Paeds Flashcards
Describe the APGAR assessment
Neonatal Ax Appearance, pulse, grimace, activity, respiration Each scored 0-2 Score of 0-3 = sig distress 4-6 = mild distress
Asymmetrical Tonic Neck Reflex
0-4 mo
Head turned to one side with ipsi arm extended and contra flexed
Moro Reflex
When feeling like falling will open arms and bring them back to chest
Grasping Reflex
0-4mo
Grasp when pressure is out on palm, will relax if stroke back of hand
Stepping Reflex
Body weight shift and will make stepping motions (first 2 mo)
Symmetrical Tonic Neck Reflex
3mo
Neck flexion causes UE flex and ext LE
Neck extension causes UE ext and LE flex
Plantar Grasp Reflex
28wks -9-10mo
Pressure to base of toe = toe flexion
Rooting Reflex
Up to 3 mo
Stroke side of cheek and will open mouth and turn towards side of stim
Describe the 3 postural reactions
Righting - head will orient to upright position
Equilibrium - related to trunk stability
Protective - extending arms with sudden displacement so not to fall
Development - Birth to 3 mo
Able to turn head to side, brief head righting, random kicks in supine, maintain head midline, reflex grasp
Development - 4-5 mo
Able to prop with extended elbows, head control, rolls, supported sitting (good head control, turns head), WB in standing when supported, grasp/hold small toys, inc frequency of reaching
Development - 5 mo
Head control in sitting
Development - 6 mo
Sitting independent, use hands for play, stands with support, straight reaching path, radial-palmar grasp
Development - 7 mo
Anticipate and orient hand for reach and grasp, commando crawling
Development - 8-9 mo
4 point kneel, moves from sit to prone, pivots in sitting, may pull to stand, points and pokes, pincer grip
Development - 10-11 mo
Transfer from sit to stand, picks up objects from floor , stands hands free briefly; mobility (cruising, crawls, walking with hands held)
Development - 12-18 mo
Walks independently, squats, stairs with rail/hands, throws ball, walks backwards and sideways
Development - 2-2.5yrs
Propels or steers push toys, walk on tiptoes, jumps, stands on one foot, ascend and descend stairs
Development - 3-5yrs
Climb stairs independently, run faster and more controlled, walk straight line, dress and eat independent, skip
Prader-Willi Syndrome (s/s)
Related to disturbance in hypothalamus, genetic deletion (chromosome 15 usually)
S/S: hypotonia, intellectual impairment, short stature, hyperphagia (extreme obesity, behaviour problems)
Neonatal Respiratory Distress Syndrome (+ s/s)
<37 weeks gestation due to lack of surfactant
S/S: tachypnea, indrawing, cyanosis, occurs soon after birth
Arthrogryposis Multiplex Congenital (+s/s)
Rare non progressive neuromuscular syndrome (unknown etiology)
S/S: joint contractures, muscle weakness, poor muscle development
Fibrosis - can lead to scoliosis, heart defects, resp problems
Salter Harris #
Affects growth plate in children
Pagets Disease (+s/s)
Localized disorder of bone remodelling (excessive resorption followed by increase in bone formation) = structurally disorganized mosaic of bone = weaker, larger, less compact, more vascular, more susceptible to #
S/S: usually asymptomatic, bone pain, secondary OA, deformity, excess warmth, neuro complications
Acromegaly (+ complications)
Pituitary gland produces excess growth hormone during adulthood = increased bone size (in children = gigantism)
Complications: HTN, OA, cardiomyopathy, DM, precancerous growths on lining of colon, sleep apnea, carpal tunnel, uterine fibroids, hypopituitarism
Osgood-Schlatter Syndrome
Activity related pain and swelling of insertion of patellar tendon on tib tub = self limiting
Caused by minor degree of separation of tib tub, associated with patella alta
Usually 10-15yrs (boys more)
Osteochondritis Dissecans
Lesion of subchondral bone and articular surface (distal femur most common)
Due to ischemic necrosis
Torticollis (+ causes, presentations)
Rotational deformity of Csp with secondary head tilting (lat tilt and contra rotation)
Types:
Congenital Muscular - uni shortening of SCM at birth (causes: birth trauma, intrauterine malposition, perinatal compartment syndrome, genetics, more time on back)
Presentations:
SCM ‘tumor’ - palpable mass
Muscular - thickening of SCM
Postural - clinical features but no mass or shortening
Describe 4 possible outcome measures.
Functional Mobility Scale - want high score, questions not observation, used to figure out devices - rates walking at 5, 50, 500m
GMFCS - 5 levels (1 = high; 5 = limited), based on self initiated motion
GMFM - standard test for gross motor for CP, all items a 5yo would do
COPM - identifies goals in self care, productivity, leisure
