Everything Pediatric ): Flashcards
What are Neural-Maturationist Theories
Functional behaviors develop with the nervous system = NATURE
WHat are cognitive theories
Environment derives development = NURTURE
What are the 3 stages of motor learning
Cognitve: Understanding
Assoicative: Fine tuning
Autonomous: automatic
What is the direction in the body of reflexes and motor development
Cephalcaudal (head and neck before trunk)
proximodistal (proximal control. before distal)
Reflex to voluntary
General to specific
What is a developmental spiral
REGRESS to previous developmental positioa n for higher gross motor task
Describe asymmetrical tonic neck reflex
“football throw” when head turned, arm + leg in front of head is extended and back arm is flexed
Birth to 4-6 months (first half of year)
If not integrated
- visual pursuit issues
- Rolling issues
- Crawling issues
- Skeletal deformities
Related to UE movement with head turn
Symmetrical tonic neck reflex
in quadruped, head ext means arms also ext and legs flex, and vice versa. Symmetrical b/c arms do the what head does on both sides. Legs do opposite on both sides.
6-12 months (second half of year)
If not integrated, then prone prop on arms, crawling + hand and knee position , sitting balance,
use of hands when looking at object
Tonic Labrinthine Reflex
More ext tone in supine
Flexion tone in prone
Birth to 6 month (first half of year)
Related to and would cause issues with beginner level transfers for babies (rolling, coming into sitting, prop on elbows, balance)
Grasp Reflex
Birth-6 months (first half of year)
Pressure to palm, fingers should curl
Related to WB on hands and grasping objects
Rooting reflex
Touch cheek, baby head should turn to that side
30 weeks gestation to 6 months (First half of year)
Related to oral development, social, visual, optic tracking
Galant Reflex
Stroke back causes curved hip and lateral trunk flexion on that side
30 weeks gestation to 2 - 9 months (long range)
If not integrated, it can lead to impaired sitting balance and scoliosis
Moro vs startle reflex
Allowing head to fall into extension
Fully horz abd then adducts arms
Moro: hands open
Startle (in response to noise, stimulus): hands closed
28 weeks gestation to 5 months (first half of year)
Related to Balance reactions, protective response, eye-hand coordination
Stepping/walking reflex
When placed on soles of feet supported, reciprocal knee bends should occur
30 weeks gestation to 2 months
Related to walking, balance, reciprocal gait
Landau Reflex
Head and feet up “superman”
3 months to 2 years (up to 2 years)
Related to neck, back, core muscle tone
Positive support reflex
Hold baby on balls of feet and they should stiffen their legs and trunk in extension
30 weeks gestation to 2 months (first quarter of year)
Relates to standing balance, walking, weight shift
Plantar grasp reflex
Stimulus of pressure at base of toes should cause toe flexion
30 weeks gestation to 9 months (long range 3 quarters of year)
Related to standing on feet, weight shifting
Gross motor milestones 3 month
Prone prop, hands to midline, open hands, can hold head in prone
(Basic lying transfers, prone everything, open hand)
4 months
Hold head w/o support, hold objects, put things in mouth
Improvement from 4 mo But nothing crazy
When does rolling occur
4-6 months
When does sitting and army crawl occur
6 - 9 months (using hands for support) for sitting, and crawl begins and gets better up to at 9 months
What occurs at 9 months
Able to pull to stand with support (maybe), sit w/o support, better with hands (e.g raking food, switching objects)
(makes sense because enaring time where walking occurs but not quite there)
What occurs around 10 -14 months
Walking started with supported, then independent, standing independent
Wlking avg age is 12 months=1 year
Pick food up to eat
15 months-17 months
More independent walking and eating, climbing stairs (not walking)
Different types types of crawling
Crawling is on belly (think army crawl)
Creeping is on hands and knees. Evidecnce on effects of crawling milestones limited
18-26 months and beyond to 3 years
Feed yourself, running, walk on stairs, jumping
2-3 years
Can balance on one stance leg, kick ball, run, tricycle , walk stairs, greater fine motor like twisting and turning pages
After 3, greater fine motor skills like eating with utensil and putting on clothes.
