Mod 6: Peds/Pregnancy Flashcards by Alyssa Donley

ideal position for exercise after 1st trimester

L sidelying

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preg: mobilize (2)
general strength?

mobilize rib cage & thoracic spine
core & lumbar strength for stability & posture, Kegels, TAs

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this mm spasm/shorten d/t postural changes & hip ER in preg

piriformis

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techniques for standing posture in preg

weight on heels to center shifted COM
relax glutes
scap retraction to lift ribs
chin tuck
knees slightly bent (not locked)

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diastasis recti diagnosis

hooklying- rectus abs crunch w/ 2 finger width or greate

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aerobic ex FITT in preg

50-60% MHR, 30 min

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absolute contraindications for aerobic ex

heart disease
RLD
PTL risks
persistent bleeding
active labor
preeclampsia
placenta previa

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relative contraindications for aerobic ex

severe anemia
cardiac arrhythmia
chronic bronchitis
poor controlled DM 1, seizures, hyperthyroidism
extreme over/underweight

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Contraindicated modalities in preg

electrotherapy or US on trunk
hydrotherapy (inc. core body >100.8F)
diathermy
mech. traction
prolonged positioning- supine, prone, R sidelying

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Avoid these exercises on preg Bedrest

abdominal exercise (TA set, rectus abs)
no Valsalva

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APGAR categories
-when calculated
-passing score is ___

appearance, pulse rate, grimace, activity, respiration
check at 1 min & 5 min after birth
7-10 score

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Steps in Motor Planning (7)

attend to instructions/listen
recall them in correct sequence
carry out task
adapt motor behavior to complete task
recognize success/failure
interpret problems leading to failure
re-adjust/modify

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receipt & propulsion requires judging ____ (3)

speed, direction, distance

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when might primitive reflexes reemerge?

when stressed or injured
if UMN lesion

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Name 2 transitional reflexes, not present at birth

STNR
Landau

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-stroke sole of foot in upward direction & toes fan out
from birth - 12/24 mo

Babinski reflex

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touch on cheek causes head to turn with mouth open
28 wks gestation to 3 mo

rooting reflex

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rooting reflex integration for:

head control development, optical righting

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when head drops into extension, arms abduct/ fingers open and then cross into adduction with crying
28 wks gestation to 5 mo

moro reflex

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moro reflex integrates for:

sitting progression; balance reactions, protective response, hand-eye coordination

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pressure applied to extended LE and the opposite LE flexes
birth to 6 wks

crossed extension reflex

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pressure on palm of hand cause baby to grip
birth to 4 mo

palmar grasp

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palmar grasp integrates for:

WB on hands, voluntary grasp/release, pushing prone to supine

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pressure to base of toes causes toe flexion
28 wks to 9 mo

plantar grasp

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plantar grasp integrated for:

LE WB with flat feet, balance reactions, weight shifts in standing

touch skin along spine from shoulder to hip causes lateral flexion to same side of stimulus 30 wks gestation to 2 mo

Galant's Response

Galant's response integrates for:

sitting balance

head turns side & arm/ leg on face side extend, arm/leg on scalp side flex birth to 6 mo

asymmetrical tonic neck reflex

ATNR integrates for:

rolling, crawling, feeding, visual tracking, midline use of hands

head position into flexion causes arm flexion/ leg extension head position into extension causes arm extension/leg flexion 6-8. mo

symmetrical tonic neck reflex (STNR)

STNR integrates for:

POE, quadruped, crawling reciprocally, sitting balance

position of head causes body/extremities held in extension in supine -body/extremities held in flexion in prone birth to 6 mo

Tonic Labyrinthine Reflex TLR

TLR reflex integrates for:

initiating rolling, POE, supine to sit transitions, sitting balance

loud sudden noise causes arms to abduct w/ elbows flexed & hands closed 28 wks gestation to 5 mo

startle reflex

startle reflex integrates for:

sitting balance, protective response in sitting, hand-eye coordination, attention

weight placed on balls of feet when upright causes trunk/LE to extend 35 wks gestation to 5 mo

positive support

positive support reflex integrates for:

standing/walking, balance reactions, possible contractures

supported upright w/ feet on solid surface cause reciprocal flex/ext of legs 38 wks gestation to 2 mo

walking/stepping reflex

walk/step reflex integrate for:

standing/walking, balance reactions, weight shifting

child held suspended in prone causes extension of head, trunk & LEs 3mo to 12/24 mo

