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ObPeds > Exam II > Flashcards

Exam II Flashcards

1
Q

When can the infant raise their head prone?

A

2 months

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2
Q

When can the infant roll from prone to supine?

A

4 months

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3
Q

When can the infant sit using tripod position?

A

6 months

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4
Q

When can the infant crawl?

A

9 months

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5
Q

When can the infant stand without support?

A

12 months

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6
Q

What is a concern with early walkers?

A

more stress on bone causing genu varus

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7
Q

What is the Gower sign?

A

when a child rises from sitting to standing by placing hands on legs and pushing the trunk up

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8
Q

What does the gower sign indicate?

A

muscular dystrophy

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9
Q

What other issue is commonly seen with developmental hip dysplasia?

A

torticollis

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10
Q

What increases the risk of developmental hip dysplasia?

A

breech

intrauterine constraint

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11
Q

What characterizes a subluxation in acetabular dysplasia?

A

femur head remains in contact with acetabulum, but joint ligaments and capsule are stretched

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12
Q

What is the most common exam finding with developmental hip dysplasia?

A

decreased hip abduction

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13
Q

What are two orthopedic tests done to assess developmental hip dysplasia?

A

Barlow’s

Ortolani’s

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14
Q

What does Allis sign detect?

A

shortened femur

dDx: hip dislocation

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15
Q

What is the MC kind of scoliosis in girls?

A

idiopathic structural scoliosis

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16
Q

Which nerves are involved in Erb’s Palsy?

A

C5/C6

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17
Q

What are some impaired findings in an infant with Erb’s Palsy?

A

asymmetrical moro, biceps and radial reflexes

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18
Q

What is the MC foot problem in infants?

A

metatarsus adductus

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19
Q

Which two foot problems are due to intrauterine constraint?

A
  • tibial torsion

- metatarsus adductus

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20
Q

Is “pes planus” normal in an infant?

A

yes, the longitudinal arch is obscured by a fat pad until 3yrs

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21
Q

Which part of the foot is involved in metatarsus adductus?

A

the forefood

heel and ankle are not involved

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22
Q

Which sitting position places stress on the joints and may cause intoeing & femoral anteversion?

A

reverse tailor position

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23
Q

What are some clinical findings for femoral anteversion?

A
  • inc. internal hip rotation (>70)
  • femurs twist medially
  • patella faces inward
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24
Q

What are the 3 things you need to ask yourself when assessing and infant/child?

A
  1. outside normal range
  2. appropriate for their age
  3. is it symmetric
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25
Q

What is the measurement for genu varum?

A

1 inch between knees

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26
Q

When should you evaluate a genu varum further?

A
  • asymmetry of tibiofemoral angle

- space between knees >1.5 inches

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27
Q

What is the measurement for genu valgum?

A

1 inch between medial maleoli

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28
Q

When is genu valgum common?

A

2-4 years

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29
Q

When should you evaluate a genu valgum further?

A
  • asymmetry of tibiofemoral angle

- space between knees >2 inches

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30
Q

What are some characteristics of Talipes Equinovarus?

A
  • congenital defect of ankle and foot
  • inversion of foot at the ankle
  • plantar flexion
  • bilateral involvement 30-50% of cases
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31
Q

What is the treatment for Talipes Equinovarus?

A

Ponseti Method

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32
Q

What is the Ponseti Method?

A
  • series of manipulation and casting
  • tenotomy (achiles)
  • food abduction brace (Denis Browne Bar)
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33
Q

What are some characteristics of Talipes Calcaneovalgus?

A
  • exaggerated dorsiflexion
  • from uterine positioning
  • resolves spontaneously
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34
Q

What is another name for radial head subluxation and what is the etiology?

A
  • Nursemaid’s Elbow

- jerking the arm upward while elbow is extended

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35
Q

Where is the pain located with a Nursemaid’s Elbow injury?

