pediatrics Flashcards
APGAR table
go over it
apgar scoring
8-10 - normal
5-7 - need O2
<5 - may need resuscitation
does cephalic or caudal develop first?
cephalic - shoulder and head stability before hip
when is flexor vs extensor tone first
flexor tone - when first born
extensor tone - when first standing
pedes reflexes
go over quizlet
early gait position
high guard, hip abduction/ER, crouched, wide BOS, pronated feet, hips and knees flexed, no heel strike
reflexes integrated 1-2 months
flexor withdrawl and crossed extension
reflexes integrates 3 months
rooting
reflexes integrated 2-5 months
traction
reflexes integrated 6 months
PAMS TP
palmar, ATNR, MORO, sucking, TLR, positive support reflex
reflexes integrated at 9 months
plantar grasp
reflexes integrated by 12 months
BS
babinski, STNR
ataxic CP
- always hypotonic
- from cerebellum
- decreased coordination, decreased balance, nystagmus
- wide BOS
spastic CP
- velocity dependent spasticity
- synergy patterns
- scissoring gait, crouched gait, toe walking
- contractures
hypotonic/dyskinetic CP
- fluctuating tone: start hypotonic - go into hypertonicity
- from basal ganglia
- intention tremor
- involuntary slow writhing movements
- poor stability
plagiocephaly
- ipsilateral occipital flattening, and frontal bossing and anterior displacement of ear
- contralateral occipital bossing and frontal flattening
- fron prolonged asymmetrical pressure on premature skull
- treatment: helmet
torticollis
- named for tight SCM side (side of bend)
- opposite side to plagiocephaly
- treatment:
stretching, football hold with ipsi side down so they try to do head righting, visual tracking
down’s syndrome
- result from extra full or partial copy of 21st chromosome (aka trisomy 21)
- increased risk with age of mother
- forceful neck flexion and rotation should be avoided due to laxity of odontoid ligament and potential for subluxation of atlanto-axial joint
- encourage motor function
- avoid hyperextension of elbows and knees during WB
- hypermobile, hypertonic, tend to be in extension, ligamentous laxity
- delayed motor milestones (esp. running and jumping)
- deficits in memory and expressive language
- postural control and coordination impairments
- decreased quad and hip abd strength
dyspraxia
inability to imitate movement
- seen with autism
duchenne muscular dystrophy
- only in males, x linked recessive gene
- dystrophin gene is missing
- gowers sign
- proximal to distal weakness, core weakness
- weakness starts at 3 y/o
- lordosis, kyphoscoliosis
- decreased cardiopulm function
DMD treatment
- maintain mobility and ROM as long as possible
- dont overfatigue
Schuermann disease
- shmorl’s nodes - cracks in vertebrae - lead to back pain
- make wedged t/s which lead to kyphosis
- pain with thoracic extension/rotation and prolonged sitting/standing/physical activity
- increased thoracic kyphosis, lumbar lordosis
- PT interventions: Schroth method: stretch ant mm, strengthen post mm
Erb’s palsy
Nerve roots:
MOI:
Loss of movement:
Deformity:
Nerve roots: C5-C6
MOI: stretching head downward
Loss of movement: loss of abduction and shoulder ER
Deformity: waiters tip
Klumpke’s palsy
Nerve roots:
MOI:
Loss of movement:
Deformity:
Nerve roots: C8-T1
MOI: stretch of arm overhead
Loss of movement: paralysis of intrinsic hand mm
Deformity: claw hand (pull KLUMP of grass out of ground
