tonic Neck
(ATNR)

A

birth

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47
Q

when is integration of Asymmetrical Tonic Neck
(ATNR)

A

Asymmetrical Tonic Neck
(ATNR)

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48
Q

Asymmetrical Tonic Neck
(ATNR) stimulus

A

Rotation of the head to one side

49
Q

Asymmetrical Tonic Neck
(ATNR) response

A

Flexion of skull limbs, extension of
the jaw limbs, “bow and arrow”
posture

50
Q

do you have reflex before cortex input

A

yes

51
Q

Palmar Grasp onset

A

birth

52
Q

Palmar Grasp intergated

A

4-6 months

53
Q

what comes first in childeren general movement or localized movement

A

generalized big movement

54
Q

Palmar Grasp stimulus

A

Maintained pressure to palm
of hand

55
Q

Palmar Grasp response

A

Maintained flexion of fingers

56
Q

do infants have flexore or extensor tone first

A

flexor tone - this is seen when babies are on their back (first)

extensor tone is seen when babies start to move against gravity

57
Q

Moro onset

A

28 weeks gestation

58
Q

MORO intregrated

A

5-6 months

59
Q

to babies develope in caudal to cephalic development or the other way

A

cephalic to caudal

babies develop more control in their upper body before their lower body

60
Q

do babies develope proximal or distally first

A

proximal to distal

61
Q

what does cephalic mean

A

head

62
Q

what does caudal

A

tail

63
Q

what is the stimulus for MORO reflex

A

Drop patient backward from
sitting position

64
Q

what is the response for the moro reflex

A

Extension, abduction of UEs, hand
opening and crying followed by flexion,
adduction of arms across chest

65
Q

Symmetrical Tonic
Labyrinthine (TLR / STLR) onset

A

birth

66
Q

TLR/ALTR Integrated:

A

6 months

67
Q

when do we start to see belly crawl

A

3-9 months

68
Q

Symmetrical Tonic
Labyrinthine (TLR / STLR) stimulus

A

Prone or supine position

69
Q

Symmetrical Tonic
Labyrinthine (TLR / STLR) response

A

Prone: increased flexor tone of all limbs

Supine: increased extensor tone of all
limbs

70
Q

Positive Supporting onset

A

birth

71
Q

Positive Supporting intrgrated

A

6 months

72
Q

Positive Supporting stimulus

A

Contact to the ball of the
foot in upright standing
position

73
Q

Positive Supporting response

A

Rigid extension (co-contraction) of the LEs

74
Q

Plantar Grasp onset

A

28 weeks

75
Q

plantar grasp intregrated

A

9 months

76
Q

plantar grasp stimulus

A

Maintained pressure to
ball of foot under toes

77
Q

plantar grasp response

A

Maintained flexion of toes

78
Q

Symmetrical tonic
neck (STNR) stimulus

A

Flexion or extension of
the head

79
Q

Symmetrical tonic
neck (STNR) response - head flexion

A

flexion of UEs,
extension of LEs

80
Q

Symmetrical tonic
neck (STNR) response - head extension

A

extension of UEs,
flexion of LEs

81
Q

what can a baby start s to creep

A

9-10 months

82
Q

when can a baby start to walk unassisted

A

10-15 months

83
Q

Classification of Cerebral Palsy - Spastic:

A

Velocity dependent resistance of a muscle to stretch

̶Synergy patterns, contractures, crouched gait, toe walking

84
Q

Classification of Cerebral Palsy: Ataxia

A

Disorder of coordination, force, and timing, associated with
cerebellar involvement

̶Floppy baby/low tone, tremor, poor balance, wide BOS, nystagmus

85
Q

Classification of Cerebral Palsy-
Dyskinetic:

A

Disorder of basal ganglia, characterized by involuntary
movements that are slow and writhing

̶Poor stability, hand tremor, fluctuating tone, hypo becomes hyper

86
Q

Gross Motor Classification of CP - level 1

A

Patient will walk without restrictions but will have limitations in more
advanced gross motor skills.

