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Special Pops > Lab Midterm > Flashcards

Lab Midterm Flashcards

1
Q

Signs and symptoms webster’s coronal suture technique

A

Increase intracranial pressure
Bulging and/or eccentric head shape
Palpable suture, palpates like a ridge, firm spaghetti

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2
Q

Webster’s coronal suture technique analysis

A
  1. Measure circumference of child’s head from glabella over EOP back to glabella
  2. Measure the right and left sides of the head from glabella to EOP - should add to equal the circumference. If uneven, side of larger measurement is fixated side
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3
Q

Webster coronal correction

A 
PP = on parent’s chest
SCP = posterior aspect of frontal bone and anterior aspect of parietal bone, straddling coronal suture
CP = size of SCP will determeine size of CP - infants = pinky tips; toddler = index or thumbs
LOD = AP and PA separating sutures
THRUST = 3 quick thrusts pushing the suture apart, may use toggle head piece for a drop

Fingers straddle the coronal suture to allow you to push it apart

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4
Q

Pediatric clinic exam appearance

A 
Alert
Hyperactive
Attentive
Lethargic
Hyper-irritable
Communicative
Curious
NAD
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5
Q

Pediatric clinic exam - reflexers

A

Moro startle
Blink, dazzle
Acoustic blink

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6
Q

Brachycephaly

A

Flattened on the back

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7
Q

Plagiocephaly

A

Flattened diagnollogy on back

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8
Q

Scaphocephally

A

Smushed length wise, longer head front to back

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9
Q

Caniosynestosis

A

Bigger forehead or upper head

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10
Q

To realign head shapes

A

Sleeping aides
Postural aides
The helmet

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11
Q

Head reflexes pediatric exam

A

TMJ function

Asymmetric tonic neck reflex

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12
Q

Mouth and face reflexes

A

Rooting

Sucking

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13
Q

Tongue

A

Tongue tied - fenulum of tongue
Lip tied
Protrusion of tongue

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14
Q

Protrusion of tongue

A 
Macroglossia - down syndrome
Small mouth - diGeorge syndrome
Hypotonia
Masses
Mouth breathing
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15
Q

Facial symmetry

A

Eyes
Eye brows
Ears

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16
Q

Facial paralysis

A

Bells palsy

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17
Q

Skin rashes

A

Baby acne
Diaper rash
Allergic reaction

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18
Q

Dehydration

A

Anterior fontanell

Chapped lips

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19
Q

Tenting

Skin with decreased turgor remains elevated after being pulled up and released

A

Dehydration

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20
Q

Brachial plexus injury

A

Arm at side, fist facing backward

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21
Q

Upper extremity reflex

A

Palmar grasp

Negative palmar grasp

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22
Q

Ortalani

A

Palpable click or clunk

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23
Q

Inguinal and gluteal folds

A

Should be symmetric, if not check hips

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24
Q

Lower extremity reflexes

A

Placing
Stepping
Parachute

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25
Q

Frank breech

A

Legs in splits high V

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26
Q

Placing reflex

A

0-6 weeks

Hold infant under arms and touch the dorsum of the infant’s foot to the examining table

Normal = infant should flex the knee and bring foot up onto surface followed by the other foot

Abnormal = paresis to breech delivery or hip abnormalities

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27
Q

Stepping reflex

A

0-6 weeks

Hold infant under arms and touches the soles of infant’s feet onto table

Normal = infant flexes both knees followed by extension of the knees

Abnormal = paresis to breech delivery or hip abnormalities

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28
Q

Gallants: AKA trunk incurvation reflex

A

0-8 weeks

Hold infant in prone position supported securely under abdomen. Examiner strokes one side of paravertebral muscles from occiput to base of sacrum bilaterally

Normal = infant should extend and laterally flex head and trunk to the side of stimulus

Abnormal = lower motor neuron lesion

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29
Q

Moro AKA startle reflex

A

0-4 months

Hold infant supine and abruptly changes head position of infant 1-2cm

Normal = initially the infant should symmetrically extend and full abduct the arms bilateral concomitant with extension of the trunk and flexion of the knees and hips, then followed by an embrace response

