Neonate Flashcards
Full term gestation
38-42 weeks (40 is normal)
Pre-term gestation
Before end of 37 week
Postterm gestation
Anytime after 42 weeks
Normal birth weight
5.5-9.5 pounds
AGA
Appropriate for gestational age (between 10th and 90th percentile)
SGA
Smaller for gestational age (below 10th percentile)
LGA
Large for gestational age (above 90th percentile)
LBW
Low birth weight (less than 2500g or 5 lbs, 8oz)
VLBW
Very low birth weight (less than 1500 g or 3lbs, 5oz)
ELBW
Extra low birth weight (less than 1000g or 2lbs, 3oz)
Typical pattern for baby weight
Lose 5-7% of body weight after birth then will gain 4-8 ounces per week. At 6 months they should be double the birth weight and at one year they should be 2.5 to 3 times birth weight
Normocephaly
13.5 inches
Microcephaly
Below the 10th percentile
Macrocephaly
Above 90th percentile
Failure to thrive
Babies weight falls below the 3rd percentile
Amino acid disorders
Body unable to breakdown proteins and they build up in the body. This can lead to mental retardation and other problems
Fatty acid disorders
Interfere with turning fats into energy. Can cause seizures, poor breathing, problems with blood sugar, heart and muscle function
Organic acid disorders
Interferes with ability to remove certain waste products from the blood
Galactosemia
Can’t break down galactose
Sickle cell disease
Autosomal recessive disorder that causes abnormal RBC’s which can lead to clots. It affects the spleen so most patients are immunocompromised.
Cystic fibrosis
Autosomal recessive disorder where the body produces excessive thick mucous that clogs lungs and creates an environment for infection
Hyperbilirubinemia
Increase in bilirubin because of a high turnover rate of RBCs or immature liver. Can also occur if Rh- mother has Rh+ child
What does APGAR stand for?
Appearance Pulse Grimace Activity Respiration
When is the Apgar taken?
1 minute and 5 minutes after birth (7-10 is a good score)
Infant respiratory rate
30-50 breaths/min
Infant heart rate
100-160 beats/min
Cradle cap
Scaly patches on scalp
Hemangiomas
Many capillaries in one area (blister-like)
Milia
Milk rash that is caused from distended sebaceous glands
Stork bites
Red patches caused from accumulation of blood vessels
Erb’s palsy
C5,C6
Waiter’s tip position
Klumpke’s palsy
C8,T1
Claw hand
Signs of developmental dyplasia of the hip
Unequal crease in thigh
Difference in knee height (shorter knee is one affected)
Ortolani Test
Reduce dislocated hip
Flex hips to 90, abduct hips, and pull up on greater trochanter
Barlow test
Flex knees, adduct hip, and load through the knees
Club foot
Talipes equinovarus
Foot is adducted and plantar flexed
Stage I
Deep sleep, eyes closed, no movement
Stage II
Light sleep, eyes shut
Stage III
Just starting to wake up
Stage IV
Awake, but not moving too much
Stage V
Wide awake, kicking, and looking around
How to check passive tone
Heel to ear
Popliteal angle - flex hip to 90 and try to extend knee (normal is 90-100)
Scarf sign - take arm across neck (should meet resistance at midline)
How to evaluate active muscle tone
Ability to adjust to a new position
Pull to sit
Spontaneous movement
Hip ROM at birth
Flexion contracture of 30 degrees
Lateral rotation is greater than medial rotation
Coxa valga - max 150 degrees
Antetorsion exceeds 25 degrees
Knee ROM at birth
flexion contracture 30 degrees Genu varum (bowlegs)
Talocrural ROM at brith
Dorsiflexion 70 degrees
Vertebral column at birth
Concave anteriorly
How does development proceed?
