Normal Human Development Flashcards
What is growth?
Quantitative changes in size, dimension, or structure–quantitative (it can be measured) (e.g., height, weight, head circumference)
How do we measure head circumference?
Tape measurement (globella or most prortuded part of forehead, and then it should cross across the occipital protuberance and then goes back to the golbella)
Hanggang kelan ba lumalaki ang head circumference?
20-21 years old
What is development?
Quantitative and qualitative changes that occure throughout life. These are refinement of skills.
What is adaptation?
These are changes in response to the environment or situation demands
Why do we need to adapt?
For survival (e.g., skin color, antibody formation)
What is assimilation?
Assimilation is application of past information to new information (e.g., using concepts learned from undergrad → boards review)
What is accommodation?
Accommodation is alteration of past information in light of new information (e.g., eat a watermelon seed)
What is fetal age?
Age of fetus
There are two ways to get the fetal age, what are they?
Gestational age
Conceptional age
What is gestational age?
Also known as age of gestation (AOG), measured from the first after the last menstruation.
This is the most common indicator of fetal age
This is the most common indicator of fetal age. What is this called?
Gestational age
What are the terms used in gestational age? Their week counts?
Normal term (38 - 42 weeks)
Pre-term < 38 weeks
Post-term > 42 weeks
What is conceptional age?
Age of conception/AOC
Measured from the last sexual intercourse
Considered as the most accurate
What is chronologic age?
Age counted from birth
What is the adjusted age?
Used to assess which milestones are expected of a preterm infant
How do we compute the adjusted age?
Chronological age in months - 40 weeks - AOG (age of gestation) / 4 weeks
Chronological age (weeks - (40 weeks - AOG)
You have a 9-month old px born at the 25th week of gestation
9 months - (40 weeks - 24 weeks/4 weeks)
9 months - (16 weeks/4 weeks)
9 months - 4 months
5 months
What is ovulation? It is triggered by?
- It is the formation of one or more egg cell
- Triggers by luteinizing hormone
What is ovum?
Product of a 28-day ovarian cycle (ovum is synonymous to egg cell)
What is fertilization?
- Chromosomal union of the sperm cell and egg cell (the egg cell and sperm cell unite, haploid cells)
What is zygote? When is it called zygote?
Fertilized egg cell
We call it zygote from fertilization → implantation
What is morula?
It is spherical ball of cell undergoing rapid mitosis
What is blastocyst?
Advanced form of morula capable of implantation (implanted at the uterus)
What is an embryo?
From implantation → to 5-8 weeks (2 months)
What is a fetus?
5-8 weeks (2 months) → term
What is gastrula?
Formation of primary germinal layers (precursor of the primary germinal layers)
What is conceptus?
Developing placenta and embryo
What is the correct cycle of embryonic development?
Ovulation → ovum → fertilization → zygote → morula → blastocyst → embryo → fetus → gastrula → conceptus
What are the 3 primary germinal layers?
Ectoderm, mesoderm, endoderm
The process of forming the gastrula is called __________.
Gastrulation
What is ectoderm? It is a precursor to?
Outermost layer
Precursor to the integumentary system and nervous system
What is the mesoderm? It is a precursor to?
Middle layer
Precursor to:
- renal system,
- musculoskeletal system,
- cardiovascular system, and
- reproductive system
What is endoderm? Precursor to?
It is the innermost layer.
Precursor to: endocrine, digestive, and respiratory
What is Piaget’s Cognitive Development?
- Child is actively responsible for development
- Child is explorative and curious
- Child learns from 5 senses
Give an example for Piaget’s Cognitive Development
A child learns that something is hot by touching it. So, the child will no longer touch it.
What are the four stages of Piaget’s Cognitive Development?
Sensorimotor, Preoperational, Concrete Operational, and Formal Operational
Immature reflexes, circular reaction (cause and effect reaction). What stage is this in Piaget’s and what is the expected age for this stage.
Sensorimotor Stage. Birth to 2 years old
Symbolic language, active play, egocentricity. What age is this expected and what stage is this in Piaget’s Cognitive Development?
