Intro to Pediatrics Flashcards
Infancy stage of development?
0-1 year
Neonatal stage of development?
O - 2 weeks
Infant Stage of development
3 weeks - 1 year
Toddlerhood Stage of development
13m - 2y 11 M
Early childhood Stage of development
3 years - 10 years, 11 M
Preschool stages development Stage of development
3yrs - 5 yrs
Elementary school stages of development
5 yrs - 10yr, 11 m
Adolescence stages of development
11 yrs - 18 yrs
Young adulthood stages of development
18 - 22yrs
Adulthood stages of development?
22-40yrs
Middle age stages of development?
40-65 yrs
Late adulthood stages of development?
65+ yrs
Infancy (erikson)
0-l yr / trust vs. Mistrust
Resolved by: Hope
Early childhood (erikson)
1-3 yrs / autonomy vs. shame
Resolved by: will
Play Age (erikson)
3-6 yrs/ Initiative vs. Guilt
Resolved by: Purpose
School age (erikson)
6-12 yrs /industry vs. Inferiority
Resolved by: Competence
Adolescence (erikson)
12-19 yrs / identity vs, role confusion
Resolved by: Fidelity
Early adulthood (erikson)
20-25 yrs / intimacy vs. Isolation
Resolved by: Love
Adulthood (Erikson)
26-64yrs / generavity vs. Stagnation
Resolved by: Care
Old Age (erikson)
65+/ego integrity vs. Despair
Resolved by: Wisdom
Role of Play
-main occupation of child
-acquisition of normal development
Role of Family
-families have greatest influence on child’s development
-child’s care will impact all family
-caregivers
-Home environment
-Culture
ICF Model
-International classification of functioning disability in health
-Body Structures/Functions
-Health Conditions
-Activities
-Participation
-Environment
-Personal Factors
Evidence-Based Practice (4 elements)
-Patient/family situation
-Clinical expertise
-Research
4 Elements:
-awareness
-Consultation
-Judgement
-Creativity
Examination
-the process of obtaining data
- Hx
- Systems review
- Tests and measures
Evaluation
-making clinical judgments based on exam
Diagnosis
-process and end result to organize daa to determine syndromes/categories to determine prognosis and interventions
Prognosis
-includes Plan of care: specifies interventions, timing and frequency
-determination of level of improvement possible with interventions
-improves full collaboration
Intervention
-purposeful and skilled interaction of PTto produce changes consistent with diagnosis and prognosis
Factors affecting Interventions
-age
-growth
-chronicity or severity
-comorbidities
-degree of limitations
-level of cognition and cooperation
-family desires
-caregiver abilities
-resources
-other services
-community support, psychosocial, and socioeconomic factors
Outcomes
-results of interventions
-Based on
1. goal achievement
2. Improved performance
3. Satisfaction
4. Prevention of secondary problems
Positive Support/Primary Standing Reflex
Appears: 35w gestation
Integrates: 1-2 m
Stimulus: feet on flat surface
Response: Ext legs and accept weight for a few seconds
Support & Stepping/Automatic Walking Reflex
Appears: 37 weeks gestation
Integrates: 3-4 months (reappears at 10-15 months to prep for walking)
Stimulus: Feet flat on surface
Response: Attempts steps
Asymmetric Tonic Neck Reflex (ATNR)
Appears: 20 weeks gestation
Integrates: 4-5 months
Stimulus: in supine, head rotates
Response: ipsi arm and leg EXT, contra arm and leg FLX
If retained: have difficulties with motor skills like running, cycling, throwing, and catching balls
Tonic Labyrinth Reflex
Appears: At birth (best seen at 3m)
Integrates: 6 months
Stimulus: Prone laying or supine laying
Response: Prone= FLX tone in all limbs; Supine= EXT tone in all limbs
If retained: have difficulties with motor skills like running, cycling, throwing, and catching balls
Upper Extremity Parachute
Emerges: 6 to 7 months.