Abnormal = hemi paresis of upper or lower extermity is asymmetrical response is produced, brachial plexus injury, spinal cord injury

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30
Q

Rooting reflex

A

0-4 months while awake; 0-7 months while asleep

Firmly strokes above the ramus of the mandible towards the mouth, bilaterally

Normal = infant moves towards side of stimulus

Abnormal = CN V or CN VII lesion or general CNS disorder

31
Q

Sucking reflex

A

0-4 months

Inserts clean finger into infant’s mouth and lightly strokes the hard palate

Normal = infant starts to suckle

Abnormal = general CNS disorder

32
Q

Vertical suspension

A

0-6 months

Supports the upright infant around the torso, then raises the infant suddenly upwards

Normal = the infant should bilaterally flex his hips and knees

Abnormal = hip joint abnormalitis, or spastic paraplegia

33
Q

Palmar/plantar grasp

A

0-6 months

Places finger on the infant’s palm

Normal = infant grasp examiner’s finger

Abnormal = cerebral dysfunction. A persistent fist presentation during waking hours after 2 months of age may suggest CNS disorder like CP

34
Q

Blink aka Dazzle reflex

A

0-1 year

Shine pen light into infant’s eyes

Normal = infant blinks

Abnormal = blindness or decreased visual acuity

35
Q

Acoustic blink AKA cochleopalpebral

A

0-gradually disappears

Make a loud noise away from infant’s visual gaze

Normal = infant should blink eyes

Abnormal = decreased or total hearing loss

36
Q

ATNR: Asymmetrical tonic neck reflex

A

2 weeks - 6 months

Infant is supine. Examiner rotates infant’s head for 30 seconds, bilaterally

Normal = infant takes on a fencing type posture. The infant should extend the upper and lower extremity on the side of head rotation and flex the upper and lower extrmeity on the contralateral side.

Abnormal = a persistent ATNR is abnormal and may indicate ipsilateral hemi paresis or CNS damage

37
Q

.Landau reflex

A

2 weeks-2 years

Hold baby under belly, the back arches

Normal = neck extends and back arche while extremities extend. When the head is passively flexed the child will flex hips and torso.

Abnormal = present after 2 years may indicate poor motor development

38
Q

Neck righting reflex

A

0-10 months

Infant is lying supine. Examiner rotates infant’s head to one side

Normal = infant should rotated trunk to the side of head rotation

Abnormal = cerebral damage

39
Q

Parachute reflex

A

6 months-1 year

With infant suspended in the prone position, the examiner quickly changes head posiitoining of infant mimicking a fall

Normal = the infant should extend arms down as to brace the fall

Abnormal = assess upper extremity function and asymmetry may indicate paresis

40
Q

Digital response reflex

A

0-6 months

Stroke the ulnar side of the infant’s hand

Normal = infant extends thumb and fingers followed by grasp

Abnormal = cerebral dysfunction

41
Q

Babinski reflex

A

0-1 year

Stroke plantar surface of the foot from the heel towards the toes but not across the ball of the foot

Normal = extension and fanning of the toes with flexor response of the first toe

Abnormal = possible CNS dysfunction

42
Q

Otolith righting reflex

A

0-?

Hold infant under arms then tilts infant to one side

Normal = the infant should try to laterally flex head to maintain horizon

Abnormal = general CNS damage

43
Q

Anal aka anal wink reflex

A

0-?

Stroke the perianal region

Normal = contraction of the external sphincter

Abnormal = dysfunction of lower sacral segment

44
Q

Corneal reflex

A

0-…

Tough infant’s cornea with cotton wisp

Normal = blinking and tearing

Abnormal = brain or CNS damage

45
Q

Suck/swallow reflex

A

As liquid moves into the mouth, the tongue moves it back into the mouth

46
Q

Tongue thrust reflex

A

When lips are touched, baby moves tongue out of mouth

47
Q

Cross extensor

A

Stroke sole of one foot causes extension of contralateral leg

48
Q

Brudzinski test

A

Tuck chin to chest

Positive resistance, pain and/or hip flexion

Indicates might be meningeal irritation

49
Q

Kernig

A

Supine-bring knee and hip to 90 degrees then extend leg

Positive and/or pain

Indicates might be meningeal irritation

50
Q

Ortolani

A

Supine, place chiro index on greater trochanter and thumb on lesser trochanter, move hip into flexion then externally rotate

