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A: pediatrics > lecture 1: part 2 new born and primitve reflexes > Flashcards

lecture 1: part 2 new born and primitve reflexes Flashcards

1
Q

what are the 3 periods that gestation is divide into and how long is it

A

first trimester: weeks 1-12

second: weeks 13-26

third: weeks 27-40

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2
Q

when during gestation development is all major body systems established

A

first trimester: weeks 1-12

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3
Q

what happens during the second trimester (weeks 13-26

A

body proportion grow to newborn proportions

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4
Q

what happens during the 3rd trimester: weeks 27-40

A

body weight triples
body length doubles
body fat accumulates (helps w body temperature)
@ 36 weeks the lungs are developed

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5
Q

at how many weeks do the lungs become developed

A

36 weeks

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6
Q

when is a baby considered an embryo

A

first 8 weeks

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7
Q

when is a baby considered a fetus

A

8weeks until birth (40 weeks full gestation)

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8
Q

when is full gestation

A

40 weeks

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9
Q

what are common detrimental environmental influences on the perinatal that could influence development

A

STORCH
tobacco
smoke
alcohol
caffeine
drugs

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10
Q

what is STORCH

A

Syphillis
Toxoplasmosis
Other infections (HIV, Coxsackievirus, Varicella-Zoster Virus)
Rubella
CMV
Herpes

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11
Q

what is teh typical development of a child dependent on

A

 Nervous system maturation
 Genetics
 Environment

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12
Q

what are the directional typical development

A

 Cephalo-caudal (head to toe)
 Proximal to distal
 Gross motor to fine motor

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13
Q

what do newborns need to do

A

breathe , suck and swallow

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14
Q

what is the apgar score

A

test performed by delivering medical team to assess the infant

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15
Q

when is the apgar score delivered at

A

1 minute and 5 min and 10 minutes (if needed)

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16
Q

the apgar score is based on a total score of what

A

1 to 10 ( the higher the score , the better the baby is doing after birth

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17
Q

when is a new born , born

A

38-42 weeks (40 weeks is full term)

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18
Q

when is an infant considered premature? extreme premature

A

< 37 weeks

<28 weeks

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19
Q

what does a new born look like

A

head proportionately larger with short LEs

kyphotic, horizontal ribs

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20
Q

what is the ROM differences for a newborn

A

excessive DF
30° flexion contracture at hips and knees

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21
Q

what is a new born dominated by

A

flexion anf lack of antigravity mm control

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22
Q

In PRONE , how is the newborns UE , LE and head

A

 UE flexion, held to
body, hands fisted

 LE flexion, highly
positioned pelvis

 Head: turned to
one side

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23
Q

In SUPINE , how is the newborns UE , LE and head

A

 UE flexion

 LE flexion,
abduction,
external rotation

 Head: turned to
one side
-No anti-gravity neck flexion so
unable to hold in midline

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24
Q

During a pull to sit in a new born how is the head , what is present thruough the C curve and at the hips

A

head lag

flexion throughout C curve

flexed at hips

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25
Q

Pertaining to a NEWBORN, how is the head and C curve during SITTING

A

head forward: no control and head bobbing

C curve with flexion - no antigravity extension

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26
Q

what colors do a NEWBORN see

A

black and white

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27
Q

pertaining to a NEWBORN , is it easiest to fixate on a moving object ___ and ____

A

laterally and vertically

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28
Q

newborns prefer strong ___ colors

A

contracts at 8-9 inches away

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29
Q

what’s are primitive reflexes

A

involuntary motions that aid in the development of certain skills

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30
Q

As the baby’s brain matures and goes through
typically development these primitive reflexes and
associated involuntary movements should be
replaced with ___ ones.

A

voluntary

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31
Q

As the child’s CNS matures, the involuntary movements become controlled motor responses. If this doesn’t happen, the child will struggle with both ____ and ___ skills.

A

motor and cognitive

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32
Q

A 2018 study by Gieyztor, et al. suggested that preschool children who retained the ___ and ____ reflexes had difficulty with motor skills

A

TLR and ATNR

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33
Q

The same study of 35 children concluded that children with an unintegrated ___ reflex showed poor posture, poor eye-hand coordination, and focusing difficulties. They also had difficulty sitting still at a desk, learning to swim, and playing ball games. Ditto for children who retained the plantar, palmer, and Galant reflexes.

A

STNR

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34
Q

An unintegrated ATNR reflex could have
an adverse affect that may also lead to what?

