L3: Typ Childhood Dev 0-6mos Flashcards
Stages of Development:
Starting w/ Prenatal stage…
- Prenatal
- Germinal, Embryologic, Fetal
- Neonatal/Infant
- Toddler
- Preschooler
- Adolescence
Prenatal stage subcats:
Germinal
Embryologic
Fetal
Prenatal Development
How many trimesters?
3!
Prenatal Development
First trimester→ Conception-12wks
Key Points:
- 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
Prenatal Development
Second Trimester→ 13-28wks
Key Points:
- Dev. continues w/ no NEW mvmts
- Sleep cycles around 26-28wks gestation
- **Surfactant: 27-30wks
Prenatal Development
Third Trimester→ 29-40wks
Key Points:
- Generalized mvmt DECs (tigher space in womb)
-
Bw 37 and 40wks gestation→ Fetus begins birth process
- “Full-term” babies
Correcting Age for Prematurity
Example #1:
- 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
Correcting Age for Prematurity
Ex. #2
- 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)
- born 33wks so 7wks premature
Reflexes:
Flexor W/drawal
28wks gestation to 1-2mos
-
Integrates:
- 1-2mos after birth
-
Stimulus:
- Noxious stim sole of foot
-
Response:
- Flexion w/drawal of leg
Reflexes
Crossed Extension
28wks gestation to 1-2mos
-
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
Reflexes
Positive Support
35wks gestation to 2mos
- Integrates:
- 1-2mos after birth, inconsist
-
Stimulus:
- Balls of feet in contact w/ firm surface
-
Response:
- Legs EXT to support BW
Positive Support Reflex
Interferes w/ what if does not integrate?
- Standing/Walking
- Balance rxns and wt shift in standing
- Can lead to contractures of ankles into PF
Reflexes
Automatic Walking/Reflex Stepping
37wks gestation to 2-3mos
- Integrates:
- 2-3mos after birth
-
Stimulus:
- Hold upright w/ feet on support
-
Response:
- High stepping mvmts w/ regular rhythm
Automatic Stepping/Reflex Stepping
Interferes w/ what if does not integrate?
- Standing and walking
- Balance rxns and wt shifting
- Development of smooth, coordinated reciprocal mvms of LEs
Reflexes
Galant/Trunk Incurvation
28wks gestation to 3mos
- Integrates:
- 3mos after birth
-
Stimulus:
- In prone→ stroke paravertebral skin (shoulder→hip)
-
Response:
- Lateral curvature of trunk on stim’d side
Galant/Trunk Incurvation
Interferes w/ what if does not integrate?
- Dev. of sitting balance
- Can lead to scoliosis
Reflexes
Rooting
28wks gestation to 3-4mos
- Integration:
- 3-4mos after birth
-
Stimulus:
- Touch to perioral area of hungry infant
-
Response:
- Turns head and lips towards stim.
Rooting reflex
Interferes w/ what if does not integrate?
- Oral-motor development
- Dev of midline control of head
- Optical righting, visual tracking, social interaction
Reflexes
Moro**** KNOW ALL OF THIS
28wks gestation
Integrates→ 3-5mos after birth
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 Reflex
Interferes w/ what if does not integrate?
- Balance rxns in sitting
- Protective resp’s in sitting
- Hand-eye coord, visual tracking
CLASSIC sign of neuro deficits if this reflex sticks around…
Moro
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!)
Integrates 4-5mos after birth
-
Stimulus:
- Turning of head
-
Response:
- Facial arm EXTs/ABDs
- Occipital arm Flexes/ADD’s
*Fencing Pose
ATNR
Interferes w/ what if does not integrate?
- Feeding
- Visual tracking
- Midline use of hands
- B/L hand use
- Rolling
- Dev of crawling
- Can lead to skeletal deforms (scoliosis, hip sublux/disloc.)
Reflexes
Suck-Swallow
34-38 wks gestation to 5mos
- 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
Reflexes
Palmar Grasp
28wks gestation to 4-7mos
- 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 -__-
Palmar Grasp
Interferes w/ what if does not integrate?
- Ability to grasp/release objs voluntarily
- Wt bearing on open hand for propping, crawling, protective responses
Reflexes
Plantar Grasp
28wks gestation to 9mos
- 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
Interferes w/ what if does not integrate?
- Ability to stand w/ feet flat on surf
- Balance rxns and wt shift in standing
Symmetrical Tonic Neck Reflex (STNR)
6-12mos
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
Symmetrical Tonic Neck Reflex (STNR)
Interferes w/ what if does not integrate?
- 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.
Tonic Labyrinthe Reflex (TLR)
Birth-6mos
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
Tonic Labyrinthe Reflex (TLR)
Interferes w/ what if does not integrate?
- 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
Startle Reflex
28wks gestation-5mos
Stimulus: Loud, sudden noise
Response: Similar to MORO, but elbows flexed and hands closed
Nrml age response: 28wks gestation-5mos
Startle Reflex
Interferes w/ what if does not integrate?
- Sitting balance
- Protective responses in sitting
- Hand-eye coord, visual tracking
- Social interaction, attn
REFLEXES IN ACTION VIDEOS !!!
L3: SLIDE 30******