Positive palpable clunk

Indicates instability or dislocation of hip

51
Q

Barlow

A

Hand placement same as above distract and internally rotate

Positive palpable clunk

Indicates instability or dislocation of hip

52
Q

CN I

A

Pulls away from strong odor

53
Q

CN II

A

Blink reflex

54
Q

CN III, IV, VI

A

Tracking not reliable

55
Q

CN V

A

Sucking

Rooting

56
Q

CN VII

A

Moro crying

57
Q

CN VIII

A

Acoustic blink

58
Q

CN IX, X, XII

A

Swallowing, gag reflex

59
Q

CN XI

A

Rotating baby’s head via sound or light

60
Q

Leopolds first maneuver

A

Fundal grip

Locate the fetal part at the lower uterine segment, then apply slight counter pressure at the uterine fundus with your opposite hand, feeling for movement of the fetus. This movement is called balottement

61
Q

Leopald second maneuver

A

Umbilical grip

Locate the fetal part at the uterine fundus, then apply slight counter pressure to the lower uterine segment with your opposite hand, feeling for movement of the fetus. This movement is called ballottment

62
Q

Third maneuver leopold

A

Pawlick’s grip

Palpate down the lateral walls of the uterus moving toward the cervical area, this is to determine the side the spine is on versus the side of the extremities

63
Q

Fourth leopold maneuver

A

Pelvic grip

Locate the cephalic prominence, this will determine if the presenting portion of the head is the occiput or the sinciput

Occiput = palpates on the side opposite the spine

Sinciput = palpates on the same side of the spine

64
Q

Fetal auscultation

A

Utilizing a fetal stethoscope may assist you in confirming the fetal position.

The fetal heartbeat is fast and easy to differentiate from the mothers.

A strong fetal heartbeat above the umbilicus indicates the head is up, breech.

A strong fetal heartbeat below the umbilicus indicates the head is down.

65
Q

Vertex

A

Longitudinal lie, caudal presentation with head in slight flexion

66
Q

Facial or brow position

A

With the face up toward the mother’s abdomen and in the longitudinal position with head down

67
Q

Frank breech position

A

The head is located near the top of the uterus and buttocks facing the birth canal with both hips in flexion and knees in extension

68
Q

Complete breech

A

The head will be located near the top of the uterus, legs folded at the knees and crossed, and feet near the buttocks

69
Q

Incomplete breech

A

This presentation has the baby in the head position with one leg in extension and both hips in flexion

70
Q

Transverse lie

A

The baby will be in the horizontal position

71
Q

Footling breech

A

The baby is head up with one hip in extension and one hip in flexion

72
Q

Webster’s technique

A
  1. Check for leg lag
  2. Adjust on the sacrum on the side of leg lag
  3. Re-check the leg lag
  4. Hold abdominal trigger points in the lower quadrant opposite leg lag
  5. Repeat every other day - adjust nothing else that day
  6. Continue for up to 3 weeks
73
Q

Facial brow presentation technique

A
  1. Check for leg lag
  2. Adjust on the sacrum on the side of leg lag
  3. Re-check the leg lag
  4. Hold abdominal trigger points in the lower quadrant on the ipsilateral side of leg lag
  5. Repeat every other day - adjust nothing else that day
  6. Continue for up to 3 weeks
74
Q

Transverse lie presentation technique

A
  1. Check for leg lag
  2. Adjust on the sacrum as a BP
  3. Re-check the leg lag
  4. Hold abdominal trigger points in the lower quadrant on bilaterally
  5. Repeat every other day - adjust nothing else that day
  6. Continue for up to 3 weeks
  7. If there is leg lag and the baby has moved around, begin with basic turning procedure

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