Newborn Flashcards
Neonatal period
first 4 weeks
Ductus arteriosus
closes within hours of birth
During fetal development, the ductus arteriosus serves as..
a shunt between the pulmonary artery and the aorta
Persistent Fetal Circulation or PDA
Pulmonary Hypertension
Common in preemies
Usually closes naturally
Increase in bilirubin levels, due to liver function
Lots of reasons: Idiopathic, premature, blood incompatibility
Lead to Kernicterus-potential for brain damage
Jaundice
Meconium
in the poop @ birth
Colostrum
Nutrient in breast milk soon after birth
Brain damage that occurs prior to, during or shortly after the birth process
Cerebral Palsy
For old therapist, neonatal reflexes are considered
stereotypical, obligatory response to a given stimuli
Integration of reflexes
As neurological development occurs
No longer the preferred pattern
No longer obligatory
Indication of delay or brain damage
Reemergence after brain damage and in times of stress
Suck swallow reflex
Appears @ 28 weeks gestation
Trigger: downward pressure on the tongue
Response: rhythmic sucking, lips, tongue and jaw (suckling)
Integrates: 2-5 months
— To a mature suck after 2-5 months
Optical righting
same as labyrinthine, except frequently tested in sitting w/ no blind fold
Appears @ birth-2 months
Trigger: hold baby in space, tilt the body (blindfolded)
Response: will attempt (may not be successful, especially early) to right the head
Integrated: life long
Body on Neck, Neck on Body or Body on body
Appears (birth immature-flop) 4-6 months(log)
Trigger:
BON: contact surface with chest
NOB -turn the head
BOB- turn the hips
Response:
BON: head goes into extensions
NOB: body turns in direction of head
BOB: head and upper trunk turn toward hips
Integration:
BON: lifelong
NOB and BOB @ 5 years
Moro or Startle Reflex
Appears @ 28 weeks
Trigger: drop baby w/ loud noise
Response: extension and education of upper limbs
Integrated @ 5-6 months
Traction reflex
Appears @ 28 weeks gestation
Trigger: place baby on back, grab wrists and gently pull to sit
Response: Flexion of shoulder, elbow and wrist (as if they are “helping”)
Integration 2-5 months
Flexor withdrawal reflex
Appears @ 28 weeks
Trigger: poke the baby
Response: pulls leg into flexion
Purpose: protection
Integration 1-2 months (life long)
Crossed extension reflex
Appears @ 28 weeks
Onset: 28 weeks gest
Trigger: Just like Flexor Withdrawal, but hold the leg
Response: other leg will flex and then extend as to avoid stimuli
Integration: 1-2 months
Grasp reflex
Palmar
Appears @ birth
Trigger: pressure to palm
Response: grasp
Integrated 4- (6)11 months
Plantar Onset: 28 weeks Trigger: pressure to foot ́ Response: toes curl Integrated: 9 months Babinski Reflex or Sign NOT NORMAL!! “may see in children” Flexor withdrawal
Galant
Appears @ 28 weeks
Trigger: run stimulus up the side of the spine
Response: curvature toward stimulus
Do both sides- spinal extension
Integration- 2 months
Lower extremity placing
Onset: 35 weeks
Trigger: rub the top of the foot against a table
Response: the baby will “step” up on the table
Hip and knee flexion, ankle dorsiflexion followed by extension
Integration: 2 months
Upper extremity placing
Onset: birth
Trigger: rub the top of the foot against a table
Response: the baby will “step” up on the table
Hip and knee flexion, ankle dorsiflexion followed by extension
Integration: 2 months
Postural support reaction — Positive support reflex
Onset: 35 weeks
Trigger: hold baby up , lower to a table to feet touch it
Reaction: baby attempts to “stand”
Integration: 1-2 months
Parents worry when they quit
Spontaneous stepping reflex — primitive stepping; “walking”
Onset 37 weeks — To walk the womb
Trigger: Feet on a surface, lean baby forward
Response: will “step”
Integration: 1-2 months
ATNR: Asymmetric Tonic Neck Reflex — Cupid/fencing position
Eye hand coordination and reaching
Onset: birth
Trigger: Turn head in a direction
Response: arm (leg) will extend in direction of head, other arm (leg) will flex
Integrated 4-6 months
Early life motor control is:
Dominated by Reflexes
Gravity dependent
Senses
Sense of Taste
Sense of Smell
Sense of Touch/tactile
Reflexes
Rocking
Vestibular
Babies are not blind
Do like high contrast, preference for colors about 4 months
Faces- mom at a month
8-12 inches for best reception
Visual
Response to facial expressions requires
sight , sound and cognition
Preference for patsy or blanket demonstrates
tactile, sight, cognition
gastroesophageal reflux
GERD
Lung immaturity
RDS-Respiratory Distress Syndrome
BPD-BronchoPulmonary Dysplasia
Iatrogenic
Cardiac immaturity
Persistent fetal Circulation
PDA
Musculoskeletal system immaturity
Hypotonic- till 34 weeks
— Cephalocaudal
Very Malleable
— Craniofacial molding
— Clonus: unintentional resistance
Neurological immaturity
Very tender
Hypoxic ischemic encephalopathy
Intraventricular hemorrhage
Vision immaturity
Retinopathy of prematurity (ROP)
