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NPTE > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

APGAR: Appearance scores

A

0 = blue
1 = blue extremities
2 = no blue

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2
Q

APGAR: Pulse scores

A

0 = absent
1 = <100bpm
2 = 100-140bpm

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3
Q

APGAR: Grimace scores

A

0 = no response
1 = grimace
2 = cry/withdrawal

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4
Q

APGAR: Activity scores

A

0 = flaccid
1 = some flexion
2 = active motion

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5
Q

APGAR: Respiration scores

A

0 = absent
1 = weak cry/hypoventilation
2 = strong cry

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6
Q

When is APGAR checked?

A

-1min
-5mins
-10mins if needed (if normal score at 5min, no need to check again)

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7
Q

What is a normal APGAR score?

A

> /= 8/10

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8
Q

Interventions for abnormal APGAR scores

A

5-7 = blow-by oxygen
<6 = resuscitation
3-4 = bag mask ventilation

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9
Q

General rules of gross motor development:
a) reflexes before cortex
b) cortex before reflexes

A

a) reflexes before cortex

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10
Q

General rules of gross motor development:
a) localized before general responses
b) general before localized responses

A

b) general before localized responses

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11
Q

General rules of gross motor development: order of tone?

A

Gravity (supine): flexor before extensor
Antigravity (upright): extensor before flexor

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12
Q

General rules of gross motor development: order of body regions?

A

-Cephalic to caudal
-Proximal to distal

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13
Q

Key Milestones at month 3

A

-Prone on elbows
-Lift head in prone
-Belly crawl

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14
Q

Key Milestones at month 4

A

-Supine > sidelying

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15
Q

Key Milestones at months 5-6

A

-Prone > supine
-Pull to sit
-Sit w/ UE support
-Feet to mouth

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16
Q

Key Milestones at months 6-7

A

-Supine > prone
-Quadruped
-Ring sit
-Trunk rotation in sitting
-Transfer objects btwn hands

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17
Q

Key Milestones at months 9-10

A

-Quadruped creeping
-Cruising sideways
-Pull to stand
-Pincher grasp
-3 jaw chuck grasp (looks like ASL no)

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18
Q

Key Milestones at months 10-15

A

-Walking unassisted
-In/out of squat
-Controlled grasp & release
-Stacks 2 cubes

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19
Q

Flexor Withdrawal Reflex: stimulus, response, & when is it integrated?

A

Stimulus: noxious to sole of foot.
Response: toes ext, DF, LE flex.
Integrated: 2mo

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20
Q

Crossed Extension Reflex: stimulus, response, & when is it integrated?

A

Stimulus: noxious to ball of foot
Response: opposite (unstimulated) LE flexes, then adducts & extends.
Integrated: 2mo

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21
Q

Rooting Reflex: stimulus, response, & when is it integrated?

A

Stimulus: stroke cheek
Response: head turns toward direction of stimulus, mouth opens.
Integrated: 3mo

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22
Q

Traction Reflex: stimulus, response, & when is it integrated?

A

Stimulus: grasp arm & pull from supine > sit.
Response: total flexion of UE.
Integrated: 5mo

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23
Q

Asymmetric Tonic Neck Reflex (ATNR): stimulus, response, & when is it integrated?

A

Stimulus: rotate head to one side in supine.
Response: bow & arrow posture (flexion away from head turn, extension on side of head turn).
Integrated: 6mo

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24
Q

Palmar Grasp Reflex: stimulus, response, & when is it integrated?

A

Stimulus: pressure on palm.
Response: fingers flex.
Integrated: 6mo

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25
Q

Moro Reflex: stimulus, response, & when is it integrated?

A

Stimulus: drop backward from sitting > supine.
Response: UE extend & abduct, hands open. Then UE flex & adduct, arms cross over chest.
Integrated: 6mo

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26
Q

Symmetric Tonic Labyrinth Reflex (TLR): stimulus, response, & when is it integrated?

A

Stimulus: prone or supine position.
Response (Prone): increased flexor tone.
Response (Supine): increased extensor tone.
Integrated: 6mo

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27
Q

Positive Support Reflex: stimulus, response, & when is it integrated?

A

Stimulus: contact ball of foot in standing.
Response: rigid extension of LEs.
Integrated: 6mo

28
Q

Plantar Grasp Reflex: stimulus, response, & when is it integrated?

A

Stimulus: pressure on ball of foot.
Response: toes flex.
Integrated: 9mo

29
Q

Symmetric Tonic Neck Reflex (STNR): stimulus, response, & when is it integrated?

A

Stimulus: head flexion or extension in quadruped.
Response (Flexion): UE flex, LE extend.
Response (Extension): UE extend, LE flex.
Integrated: 12mo

30
Q

Startle Reflex: stimulus, response, & when is it integrated?

