Pediatrics Flashcards
What is Maslow’s Hierarchy of Basic Needs?
Physiological needs
Need for safety
Need for love and belonging
Need for a sense of self-esteem
Need for self-actualization
What is spina bifida occulta?
It’s the mildest and most common type. Results in a small separation or gap in one or more of the bones of the spine (vertebrae). Many people who have spina bifida occulta don’t even know it, unless the condition is discovered during an imaging test done for unrelated reasons.
What is spina bifida myelomeningocele?
Myelomeningocele is a severe type of spina bifida in which the membranes and the spinal nerves protrude at birth, forming a sac on the baby’s back. The exposed nervous system may become infected, so prompt surgery is needed after birth.
What is spina bifida meningocele?
This rare type of spina bifida is characterized by a sac of spinal fluid bulging through an opening in the spine. No nerves are affected in this type, and the spinal cord isn’t in the fluid sac. Babies with meningocele may have some minor problems with functioning, including those affecting the bladder and bowels.
What is anencephaly?
A baby born with an underdeveloped brain and an incomplete skull.
Anencephaly is a defect in the formation of a baby’s neural tube during development. A baby born with anencephaly might be stillborn or survive only a few hours to a few days after birth.
The main symptom is unconsciousness.
There is no cure for anencephaly. Treatment aims at making the baby as comfortable as possible.
What happens in early infancy (B-3m)?
Head control
- To 45º - 1-2m
- 90º - 2-3m
Visual tracking
- Cross midline at 2-3m.
- “Nystagmus” normal
Social skills
- Smiles: 2-3m
Describe sitting in middle infancy?
4m: pulls to sit.
5m: sits supported.
6m: 3-point or prop sit.
What other developmental milestones occur in middle infancy?
Bring hands to midline.
- 4m: hold bottle.
- 5m: play - hands and feet.
True suck
- 4m: disassociation of parts
- 4m: start of spoon feeding.
- 5-6m - active lip
Vocalization (4-5m)
- Laughing
- Babbling
What fine motor and hand development occurs from B-6m?
Birth-grasp is reflexive.
- Hands to mouth or eyes
- Hands typically fisted.
3 months
- Hands relax in open position.
4 months
- Hands to midline away from body slightly
5 months
- 5-6m: begins reaching
- 5-6m: Ulnar palmer (palmer) grasp
- Raking begins.
Describe late infancy (7-9m).
Protective reactions
Sitting -tall and stable
Prone work
7m: radial palmer grasp
8-9m: lateral pincer grasp
9m: voluntary release
Describe the development of sitting.
Newborn- slumped, C-shape, no head control
4-5 months: 3-point sit, some extension
6-8 months: sits erect and stable.
7-8 months: dynamic sitter (rotation is added)
- W sitting
Describe prone development.
Newborn-flexed with reflex driven movement
1-2m: head against gravity (45º)
3-4m: prop on arms (head at 90º, 3months)
4-5m: rolling.
6m: roll to sit.
7-8m: “crawl”, commando
8m: all fours and rock
9m: creep
Describe FM and hand development in late infancy?
10-11m: inferior pincer grasp
- Can now pick up a pea and put it in their ear.
11-12m: pincer (pad to pad) grasp
12m: tip pincer
Also look at position of wrist, immature wrist flexed, mature wrist stable
Describe ambulation in late infancy.
10-11m: pulls to stand
10-11m: cruises
Walks with two hands held.
Walks with one hand held.
Walks independently.
- Wide base
- High guard
What developmental milestones occur in late infancy?
8m: object permanence
8m: understand impact to environment.
8m: becomes “emotional”, happy, mad etc.
8-10m: begins to form attachments
- Strong research to suggestion, attachment in the first-year influences lifelong ability to attach.
11-12m: first words
12m: stranger anxiety
Describe feeding milestones in late infancy.
7m: eats from spoon
- Teeth start to show up (6m on)
- Munching pattern
- Finger feeds
10-12m:
- Can eat most foods.
- Rotary chew and tongue movement
What postural skills develop in preschool?
The ability to put your body where you want it and maintain it there.
- Upright against gravity
- Balance
- Stability
* Static
* Dynamic rotation
* Stability limits
- Flow
* Mobility
* Stability
* Stability superimposed on mobility.
What postural development occurs from 12-18 months?
Good walker and getting better!
Sit in a small chair.
Plays well is standing (dynamic)
Squats to pick things up.
Pushes and pulls toys.
Climb into big chair.
Up the stairs holding hand.
Flings things
Starts to run.
High support.
What postural development occurs from 18-24 months?
Loves gross motor play (this is how they get good at it)
Runs, climbs.
Jungle gym/slides
Push cars
Kicks ball forward.
Throws ball at target.
Jumps up and down (in place 2 feet)
Walks up and down the stairs.
- Holding on
What postural development occurs from 24-36 months?
Very good walker and runner, stable on feet
Rides peddle car or tricycle.
Coordination of reciprocal LE
Catches ball against chest.
Jumps from step.
Hops on one foot (toward 3)
What postural development occurs from 3-4y?
Confidence in motor skills
- Running, jumping
- Skipping
- Stands on one foot.
- Alternates feet on stairs
- Jumps from higher levels.
Describe the sensory system in preschoolers.
Eyes, ears, noise, taste, balance, proprioception, tactile
- Working together for function
- Perceptual motor skill- a volitional motor response to sensory stimuli (or perceived stimuli)
- Visual perceptual skills - the ability to interpret visual stimuli and make (or not) a response.
Kids with delayed sensory perceptual skills, often hit major milestones, walking, running.
- Clumsy
- Fall apart with complex tasks.
* Climbing
* Walking in line
* Fine motor tasks
- ASD
Describe sensory integration in preschoolers.
The ability of the brain (CNS) to automatically combine all the information coming in from the senses (PNS) and make accurate decisions.
- A. Jean Ayres 1950
Sensory information is interpreted and combined with past experiences and abilities to create new experiences.
- Innate drive to seek sensory experiences.
- “Sensory rich diet/environment”
Describe visual skills and visual perception in preschoolers.
Visual scanning - saccadic eye movement
Visual tracking
Visual acuity (ETDRS chart vs Snellen)
- Static (by 5yrs)
- Dynamic quickly follows.
- Important for “eye hand coordination”
- Early identification
Visual discrimination (tie to motor and cognitive)
- Telling things apart without touching
- Size, shape, color
- Visual matching
* Figure ground
Describe the sense of touch in preschoolers.
Once reflexes are integrated
Information about the environment
Tied to cognition.
Discriminative touch
- Favorite blanket
- Needed to develop dexterity and hand skills.
- Holding a baby chick vs. a jump rope handle
Haptic perception
- Memory and experience
- Knowing what something feels like without touching.
Common issue tactile defensiveness
- Avoids tactile.
- Craves firm.
Describe the development of self care skills in preschoolers.
1yr. - assist with dressing holds arms out, pulls off shoes and socks.
2yrs. - removes all clothes, can put on a shirt (may be backwards)
3yrs. - shirt and shoes (wrong feet ok), unites shoes, large buttons, and easy openers.
4yr. – zippers, shoes on right feet, dress without help (maybe a little)
- Tying shoes (4-5 yrs.)
Describe school readiness in preschoolers.
Typically, independent with ADLS
- Help with buttons, juice boxes.
Communication skills
Using materials
- Crayons, scissors
- Often switch or support with other hand
- Hand dominance by 5-7 yrs.
In hand manipulation skills
- Translation
* Tip to palm
* Palm to tip
- Shift
- Rotation (simple complex)
- Intact by 7- improves into adulthood.
