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NBCOT > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Rooting reflex

A

Onset: 28 weeks gestation
Integrated: 3 months
Test: stroke baby’s cheek/mouth/lip
Response: head, tongue, mouth moves towards stimulis
- search & locate food, automatic, searching reflex

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2
Q

Suck-swallow reflex

A

Onset: 28 weeks gestation
Integrated: 2-5 months
Test: place finger inside baby’s mouth
Response: strong & rhythmical sucking
- eat food, ingestion for nourishment

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3
Q

Traction reflex

A

Onset: 28 weeks gestation
Integrated: 2-5 months
Test: pull baby up by forearms & pull to sit
Response: head lag due to little head control, complete flexion of UEs including hands (grasping to hold on)
- enhances reflexive grasp to gain voluntary control of this reflex

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4
Q

Moro reflex

A

Onset: 28 weeks gestation
Integrated: 4-6 months
Test: rapidly drop head backward to create falling sensation
response: phase 1: arm extension & abduction, phase 2: arm flexion, adduction, crying
- started & responds to unexpected environmental changes (loud noises, rapid movement)
- alarm system/fight or flight

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5
Q

Plantar grasp

A

Onset: 28 weeks gestation
Integrated: 9 months
Test: apply pressure with thumb on baby’s ball of foot
Response: toes curl in flexion
- provides tactile input to sole of food, prepares for walking, running, balance
- reflex retained = hypersensitivity to touch, gravitational insecurity while standing

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6
Q

Galant reflex

A

Onset: 32 weeks gestation
Integrated: 2 months
Test: hold baby in prone suspension & stroke one side of spine from neck to bottom
Response: lateral trunk flexion on stimulated side
- hip movement & ROM in preparation for walking & crawling
- facilitates lateral trunk movement, trunk stabilization, crawling

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7
Q

Palmar grasp reflex

A

Onset: 37 weeks gestation
Integrated: 4-6 months
Test: place finger in baby’s palm & apply pressure
Response: reflexive grasp with finger flexion
- increases tactile stimulation on palms and reflexive grasp
- not integrated: poor FM coordination, poor motor coordination (grasp & release), hand manipulation skills

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8
Q

ATNR

A

Onset: 37 weeks gestation
Integrated: 4-6 months
Test: baby supine, rotate head to side 90 degrees & hold for 5 seconds
Response: face side: arm extension, skull side: arm flexion
- fencing pose, precursor to hand-eye coordination
- if retained: poor reading comprehension due to issues crossing midline including eyes, poor visual tracking & eye pursuits, poor handwriting (head rotation —> arm extension on face side)
- if not integrated: difficulty bringing hands to midline, holding objects with both hands, bringing objects to the mouth, reaching for something in front of them

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9
Q

TLR (tonic labyrinthine reflex)

A

Onset: 37 weeks gestation
Integrated: 6 months
TLR prone:
- test: baby in prone
- response: body in flexor tone
TLR supine:
- test: baby in supine
- response: body in extensor tone

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10
Q

TLR impairments if it persists

A

Prone: extending head in prone (since in prone there is an increase in flexor tone, making it difficult to extend the head in prone)
Supine: sitting up independently, which requires flexing the neck (extensor tone dominates & makes it difficulty
- poor posture, muscle tone, coordination

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11
Q

STNR

A

Onset: 4-6 months
Integrated: 8-12 months
Test:
1) place in crawling position & flex the head —> arms flex, legs extend
2) place in crawling position & extend the head —> arms extend, legs flex
- precursor to crawling
- promotes static quadruped position in prep for crawling

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12
Q

Impairments if STNR persists

A
  • difficulty sitting up from supine (requires neck flexion)
  • head flexion = hips & legs will extend & interfere with sitting up
  • poor muscle tone & posture (sitting posture if UE and LE are doing the opposite movements)
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13
Q

Landau reflex

A

Onset: 3-4 months
Integrated: 12-24 months
test: hold baby in horizontal prone suspension
Response: total extension of head, trunk, & extremities
- breaks up flexor tone, facilitates prone extension for posture
- Superman pose

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14
Q

Neck righting acting on body

A

Onset: 4-6 months
Integrated: 5 years
Test: baby supine, rotate head fully to one side
Response: log rolling (all towards head as 1 unit) to maintain alignment
- allows rolling (supine to side lying), maintain alignment
- precursor to crawling

