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MY NPTE > Pediatrics > Flashcards

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
Q

CP prognosis is good if child is walking by age

A

2

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26
Q

Modified Ashworth Scale

A

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

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27
Q

Ashworth 1

A

slight increase, catch at end

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28
Q

Ashworth 1+

A

slight increase with min resistance throughout ROM

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29
Q

Ashworth 2

A

marked increase through ROM but affected limb moved easily

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30
Q

Ashworth 3

A

definitive increase in tone, passive movement difficult

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31
Q

Ashworth 4

A

affected part is rigid

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32
Q

If you see motor decline and head tilr with DS…

A

Possible AA instability

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33
Q

Normal APGAR scoring

A

7 to 10 within first 5 minutes

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34
Q

APGAR score

A

0, 1, or 2 on each item

Appearance
Pulse
Grimace
Activity
Respiration

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35
Q

Erbs Palsy vs Klumpkes palsy

A

Erbs C5-C6
Klumpkes C8-T1

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36
Q

Prognosis for DMD

A

X linked recessive
2-5 years at diagnosus
Lose ability to walk after 10-12 years
Lifespan to approx 20

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37
Q

Normal development of independent sitting

A

6-7 months

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38
Q

Normal development of independent pivot in sitting

A

8-9 months

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39
Q

Normal development of Independently transition from standing to sitting

A

8-9 months

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40
Q

Moro vs startle refelx

A

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

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41
Q

ATNR

A

extension of arm and leg on side of head turn

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42
Q

Stimulus for ATNR

A

head turn

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43
Q

Normal integration of ATNR

A

4-5 months

begins in utero to help baby twist and turn in birth canal

44
Q

Problems that arise if ATNR is not integrated by 4-5 months

A

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
Q

Stimulus for STNR

A

head position into flexion or extension

46
Q

Normal integration of STNR

A

8 months

47
Q

Problems that arise if STNR is not integrated by 8 months

A

interferes with prone propping, reciprocal crawling, sitting balance, gait, hand eye coordination

48
Q

STNR

A

UE flexed with head in flexion
UE extended with head in ext

LE always do opposite

49
Q

STNR is a precursor to

A

crawling

many retained STNR babies skip crawling or W sit

50
Q

Moro reflex stimulus

A

dropping head into extension

51
Q

Moro reflex

A

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
Q

Normal integration moro reflex

A

3-5 months

53
Q

Problems that arise if Moro reflex is not integrated by 3-5 months

A

decreased balance and protective reactions in sitting, hand eye coordination

54
Q

Startle reflex stimulus

A

loud noise or bright light
integrated by 3-5 months

55
Q

Normal integration startle reflex

A

3-5 months

56
Q

Startle reflex

A

abduction and extension of UE in response to sound or light

57
Q

Problems that arise if Startle reflex is not integrated by 3-5 months

A

oversensitivity to stimuli, easily distracted/scared in loud environments, sitting balance, social interaction

58
Q

Galant reflex normal integration

A

2-3 months

59
Q

Galant reflex stimulus

A

in prone, touch skin on spine from shoulder to hip

60
Q

Galant reflex

A

ipsilateral lateral trunk extension to side of stimulus

61
Q

If galant reflex is not integrated by 2-3 months….

A

could lead to problems with sitting balance, scoliosis, fidgeting/hypersensitivity w wearing clothes

62
Q

Tonic labyrinthe reflex stimulus

A

position in supine - extremities in extension

position in prone - extremities flexed

63
Q

Normal integration Tonic labyrinthe reflex

A

4-6 months

64
Q

Problems if tonic labyrinthe reflex isnt integrated by 4-6 months

A

affects anti gravity control, head/body orientation

65
Q

Palmar grasp reflex stimulus

A

pressure to ulnar side of hand produces grip

66
Q

Palmar grasp reflex normal integration

A

4-7 months

67
Q

Problems if palmar grasp reflex isnt integrated by 4-7 months

A

reduction in voluntary grasp and release
interferes with ability to weight bear on open hand