A

pain in the elbow and the wrist (both articulations)

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36
Q

What is Legg-Calve-Perthes?

A

AVN of the humeral head

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37
Q

When is Legg-Calve-Perthes MC seen?

A

in boys 2-10 years old

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38
Q

What is the referred pain patter in Legg-Calve-Perthes?

A

medial thigh, knee or groin

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39
Q

When is SCFE MC seen and what is the referred pain pattern?

A
  • boys 8-16 yoa

- knee pain

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40
Q

Until what age does the brain keep growing?

A

12-15 years

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41
Q

What is the pattern of motor maturation?

A

cephalocaudally

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42
Q

Doll’s eye maneuver involves which cranial nerve?

A

CN VIII

43
Q

Which reflexes test CN V?

A
  • rooting reflex

- sucking reflex (also CN XI,X, XII)

44
Q

Which DTR is present at birth?

A

patellar reflex

45
Q

Which DTRs appear around 6 months?

A

achilles and brachioradialis reflexes

46
Q

When are primitive reflexes present until?

A

birth to 6 months

47
Q

Until when is the Babinski sign present?

A

16-24 months

48
Q

What facilitates the palmar grasp?

A

suckling

disappears by 3 months

49
Q

When does the plantar grasp disappear?

A

8 months

50
Q

When does the moro refelx diminish?

A

3-4 months

51
Q

What is the Placing reflex?

A

touch the dorsum of the foot and observe flexion of hips and knees

52
Q

How is the Galant reflex performed?

A

with infant prone over hand, run finger along paraspinals on one side, infant should curve toward that side

53
Q

How is the Perez relfex performed?

A

stroke finger over spinous processes from sacrum to occiput

54
Q

What is the response to Perez?

A

infant extends head and brings knees to chest; urinates

55
Q

When does Fencer’s appear/disappear?

A

2-3 months

6 months

56
Q

What is the Neck Righting reflex?

A

infant turns its whole body in the direction the head is turned

57
Q

When does the Neck Righting reflex appear?

A

around 3 months

after fencer’s disappears

58
Q

What type of touch is not typically tested in kids?

A

superficial pain

59
Q

What are nuerological soft signs?

A

nonfocal, functional neurologic findings

-provide subtle cues to an underlying CNS deficit

60
Q

What is the soft finding associated with walking/running gait?

A

stiff-legged w/ foot slapping, unusual arm posture

61
Q

What is the soft finding associated with motor-stance?

A

difficulty maintaining stance

  • extended arms
  • feet together
  • eyes closed
62
Q

What is the soft finding associated with one-foot standing?

A

unable to remain stance longer than 5-10 sec

63
Q

What is the soft finding associated with heel/toe walking?

A

unable to do for 10ft

64
Q

What is a common finding in traumatic brain injuries?

A

fever

-nervous system unable to control temp.

65
Q

Which meningitis symptom symptom is not present in infants?

A

nuchal rigidity

until 6-9 months

66
Q

What should you automatically think of when an infant has a fever?

A

meningitis

67
Q

What are some characteristics of Spastic CP?

A
  • hypertonicity
  • tremors
  • scissor gait
  • toe walking
68
Q

What are some characteristics of Dyskinetic CP?

A
  • involuntary slow writhing movements of extremities

- tremors may be present

69
Q

What are some characteristics of Ataxic CP?

A

abnormalities of movement involving balance and position of trunk and extremities

70
Q

What is the incidence of Generalized Seizure Disorder in children?

A

75% new cases develop during childhood and adolescence

71
Q

What is the peak age of incidence of SOLs/intracranial tumors?

A

3-12 years

50-70 years

72
Q

What is the MC cause of congenital torticollis?

A

birth trauma w/ resultant hematoma formation

-breech or difficult forceps deleivery

73
Q

What is another issue present in infants with congenital muscular torticollis?

A

20% have congenital hip dysplasia

74
Q

What is standard management for torticollis?

