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Pediatrics 3B > Pedia 3B - Applied Neurology - Primative Reflexes > Flashcards

Pedia 3B - Applied Neurology - Primative Reflexes Flashcards

0
Q 
Reflex: Palmar Grasp 
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A 
Reflex: Palmar Grasp 
Onset (AOG): 28w
Fully Developed: 32w
Duration/disappears: 2-3m
Elicitation: Dr finger in baby's palm
Normal: thumb locks onto finger tightly
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1
Q 
Reflex:  Plantar 
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Plantar
Onset (AOG): 11w
Fully Developed:
Duration/disappears: 7-9m
Elicitation: Stimulate Metatarsal arch of foot
Normal: Ball of foot drops and “grasps” w/feet; ready to cruise

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2
Q 
Reflex:  Rooting
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Rooting
Onset (AOG): 32w
Fully Developed: 36w
Duration/disappears: Less prominent after 1m
Elicitation: Stroke cheek
Normal: Infant turns toward stimulus and makes sucking motions

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3
Q 
Reflex: Moro  
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Moro
Onset (AOG): 28-32w
Fully Developed: 37w
Duration/disappears: 5-6m
Elicitation: Sudden drop of head (rel. to trunk
Normal: Abduction+Ext of arms+Legs flexed –> Abduction and flexion, flexed fists and flexed flegs

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4
Q 
Reflex:  Tonic Neck
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Tonic Neck
Onset (AOG): 35w
Fully Developed: 1m
Duration/disappears: 6-7m
Elicitation: Head of a relaxed child, laying on back, is rotated to side
Normal: “Fencer stance”
Arm faced extends straight away from body w/hand partially open
Arm on far side - flexed and fist clenched

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5
Q 
Reflex:  Placing/Stepping
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Placing/Stepping
Onset (AOG): 37w
Fully Developed:
Duration/disappears: 4-5m; pt can creep/crawl
Elicitation: Stimulate dorsum of foot against table edge
Normal: Stepping/walking movement

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6
Q 
Reflex: Parachute  
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Parachute
Onset (AOG): 4-9 (7-8?)
Fully Developed: 10-11
Duration/disappears: Masked by voluntary (Remains?)
Elicitation: Hold child upright and rotate body forward by hips (as if falling fwd)
Normal: Arms ext as if to break fall

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7
Q 
Reflex:  Landau  
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A 
Reflex:  Landau  
Onset (AOG): 9-10m
Fully Developed: 
Duration/disappears: Masked by voluntary action 
Elicitation: Hold in horizontal/prone position 
Normal: Superman pose 
Ext neck,head,arms 
Flex lower extremities
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9
Q 
Reflex:  Righting 
Onset (AOG):
Fully Developed:
Duration/disappears: 
Elicitation: 
Normal
A

Reflex: Righting
Onset (AOG): 4-8m
Fully Developed:
Duration/disappears: Masked by voluntary
Elicitation: Supine, turn head to one side (sequential manner)
Normal: Rotates shoulder, trunk then pelvis