A

poor eye
tracking

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35
Q

Asymmetrical tonic neck reflex (ATNR)

  • weeks of gestation that it appears:
  • integrates:
  • stimulus
    -response:
A
  • weeks of gestation that it appears: 20
  • integrates: 4-5 months
  • stimulus: turning of head

-response: facial arm extends and abducts , occipital arm flexes and abducts

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36
Q

Rooting reflex

  • weeks of gestation that it appears:
  • integrates:
  • stimulus
    -response:
A
  • weeks of gestation that it appears: 28 weeks
  • integrates: 3 months
  • stimulus: touch to perioral area of hungry infant

-response: turns head and lips toward stimulus

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37
Q

Suck-swallow

-weeks of gestation that it appears:
- integrates:
- stimulus
-response:

A
  • weeks of gestation that it appears: 28-34 weeks
  • integrates: 5 months
  • stimulus: touch to lips and inside mouth for suckling and liquid for swallowing

-response: rhythm is excursions of jaw

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38
Q

Palmar grasp

-weeks of gestation that it appears:
- integrates:
- stimulus
-response:

A
  • weeks of gestation that it appears: 28 weeks
  • integrates: 4-7 months
  • stimulus: pressure on palm of hand

-response: flexion of fingers

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39
Q

plantar grasp

-weeks of gestation that it appears:
- integrates:
- stimulus
-response:

A
  • weeks of gestation that it appears: 28 weeks
  • integrates: 9 months
  • stimulus: supported standing on feet or pressure to sole fo the foot just distal to MT head

-response: flexion of toes

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40
Q

flexor withdrawal

-weeks of gestation that it appears:
- integrates:
- stimulus
-response:

A

-weeks of gestation that it appears: 28

  • integrates:1-2 months
  • stimulus: noxious stimulus to sole of foot

-response: flexion withdrawal of leg

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41
Q

crossed extension

-weeks of gestation that it appears:
- integrates:
- stimulus
-response:

A

-weeks of gestation that it appears: 28 weeks

  • integrates: 1-2 months
  • stimulus : noxious stimulus to sole of foot

-response: flexion of stimulated leg and then extension of opposite leg with adduction

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42
Q

Galant (trunk incurvation)

-weeks of gestation that it appears:
- integrates:
- stimulus
-response:

A

-weeks of gestation that it appears: 28 weeks

  • integrates: 3 months
  • stimulus: in prone , stroke paravetebral skin

-response: lateral curvature of trunk on stimulated side

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43
Q

Moro

-weeks of gestation that it appears:
- integrates:
- stimulus
-response:

A

-weeks of gestation that it appears: 28 weeks

  • integrates: 3-5 months
  • stimulus: head drop backwards ( stimulate for the startle reflex is loud noise with same response)

-response: abduction and extension of arms , splaying of fingers , may be followed by arm flexing and adduction

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44
Q

positive support

-weeks of gestation that it appears:
- integrates:
- stimulus
-response:

A

-weeks of gestation that it appears: 35 weeks

  • integrates: 1-2 months
  • stimulus: ball of feet in contact with firm surface

-response: legs extend to support weight

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45
Q

automatic walking/ reflex stepping

-weeks of gestation that it appears:
- integrates:
- stimulus
-response:

A

-weeks of gestation that it appears: 37 weeks

  • integrates: 3-4 months
  • stimulus : hold upright with feet on support

-response: high stepping movements with regular rhythm

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46
Q

Symmetrical tonic neck reflex (STNR)

-weeks of gestation that it appears:
- integrates:
- stimulus
-response:

A

-weeks of gestation that it appears: 4-6 months after full term delivery

  • integrates: 8-12 months
  • stimulus: flexion or extension of head

-response: with head flexion , arms flex and hip extend , with head extension arms extend and hips flex

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47
Q

during a positive support/ primary stnading reflex how long will the bay extend his legs before flexing his legs and collapsing into a sitting position

A

20-30 seconds

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48
Q

when does teh stepping/automatic walking reflex re appears at

A

10-15 months

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49
Q

when does the sucking reflex appear and integrate

A

appear around 28 weeks of gestation

integrated by 3 months

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50
Q

when does the moro reflex start to integrate by

A

3 month s

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51
Q

he palmar grasp reflex is a primitive, ____ response to a mechanical stimulus present in a newborn.

A

involuntary

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52
Q

what does the integration of the palmar grasp reflex signifies

A

cortical maturation and the development of voluntary motor milestones

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53
Q

a week response to the palmar grasps before 6 months or even after 7 months can be possible injury to what

A

peripheral nerve (root, plexus , or SC)

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54
Q

persistence of the palmar grasp reflex beyond 7 months is usually present in children
with what ?

