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Pediatrics Flashcards

1
Q

Manifestations also associated with equinovarus

A

increased hip IR
decreased tibial ER
tibial shortening

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2
Q

Legg Calve Perthes vs SCFE patient population

A

LCP - ages 2-12
SCFE - occurs more in adolescent years (11-15)
-overweight

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3
Q

LCP disease presentation

A

antalgic gait
shortened stance phase affected side Trendeleburg
reduced hip ROM
groin pain referred to medial knee

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4
Q

SCFE presentation

A

decreased hip IR, increased retroversion
12-15 - more adolecent years
obesity
groin pain, painful WB
toe out gait

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5
Q

Hydrocephalus

A

hydrocephalous is obstruction of CSF and backing up of fluid in the brain

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6
Q

What is a shunt

A

Tube that connects from CSF in brain and bypasses to the abdomen

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7
Q

Symptoms of shunt failure

A

in infant - head changes shape because of soft skull

sunsetting of eyes
lethargic
fever vomiting headache
personality change/irritability
seizures

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8
Q

Orthotics for spina bifida L1-2

A

Have some hip flexion intact, so KAFO with walker or forearm crutches

mostly WC tho d/t high energy expenditure

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9
Q

Functional diagnosis for spina bifida L1-2

A

WC for all mobility except physiologic benefits

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10
Q

Functional diagnosis for spina bifida L3

A

Strong hip flexion, weak hip rotators, partial quad innervation

WC for all mobility except physiologic benefits

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11
Q

Orthotics for spina bifida L3

A

Knee extension intact - depends mainly on quad strength

if less than 4/5 KAFO with walker/forearm crutches
if more than 4/5 AFO walker/forearm crutches

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12
Q

At what level spina bifida does community ambulation become possible

A

L4

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13
Q

Orthotics for spina bifida L4

A

AFO with posterior stop
forearm crutches/cane

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14
Q

Orthotics for spina bifida L5

A

AFO with posterior stop
cane

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15
Q

Orthotics for spina bifida S1-2

A

no devices needed

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16
Q

What allergy do patient with myelodysplasia often have

A

LATEX

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17
Q

Arnold Chiari malformation

A

brainstem pushed down through foramen magnum

swallowing difficulty
aspiration
facial palsy
ataxia
UE weakness
nystagmus

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18
Q

PT role with spina bifida

A

Promote proper joint formation through early weightbearing and positioning
Prevent osteoporosis
strengthening
adaptive equipment

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19
Q

GMFCS scale

A

Level 1 - can run and jump, climb stairs with **NO RAILING, basically most activities but may be slower and more clumsy
decreased speed balance and coordination
Level 2 - can climb stairs **WITH RAILING, minimal running or jumping, difficulty with uneven surfaces or crowds - forearm crutch
Level 3 - manual of power WC - limitation in home and community
Level 4 - power mobility
Level 5 - severe

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20
Q

Level 1 GMFCS

A

can run and jump, climb stairs with no AD, basically most activities but may be slower and more clumsy
decreased speed balance and coordination

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21
Q

Level 2 GMFCS

A

can climb stairs **WITH RAILING, minimal running or jumping, difficulty with uneven surfaces or crowds

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22
Q

Level 3 GMFCS

A

walks with AD and may propel a manual wheelchair for longer distances

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23
Q

Level 4 GMFCS

A

walking ability severely limited but may go short distances
WC most of the time with some use of power
struggle with standing transfer