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10
Q

Developmental Milestones: Gross

Runs

A

24m

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11
Q

Developmental Milestones: Gross

Walks upstairs w/assistance

A

18m

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12
Q

Developmental Milestones: Gross

Walks w/1 hand held

A

12m

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13
Q

Developmental Milestones: Gross

Pulls to stand

A

9m

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14
Q

Developmental Milestones: Gross

Sits momentarily

A

6m

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15
Q

Developmental Milestones: Gross

Supports weight on forearms

A

3m

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16
Q

Developmental Milestones: Fine Motor

Opens hands spontaneously

A

3m

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17
Q

Developmental Milestones: Fine Motor

Transfers objects

A

6m

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18
Q

Developmental Milestones: Fine Motor

Pincer grasp

A

9m

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19
Q

Developmental Milestones: Fine Motor

Releases object on command

A

12m

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20
Q

Developmental Milestones: Fine Motor

Feeds from a spoon

A

18m

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21
Q

Developmental Milestones: Fine Motor

Builds a tower of 6 blocks

A

24m

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22
Q

Developmental Milestones: Social skills

Smiles appropriately

A

3m

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23
Q

Developmental Milestones: Social skills

Social smile

A

2m

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24
Q

Developmental Milestones: Social skills

Shows likes/dislikes

A

6m

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25
Q

Developmental Milestones: Social skills

Plays peek-a-boo & pat-a-cake

A

9m

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26
Q

Developmental Milestones: Social skills

Comes when called

A

12m

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27
Q

Developmental Milestones: Social skills

Mimics actions of others

A

18m

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28
Q

Developmental Milestones: Social skills

Plays with others

A

24m

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29
Q

Developmental Milestones: Language

Coos/Laughs

A

3m

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30
Q

Developmental Milestones: Language

Babbles

A

6m

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31
Q

Developmental Milestones: Language

Imitates sounds

A

9m

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32
Q

Developmental Milestones: Language

1-2 meaningful words

A

12m

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33
Q

Developmental Milestones: Language

At least 6 words

A

18

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34
Q

Developmental Milestones: Language

2-3 word sentences

A

24m

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35
Q

Head circumference growth in PRETERM

A

1st week: 0.5cm
2nd week: 0.5cm
3rd week: 0.75cm
4th week+: 1cm/week until 40th

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36
Q

Head circumference growth in TERM

A

34-35 @Birth
44cm @6m
47cm @1y

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37
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Depth- Elevated disc (Phyiologic Cup Obliterated)

A

Papilledema

Papillitis

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38
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Depth- Shallow

A

Optic Atrophy

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39
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Edge: Blurred

A

Papilledema

Papillitis

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40
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Edge: Very sharp

A

Optic Atrophy

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41
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Vessels - Engorged

A

Papilledema

Papillitis

42
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Vessels - Narrow/Few

A

Optic Atrophy

43
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Color - No Venous pulse

A

Papilledema

Papillitis

44
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Color - Hyperemic

A

Papilledema

Papillitis

45
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Color - Hemorrhages

A

Papilledema

Papillitis

46
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Vision - Good (or enlarged blind spot)

A

Papilledema

47
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Vision - Poor (or loss of central)

A

Papillitis

48
Q

Optic Fundus: Papilledema, Papillitis, Optic Atrophy:

Vision - Reduced

A

Optic Atrophy

49
Q

Visual acuity in an infant

A

20/150

50
Q

Visual acuity reaches adult level of 20/20 at

A

6m

51
Q

Dazzle Reflex:
Definition:
Present:
Note:

A

Involuntary avoidance response to a light shined in eyes
Present in 28week old PRE-mature infants
By 32w, eyes remain closed until light is removed

52
Q

Blink Reflex:
Definition:
Present:
Note:

A

Fxn’l vision
Close when object moves to eye
(-) in newborn
(+) 3-4m (ALL by 1y/o, otherwise likely blind)

53
Q

Turn eyes to sound by

A

7-8w

54
Q

Turn head to sound by

A

3-4m

55
Q

Weber
Defective ear =
Better ear =

A

Defective ear = Conductive HL

Better ear = Sensorineural HL

56
Q

Rinne

  • should be (AC vs BC)
  • Bone > Air
  • Air > Bone
A
  • AC > BC
    • Normal or
    • Sensorineural HL
  • AC < BC = Conductive HL
57
Q

Muscle stretch:

Jaw Jerk

A

CN V

58
Q

Muscle stretch:

Biceps

A

C5-6

Also in Brachio-radialis

59
Q

Muscle stretch:

Triceps

A

C6-8

60
Q

Muscle stretch:

Brachio-radialis

A

C5-6

Also in Biceps

61
Q

Muscle stretch:

Patellar:

A

L2-L4

62
Q

Muscle stretch:

Ankle

A

S1-2

63
Q

Muscle stretch:

Asking patient to contract a muscle you are not testing

A

Jendrassik Maneuver

64
Q

Superficial Reflexes: How/What

Umbilical migration test (Beevor’s)

A

Stroke quadrants of abdomen towards umbilicus –> Umbilicus moves towards orgin of stimulus

Tests for injury between T10-T12

65
Q

Superficial Reflexes: How/What

Cremasteric Reflex

A

L1-L2

Stroke inner thigh towards testicle –> ipislateral testicle moves upward

66
Q

Superficial Reflexes: How/What

Anal pucker

A

S4-5

Pricking the skin around anus –> Quick twitch-like constriction of sphincter

67
Q

Superficial Reflexes: How/What

Ext Toe Sign -

A

Pyramidal tract function

- Normal up to 2 years old (“up to 2 1/2”)

68
Q

Superficial Reflexes: How/What

Chaddock

A

Extensor toe sign - lateral side of foot

69
Q

Superficial Reflexes: How/What

Schaeffer

A

Ext toe sign - Squeeze hard on achillies

70
Q

Superficial Reflexes: How/What

Oppenheim

A

Ext toe sign - Squeeze calf muscles

71
Q

Superficial Reflexes: How/What

Bing

A

Ext toe sign - multiple light pinpricks on dorso-lateral surface of foot

72
Q

Abnormal movements:
Incessant, random, moderately quick movements

“Milkmaids”