A

spastic cerebral palsy.

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55
Q

the palmar grasp reflex can also reappear in adulthood, indicating a ___ ___
affecting the ____ or ____ frontal cortex (e.g., ischemic or hemorrhagic
stroke)

A

cortical lesion

medial or lateral

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56
Q

when is the tonic labyrinthine reflex present and integrated by

A

present at birth and integrated by 6 months

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57
Q

Tonic Labyrinthine Reflex (TLR) , tone in prone and supine ?

A

 Prone – infant with greater flexion tone
 Supine – infant with greater extension tone

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58
Q

for the Tonic Labyrinthine Reflex (TLR) when the neck is extended what is increased ? what about when the neck is flexed ?

A

-Neck extended: Increased
extensor tone and extension
of all limbs.

 Neck flexed: Increased
flexor tone and flexion of all
limbs

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59
Q

when is the Tonic Labyrinthine Reflex (TLR) best seen at

A

3 months

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60
Q

are Tonic Labyrinthine Reflex (TLR) and symmetrical tonic neck reflex the same

A

NOOOOO w tonic u are holding baby

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61
Q

if the Galant reflex does not integrate by 9 months what may result in a problem be with

A

inability to sit still

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62
Q

what is the big development at one mounts

A

reduced effects of physiologic flexion as extension develops

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63
Q

for ONE month PRONE there is less what and what does the head do

A

less UE flexion , hip flexion , more anterior pelvic tilt

Head: able to lift
head momentarily
 More active neck extension

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64
Q

for ONE month supine there is less what and what does the head do

A

less UE flexion , some reaching , hands fisted

less LE flexion reciprocal symmetric kicking

head is turned to one side (no anti gravity flexion yet)

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65
Q

during a ONE month old pull to sit is more pronounced wheat lag due to what and what is the spine and hips in

A

due to loss for physiologic flexion

spine and hips in flexion

66
Q

how is the head and curved spine in supported sitting for a ONE month old

A

head forward

curved spine: no anti gravity trunk end tension

67
Q

What is a 2 month old baby characterized by

A

 Decreased flexion dominance
 Increased extension
 Asymmetry: extension not balanced by
flexion

68
Q

Describe what 2 month baby in PRONE would look like (UE. LE, head) where do they weight bear?

A

Less UE flexion , more shoulder abduction

Less LE flexion , pelvis closer to surface

Head: able to lift head 45°

WB on elbows , elbows behind shoulders

69
Q

In a 2 month old baby in SUPINE what is increased and increased? what reflect is present

A

increased shoulder ER

decreased hip flexion , abduction and ER

increased neck rotation

ATNR present with neck rotation (integrated at 4-6 months)

70
Q

decreased a pull to sit in a 2 month old baby

A

Continued head lag
and flexion throughout
the spine

71
Q

describe supported sitting in a 2 month old baby

A

head bob

flexion thru spine; no antigravity trunk extension

72
Q

at 2 months do babies have anti gravity trunk extension

A

no

73
Q

what reflex is integrated at 2 months

A

positive support/ primary standing

74
Q

for a 2 month old baby in stnading do they accept weight thru their LE

A

NO

75
Q

what is the typical emergence for a baby at 3 months

A

emergency of symmetry and balance of neck flexors and extensors

emergence of midline orientation

body awareness

76
Q

how is the UE , LE and head for a 3 month baby in PRONE?

A

UE increased abduction

hip extension , abduction , ER , pelvis flat on surface , knee flexed , feet together

head is able to lift 90° - upper trunk extension

77
Q

where do babies WB in PRONE as a 3 month old

A

on forearms - elbows in line with shoulders

78
Q

when does the babies hands come together , resting in midline on chest with some reaching

A

3 months

79
Q

how is the LE and head for a 3 month old baby in SUPINE

A

hip and knee flexion , abduction , still some ER , heels together

HEAD is in midline - chin tuck - neck flexor activities

80
Q

at what age do babies begin to chin tuck

A

3 months

81
Q

what is head righting ? and when is it the strongest

A

When suspended in a vertical position and tilted slowly side to side, the child will move their head to a vertical position

strongest at 3 months

82
Q

describe what a pull to sit looks like for a 3 months old

A

asymmetric head lifting

neck flexors work inconsistently with extensors

83
Q

describe what a sitting looks like for a 3 months old

A

Head in midline: shoulder elevation and upper cervical extension

Flexion throughout the spine: still not enough trunk extension

84
Q

what is the standing position for a 3 month old

A

some weight on feet again

hip abducted

knees in stiff extension

toes curled (plantar reflex)

