class 6: peds Flashcards
1
Q
what is APGAR Score
A
a clinical assessment that evaluates a newborn’s health shortly after birth
2
Q
what are the 5 categories of the APGAR score
A
apperence
pulse
grimace
activity
respiration
3
Q
appearance - 0
A
blue
4
Q
appearance - 1
A
blue extremities
5
Q
appearance - 2
A
no blue
6
Q
pulse - 0
A
absent
7
Q
pulse - 1
A
<100
8
Q
pulse - 2
A
100 -140
9
Q
grimace - 0
A
no response
10
Q
grimace - 1
A
grimace
11
Q
grimace - 2
A
cry or withdrawal
12
Q
activity (muscle tone) - 0
A
flaccid
13
Q
activity (muscle tone) - 1
A
some flexion
14
Q
activity (muscle tone) - 2
A
active motion in the muscles
15
Q
respiration - 0
A
absent
16
Q
respiration - 1
A
cry
hypoventilationn
17
Q
respiration - 2
A
strong cry
18
Q
when is APGAR checked
A
1 min
no normal - 5 mins
not normal - 10 min
19
Q
Month 3
A
● Prone on elbows
● Can lift head in prone
● Belly crawl (3-9 mo)
20
Q
what is normal on APGAR
A
8-10
21
Q
Months 3 - 4
A
● Supine to sidelying
22
Q
Months 5 - 6
A
● Prone to supine
● Pull to sit without head lag
● Sitting with UE support
● Feet to mouth
23
Q
Months 6 - 7
A
● Supine to prone
● Quadruped
● Independent ring
sitting
● Transfers objects
between hands
● Trunk rotation in
sitting
24
Q
Months 9-10
A
● Quadruped creeping
● Cruises to sideways
● Plantigrade, pulls to stand
● Improving grasping skills,
pincer, three jaw chuck
(10 mo)
25
Months 10 - 15
● Begins to walk unassisted
● Transitions in and out of
squatting (10 mo)
● Controls grasp AND
release
● Stacks two cubes
26
Crawling
army crawl, on belly
27
Creeping-
quadruped
28
poem for children
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.
29
Integrated:
When the reflex disappears to allow for normal development
30
Persistent:
A reflex that has not integrated and indicative of central nervous
system (CNS) dysfunction
31
onset of flexor withdrawl
28 weeks gestation
32
what is the stimulus for flexor withdrawl
Noxious stimulus (pinprick) to
sole of foot
33
integrated of flexor withdrawl
1-2 months
34
what is the normal response to flexor withdrawl
Toes extend, foot dorsiflexes, LE
flexes uncontrollably
35
onset of Crossed Extension
28 weeks gestation
36
intrgration of Crossed Extension
1-2 months
37
Crossed Extension stimulation
Noxious stimulus to ball of foot
of LE fixed in extension
38
onset Rooting
28 weeks gestation
39
Crossed Extension response
Opposite LE flexes, then adducts
and extends
40
intregrated rooting
3 months
41
rooting stimulus
Stroking the side of baby’s
cheek
42
rooting response
Head turns toward stimulus and
mouth opens
43
Traction onset
28 weeks’ gestation
44
Traction intregration
2-5 months
45
traction stimulus
Grasp forearm and pull up from
supine into sitting position
46
traction response
Grasp and total flexion of the UE
47
what is onset of Asymmetrical Tonic Neck
(ATNR)
birth
48
when is integration of Asymmetrical Tonic Neck
(ATNR)
4-6 months
49
Asymmetrical Tonic Neck
(ATNR) stimulus
Rotation of the head to one side
50
Asymmetrical Tonic Neck
(ATNR) response
Flexion of skull limbs, extension of
the jaw limbs, “bow and arrow”
posture
51
do you have reflex before cortex input
yes
52
Palmar Grasp onset
birth
53
Palmar Grasp intergated
4-6 months
54
what comes first in childeren general movement or localized movement
generalized big movement
55
Palmar Grasp stimulus
Maintained pressure to palm
of hand
56
Palmar Grasp response
Maintained flexion of fingers
57
do infants have flexore or extensor tone first
flexor tone - this is seen when babies are on their back (first)
extensor tone is seen when babies start to move against gravity
58
Moro onset
28 weeks gestation
59
MORO intregrated
5-6 months
60
to babies develope in caudal to cephalic development or the other way
cephalic to caudal
babies develop more control in their upper body before their lower body
61
do babies develope proximal or distally first
proximal to distal
62
what does cephalic mean
head
63
what does caudal
tail
64
what is the stimulus for MORO reflex
Drop patient backward from
sitting position
65
what is the response for the moro reflex
Extension, abduction of UEs, hand
opening and crying followed by flexion,
adduction of arms across chest
66
Symmetrical Tonic
Labyrinthine (TLR / STLR) onset
birth
67
TLR/ALTR Integrated:
6 months
68
when do we start to see belly crawl
3-9 months
69
Symmetrical Tonic
Labyrinthine (TLR / STLR) stimulus
Prone or supine position
70
Symmetrical Tonic
Labyrinthine (TLR / STLR) response
Prone: increased flexor tone of all limbs
Supine: increased extensor tone of all
limbs
71
Positive Supporting onset
birth
72
Positive Supporting intrgrated
6 months
73
Positive Supporting stimulus
Contact to the ball of the
foot in upright standing
position
74
Positive Supporting response
Rigid extension (co-contraction) of the LEs
75
Plantar Grasp onset
28 weeks
76
plantar grasp intregrated
9 months
77
plantar grasp stimulus
Maintained pressure to
ball of foot under toes
78
plantar grasp response
Maintained flexion of toes
79
Symmetrical tonic
neck (STNR) stimulus
Flexion or extension of
the head
80
Symmetrical tonic
neck (STNR) response - head flexion
flexion of UEs,
extension of LEs
81
Symmetrical tonic
neck (STNR) response - head extension
extension of UEs,
flexion of LEs
82
what can a baby start s to creep
9-10 months
83
when can a baby start to walk unassisted
10-15 months
84
Classification of Cerebral Palsy - Spastic:
Velocity dependent resistance of a muscle to stretch
̶Synergy patterns, contractures, crouched gait, toe walking
85
Classification of Cerebral Palsy: Ataxia
Disorder of coordination, force, and timing, associated with
cerebellar involvement
̶Floppy baby/low tone, tremor, poor balance, wide BOS, nystagmus
86
Classification of Cerebral Palsy-
Dyskinetic:
Disorder of basal ganglia, characterized by involuntary
movements that are slow and writhing
̶Poor stability, hand tremor, fluctuating tone, hypo becomes hyper
87
Gross Motor Classification of CP - level 1
Patient will walk without restrictions but will have limitations in more
advanced gross motor skills.