-Protection of head when positioned head first, symmetrical arm extension and abduction
Anterior Protective Extension
Emerges: 6 to 9 months,
-hand go in front to catch in sitting
-first protective extension
Lateral protective extension
Emergence: 6 to 9 months
-put arm out laterally in sitting
-emerges after anterior
Posterior protective extension
Emergence: 9-11 months
-catch from fall backward in sitting
-last to emerge
Gestation Time w/ Development
First Trimester: 1-12 weeks
-all major body systems
Second Trimester: 13-26 weeks
-body proportions grow to newborn proportions
Third Trimester: 27-40 weeks
-body weight triples and body length doubles
-body fat accumulates to aid in body temp regulation
-lungs developed at 36 weeks
STORCH
-Syphilis
-Toxoplasmosis
-Other infections
-Rubella
-CMV
-Herpes simplex
Typical Development
Dependent on: NS, genetics, environment
Direction: cephalo-caudal, proximal to distal, gross motor to fine motor
Newborn Overview
-38-42 weeks (not premature until 37, extreme at 28)
-head larger
-kyphosis with horizontal ribs
-ROM differences: inc DF, 30deg flx contractions of hip and knees
-Need to breathe, suck, and swallow
-Vision best at 8-9 inches, prefer strong contrast
Apgar Score
Newborn Positions
Prone: UE and LE flexion, head turned with weight-bearing
Supine: UE flexion, LE flexion/abd/ER, head turned with weight-bearing
Pull to sit: head lag
Sitting: head forward w/ no control, C curve throughout spine
Primitive Reflexes
-involuntary movements that become controlled motor responses
-If they are retained they will struggle with motor and cognitive skills
Flexor Withdrawl Reflex
Appears: 28 weeks gestation
Integrates: 1-2m
Stimulus: noxious stimulus to sole of foot
Response: Flexion withdrawal of leg
Crossed Extension Reflex
Appears: 28 weeks gestation
Integrates: 1-2 months
Stimulus: Noxious stimulus to sole of foot
Response: FLX of ipsi leg and then EXT of contra with ADD
Rooting
Appears: 28 weeks gestation
Integrates: 3 months
Stimulus: stroking cheek
Response: turns towards stimulus
Sucking
Appears: 28 weeks gestation
Integrates: 3 months
Stimulus: nipple in mouth
Response: sucks
Suck-Swallow
Appears: 28-34 weeks gestation
Integrates: 5 months (becomes voluntary)
Stimulus: nipple in mouth
Response: rhythmic excursion of jaw
Moro Reflex
Appears: 28 weeks gestation
Integrates: 3-5 months
Stimulus: Sudden change in head ext in relation to trunk
Response: crying, shoulder flx/abd, elbow ext (out then in)
Palmar Grasp Reflex
Appears: 25-28 weeks gestation
Integrates: 4-7 months
Stimulus: Maintained mechanical stimulus to palm
Response: grasp;
-signifies cortical maturation
-weak reflex common with spastic cerebral palsy
-Reappearance can signify cortical lesion
Symmetrical Tonic Neck Reflex
-Upper body in sync, LE opp
Appears: 4 to 6m
Integrates: 8 to 12m
Stimulus: Head flexion or extension
Response:
-Head flx: arms FLX, hips EXT
-Head ext: arms EXT, hips FLX
Plantar Grasp Reflex
Appears: 28 weeks gestation
Integrates: 9 months
Stimulus: Pressure at sole of foot distal to met heads
Response: FLX of toes
Galant Reflex
Appears: 28 weeks gestation
Integrates: 3-6 months
Stimulus: Stroking down lateral trunk
Response: IPSI lat side bend toward stimulus
If retained past 9 Months: can cause fidgeting or inability to sit still
Head Righting
-present at birth, strongest 3 months
-when tilted to the side and child will move their head to a vertical position
-flexion of the trunk
Landau Response
Appears: 3-5 months
Integrates: 12 months
-in prone horizontal suspension, head and LE and head extend
-when head flexes, LE flex
Righting Reactions
-organized in midbrain
-act of realigning the head or trunk together or to an outside stimulus
Equilibrium
-act of re-establishing balance
Anterior Righting
Emerges: 9 Months
-in sitting, pull gently at shoulders
-ext head and arms forward to recover balance
Prematurity
Before 37 Weeks
Extreme Prematurity
Before 28 weeks
Very Low Birth Weigh
<1500g