85
Q

when is automatic walking integrated

A

at 3 months

86
Q

what is the simple overview for a 4 months old

A

symmetry and balance good between flexors and extensors

good head control

87
Q

describe how a baby is when PRONE at 4 months ( UE < LE < Head)

A

scapular adduction w trunk extension

hip extension and adduction , increased anterior pelvic tilt with lumbar extension

head and chest lifted

88
Q

where does the baby WB in prone at 4 months

A

on forearms , elbows close to body

89
Q

when may a baby accidentally roll over to their sides

A

4 mths

90
Q

when does a bay start reaching above body in midline , hands to knees

A

4 months

91
Q

how is a baby laying in supine at 4 months

A

increased pelvic control , postieror pelvic tilt with hands to knees

head in midline

92
Q

how is the babies pull to sit at 4 months of age

A

no head lag

assists to sit with upper chest and UE flexion , overflow to abs and LE

93
Q

at what age does a baby not have anymore head lag when going from pull to sit

A

4 months

94
Q

how is the head , hips and spine for a baby sitting at 4 months

A

head in midline

hips flexed

curved spine below point of upper trunk extension

95
Q

how is the baby standing at 4 months

A

can be held by hands instead of chest

pelvis behind shoulders

les nay be flex or extend

96
Q

when does a baby develope very beginnings of lateral weight shift and lateral righting reactions
of head and trunk

A

5 months

97
Q

how is the baby positioned in PRONE at 5 months

____ arm WB

weight shift on ____ with reaching

hip ____ and ____

____ and ___ trunk lifted

A

extended arm WB

weight shift on forearms with reaching

hip extension and adduction

head and upper trunk lifted

98
Q

what is “swimming” and when does it start

A

total spinal extension ,movement of UE and LE

start at 5 months

99
Q

when a baby is PRONE reaching at 5 months how is the weight bearing side and reaching side of the LE positioned ? and what is developed

A

Weight bearing side: hip extension, adduction, IR

Reaching side: hip hike, hip flexion, abduction, external rotation

Development of lower extremity dissociation

100
Q

when ,may a baby roll prone to supine

A

5 months

101
Q

how is the baby reaching in SUPINE at 5 months

A

reaching w full shoulder flexion and adduction , elbow , wrist and finger extension - hands to feet

102
Q

when does a baby have increased pelvic control , posteiror pelvic tilt with feet to hands and mouth

A

5 months

103
Q

when does a baby do asymmetrical rolling to sidelying ?

A

5 months

UE and LE dissociation

104
Q

how is the baby positioned in sidelying at 5 months

A

lateral flexion of head away from floor

elongation of WB side -

105
Q

how is the babies LE positioned during SIDELYING at 5 months

A

bottom leg: extended and adducted

top leg: flexed and abducted

106
Q

 No head lag
 Increased
abdominal
control, increased
LE flexion
 Holds head in line
with body
 Assists with upper
extremities

what month does this pull to sit describe

A

5 months

107
Q

how is the baby sitting at 5 months

A

head in midline

flexion at hips , propping on arms or high guard position to stabilize

108
Q

how is the baby standing at 5 months

A

may pull to stand with knee extension and PF

hips in abduction adn ER

hips almost in line w shoulder

lumbar lordosis

109
Q

when dos the mature landau response occur

A

6 months

110
Q

when do postural responses emerge

A

6 months

111
Q

 Good head control in all directions
 Increased control of shoulder girdle
 Mature Landau response
 Prone equilibrium reactions, emerging
in supine
 Postural responses emerge

this overview describes a baby at how many months

A

6

112
Q

what is the landau response

A

in prone , horizontal suspension , head is above horizontal with trunk and extremity extension

examiner flexed the neck and hips so the feet go down

113
Q

when does the landau reflex emerge and last till

A

3-5 months and last until 12 months

114
Q

how is a 6 month old baby in PRONE

A

reaches foward w weight shift on extended arm
- shoulder girdle stability
- elbow, wrist and finger extension

less anterior tilts

“mature swimming”

115
Q

how is the baby reaching in SUPINE at 6 months

A

bilaterally , transfers objects from one hand to another

head: chin tuck

116
Q

how is the babies head in SUPINE at 6 months

A

in chin tuck

117
Q

when can a bay pull to sit independently

A

6 months

118
Q

how is the baby sitting at 6 months

A

back straight

PPT , hips flexed, abducted and ER

UE used for reaching

anterior protective extension

119
Q

where is righting reactions organized

A

in midbrain

120
Q

what is the righting

A

beings able to realign the head or trunk with each other w an outside stimulus

121
Q

when is usually the first of the protective extensions to emerge and when

A

anterior protective extension around 6-9 months

122
Q

what is the anterior protective extension

A

when the baby is in sitting and u push them foward their arms should extend in front to prevent from falling

