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My Stuff > Pediatric Hypotonia > Flashcards

Pediatric Hypotonia Flashcards

1
Q

Passive resistance to muscle movement

A

Tone

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2
Q

Tone is maintained by _______, ________, and ________.

A

cerebellum at the red nucleus, basal ganglia, and motor strip

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3
Q

Loss of strength

A

Weakness

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4
Q

Possible causes of infantile hypotonia

A

Pathology of CNS, motor neurons, peripheral nerves, or muscles

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5
Q

What three histories are most important to obtain during assessment of a hypotonic infant?

A

Prenatal, perinatal, and familial

TORCH exposure, term delivery, APGAR score, and milestones

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6
Q

Components of APGAR score

A 
Activity
Pulse
Grimace
Appearance
Respiration
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7
Q

How high does the APGAR score go?

A

10

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8
Q

Macroglossia, eye folds, palmar crease, hypotonia, congenital heart defects

A

Down’s syndrome (Trisomy 21)

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9
Q

Severe hypotonia, thin upper lip, almond shapes eyes, short stature, hyperphagia, developmental delay

A

Prader Willi syndrome

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10
Q

Motor milestone at 3 months

A

Holds head at 90 degrees in vertral suspension

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11
Q

Fine motor and vision milestone at 3 months

A

Holds an object placed in the hand

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12
Q

Hearing, speech, and language milestone at 3 months

A

Turns to sound

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13
Q

Social, emotional, and behavioral milestones at 3 months

A

Hand regard, laughs, squeals

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14
Q

Milestone red flags at 3 months

A

Lack of social response or vocalization

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15
Q

Motor milestones at 6 months

A

No head lag on pull to sit; sits with support; lifts up on forearms in prone position

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16
Q

Fine motor and vision milestones at 6 months

A

Palmar grasp of objects; transfers objects hand to hand

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17
Q

Hearing, speech, and language milestone at 6 months

A

Vocalizations

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18
Q

Social, emotional, and behavioral milestone at 6 months

A

May finger feed self

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19
Q

Milestone red flags at 6 months

A

Poor head control; floppiness; not reaching

20
Q

Motor milestones at 12 months

A

Pulls to stand; cruises; may stand alone briefly; may walk alone

21
Q

Fine motor and vision milestones at 12 months

A

Puts block in cup; casts about

22
Q

Hearing, speech, and language milestones at 12 months

A

One or two words; imitates adult sounds

23
Q

Social, emotional, and behavioral milestones at 12 months

A

Imitates actives; object permanence established; stranger anxiety established; points to indicate want

24
Q

Milestone red flags at 12 months

A

Not communicating by gestures such as pointing; not weight bearing through legs

25
Q

Inability to process phospholipids or bile acids, hypotonia, seizures, diminished or absent tendon reflexes, usually die within 1 year

A

Zellweger syndrome

26
Q

Autosomal recessive; normal development initially then obvious hypotonia, weakness, and decreased movement; respiratory distress; cardiomegaly and hepatomegaly; absent DTRs; usually die by 2 years old

A

Pompe’s disease

27
Q

Constipation, hypotonia, ophthalmoplegia, bulbar signs, descending paralysis, stool culture for diagnosis

A

Infantile botulism

28
Q

Severe hypotonia, difficulties with sucking and swallowing, respiratory problems develop, normal sensation and IQ, no reflexes, degeneration of alpha motor neurons

A

Spinal muscle atrophy

29
Q

Ptosis, fatigue with feeding, decreased strength with repeated stimulus, diagnosed with EMG

A

Myasthenia Gravis

30
Q

Passive resistance to movement of the extremities; rapid contraction in response to high intensity stretch

A

Phasic tone

31
Q

Resistance to passive movement of the axial muscles; prolonged contraction of antigravity muscles in response to low intensity stretch of gravity

A

Postural tone

32
Q

Most common cause of pediatric hypotonia

A

Hypoxia induced encephalopathy (HIE)

33
Q

Throw arms out then cry after sudden loss of support (until 6 months)

A

Moro reflex

34
Q

Turn head and observe tonic contracture on that side (until 6-7 months)

A

Tonic reflex (fencing reflex)

35
Q

Touch roof of mouth and elicit response

A

Suck reflex

36
Q

Touch side of mouth and infant turns head toward touch

A

Root reflex

37
Q

Place something in hand and infant grasps it (finger in hand)

A

Grasp reflex

38
Q

Lift child with one arm under chest and abdomen (face down, parallel with floor)

A

Horizontal suspension

39
Q

What does a normal (negative) horizontal suspension test involve?

A

Some flexion of arms and legs, attempt to lift head

40
Q

Most sensitive measure of postural tone, grasp supine infant’s hands and pull to sitting position

A

Traction response

41
Q

What does a normal (negative) traction response test involve?

A

Head lag (minimal by 2 months), flexion of arms and legs, infant tries to help

42
Q

Pick up infant and hold between hands

A

Vertical suspension

43
Q

What does a normal (negative) vertical suspension test involve?

A

Head erect in midline with flexion at knee, hip, and ankle

44
Q

Arms held in flexion against the chest for a few seconds then quickly extended and released

A

Arm recoil

45
Q

What does a normal (negative) arm recoil test involve?

A

Arms should spring back to flexed position

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