2 years old. Preoperational Stage
This is when the child is able to do logical thinking, conservation, inductive reasoning (something specific but you are able to generalize it e.g., you have a brown cat with four legs named Brownie and then you see a dog that is brown and has 4 legs and you say that the dog looks like brownie.) What age is this expected and what stage of Piaget’s Cognitive Development?
Concrete Operational Stage, 7 years old
This is when you are able to do abstract thinking, problem solving, deductive reasoning. What stage is this in Piaget’s Cognitive Development? What age is this expected?
Formal operational stage; 11 years old
He was the one who developed the psychosexual development, wherein the development of cognition is dependent on internal pleasure.
Sigmund Freud
This stage is when the child puts things in mouth. What age is this expected?
Oral stage: 0-18 months
What are the two categories under the oral stage?
Oral incorporative and oral aggressive
What is oral incorporative?
Subo ng subo, gullible, excessive eating/drinking, unusual optimism
What is oral aggressive?
Kulang sa subo, hostile, aggressive, unusual pessimism
This is the stage wherein the child takes pleasure in pooping. What age is this expected?
Anal stage; 18-36 months
What is anal aggressive?
Tae ng tae, disorganized, temper, gift giving,
What is anal retentive?
Kulang sa tae, stubborn, hoarder, organized, madamot
What is the third stage of the pyschosexual stage? What age is this expected and what is expected of the child under this stage?
Phallic stage. The age expected age is 3-6 years old. There is concept of genitals and masturbation (assessing the genitals)
What is oedipus complex? What stage is this under?
Can only be seen from boys. Desire for mom. Wants to replace father. There is castration anxiety–mimics father. Phallic stage.
What are the stages under Phallic stage?
Oedipus complex and elektra complex
WHat is elektra complex
In girls. Desire: dad. There is penis envy: weak supergego, resolved if she conceived a male child
What is the latency stage? What age is expected for this stage?
6 years - puberty
There is decreased desire for genitals. Child is busy refining other skills. Boys will play with boys and girls will play with girls.
This is the stage where the concept of reproduction happens. What age is expected for this stage?
Genital stage; puberty +
This is the first stage of psychosocial development
Trust vs Mistrust
How is trust built in the first stage?
Everything is being provided
What virtue will develop for Stage I
Hope
This is the second stage of psychosocial development. What age is expected in this stage? What virtue is under this stage
Autonomy v Shame and Doubt; 2-3 years old.
Virtue: Will
This is the third stage of psychosocial development. What virtue will be imprinted and what age is expected at this stage?
Initiative vs Guilt (4-6 years old)
Virtue: Purpose
This is the fourth stage of psychosocial development. What virtue will be imprinted and what age is expected at this stage?
Industry vs Inferiority ; 7-12 years
Virtue: Competence
This is the fifth stage of psychosocial development. What virtue will be imprinted and what age is expected at this stage?
Identity vs Role Confusion; 13 -19 years old
Virtue: Fidelity
This is the sixth stage of psychosocial development. What virtue will be imprinted and what age is expected at this stage?
Intimacy vs Isolation; 20 - 34 years old
Virtue: Love
This is the seventh stage of psychosocial development. What virtue will be imprinted and what age is expected at this stage?
Generativity vs Stagnation ; 35-65 years old
Virtue: Care
This is the last stage of psychosocial development. What virtue will be imprinted and what age is expected at this stage?
Ego Integrity vs Despair
Virtue: Wisdom
What is the apgar?
- Done at birth and every 5 minutes
- Appearance, Pulse, Grimace, Activity (Tone), Respiration
You will give 0 point in appearance, pulse, grimace, activity, respiration
- AppearanceL Cyanotic/pale;
- Pulse: 0;
- Grimace: NR (no response);
- Activity (tone): Floppy,
- Respiration: Apneic
You will give 1 point for appearance if
Px has peripheral cyanosis only
You will give one point for pulse and grimace if
Pulse: <100; Grimace: Grimace or weak cry when stimulated
You will give one point for activity (tone) of the baby if:
There is some flexion
You will give one point for respiration if:
There is slow, irregular breathing
You will give two points for appearance if:
Pink
You will give 2pts for pulse if:
100-140
You will give 2pts for Grimace if:
Cry when stimulated
You will give 2 pts for activity (tone) if:
Well flexed and resisting extension
You will give 2 pts for respiration if:
Strong cry
APGAR will not determine the development of a child. True or False
True. APGAR will show if the child needs resuscitation
If the child gets 5-7 points, what is needed for the child?