A
  • passive stretching

- increase tummy time

75
Q

What are some secondary effects of untreated torticollis?

A
  • plagiocephaly
  • facial hypoplasia
  • musculoskeletal effects
76
Q

For severe head deformity, during what age would be the best use of a helmet?

A

from 4-12 months

77
Q

What is commonly seen in the birth history in infants with colic?

A
  • long/difficult labor

- epidural & pitocin

78
Q

What does the “rule of three” pertain to regarding colic?

A

-crying for > 3 hours per week
-for > 3 days per week
-for > 3 weeks
in an infant that is well fed and otherwise healthy

79
Q

When does colic normally appear and disappear?

A

begins by 2 weeks and resolves by 4 months

80
Q

What’s the total package for colic?

A
  • chiropractic adjustments
  • modification of maternal diet
  • switch to goat’s milk
  • probiotics
  • teas
  • screen for food intolerances, allergies etc.
81
Q

What are some causes for an occiput posterior presentation?

A
  • pendulous abdomen
  • small pelvic size
  • flat sacrum
  • anterior wall placenta
82
Q

What are symptoms associated with occiput posterior?

A

-back labor caused by fetal head pressing on the sacrum putting pressure on the sacral plexus

83
Q

What effects can on occiput posterior have on the infant head?

A
  • abnormal cranial molding
  • cone head
  • caput succedaneum
84
Q

What is another name for occiput posterior?

A

sunny side up

85
Q

What happens to the umbilical cord when exposed to air for a prolonged period of time?

A

it begins to constrict cutting off blood flow

86
Q

What are some risk factors for face presentation?

A
  • lax uterus
  • flat pelvis
  • multiple fetuses
  • anencephaly
  • neck spasm (fetus)
87
Q

What are some risk factors for parietal presentation?

A
  • flat/platypelloid pelvis

- pitocin & epidural

88
Q

What is a common injury with parietal presentation?

A
  • traction and/or compression of brachial plexus

- cephalhematoma

89
Q

What is the MC compound presentation?

A

nuchal arm: arm alongside of head

90
Q

What are some risk factors for a compound presentation?

A
  • malposition
  • malpresentation
  • small infant
  • mulitparous (lax uterus)
91
Q

What are some consequences of a forceps delivery?

A
  • depression fractures
  • birth marks
  • iatrogenic torticollis
  • brachial plexus damage
  • subluxation
92
Q

What are some consequences of a vacuum delivery?

A
  • cone head
  • caput succedaneum
  • subluxation of parietal bones
93
Q

What is dystocia?

A

difficult labor caused by inadequate uterine function, pelvic contraction, and baby malpresentation

94
Q

What are some variables that may distort Webster’s during knee flexion?

A
  • knee subluxation
  • collateral/cruciate tears
  • knee edema
  • scar tissue
  • quad splinting
  • lumbar subluxation
95
Q

What do you contact on sacrum when using Webster’s?

A 
sacral notch (NOT ala)
==>lateral and inferior to 2nd sacral tubercle
96
Q

What is the preferred mode of adjusting for Webster’s?

A

low force, P-A drop technique

97
Q

What is the DS in Webster’s?

A

stand on side of resistance

98
Q

What does a negative Derifield suggest?

A

anterior inferior sacrum

99
Q

What are some findings found with a -D?

A

SI, pubic bone, ischial tuberosity, medial aspect of knee tenderness and thick achilles tendon on the side of involvment

100
Q

For sacral leg checks, the higher leg indicates ___?

A

side of apex deviation

SAR or SAL

101
Q

What are some conditions that may prevent the fetus from turning?

A
  • multiple babies
  • oligohydramnios
  • placenta previa
  • short umbilical cord
  • uterine abnormalities
102
Q

When are ECVs typically done?

A

37 weeks

103
Q

What is the MC type of HA in children?

A

migraines

104
Q

What is the MC type of migraine?

A

basilar type

ObPeds (3 decks)

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