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15
Q

Body righting acting on body

A

Onset: 4-6 months
Integrated: 5 years
Test; supine & bend one hip & knee towards chest
Response: segmental rolling (mature, body parts rolling in segments) of upper trunk & spine to maintain head & body alignment
- helps to facilitate rolling from supine to side lying but uses leg to initiate roll

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16
Q

Optical head righting

A

Onset: birth to 2 months
Integrated: persists throughout life
Test: hold baby suspended vertically & tilt off center (move side to side or forward & backward)
Response: upright positioning of head, orients head in space
- corrects head in space when body not upright
- uses visual cues in environment to maintain head in up position

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17
Q

Labyrinthine righting

A

Onset: birth to 2 months
Integration: persists throughout life
Test: cover eyes (no visual cues) but maintain head in upright & rinse to vertical in relation to gravity as body follows head movement
- orients head in space
- mediated by vestibular system (labyrinth in the ear)

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18
Q

Downward parachute

A

Onset: 4 months
Integrated: persists
Test: lower baby towards surface while suspended vertically
Response: extension of LEs
- protection/anticipation of fall
- accurate placement of feet

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19
Q

Forward parachute

A

Onset: 6-9 months
Integrated: persists
Test: quickly tip baby forward while vertically suspended
Response: rapid UE extension/neck in anticipation
- protective response for falls

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20
Q

Sideward parachute

A

Onset: 7 months
Integration: persists
Test: tip baby to the side while sitting
Response: arm extends & abducts to the side
- protects against falls

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21
Q

Backwards parachute

A

Onset: 9-10 months
Integration: persists
Test: quickly tip baby back while sitting
Response: backward arm extension, arm extension to one side spinal rotation
- protects against falls

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22
Q

Prone tilting

A

Onset: 5 months
Test: position baby in prone on tilt board & raise 1 side of the surface
Response: spine curves on raised side, both arms & legs will extend & abduct
- maintain equilibrium without arm support
- ability to make postural adjustments

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23
Q

Supine tilting

A

Onset: 7-8 months
Test: position baby supine/sitting on tilt board & raise 1 side
Response: spine curves on raised side, both arms & legs will extend & abduct
- maintain equilibrium without arm support
- ability to make postural adjustments

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24
Q

Quadruped tilting

A

Onset: 9-12 months
Test: position baby on all 4s on tilt board & raise 1 side
Response: spine curves on raised side, both arms & legs will extend & abduct
- maintain equilibrium without arm support
- ability to make postural adjustments

25
Q

Standing tilting

A

Onset: 12-21 months
Test: baby standing on tilt board & raise 1 side
Response: spine curves on raised side, both arms & legs will extend & abduct
- maintain equilibrium without arm support
- ability to make postural adjustments

26
Q

First line of defense for falls

A

Equilibrium reactions

27
Q

2nd line of defense for falls

A

Protective reactions

28
Q

Reflexes that emerge before birth

A

1) rooting: integrated 3 months
2) suck-swallow: integrated 2-5 months
3) traction: integrated 2-5 months
4) Moro: integrated 4-6 months
5) plantar grasp: integrated 9 months
6) galant: integrated 2 months
7) ATNR: integrated 4-6 months
8) TLR: integrated 6 months

29
Q

Reflexes that emerge from birth

A

1) STNR: integrated 8-12 months
2) Landau: integrated 12-24 months

30
Q

Righting reactions

A
  • Postural reflex present from approx 3-6m that functions to orient the body in response to visual & vestibular input
  • Help to assume a position by maintaining/restoring normal head position
    1) body on body
    2) neck on body
    3) body on head
  • all integrated at 5 years
31
Q

Lifetime reflexes that persist

A

1) optical head righting
2) labyrinthine righting
3) protective reactions
4) equilibrium reactions

32
Q

Protective & equilibrium reactions

A

Protective:
1) downward parachute
2) forward parachute
3) sideward parachute
4) backward parachute

Equilibrium:
1) prone tilting
2) supine tilting
3) quadruped tilting
4) standing tilting

33
Q

Exploratory play

A

Play occupation that uses sensory input to learn new experiences (e.g. infant touching mother’s face)

  • also referred to as sensorimotor play
34
Q

Relational play

A

Play occupation that uses toys consistent with their intended purpose (e.g. pretending to self-feed with a spoon)