A

Stimulus: sudden loud noise
Response: UE extend & abduct.
Integrated: persists

31
Q

Which reflex does not onset until 4-6mo after birth?

A

STNR

32
Q

Plagiocephaly skull deformation

A

Ipsilateral:
-Occipital flattening.
-Frontal bossing (protruding).
-Ear displaced anteriorly.

Contralateral:
-Occipital bossing.

33
Q

Plagiocephaly treatment

A

Helmet

34
Q

What does Left Plagiocephaly look like?

A

Left occipital flattening.
Left frontal bossing.
Right occipital bossing.

35
Q

Torticollis presentation

A

Side bend toward
Rotate away

36
Q

How do Plagiocephaly & Torticollis relate?

A

Opposite sides.
Left plagiocephaly = right torticollis.

37
Q

Torticollis treatment

A

SCM stretching

38
Q

Spastic Cerebral Palsy: definition & presentation

A

Velocity-dependent resistance to stretch.
Synergy patterns.
Contractures.
Crouch gait.
Toe walking.

39
Q

Ataxic Cerebral Palsy: definition & presentation

A

Disorder of coordination, force, & timing; cerebellar involvement.
Low tone.
Tremor.
Poor balance.
Wide BOS.
Nystagmus.

40
Q

Dyskinetic Cerebral Palsy: definition & presentation

A

Slow, writhing movements; basal ganglia involved.
Poor stability.
Hand tremors.
Fluctuating tone.

41
Q

Cerebral Palsy GMFCS Level 1

A

Walks without restrictions.
Some limitations w/ advanced motor skills.

42
Q

Cerebral Palsy GMFCS Level 2

A

Walks without a device.
Limitations with community ambulation (e.g., difficulty with stairs).

43
Q

Cerebral Palsy GMFCS Level 3

A

Walks with a device.
Limitations with community ambulation (may require manual WC).

44
Q

Cerebral Palsy GMFCS Level 4

A

Mobility severely limited.
Power WC for community.

45
Q

Cerebral Palsy GMFCS Level 5

A

Mobility severely limited, even with assistive tech.
Requires caregiver.

46
Q

Down Syndrome definition

A

Trisomy 21 (extra chromosome 21)

47
Q

What increases risk of Down Syndrome?

A

Geriatric pregnancy

48
Q

Down Syndrome: precautions

A

Avoid forceful neck flexion & rotation (risk of subluxing AA joint).
Avoid hyperextension of elbows & knees when WB (d/t hypotonia).

49
Q

Down Syndrome: common sxs

A

Delayed milestones, especially running & jumping.
Impaired postural control.
Weak quads.
Weak hip abductors.

50
Q

Down Syndrome: treatments should ideally include…

A

Encourage WB - standing/walking activities.
Exercises that address both gross & fine motor skills.

51
Q

What is Dyspraxia & what condition is it commonly seen with?

A

Difficulty imitating movements.
Autism.

52
Q

Sensory Seeking definition

A

Hypo-reactive to sensory input.

53
Q

Sensory Avoiding definition

A

Hyper-reactive to sensory input.

54
Q

Duchenne Muscular Dystrophy definition

A

X-linked (boys only).
Destruction of muscle cells.
Pseudohypertrophy: fat & collagen fill muscles.
Short lifespan, strength WILL decline.

55
Q

Duchenne Muscular Dystrophy: key characteristic

A

Gower’s Sign: puts hands on knees & “walks” up legs to stand upright.

56
Q

Duchenne Muscular Dystrophy: treatments & precautions

A

-Focus on maintaining mobility for as long as possible & preventing contractures.
-Strength will decline no matter what, so less focus on strengthening.
-Do NOT over-fatigue!

57
Q

Scheurrman Disease: definition & radiograph presentation

A

-Juvenile kyphosis.
-Schmorl Nodes (wedging of thoracic vertebrae).

58
Q

Scheurrman Disease: presentation

A

-Pain w/ thoracic extension.
-Agg by standing or sitting for prolonged time.
-Increased thoracic kyphosis.
-Increased lumbar lordosis.

59
Q

Scheurrman Disease: interventions

A

Stretch pecs
Strengthen thoracic extensors
Scapular stabilization

60
Q

Nerve roots involved with Erb’s Palsy

A

C5-6

61
Q

Nerve roots involved with Klumpke’s Palsy

A

C8-T1

62
Q

Erb’s Palsy: MOI

A

Stretch head downwards

63
Q

Klumpke’s Palsy: MOI

A

Stretch arm above head

64
Q

Erb’s Palsy: deformity & sxs

A

-Waiter’s Tip deformity
-Shoulder & elbow mm affected
-Loss of abd & ER
-Sensory loss of radial arm

65
Q

Klumpke’s Palsy: deformity & sxs

A

-Claw Hand deformity
-Paralysis of hand intrinsics (non-functional hand)
-Sensory loss of ulnar arm

NPTE (28 decks)

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