Pediatric

Question 1

3 months developmental sequence

Answer 1

• prone on elbows, weight bearing on forearms
• elbows in line w/ shoulders, head elevated to 90
• head in midline in supine, hands on chest
• increased back extension w/ scap adduction in supported sitting

Question 2

4 month developmental sequence

Answer 2

• sits w/ support
• no head lag in pull to sit
• laughs out loud

Question 3

5 month developmental sequence

Answer 3

• rolls from prone to supine
• head control in supported sitting

Question 4

6 month developmental sequence

Answer 4

• rolls supine to prone
• independent sitting
• pulls to stand w/ hands held, bounces

Question 5

At what month do babies recognize tone of voice?

Answer 5

7 months

Question 5

7 months developmental sequence

Answer 5

• can maintain quadruped
• recognizes tone of voice
• belly crawls

Question 6

8-9 months developmental sequence

Answer 6

• pulls to stand through kneeling at furniture
• may stand independently for 1-2 sec
• can transfer objects from 1 hand to another

Question 7

10-15 months developmental sequence

Answer 7

• begins to walk unassisted
• begins self feeding
• searches for hidden toys

Question 8

20 months developmental sequence

Answer 8

• ascends stairs step to pattern
• jumps off bottom step

Question 9

2 years developmental sequence

Answer 9

• reciprocal stair climbing

Question 10

Newborn has decreased ROM into _______, due to physiological ________.

Increased ______ at ankle and _______ of wrists

Answer 10

decreased extension due to physiological flexion

increased DF and flexion of wrists

Question 11

protective extension

Answer 11

Results in the child extending his or her head, extending the arms and fingers outward as to protect the child from falling

Question 12

body-righting reaction acting on the head (BOH)

Answer 12

head righting w/ respects w/ gravity to maintain orientation of head in space
- begins 4-6 months and persists through life

Question 13

body-righting reaction acting on the body (BOB)

Answer 13

rotation of head or thorax results in rolling over
- begins at 6-8 months and persists

Question 14

tilting reactions
- When do prone, supine, sitting, quadruped begin?

Answer 14

slow shifting of BoS or slow displacement of body in space
- prone begins at 5 months
- supine begins at 7 months
- sitting at 8 months
- quadruped at 12 months

Question 15

Prognosis for CP: Good prognosis for ambulation if child can _________.

Answer 15

sit independently by 2 years of age

Question 16

Erb’s paralysis vs Klumpke’s paralysis

Answer 16

Erb’s - involves C5-C6
- results in 1:1 humeroscapular movement (only have use of the hand)

Klumpke’s - involves C8-T1
- results in decreased wrist and hand function

Question 17

What should be avoided w/ down syndrome?

Answer 17

Avoid:
- hyperextension of elbows and knees during weight bearing
- avoid all traction
- forceful neck flexion and rotation due to atlantoaxial ligament laxity

Question 18

Duchenne’s Muscular Dystrophy pathology

Answer 18

x-linked recessive, inherited by boys, carried by recessive gene of mother
- results in destruction of muscle cells

Question 19

Duchenne’s MD diagnosis

Answer 19

3-6 years
- progressive weakness, delay in walking, difficulty rising from supine to sitting, frequent falls
- proximal shoulder or pelvic muscle weakness occurs before distal weakness
- positive Gower’s sign
- cardiac tissue involved (avoid max exertion)

Question 20

thoracic spina bifida orthosis

Answer 20

THKAFO or RGO

Question 21

L1-2 spina bifida orthosis

Answer 21

KAFO

Question 22

L3 spina bifida orthosis

Answer 22

KAFO if quads <4/5

AFO if quads > 4/5

Question 23

L4 spina bifida orthosis

Answer 23

AFO w/ posterior strap

Question 24

L5 spina bifida orthosis

Answer 24

AFO w/ posterior strap

Question 25

S1 spina bifida orthosis

Answer 25

FO, maybe AFO

Question 26

S2 spina bifida orthosis

Answer 26

no orthosis

Question 27

common symptoms of tethered spinal cord

Answer 27

• loss or decrease of motor function
• changes in gait or walking pattern
• new onset or rapid progression of scoliosis, or curving of spine (kyphosis)
• changes in bowel/bladder function
• spasticity (involuntary muscle contractions)
• sensory loss
• back pain