4-6 years
1 foot hopping (5 yo) , catching, skipping/gallop, hold writing utensil correctly
What is VP shunt failure
Shunt for csf
Sx
- Sunsetting eyes
- Flu symptoms
- Swelling redness around shunt
- Chnage in function
Medical Emergency
Tethered Cord
Cord folds wrong way
Sx
- Rapid scoliosis
- Change in urological function
- Back pain worsens
- Around growth spurt
Medical Emergency
Muscular Dystrophy
Signs
- Gowers sign
- Weak hip ext
- Tight hip flex, gastroc
- pesudohypertrophy of calves
- Lorddosis
Refer out
Juvenile Arthritis
- Joint Pain and Swelling
- Morning stiffness
- Weak
- Fatigue
- Delayed milestones
- Refer out
Spondylolisthesis
Common cause of LBP in peds (Isthmic spondy)
Common with hypermobile females 10 -15
Cheerleaders, gymnastics
step defromity
Oblique radiograph used
Describe the AIMS. Name, purpose, age range
Alberta Infant Motor Scale
- Identify delayed development
0 to 18 months old
Describe the Bayley Test
Developmental Delay for 1-42 months old
Peabody
TOTAL motor development (fine and gross motor)
Bruininks-Oseretsky Test of Motor Proficiency (BOT)
4-25 years old but really 14 yo is ceiling effect
All around for coordinator, strength, balance, gross and fine motor
= all around for kids including older kids (not babies)
Pedi
6 mo - 8 years old
Functional abilities specifically
GMFM/GMFCS
5 mo to 16 yo for kids with CP (gross motor function) and downs syndrome
level 1 - Independent community ambulator
Level 2- Household ambulator. may need AD
Level 3 - household w/ AD, man wheelchair in community
Level 4 - Requires self mobility wheelchair with power wheelchair
Level 5 - Requires full assistance to get around (manual wheelchair that others push)
PEDI
Pediatric evaluation of disability
6 months to 7.5 years for functional activities (self care, social, mobility)
SFA- School function Asessement
Kindegarden to 6th grade for school function specifically like tasks there
Torticollis
Tight SCM causes ipsilateral sidebend and cont rotation (textbook) but could be mixed
R sided torticollis would have R sb etc.
Rule out trochlear nerve palsy (head tilt could be compensation for inability to move eyes inward/outward and downward
limited AROM on opp side to to tightness passively on affected side
Tight band or nodule (man therapy)
Decreased tummy time, asymm gross milestones
Cranial deformity (plagiocephaly) flat spot on one side due to increased pressure
Cerebral Palsy
Happens fatally or in infancy
Not progressive
Spastic - stiff due to motor cortex
Dyskinetic - Involuntary movements due to Basal ganglia
Ataxia -Shaky, uncoordinated due to cerebllum
Crouched gait hip flexed knee flex ankle df
Down Syndrome
Hypotonic (less contraction, weak)
Hypermobile
Antanto axial instability
Gross motor milestones accomplished but in 2x the amount of time as normal
Flat nasal bridge
Brain smaller, cogntive impairment
Spina Bifida
LMN pathology
Affects everything below affected level
Spina bifida occulta is not symptonatic
menening/meningocele is more severe
LE paralysis
Sensory
Hydrocephalus
Latex allergy
Strabismus (crossed eye)
Arnold Chiari Malfromation
Deformities and joint contracure
CLubfoot - talipes equinavourus
Cranial nerve involvement
*Glute max is big predictor of community ambulation
*Everything below level is affected so
L1-L2 spini bifida is more severe than sacral level b/c more LE affected
L1-L2 requires HKAFO, wheelchair
L3 Forearm crutches maybe household ambulation
L4-L5 AFO, AD for longer distances
Sacral Leve - community ambulation, AFO
Movement Asessment Battery for Children
For developmental cooridnation disorder
Apgar
Good is 7-10
1-3 need immediate medical attention
2.5 to 3 years old
Able to jump
Weefim
WeeFIM, or the Pediatric Functional Independence Measure, is a tool that measures a child’s disability by assessing their independence in daily tasks
Walk, and walk stairs, before you jump, then tippy toe then one foot and skipping etc
Crawl on belly 6 months
Creep 7-9 months
SMA
severe muscle dysfunction and atrophy
SMA 1 die within 2 years
SMA 2 life spans 20-40 years