123
Q

what protective extension usually comes after anterior protective extension and when does it emerge

A

lateral protective extension and around 6-9 months

124
Q

what is the lateral protective extension

A

when the baby is in sitting and u push their hips laterally and their arms should extend to prevent from falling

125
Q

how is the baby stnading at 6 months old

A

able to stand holding fingers

full WB on feet

hips abducted

can bounce up and down with feet on floor

126
Q

when is a baby able to stand by holding fingers

A

6 months

127
Q

 Variety of positions and
movements
 Very active against gravity
 Little time spent in supine

what age does this overview describe

A

7 months

128
Q

how is the baby positioned in PRONE at 7 months

A

quadruped - tummy off the floor

rocks in quadruped

belly crawl

129
Q

when does a baby not line supine anymore and rolls out of it

A

7 months

130
Q

when does a baby develope trunk rotation in sitting and assumes sitting from quadruped

A

7 months

131
Q

how does a baby frequently play at 7 months

A

in sidelying

132
Q

how is the baby stnading at 7 months

A

minimal support

pulls self to stand

133
Q

what is upper extremity parachute and when does it emerge

A

baby is prone horizontal at the chest , you move child toward surface head first and the baby shoudl have symmetrical arm extension and abduction
‘
emerges at 6-7 months

134
Q

when does a baby start to play in supported standing or kneeling

A

8 months

135
Q

8 months PRONE :

what is the primary mode of locomotion and how does the baby transition from quadruped to sitting

A

hands and knees

uses lateral righting

136
Q

Good trunk
extension
 Decreased lower
extremity positional stability
 Rotation-counter
balanced by sideward
protective extension or
equilibrium reactions
 Sitting to quadruped

this deszcribes what age of sitting

A

8 months

137
Q

how does a baby stand at 8 months

A

pulls to stand through kneeling , half kneeling

rotated trunk over LE
cruses sideways

stnading with one hand held

138
Q

when can a bay stand with one hand held

A

8 months

139
Q

what is crawling the primary means of locomotion

A

9 months

140
Q

when is sitting the MOST functional versatile position

A

9 months

141
Q

would we rather a baby side sit or w sit

A

side sit

142
Q

what is the last protective extension to emerge and when does it emerge

A

postieor

9-11 months

143
Q

what is anterior righting and when does it emerge

A

when the baby is sitting , phill them back on shoulder and the baby shoudl extend head and arms foward to recorder balance

around 9 months

144
Q

how is the baby kneeling at 9 months

A

hip extension incomplete

may move to hal kneeling to play

145
Q

how does a baby pull to stand at 9 months

A

uses UE

cruises around furniture

146
Q

how is. a baby doing supported walking at 9 months

A

walks with 2 hand held

decreased LE abduction and ER

147
Q

what is the 10 months overview

A

exploration and practice of motor skills

plays in and out games with containers

148
Q

when is a bay able to long sit

A

10 months

149
Q

how does a baby sit for stability at 10 onths

A

tailor sitting (hip flexion ,abduction and ER)

150
Q

when does a baby start to lower self form standing and reaching for toy with one hand

A

10 months

151
Q

what is the overview for 11 mon this

A

enjoys container play , carrying toys and BI manual activites

beginning of independent standing

152
Q

at 11 months of sitting the baby demonstrated controlled trunk ____ and ____ hip control ; able to use kneeling and half kneeing more

A

rotation

increased

153
Q

how is the baby standing at 11 months

A

stands alone - no UE

wide BOS and LE abduction

squatting

154
Q

when does a bay attempt unsupported walking

A

at 11 months

155
Q

how is the baby walking at 11 months

A

upper extermity fixing

steppage gait with ER

156
Q

what is the overview at 12 moths

A

right reactions are integrated

equilibrium reactions present in all positions except standing

basic motor skills present

157
Q

at 12 onths equilibrium reactions are present in all positions except what ?

A

stranding

158
Q

how is the baby sitting at 12 months

A

rises from floor with legs - no long needs UE and able to weight shift and lift one leg

159
Q

when may a bay use squatting to play

A

12 months

160
Q

how is the baby unsupported walking at 12 months

A

trunk extension
scapular adduction
wide BOS

A: pediatrics (3 decks)

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