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Pediatrics > L3: Typ Childhood Dev 0-6mos > Flashcards

L3: Typ Childhood Dev 0-6mos Flashcards

1
Q

Stages of Development:

Starting w/ Prenatal stage…

A
  1. Prenatal
    1. Germinal, Embryologic, Fetal
  2. Neonatal/Infant
  3. Toddler
  4. Preschooler
  5. Adolescence
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2
Q

Prenatal stage subcats:

A

Germinal

Embryologic

Fetal

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3
Q

Prenatal Development

How many trimesters?

A

3!

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4
Q

Prenatal Development

First trimester→ Conception-12wks

Key Points:

A
  • Heart beats Week 4
  • Neural tube closes Week 6; check for issues when neural tube closes
  • First trimester mvmts bw 7-15wks gestation
  • Mvmt greatly expands after 9wks w/ isolated limb mvmts
  • Breathing mvmts seen by 12 weeks
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5
Q

Prenatal Development

Second Trimester→ 13-28wks

Key Points:

A
  • Dev. continues w/ no NEW mvmts
  • Sleep cycles around 26-28wks gestation
  • **Surfactant: 27-30wks
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6
Q

Prenatal Development

Third Trimester→ 29-40wks

Key Points:

A
  • Generalized mvmt DECs (tigher space in womb)
  • Bw 37 and 40wks gestation→ Fetus begins birth process
    • “Full-term” babies
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7
Q

Correcting Age for Prematurity

Example #1:

A
  • Gestational age= actual age based on birth date
  • Corrected (adjusted) Age= actual age in weeks minus weeks premature
    • For babies born before: 36wks and 6 days → correct until age 2
  • 6 mo old baby born @ 28wks
    • Weeks premature→ 12wks (3mos)- 40-28=12
    • Gestational age in wks→ 28 wks old
    • Corrected age in wks→ Actual age (wks) - wks premature= 28-12= 16
    • *At 6mos they are currently 3mos
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8
Q

Correcting Age for Prematurity

Ex. #2

A
  • 40 minus weeks born = weeks premature
  • Born on date, todays date: its been __ months
  • __ months converted into #weeks (multiply by 4)
    • Ex. 2mos=8weeks
  • Weeks from current date since birth date minus weeks premature== Corrected age
  • Ex. 40-33wks=7wks→ born on 1/18/19 and today is 3/18/19== 8 wks (2mos)
    • born 33wks so 7wks premature
      • 8 (wks from current date since birthdate) - 7 (wks premature) = 1 week (corrected age)
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9
Q

Reflexes:

Flexor W/drawal

28wks gestation to 1-2mos

A
  • Integrates:
    • 1-2mos after birth
  • Stimulus:
    • Noxious stim sole of foot
  • Response:
    • Flexion w/drawal of leg
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10
Q

Reflexes

Crossed Extension

28wks gestation to 1-2mos

A
  • Integrates:
    • 1-2mos after birth
  • Stimulus:
    • Noxious stim sole of foot
  • Response:
    • Flexion of stimulated leg and then EXT opp leg w/ ADDuction

*SAME as flex w/draw but w/ crossed EXT

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11
Q

Reflexes

Positive Support

35wks gestation to 2mos

A
  • Integrates:
    • 1-2mos after birth, inconsist
  • Stimulus:
    • Balls of feet in contact w/ firm surface
  • Response:
    • Legs EXT to support BW
Positive Support
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12
Q

Positive Support Reflex

Interferes w/ what if does not integrate?

A
  • Standing/Walking
  • Balance rxns and wt shift in standing
  • Can lead to contractures of ankles into PF
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13
Q

Reflexes

Automatic Walking/Reflex Stepping

37wks gestation to 2-3mos

A
  • Integrates:
    • 2-3mos after birth
  • Stimulus:
    • Hold upright w/ feet on support
  • Response:
    • High stepping mvmts w/ regular rhythm
Auto. Walking
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14
Q

Automatic Stepping/Reflex Stepping

Interferes w/ what if does not integrate?

A
  • Standing and walking
  • Balance rxns and wt shifting
  • Development of smooth, coordinated reciprocal mvms of LEs
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15
Q

Reflexes

Galant/Trunk Incurvation

28wks gestation to 3mos

A
  • Integrates:
    • 3mos after birth
  • Stimulus:
    • In prone→ stroke paravertebral skin (shoulder→hip)
  • Response:
    • Lateral curvature of trunk on stim’d side
Galant
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16
Q

Galant/Trunk Incurvation

Interferes w/ what if does not integrate?

A
  • Dev. of sitting balance
  • Can lead to scoliosis
17
Q

Reflexes

Rooting

28wks gestation to 3-4mos

A
  • Integration:
    • 3-4mos after birth
  • Stimulus:
    • Touch to perioral area of hungry infant
  • Response:
    • Turns head and lips towards stim.
Rooting
18
Q

Rooting reflex

Interferes w/ what if does not integrate?