Cephalocaudal (head to toe) and proximal to distal
Gross motor movements develop before fine motor movements
Primitive Reflexes
Brain-stem mediated, complex movements that begin at 25 weeks gestation and are fully present at birth. They become more difficult to elicit as the CNS matures and cortical inhibition takes over
Dynamic Systems Theory
Motor tasks emerge from many subsystems which can be influenced by physical and environmental factors
Neuronal Group Selection Theory
Neuronal groups (collection of strongly interconnected neurons) that are used more get stronger and the ones that aren’t used disappear. Neuronal groups can be affected by behavior and experience
Central pattern generator
Neural networks that can produce rhythmic patterned outputs without rhythmic sensory or central input
3 requirements for neuronal group selection
Basic repertoire of movement
Availability of sensory info to identify and select adaptive forms of movement
Means to strengthen the preferred movement response
Skinner behavioral theory
Behavior is influenced by the environment. Use positive and negative reinforcement
Piagets 4 stages
Sensorimotor
Pre-operational
Concrete operations
Formal operations
Sensorimotor
Birth to 2 years
Learns through sensory and motor experiences
Discoveries by trial and error
Repetition is important
Pre-operational
2-6 years Starts to use symbols Development of language Egocentric Influenced by fantasy
Concrete Operations
7-11 years
Ability to classify objects according to characteristics
Can solve concrete problems
Formal Operations
12 years to adult
Can deal with hypothetical and real life situations
Can think in abstract terms
Hitching
Scoot butt while seated
Bunny hopping
Bring both LE up at same time in quadraped
Bear standing
upper and lower extremity extended and trunk off floor
5 major attributes of normal walking
Stability in stance Sufficient foot clearance in swing Appropriate prepositioning of foot for initial contact Adequate step length Energy conservation
Attributes of standing posture
Wide base of support
Hips are abducted, flexed, and slight ER
Tibiofemoral varus, mild internal tibial torsion
Heels are everted
When does running begin?
6-7 months after child begins to walk
Weight at 1 year
Triples birth weight and then gains 1/2 pound a month
Weight at 2 years
Quadruples birth weight and then gains about 4-5 pounds a year
Weight at 9-10 years
Increased weight gain as puberty approaches, often about 10 pounds per year
Height at 2-3 years
Grows about 3 1/2 inches a year most children will double their birth height by 3-4 years of age
Height at 3 years to puberty
Grows about 2 inches a year
Type I growth plate fracture
Fracture line extends through physis
Type II growth plate fracture
Fracture line extends through physis and exits through metaphysic
Type III growth plate fracture
Fracture line extends from joint surface through epiphysis and across physis reulting in a part of the epiphysis being displaced
Type IV growth plate fracture
Fracture line extends from joint surface through epiphysis, physis, and metaphysis
Type V growth plate fracture
Crush type injury due to compressive forces
Galloping
First asymmetric gait mode. Seen 9-12 months after walking
Hopping
One footed; Develops to age 5
Skipping
Develops between 4-7 years old
When do girls begin adolescent growth spurt?
9-14 y.o
When do boys begin adolescent growth spurt?
11-16 y.o.
Tanner’s staging boys
Pubic hair
Penis
Scrotum
Tanner’s staging girls
Pubic hair
Breasts
Three components of examination
Patient/client history
Relevant systems review
Tests and measures
3 purposes of assessment
Evaluative - compare old and new results
Predictive - using predictive tools
Discriminative - compared to other kids
Construct validity
How well does your test (instrument) represent the trait being studied (number of pushups performed for strength)
Content validity
How well does your sample represent the population
Concurrent validity
How well does the test correlate with another well known test to measure the same trait
Predictive validity
Performance on the test predicts a beahvior
Norm referenced tests
Compares individual performance against group. Maximizes differences among individuals
Criterion referenced
Compares performance against standard
Discriminates between successive performances of one individual
Z score mean and standard deviation
0 and 1
T score mean and standard deviation
50 and 10
Standard Error of Measurement
Reliability of the response if a test were given a number of times simultaneously
The more reliable the test, the smaller the error of measurement
BOT 2 Motor Test
Norm referenced for ages 4-21 years
2 motor tests developed by PTs
AIMS and TIMP
TIMP Motor Test
34 weeks gestation to 4 months