68
Q

Positive support reflex normal integration

A

1-2 months

69
Q

Positive support reflex

A

stimulus is weight placed on balls of feet - produces stiffenening of trunk and legs into extension

70
Q

if positive support reflex is not integrated by 1-2 months…

A

interferes with standing and walking - rigid gait pattern
balance reactions/weight shifting in standing
can lead to PF contractures

71
Q

Flexor withdrawl reflex normal integration

A

1-2 months

72
Q

Flexor withdrawl reflex

A

stoke bottom of foot results in flexed LE (hip and knee flexion, DF)

73
Q

Problems if flexor withdrawl reflex is not integrated by 1-2 months

A

hypersensitivity to stimuli on sole of foot - difficulty walking on gravel or uneven surfaces

74
Q

Stepping reflex

A

lean forward while on balls of feet produces LE flexion

75
Q

Physiological flexion is normal until

A

1-2 months

76
Q

Gross motor skills at 1 month

A

can lift head but only briefly
head lag present
reflexive stepping and walking

77
Q

Fine motor skills at 1 month

A

hand fisted
can regard objects in direct line of sight
random jerky movements

78
Q

Gross motor skills 2-3 months

A

lifts head to 90
roll prone to supine
ATNR strong
needs full support in sitting

79
Q

Roll prone to supine

A

3 months

80
Q

Fine motor skills 2-3 months

A

180 degree tracking
reflexive grasp

81
Q

Gross motor skills 4-5 months

A

able to bear weight on arms
prone pivot
roll supine to sidelying
able to hold head in SUPPORTED sitting

82
Q

Which happens first: prone to supine or supine to prone

A

prone to supine 2-3 months
supine to prone 6-7 months

83
Q

Playing with feet in mouth

A

4-5 months

84
Q

Grasp at 4-5 months

A

ulnar - palmar

basically grabs everything with ulnar side of hand

85
Q

Gross motor skills 6-7 months

A

rolls supine to prone
can lift head against gravity in supine
independent UNSUPPORTED sitting

86
Q

Fine motor skills 6-7 months

A

radial palmar grasp
approach objects with one hand

87
Q

Describe the progression of grasping

A

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
Q

Gross motor function 8-9 months

A

pivots in sitting
crawling
cruising along furniture

89
Q

Stands without support (brief)

A

10-11 months

90
Q

Gross motor function 10-11 months

A

stands brief without support
pulls to stand
bear walk
walks with handheld support

91
Q

Gross motor function 12-15 months

A

Walks without support
Throws ball in sitting

92
Q

Walking up stairs 2 stairs each step occurs when

A

1.5-2 years

93
Q

1.5-2 years

A

up stairs non reciprocal
throw ball forward
picks up toy from floor
squat in play

94
Q

2 years milestones

A

runs
ride tricycle
reciprocal stairs
hopping

95
Q

Running should start at

A

2

96
Q

BOT is used for

A

typically developing child
4-21 yrs of age

97
Q

Peabody

A

0-5 years
used for children with delays

98
Q

Treatment for develomental hip dysplasia

A

Pavlik harness
abduction orthosis
spica cast

all three position intp abduction ER

99
Q

Pavlik harness

A

0-9 months
flexion abduction ER promotes spontaneous reduction of hip

worn 24 hours/day

100
Q

Most common issue with pavlik harness

A

skin irritation contact dermatitis

101
Q

Risk factors for LCPD

A

black, male, retroversion, thin

102
Q

SCFE patients prefer what position of the hip

A

ER in supine or standing

103
Q

LCPD vs SCFE tx

A

LCPD - conservative usually
SCFE - surgical usually

104
Q

Sinding larsen johannson

A

tendon injury of inferior pole of patella

105
Q

Osgood Schlatter

A

tendon injury - tibial tubercule

106
Q

Severs disease

A

tendon injury calcaneus

107
Q
A

MY NPTE (22 decks)

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