A
  • Oral-motor development
  • Dev of midline control of head
  • Optical righting, visual tracking, social interaction
19
Q

Reflexes

Moro**** KNOW ALL OF THIS

28wks gestation

Integrates→ 3-5mos after birth

A

Integrates 3-5mos after birth

  • Stimulus:
    • Head drop backwards
  • Response:
    • ABD/EXT of arms
    • Splaying of fingers
    • May be followed by arm flex and ADD

*NOTE: BIG FOR RED FLAGS!!!!–classic sign of children w/ neuro deficit if sticks around

Moro
20
Q

Moro Reflex

Interferes w/ what if does not integrate?

A
  • Balance rxns in sitting
  • Protective resp’s in sitting
  • Hand-eye coord, visual tracking
21
Q

CLASSIC sign of neuro deficits if this reflex sticks around…

A

Moro

22
Q

Reflexes

***Asymmetrical Tonic Neck Reflex (ATNR) *think Usain Bolt pose→ KNOW ALL OF THIS

20 wks gestation

Integrates 4-5mos after birth (wanna see it go away!)

A

Integrates 4-5mos after birth

  • Stimulus:
    • Turning of head
  • Response:
    • Facial arm EXTs/ABDs
    • Occipital arm Flexes/ADD’s

*Fencing Pose

23
Q

ATNR

Interferes w/ what if does not integrate?

A
  • Feeding
  • Visual tracking
  • Midline use of hands
  • B/L hand use
  • Rolling
  • Dev of crawling
  • Can lead to skeletal deforms (scoliosis, hip sublux/disloc.)
24
Q

Reflexes

Suck-Swallow

34-38 wks gestation to 5mos

A
  • Integrates:
    • 5mos after birth
  • Stimulus:
    • Touch to lips and inside mouth for suckling and liquid for swallowing
  • Response:
    • Rhythmic excursions of jaw, tongue rides up and down w/ jaw, then swallow
Suck-Swallow
25
Q

Reflexes

Palmar Grasp

28wks gestation to 4-7mos

A
  • Integrates:
    • 4-7mos after birth
  • Stimulus:
    • Pressure on palm of hand
  • Response:
    • Flexion of fingers

*the one where we think they are grabbing out finger being cute but they’re not….it’s just a reflex -__-

26
Q

Palmar Grasp

Interferes w/ what if does not integrate?

A
  • Ability to grasp/release objs voluntarily
  • Wt bearing on open hand for propping, crawling, protective responses
27
Q

Reflexes

Plantar Grasp

28wks gestation to 9mos

A
  • Integrates:
    • 9mos after birth
  • Stimulus:
    • Supported standing on feet OR pressure to sole of foot just distal to metatarsal heads
  • Response:
    • Flexion of toes
Plantar Grasp
28
Q

Plantar Grasp

Interferes w/ what if does not integrate?

A
  • Ability to stand w/ feet flat on surf
  • Balance rxns and wt shift in standing
29
Q

Symmetrical Tonic Neck Reflex (STNR)

6-12mos

A

Stimulus: Head pos, Flex/Ext

Response: Head in Flex= arms flex, legs ext; Head in Ext= arms ext, legs flex (arms follow the head*)

Nrml age response: 6-12mos

30
Q

Symmetrical Tonic Neck Reflex (STNR)

Interferes w/ what if does not integrate?

A
  • Ability to prop arms in prone pos.
  • Attaining and maintaining hands-and-knees pos
  • Crawling reciprocally
  • Sitting balance when looking around
  • Use of hands when looking @ objs in hands in sitting pos.
31
Q

Tonic Labyrinthe Reflex (TLR)

Birth-6mos

A

Stimulus: Pos of labyrinthe in inner ear-reflected head pos.

Response: In Supine= Body/Extremities in EXT; In Prone= Body/Extremities in FLEX

Nrml age response: Birth-6mos

32
Q

Tonic Labyrinthe Reflex (TLR)

Interferes w/ what if does not integrate?

A
  • Ability to initiate rolling
  • Abilit to prop on elbows w/ extd hips when prone
  • Ability to flex trunk and hips to come to sitting pos from supine pos
  • Often causes full body EXT–interferes w/ balance in sitting or standing
33
Q

Startle Reflex

28wks gestation-5mos

A

Stimulus: Loud, sudden noise

Response: Similar to MORO, but elbows flexed and hands closed

Nrml age response: 28wks gestation-5mos

34
Q

Startle Reflex

Interferes w/ what if does not integrate?

A
  • Sitting balance
  • Protective responses in sitting
  • Hand-eye coord, visual tracking
  • Social interaction, attn
35
Q

REFLEXES IN ACTION VIDEOS !!!

A

L3: SLIDE 30******

Pediatrics (27 decks)

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