  • also referred to as functional play
35
Q

Pretend play

A

Play occupation that involves making objects/toys perform intended actions (e.g. pretending to use a phone to talk)

  • also referred to as symbolic or imaginary play
36
Q

Social play

A

Play occupation that includes
- interaction with & emotionally relating to others
- behavior and skills to develop & progress throughout childhood

37
Q

Gross motor play

A

Play occupation that involves full body, kinesthetic motor movements (e.g. climbing on a play structure)

38
Q

Constructive play

A

Play occupation that involves using toys/objects to produce or build something (e.g. put together a puzzle)

39
Q

Play occupations

A

Meaningful, intrinsically motivating, & purposeful performance activities of childhood, types include:

1) exploratory play
2) relational play
3) pretend play
4) constructive play
5) social play
6) gross motor play

40
Q

Grasp pattern

A

Fine motor function of the hand, either precision or power, used to manipulate items. Patterns include

1) cylindrical grasp
2) power grasp
3) tripod grasp

41
Q

Power grasp

A

Used when stability & strength are required, involves:

  • ulnar digits flexed with ulnar side of hand controlling object
  • radial digits less flexed while manipulating object
42
Q

Hook grasp

A

Pretension grasp used to carry an item with a handle (lunchbox, briefcase) without using thumb & palm

43
Q

Cylindrical grasp

A

Used for holding a tube-shaped item (drinking glass, baseball bat)

44
Q

Lateral pinch

A

Prehensile pattern used to grasp a small item with the thumb opposed to the radial side of the index finger (placing a key in a lock)

45
Q

Pincer grasp

A

Prehensile grasp used to manipulate small objects with thumb opposed to index & middle finger (picking up a pencil)

46
Q

Tripod grasp

A

Precision grasp used to manipulate small objects with thumb opposed to index and middle finger tips, providing more stability than pincer grasp (e.g. writing tool)

47
Q

Tip pinch

A

Pinch used to pick up & hold small objects with thumb opposed to end of index finger, forming an oval shape (e.g. picking up a pin)

48
Q

Spherical grasp

A

Used to pick up & hold round items (apple, baseball)

49
Q

Primitive developmental reflexes

A
  • automatic movements performed by an infant without conscious effort in response to a stimulus, typically integrated by early childhood & are a precursor to functional movement
  • a persistent primitive reflex is typically indicative of a CNS dysfunction
50
Q

Protective extension

A

Postural response
- 6 m integrated & continues throughout life
- reflexive straightening of UEs in response to LOB

51
Q

Equilibrium reaction

A

Postural reflex
- integrated at 6m & persists throughout life
- reflexive response to maintain/recover balance
- shifting body to reorient to midline

52
Q

Emotional regulation development: neurophysiologic modulation phase

A
  • phase of emotional regulation development
  • birth -2-3 m
  • ability to regulate arousal (e.g. self sooth, respond to parental soothing)
  • activate organized patterns of behavior (e.g. routine sleep-wake cycles)
53
Q

Emotional regulation development: sensorimotor modulation phase

A

Phase of emotional regulation development
- 3-9 m
- enjoyment of sensorimotor play
- sensory exploration
- possible sensory modulation challenges

54
Q

Emotional regulation development: control phase

A
  • phase of emotional regulation development
    -12-18 m
  • emerging awareness of social demands
  • varying levels of inhibition & compliance
  • self-initiated monitoring relating to understanding of consequences
55
Q

Emotional regulation development: self-control phase

A

between 24-48 months

  • emerging sense of identity
  • demonstrated knowledge of social rules
  • minimal flexibility and adaptation to change
56
Q

Emotional regulation development: self-regulation phase

A

36 months +

  • emerging flexibility to adapt to unexpected change
  • self-awareness
  • capacity to evaluate own behavior
57
Q

Stage of motor learning: exploratory stage

A

Between 1-3 months

infant learns about the self & environment, using primitive movement patterns to
- swipe at objects
- initiate reach
- complete low level skills

58
Q

Stage of motor learning: perceptual learning

A

Between 3-6 months

Infant uses perceptual skills developed through exploration to

  • more accurate and direct reach
  • consistency of movement patterns
  • engagement in trial-and-error learning
59
Q

Stage of motor learning: skill achievement

A

Between 6-9 months

  • high adaptability
  • both perceptual learning and increased self-organization
  • using action patterns that are orderly and efficient

NBCOT (17 decks)

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