Blow-by O2
If the child gets 3-4 points in APGAR, what is needed for the child?
Mask or bag ventilation
130 - < IQ
Genius
Memorize the IQ Scoring. State them one by on
130 - < Genius,
120-129 Superior.
110 - 119 Above Average
90-109 Average,
80-89 - Below Average,
70-79 Borderline,
50-69 Mild MR (Moron),
35 - 49 Moderate MR (Imbecile),
20-34 Severe MR (Idiot),
10 -19 Profound MR (Idiot)
Flexor Withdrawal. What is the stimulus and response
Stimulus: Noxious stimulus at the sole of footing (sitting)
Response: Toes extension, DF of leg, flexion of entire extremity uncontrollably
Crossed extension. What is the stimulus and response
Stimulus: noxious stimulus at the ball of foot (supine)
Response: Opposite LE flexion, adduction, and extension
Traction. What is the stimulus and response
S: Grasp forearm and pull to sit
R: Infant grasps PT’s forearm and total flexion of UE
Moro reflex: What is the stimulus and response
Stimulus: Sudden change in head position in relation to trunk; OR drop infant backward
Response: Sudden shoulder extension, abduction, hand opening, and cry → flexion of UE and adduction across chest
Plantar grasp. What is the stimulus and response
Stimulus: Maintained pressure on ball of foot
Response: Maintained toe flexion
. Palmar grasp. What is the stimulus and response
timulus: Maintained pressure on palm of hand
Response: Maintained flexion of fingers
Startle reflex. What is the stimulus and response
Stimulus: Sudden loud or harsh noise
Response: Sudden extension, abduction → crying
This is the reflex that persists throughout life.
Startle reflex
What are the primitive/spinal reflexes
- Flexor withdrawal,
2, crossed extension, - traction,
- moro reflex,
- plantar grasp,
- palmar grasp,
- startle reflex
What are the tonic or brainstem reflexes?
- STNR (Symmetric Tonic Neck Reflex),
- ATNR,
- Positive Reaction/Support,
- TLR,
- Associated reaction
STNR. What is the stimulus and response
Stimulus: Head flexion or extension
Response: Flexion of neck → UE flexed, LE extended; Extension of neck → UE extended, LE flexed
Also known as the crawling reflex
If the STNR is not integrated, what happens?
Difficulty performing quadruped position
ATNR (Asymmetric Tonic Reflex). What is the stimulus and response
Stimulus: Head rotation to one side
Response: Fencer position
Skull side: flexed
Jaw side: extended
What happens if the ATNR is not integrated?
Difficulty with rolling, hand-to-mouth, problem with feeding
Positive reaction/support. What is the stimulus and response
Stimulus: Contact on ball of foot
Response: Rigid extension of (Both) LE
Failure to integrate the Positive reaction will
Difficulty in walking and stair negotiation
TLR (Tonic labyrinthine reflex). What is the stimulus and response
Stimulus: Prone or supine
Response:
Prone: Increased flexor tone
Supine: Increased extensor tone
Associated reactions. What is the stimulus and response
Stimulus: Resisted movement of one side
Response: Opposite limb mimics the movement of the test limp
Developmental Directions
- Proximal before distal
- Total before localized
- Medial before lateral
- Extensor antigravity before flexor A.G.
- Reflex before cortical control
- Cephalic before Caudal
- Flexor weight bearing before extensor wb
- Cervical before rostral
- Gross motor before fine motor
- Flexion before extension
Most common childhood disability
Cerebral palsy
What is cerebral palsy?
A disorder as a result of non-progressive lesion or injury of premature brain
This is the most common risk factor of cerebral palsy
Prematurity
Monoplegia
One limb
Hemiplegia
One side
Triplegia
3 limbs
Diplega
All 4s
LE more affected
Quadriplegia
All 4s
UE more affected
Tetraplegia
UE and LE are equally affected
All 4s
Paraplegia
Normal UE, abnormal LE
This is the most common type due to prematurity
Spastic diplegia
This is the worst type of CP
Spastic quadriplegia
Best prognosis. One side
Spastic hemiplegia