Landau reflex

Landau reflex absence may indicate:

hypertonia or hypotonia

3 righting reactions that orient head to vision, vestibular input & w/ tactile cues/proprioception

1- Optical righting reaction 2- labyrinthine righting reaction 3- body on head reaction

2 righting reactions to orient body to head & surface:

neck on body (for segmental rolling) body on body (head & trunk follow leg/pelvis rotation)

order(positions) that balance/tilting reactions develop

prone to supine to siting to quadruped to standing

body stabilizes in response to destabilizing forces applied anywhere to body (except supporting surface)

Postural fixation reactions

reaction that protects body from injury from a fall -extremities will break fall F/B/side

Protective Reactions

Peds Dx: shortening of STM mm d/t cramped position in utero, forceps/vacuum delivery, etc -mm tissue becomes fibrotic

Torticollis

Peds Dx: hip instability d/t cramped position in utero, birth hormones, tight swaddling -clunk, asymm. leg length

developmental dysplasia of the hip

prematurity may cause these pathologies:

respiratory distress syndrome > bronchopulm. dysplasia seizures aspiration intraventricular hemorrhage dev. delays asphyxia encephalopathy cerebral palsy

interventions for prematurity: positioning?

promote flexion avoid supine -develop midline orientation

Peds Dx: movement disorders d/t brain damage acquired in utero, during birth, or infancy before age 2 s/s: variable, abnormal mm tone, impaired movement modulation, abnormal reflexes, impaired mobility

Cerebral Palsy

2 primary motor patterns w/ CP 4 types of distribution to extremities

spastic (motor cortex, UMN) or athetoid (basal ganglia) monoplegia, diplegia, hemiplegia, quadriplegia

various forms of myelodysplasia (neural tube deficit) -in thoracic, lumbar or sacral regions -lack of folic acid causes failure of neural tube to close

spina bifida

-non fusion of spinous process of vertebrae though meninges intact -herniation of meninges, CSF & spinal cord w/ defect extending through vertebrae -cyst-like protrusion through non fused vertebrae -herniation of meninges & CSF into sac that protrudes through vertebral defect

spina bifida occulta myelomeningocele spina bifida cystica meningocele

cerebellum protrudes into cervical spine through magnum foramen d/t hydrocephalus

Arnold chiari malformation

what is used in spina bifida to prevent hydrocephalus? where does it drain?

ventricular shunt catheter drains CSF into peritoneal cavity

non-progressive NM disorder from 1st trimester s/s: cylinder like extremities, contractures, joint dislocation, mm atrophy

arthrogryposis multiplex congenita (AMC)

group of disorders characterized by difficult social interaction, communication, repetitive behaviors

autism spectrum disorder

progressive disorder caused by absence of gene required to produce dystrophin & nebulin -fat & fibrotic tissue replace mm s/s: proximal to distl weakness; no core stability

Duchenne's muscular dystrophy

precautions w/ Down Syndrome

hyperflexibility/hypermobile jts so don't overstretch congenital heart disease: know cardiac status AA jt unstable & alar ligament laxity: no tumbling/gymnastics hypotonic mm: don't overdo exercise

genetic condition diagnosed by physical attributes & behavior patterns (chrom 5 deleted) s/s: small hands/feet, hypotonia, obese, coordination & intellectual disability, constantly hungry

Prader-Willi Syndrome

progressive degeneration of anterior horn cells (LMN); autosomal recessive -progressive mm weakness/atropohy, dec DTRs, normal sensation & intelligence

spinal muscular atrophy (SMA)

who pays for medical based ped therapy?

private insurance, Medicaid, out of pocket -in private clinics, hospitals, home based

IFSP? therapy goals are related to what? for ages: ___

individualized family service plan education related goals but home based birth to 3 years

IEP? for ages: ____

individualized education plan ages 3+ to age 21

when? lifts chin in prone roll partly to side track object to midline

newborn to 1 month

when? kicks legs reciprocally roll prone to supine lift head in prone

2-3 months

when? POE roll supine to side sit alone briefly

4-5 months

when? roll supine to prone 1 arm reach sit independently radial palmar grasp

6-7 months

when? quadruped pulls to stand

8-9 months

when? crawling stands briefly without support

10-11 months

when? walks independently crawls up stairs

12-15 months

when? squats in play walk backward stairs w/ help kick/throw ball

16-24 months

when? tricycle SL hops scissors w/ help walk downstairs alt. feet

2 yrs