A

Chorea

73
Q

Abnormal movements:

Slow, writhing movements of fingers or extremities

A

Athetosis

74
Q

Abnormal movements:

Prolonged, strong contraction + relaxation of agonists and antagonists

A

Dystonia

75
Q

Abnormal movements:

Quick, stereotyped movements of face, tongue or extremities

A

Tics

76
Q

Abnormal movements:

Hand turns to palm outward as arms are raised over head

A

Pronator sign

77
Q

Abnormal movements:

Child should maintain flexed legs at right angles at knee

A

Barre sign

78
Q

Reflex: Plantar
Onset (AOG):
Fully Dev:
Duration/Disappears:

A

Reflex: Plantar
Onset (AOG): 11
Fully Dev:
Duration/Disappears: 7-9m

79
Q

Reflex: Palmar
Onset (AOG):
Fully Dev:
Duration/Disappears:

A

Reflex: Palmar
Onset (AOG): 28w
Fully Dev: 32w
Duration/Disappears: 2-3m

80
Q

Reflex: Rooting
Onset (AOG):
Fully Dev:
Duration/Disappears:

A

Reflex: Rooting
Onset (AOG): 32w
Fully Dev: 36w
Duration/Disappears: Less prominent after 1m

81
Q

Reflex: Moro
Onset (AOG):
Fully Dev:
Duration/Disappears:

A

Reflex: Moro
Onset (AOG): 28-32w
Fully Dev: 37w
Duration/Disappears: 5-6m (?)

82
Q

Reflex: Tonic Neck
Onset (AOG):
Fully Dev:
Duration/Disappears:

A

Reflex: Tonic neck
Onset (AOG): 35
Fully Dev: 1m
Duration/Disappears: 6-7m

83
Q

Reflex: Placing/Stepping
Onset (AOG):
Fully Dev:
Duration/Disappears:

A

Reflex: 37w
Onset (AOG):
Fully Dev:
Duration/Disappears: 4-5m; Pt can creep and crawl

84
Q

Reflex: Parachute
Onset (AOG):
Fully Dev:
Duration/Disappears:

A

Reflex: Parachute
Onset (AOG): 7-8m
Fully Dev: 10-11m
Duration/Disappears: Persists throughout life

85
Q

Reflex: Landau “Superman”
Onset (AOG):
Fully Dev:
Duration/Disappears:

A

Reflex: Landau “Superman”
Onset (AOG): 9-10m
Fully Dev:
Duration/Disappears: Covered up by voluntary

86
Q

Reflex: Parachute
Onset (AOG):
Fully Dev:
Duration/Disappears:

A

Reflex: Parachute
Onset (AOG): 4-9m
Fully Dev:
Duration/Disappears: Covered up by voluntary

87
Q

Reflex: Righting
Onset (AOG):
Fully Dev:
Duration/Disappears:

A

Reflex: Righting
Onset (AOG): 4-8m
Fully Dev:
Duration/Disappears: Covered up by voluntary

88
Q

Sensory Examination: Level of Involvement

Back of head

A

C2

89
Q

Sensory Examination: Level of Involvement

Shoulders

A

C4

90
Q

Sensory Examination: Level of Involvement

Thumbs

A

C6

91
Q

Sensory Examination: Level of Involvement

Nipple line

A

T4

92
Q

Sensory Examination: Level of Involvement

Umbilicus

A

T10

93
Q

Sensory Examination: Level of Involvement

Inguinal sign

A

L1

94
Q

Sensory Examination: Level of Involvement

Big toe

A

L5

95
Q

Sensory Examination: Level of Involvement

Small toe

A

S1

96
Q

Sensory Examination: Level of Involvement

Posterior thigh

A

S2

97
Q

Meningeal signs:
(+) Resistanceto flexion
(-) Resistance to extension
Inflammation in dura

A

Nuchal rigidity/catch

Protective reflex prevents stretching/lengthening

98
Q

Meningeal signs:
Bent-knee
Straight-knee-leg raising test
Neck bends to prevent stretching

A

Kernig

99
Q

Meningeal signs:

ADduction and flexion of legs as you attempt to flex the kneck –> ?

A

Brudzinski

–> knees go up to prevent stretching

100
Q

Scarf sign tests

A

If elbow passes midline –> HYPO-tonia

Pediatrics 3B (12 decks)

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