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24
Q

Level 5 GMFCS

A

Power wheelchair dependendent
struggle to stand

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25
CP prognosis is good if child is walking by age
2
26
Modified Ashworth Scale
0 - no increase in tone 1- slight increase, catch at end 1+ - slight increase with min resistance throughout ROM 2 - marked increase through ROM but affected limb moved easily 3 - definitive increase in tone, passive movement difficult 4 - affected part is rigid
27
Ashworth 1
slight increase, catch at end
28
Ashworth 1+
slight increase with min resistance throughout ROM
29
Ashworth 2
marked increase through ROM but affected limb moved easily
30
Ashworth 3
definitive increase in tone, passive movement difficult
31
Ashworth 4
affected part is rigid
32
If you see motor decline and head tilr with DS...
Possible AA instability
33
Normal APGAR scoring
7 to 10 within first 5 minutes
34
APGAR score
0, 1, or 2 on each item Appearance Pulse Grimace Activity Respiration
35
Erbs Palsy vs Klumpkes palsy
Erbs C5-C6 Klumpkes C8-T1
36
Prognosis for DMD
X linked recessive 2-5 years at diagnosus Lose ability to walk after 10-12 years Lifespan to approx 20
37
Normal development of independent sitting
6-7 months
38
Normal development of independent pivot in sitting
8-9 months
39
Normal development of Independently transition from standing to sitting
8-9 months
40
Moro vs startle refelx
moro = extension and abduction of arms with crying followed by flexion and adduction across patients chest stimulus is sudden change in position of head or trunk startle = same as moro but without flexion/adduction of arms stimulus is sudden noise
41
ATNR
extension of arm and leg on side of head turn
42
Stimulus for ATNR
head turn
43
Normal integration of ATNR
4-5 months begins in utero to help baby twist and turn in birth canal
44
Problems that arise if ATNR is not integrated by 4-5 months
trouble rolling, midline use of hands, feeding, delayed tracking and fine motor skills - think about it -- its hard to isolate movements when everytime your head moves your arm moves prone propping, crawling, sitting balance,
45
Stimulus for STNR
head position into flexion or extension
46
Normal integration of STNR
8 months
47
Problems that arise if STNR is not integrated by 8 months
interferes with prone propping, reciprocal crawling, sitting balance, gait, hand eye coordination
48
STNR
UE flexed with head in flexion UE extended with head in ext LE always do opposite
49
STNR is a precursor to
crawling many retained STNR babies skip crawling or W sit
50
Moro reflex stimulus
dropping head into extension
51
Moro reflex
upon dropping head into extension, hands abduct and extend followed by adduction and flexion across body this is similar to startle but not quite the same
52
Normal integration moro reflex
3-5 months
53
Problems that arise if Moro reflex is not integrated by 3-5 months
decreased balance and protective reactions in sitting, hand eye coordination
54
Startle reflex stimulus
loud noise or bright light integrated by 3-5 months
55
Normal integration startle reflex
3-5 months
56
Startle reflex
abduction and extension of UE in response to sound or light
57
Problems that arise if Startle reflex is not integrated by 3-5 months
oversensitivity to stimuli, easily distracted/scared in loud environments, sitting balance, social interaction
58
Galant reflex normal integration
2-3 months
59
Galant reflex stimulus
in prone, touch skin on spine from shoulder to hip
60
Galant reflex
ipsilateral lateral trunk extension to side of stimulus
61
If galant reflex is not integrated by 2-3 months....
could lead to problems with sitting balance, scoliosis, fidgeting/hypersensitivity w wearing clothes
62
Tonic labyrinthe reflex stimulus
position in supine - extremities in extension position in prone - extremities flexed
63
Normal integration Tonic labyrinthe reflex
4-6 months
64
Problems if tonic labyrinthe reflex isnt integrated by 4-6 months
affects anti gravity control, head/body orientation
65
Palmar grasp reflex stimulus
pressure to ulnar side of hand produces grip
66
Palmar grasp reflex normal integration
4-7 months
67
Problems if palmar grasp reflex isnt integrated by 4-7 months
reduction in voluntary grasp and release interferes with ability to weight bear on open hand
68
Positive support reflex normal integration
1-2 months
69
Positive support reflex
stimulus is weight placed on balls of feet - produces stiffenening of trunk and legs into extension
70
if positive support reflex is not integrated by 1-2 months...
interferes with standing and walking - rigid gait pattern balance reactions/weight shifting in standing can lead to PF contractures
71
Flexor withdrawl reflex normal integration
1-2 months
72
Flexor withdrawl reflex
stoke bottom of foot results in flexed LE (hip and knee flexion, DF)
73
Problems if flexor withdrawl reflex is not integrated by 1-2 months
hypersensitivity to stimuli on sole of foot - difficulty walking on gravel or uneven surfaces
74
Stepping reflex
lean forward while on balls of feet produces LE flexion
75
Physiological flexion is normal until
1-2 months
76
Gross motor skills at 1 month
can lift head but only briefly head lag present reflexive stepping and walking
77
Fine motor skills at 1 month
hand fisted can regard objects in direct line of sight random jerky movements
78
Gross motor skills 2-3 months
lifts head to 90 roll prone to supine ATNR strong needs full support in sitting
79
Roll prone to supine
3 months
80
Fine motor skills 2-3 months
180 degree tracking reflexive grasp
81
Gross motor skills 4-5 months
able to bear weight on arms prone pivot roll supine to sidelying able to hold head in SUPPORTED sitting
82
Which happens first: prone to supine or supine to prone
prone to supine 2-3 months supine to prone 6-7 months
83
Playing with feet in mouth
4-5 months
84
Grasp at 4-5 months
ulnar - palmar basically grabs everything with ulnar side of hand
85
Gross motor skills 6-7 months
rolls supine to prone can lift head against gravity in supine independent UNSUPPORTED sitting
86
Fine motor skills 6-7 months
radial palmar grasp approach objects with one hand
87
Describe the progression of grasping
no grasping - hands fisted 0-1 months palmar grasp 2-3 months ulnar palmar 4-5 months radial palmar 6-7 months inferior pincher grasp/radial digital grasp 8-9 months fine pincer grasp 10-11 months
88
Gross motor function 8-9 months
pivots in sitting crawling cruising along furniture
89
Stands without support (brief)
10-11 months
90
Gross motor function 10-11 months
stands brief without support pulls to stand bear walk walks with handheld support
91
Gross motor function 12-15 months
Walks without support Throws ball in sitting
92
Walking up stairs 2 stairs each step occurs when
1.5-2 years
93
1.5-2 years
up stairs non reciprocal throw ball forward picks up toy from floor squat in play
94
2 years milestones
runs ride tricycle reciprocal stairs hopping
95
Running should start at
2
96
BOT is used for
typically developing child 4-21 yrs of age
97
Peabody
0-5 years used for children with delays
98
Treatment for develomental hip dysplasia
Pavlik harness abduction orthosis spica cast all three position intp abduction ER
99
Pavlik harness
0-9 months flexion abduction ER promotes spontaneous reduction of hip worn 24 hours/day
100
Most common issue with pavlik harness
skin irritation contact dermatitis
101
Risk factors for LCPD
black, male, retroversion, thin
102
SCFE patients prefer what position of the hip
ER in supine or standing
103
LCPD vs SCFE tx
LCPD - conservative usually SCFE - surgical usually
104
Sinding larsen johannson
tendon injury of inferior pole of patella
105
Osgood Schlatter
tendon injury - tibial tubercule
106
Severs disease
tendon injury calcaneus
107

MY NPTE (22 decks)

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