Pediatric exam components Flashcards
Bly’s blocks
Components of normal development are missing or inadequate
Leads to compensations
Normal development movements of infants (two)
Axial extension in prone
Anti gravity flexion; several months after extension
Atypical development of infants
Excessive extension
Insufficient anti gravity flexion
Difficulty stabilizing one part of the body so that another can move
Infant “fixes some segment for added stability
Describe typical neck hyperextension block
Head and neck extension is balanced by flexion in 3rd or 4th month
Holding head in midline
Tucking chin
Sucking
Describe atypical neck hyperextension block
Flexion does not develop
Head and neck hyperextension
Occasional trunk and LE extension
Compensated by shoulder elevation
Intervention for atypical neck hyperextension block
Elongate head/neck extensors while activating flexors
Decrease shoulder elevation
No pull to sit
Supine on wedge– lifting head
Sitting–tucking chin
Describe typical head/neck asymmetry
Neck flexors active ~3-4 months
Midline orientation decreases stim of ATNR
Visual convergence
Bilateral extremity movements
Describe atypical head/neck asymmetry
Asymmetry and persistence of ATNR
Compensated by unilateral UE swiping and reaching
Difficulty with bilateral UE use
Asymmetrical or uncoordinated ocular movement
Intervention for atypical head/neck asymmetry
Increase head, neck, and spinal mobility
Increase active flexion and active midline orientation
Describe typical shoulder block
dynamic scapular stability
Dissociated UE and scapular movements
Trunk rotation initiated with UE reaching
Describe atypical shoulder block
Dissociation of humeral movements is prevented
Limited initiation of trunk rotation
Compensated by moving scapula and humerus as one and unable to bring the UE forward
Intervention for atypical shoulder block
Address with neck block
Increase scapulo-humeral mobility
Improve active dissociated movements
Increase scapular stability
Improve weight bearing
Improve weight shift
Describe typical pelvic-hip block anterior tilt
Active AP pelvic movements ~3-4 months
Trunk/pelvic control & hip mobility concurrent with lateral weight shift in prone
Describe atypical pelvic-hip block anterior tilt
Ant. pelvic tilt not balanced by antigravity flexion
No balance of hip abductors
Undeveloped pelvic and lower trunk control
Compensates with frog leg position to control or prevent prone weight shift
Intervention for atypical pelvic-hip block anterior tilt
Strengthen abdominal muscles
Improve hip mobility
Work on weight shift & weight bearing with trunk elongation & righting
Describe atypical pelvic-hip block posterior tilt
Very strong lumbar extension in prone with strong hip extension and ADD
Missing normal antigravity flexion activities
Extensors very tight and unelongated
Hip mobility limited in flex/ABD
Abdominal muscles inactive
Intervention for atypical pelvic-hip block posterior tilt
Elongate shortened muscles
Increase joint mobility
Activate flexor muscles
Activate normal weight shift/lateral righting reactions
