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Pediatrics > Midterm > Flashcards

Midterm Flashcards

1
Q

Transactional Model of Development

A

reciprocal relationship between the child and the caregiving environment

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2
Q

proximal vs distal environment

A

distal - curbs, wheelchair ramps, playgrounds, etc

proximal - within the home

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3
Q

What is the ACE study?

A

looks at effect of childhood trauma on health

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4
Q

Barnard-Four features of successful parent-child interactions

A
  • Sufficient repertoire of behaviors, such as body movements and facial expressions
  • Contingent responses
  • Rich interactive content in terms of play materials, positive affect, and verbal stimulation
  • Adaptive response patterns that accommodate the child’s emerging developmental skills
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5
Q

Multidisciplinary service

A

Professionals work independently but recognize and value the contributions of other professions

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6
Q

Interdisciplinary service

A

Individuals from different disciplines work together cooperatively to evaluate and develop programs.
Emphasis is on teamwork. Role definitions are relaxed.

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7
Q

Transdisciplinary service

A

There is teaching and ongoing work among professionals across traditional disciplinary boundaries. Role release occurs when a team member assumes the responsibilities of other disciplines for service delivery

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8
Q

what are positive signs? examples?

A
  • behaviors that are present and not expected in the typical population
  • lead to increased frequency or magnitude of muscle activity, movement, or movement patterns
  • hypertonia, chorea, tics, tremor
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9
Q

What are negative signs? examples?

A
  • behaviors that are absent because of the pathophysiology
  • insufficient muscle activity or insufficient control of muscle activity
  • weakness, impaired selective motor control, apraxia, ataxia
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10
Q

T/F: Negative signs are easier to detect in the clinic

A

false - positive signs are easier to detect

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11
Q

______ motor signs may be even more significant contributors to disability that _______ signs

A

Negative, positive

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12
Q

Reduced Selective Motor Control

A

impaired ability to isolate the activation of muscles in a selected pattern in response to demands of a voluntary posture or movement

  • muscles are able to generate full force in other contexts, just not voluntary
    ex: activation of knee and hip flexors during DF
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13
Q

ataxia

A

inability to generate a normal or expected voluntary movement trajectory that cannot be attributed to weakness or involuntary muscle activity about the affected joints
- can lead to decreased accuracy

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14
Q

Dysmetria

A

inaccurate motion to a target

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15
Q

Dyssnergia

A

decomposition of multijoint movements

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16
Q

Dysdiadochokinesia

A

lack of rhythmicity

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17
Q

Apraxia

A

impaired ability to accomplish previously learned and performed complex motor actions that is not explained by ataxia, reduced selective motor control, weakness, or involuntary motor activity

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18
Q

Developmental dyspraxia

A

failure to have ever acquired the ability to perform age-appropriate complex motor actions
ex: monkey bars, jump 3 times, tying shoes

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19
Q

head/neck extension response

A

facilitates extension and inhibits flexion

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20
Q

head/neck flexion response

A

facilitates flexion and inhibits extension

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21
Q

head/neck lateral flexion response

A

facilitates hip abduction

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22
Q

arms ER, supination, extended elbows response

A

facilitates trunk extension and inhibits trunk flexion

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23
Q

arms IR response

A

facilitates trunk flexion and inhibits trunk extension

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24
Q

Arms horizontal abduction w/ ER response

A

facilitates ER of hips and inhibits spasticity of pecs

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25
Q

Arms elevated overhead w/ ER response

A

very facilitatory to extension may

- may be too much

26
Q

arms diagonally backward w/ ER response

A

facilitates trunk extension and hand opening

- may use w/ ambulatory child to build extensor tone

27
Q

Abduction thumbs response

A

facilitates finger opening

28
Q

legs and pelvis flexion of hips and knees response

A

favors abduction and ER of hips, ankle DF

29
Q

legs and pelvis ER of lower extremities in standing response

A

facilitates hip abduction and ankle DF

30
Q

DF of toes 2-5 response

A

inhibits LE spasticity and facilitates DF

31
Q

anterior pelvic tilt response

A

promotes extension

32
Q

posterior pelvic tilt response

A

promotes flexion

33
Q

What is the GMFCS?

A

gross motor functional classification system

34
Q

T/F: GMFCS is an outcome measure

A

false - it is a classification system

35
Q

T/F: In CP, stiffness is usually greater distally than proximally.

A

true

36
Q

athetosis

A

slow, involuntary, and writhing movements of the limbs, face, neck, tongue, and other muscle groups

37
Q

GMFCS Level V – 90% of motor potential reached by age ___

A

3

38
Q

GMFCS Level I- 90% of motor potential reached by age ___

A

5

39
Q

What are poor prognosis for ambulation?

A
  • rigidity

- persistent tonic neck reflexes

40
Q

What are predictors of ambulation potential?

A
  • hemiplegic

- sit by 24 months

41
Q

Nearly all who eventually walk do so by age ___ – only exception are kids w/ pure athetosis

A

8

42
Q

Indications needed for posterior spinal fusion

A

curve approaching 90 degrees when the child is sitting w/ difficulty side bending back towards the middle

43
Q

benefits of standers

A
  • standing w/ abducted hip to promote compression of hip

- weight bearing helps acetabulum form, blood flow, bone density, improved digestion, breathing, alertness

44
Q

What type of deformity is more common at the foot and ankle in hemiplegia? What muscles are weak?

A

varus deformity

- weak fibularis/peroneals, spastic anterior and posterior tibialis

45
Q

Kids start to realize their differences around age __

A

6

46
Q

How to test for femoral antetorsion?

A

lay kid on stomach and IR and ER LE

47
Q

uncompensated femoral antetorsion gait

A

pigeon toe

48
Q

compensated femoral antetorsion gait

A

gait w/ external tibial torsion

49
Q

How to assess for tibial torsion? What is more common?

A

lay kid in prone and look down calcaneus and look at angle to the thigh

external is more common than internal

50
Q

What muscle is weak w/ foot flat?

A

tib posterior

51
Q

What muscle is weak w/ flat foot step?

A

poor DF

52
Q

What muscle is weak w/ toe walking?

A

PF contracture

53
Q

CP knee flexion gait cause

A

hip or knee contracture

54
Q

CP lacking hip extension gait can lead to what?

A

can lead to crouched gait and/or shorter stride length

55
Q

______ pulls tibia backwards to help extend the knee in midstance

A

Soleus

56
Q

Why is there limited swing phase knee motion in CP?

A

hip flexors supply momentum and rectus gets recruited and ends up also extending knee
- 2 joint muscles are a problem in CP

57
Q

crouched gait requirements. What does it require?

A

knee flexion > 20 during initial contact or stance phase

  • requires more quad strength, chronic stress to knee, and often results in patella alta
58
Q

The crouched position itself reduces ________ control. What muscle becomes a knee flexor that is not usually a knee flexor?

A

extensor

  • rectus femoris
59
Q

Kids exposed early on to alcohol have different ________ as that is developed early

A

facial features

60
Q

Kids exposed later in term to alcohol have _________

A

behavioral issues

61
Q

What are the causes of crouched gait? (6)

A
  • lower limb extensor weakness
  • loss of PF/knee extension couple
  • weakness of soleus
  • lever arm dysfunction due to femoral and tibial torsion
  • popliteal angle/spastic hamstrings
  • tight hip flexors

Pediatrics (5 decks)

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