87
Q

Gross Motor Classification of CP - level 2

A

Patient will walk without assistive device with limitations in walking
outdoors and in the community.

88
Q

Gross Motor Classification of CP - level 3

A

Patient will walk with assistive device with limitations in walking
outdoors and in the community.

89
Q

Gross Motor Classification of CP - level 4

A

Patient self mobility will be severely limited; children are transported
or use power mobility outdoors and in the community.

90
Q

Gross Motor Classification of CP - level 5

A

Patient self mobility will be severely limited, even with the use of
assistive technology, requires caregiver.

91
Q

what is Plagiocephaly

A

when a baby develops a flat spot on one side of the head or the whole back of the head.

92
Q

what is Plagiocephaly 2/2

A

Results from prolonged asymmetrical
pressure on the premature skull

93
Q

with Plagiocephaly what does we see at the back of the head

A

Occipitoparietal flattening and contralateral occipital bossing

94
Q

with Plagiocephaly what do we see at the front of the head

A

Ipsilateral frontal bossing and anterior displacement of the ear

95
Q

what is Torticollis?

A

torticollis occurs when your baby’s neck muscles cause their head to twist and tilt to one side

96
Q

what is down syndrmoe 2/2

A

Results from presence of full or partial extra copy of the 21st
chromosome; trisomy 21

97
Q

in early gait what do the babies feet look like

A

they are pronated

98
Q

what neck movement should be avoid in children with down syndrome

A
  • Forceful neck flexion and rotation activities should be limited due
    to laxity of odontoid ligament and potential for a subluxation of
    atlanto-axial joint
99
Q

at what age do we want to see the babinski relfex to

A

12 months

baby - up

adult - down

100
Q

poeple with down syndrome have decreased strength of what

A

Decreased quadriceps and hip abductor strength

101
Q

what is Duchenne Muscular Dystrophy seen in what popiulation

A

X-linked recessive, inherited by boys

Dystrophin gene missing – destruction of muscles’ cells

102
Q

what are the intervention for Duchenne Muscular Dystrophy

A
  • Maintain mobility as long as possible
  • Maintain joint ROM with active/passive
  • DO NOT OVER FATIGUE
103
Q

what is athetosis

A

slow writhing movements

104
Q

what is graves disease

A

n autoimmune disorder that causes the thyroid gland to produce too much thyroid hormone, leading to hyperthyroidism

bluging eyes

105
Q

what is Scheuermann Disease

A

a condition affecting the upper back (thoricic) that makes it rounded so it looks hunched over.

106
Q

exam finding with Scheuermann Disease

A

Schmorl’s Nodes and angled/wedged t/s
* Pain with thoracic extension and rotation

  • Aggravation with long periods of standing/sitting or physical activity
  • Increased thoracic kyphosis & lumbar lordotic curve
107
Q

what muscle is effected in torticollis

A

the SCM

108
Q

what is the intervention for Scheuermann Disease

A

The Schroth Method, stretch pecs, strengthen thoracic
extensors and scapular stabilizers

109
Q

what do we name the torticollis for

A

the side the SCM impacted

110
Q

what side do we name Plagiocephaly for

A

the flat side

111
Q

what is the position that we hold the baby in to fix torticollis

A

football hold

ear down on the side that is effected to get a stretch in this area

112
Q

Erb’s palsy is effecting what nerve roots

A

c5 - c6

113
Q

Erb’s palsy - MOI

A

Stretching head downward

during birth

114
Q

Erb’s palsy - loss of movement

A

Loss of abduction and
lateral rotation of the shoulder

115
Q

Erb’s palsy - deformity

A

Waiter’s tip
deformity

116
Q

Klumpke’s palsy - effecting what nerve root levels

A

C8-T1

117
Q

Klumpke’s palsy - MOI

A

Stretching of arm
overhead

during birth

118
Q

Klumpke’s palsy - loss of movement

A

Paralysis of the
intrinsic of the
hand

119
Q

Klumpke’s palsy - deformity

A

Claw hand