88
Gross Motor Classification of CP - level 2
Patient will walk without assistive device with limitations in walking
outdoors and in the community.
89
Gross Motor Classification of CP - level 3
Patient will walk with assistive device with limitations in walking
outdoors and in the community.
90
Gross Motor Classification of CP - level 4
Patient self mobility will be severely limited; children are transported
or use power mobility outdoors and in the community.
91
Gross Motor Classification of CP - level 5
Patient self mobility will be severely limited, even with the use of
assistive technology, requires caregiver.
92
what is Plagiocephaly
when a baby develops a flat spot on one side of the head or the whole back of the head.
93
what is Plagiocephaly 2/2
Results from prolonged asymmetrical
pressure on the premature skull
94
with Plagiocephaly what does we see at the back of the head
Occipitoparietal flattening and contralateral occipital bossing
95
with Plagiocephaly what do we see at the front of the head
Ipsilateral frontal bossing and anterior displacement of the ear
96
what is Torticollis?
torticollis occurs when your baby's neck muscles cause their head to twist and tilt to one side
97
what is down syndrmoe 2/2
Results from presence of full or partial extra copy of the 21st
chromosome; trisomy 21
98
in early gait what do the babies feet look like
they are pronated
99
what neck movement should be avoid in children with down syndrome
* Forceful neck flexion and rotation activities should be limited due
to laxity of odontoid ligament and potential for a subluxation of
atlanto-axial joint
100
at what age do we want to see the babinski relfex to
12 months
baby - up
adult - down
101
poeple with down syndrome have decreased strength of what
Decreased quadriceps and hip abductor strength
102
what is Duchenne Muscular Dystrophy seen in what popiulation
X-linked recessive, inherited by boys
Dystrophin gene missing – destruction of muscles’ cells
103
what are the intervention for Duchenne Muscular Dystrophy
* Maintain mobility as long as possible
* Maintain joint ROM with active/passive
* DO NOT OVER FATIGUE
104
what is athetosis
slow writhing movements
105
what is graves disease
n autoimmune disorder that causes the thyroid gland to produce too much thyroid hormone, leading to hyperthyroidism
bluging eyes
106
what is Scheuermann Disease
a condition affecting the upper back (thoricic) that makes it rounded so it looks hunched over.
107
what pop is Scheuermann Disease seen in
male teens
108
exam finding with Scheuermann Disease
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
109
what muscle is effected in torticollis
the SCM
110
what is the intervention for Scheuermann Disease
The Schroth Method, stretch pecs, strengthen thoracic
extensors and scapular stabilizers
111
what do we name the torticollis for
the side the SCM impacted
112
what side do we name Plagiocephaly for
the flat side
113
what is the position that we hold the baby in to fix torticollis
football hold
ear down on the side that is effected to get a stretch in this area
114
Erb’s palsy is effecting what nerve roots
c5 - c6
115
Erb’s palsy - MOI
Stretching head downward
during birth
116
Erb’s palsy - loss of movement
Loss of abduction and
lateral rotation of the shoulder
117
Erb’s palsy - deformity
Waiter’s tip
deformity
118
Klumpke’s palsy - effecting what nerve root levels
C8-T1
119
Klumpke’s palsy - MOI
Stretching of arm
overhead
during birth
120
Klumpke’s palsy - loss of movement
Paralysis of the
intrinsic of the
hand
121
Klumpke’s palsy - deformity
Claw hand
122
what is one of our first treatment for plageocephly
tummy time
helment - 23 hours a day (all times)
123
what is cerebral palsy
Cerebral palsy is a group of conditions that affect movement and posture.
It's caused by damage that occurs to the developing brain, most often before birth
124
are patient with duchennes muscle dystrophy hyper or hypotonic
normally hypotonic
125
what is gower's sign
seen with duchennes muscle dystrophy
quad postion and then walking up you leg to assume standing position
126
what are scholres nodes
end plates cracks
bulge (protrusion) of the jelly-like contents of the vertebral disc into the growth cartilage of bone (vertebra) above or below the disc
