Pediatrics Flashcards
1
Q
______ = neonatal Ax w/ 5 aspects
A
APGAR
2
Q
5 aspects of APGAR?
A
- appearance
- pulse
- grimace
- activity
- respiration
3
Q
Scoring of the APGAR?
A
0 (non exisent) to 2 (normal and strong)
4
Q
APGAR: core of __ - ___ indicates being born in significant distress; __ - ___ = mild distress
A
0-3;4-6
5
Q
5 goals of of pediatric physio?
A
- participation
- motor abilities
- functional mobility
- health
- prevention
6
Q
_______ _____ _____ ______ = head turned to one side w/ extension of ipsilateral and flexion of contralateral arm (fencers pose_
A
asymmetrical tonic neck reflex (ATNR)
7
Q
ATNR = __ - __ months
A
0-4
8
Q
_____ reflex = when feeling like they are falling the child will open their arms then bring them back to their chest
A
moro
9
Q
_______ reflex = grasp when pressure is put on palm of hand, will relax if you stroke back of hand
A
grasping
10
Q
grasping reflex = __ - __ months
A
0-4
11
Q
_____ reflex = body weight shift and the baby will make stepping motions
A
stepping
12
Q
Babinski = normal in infants until __ - __ months, extension of big toe and fanning of the rest w/ stimulation of sole of foot
A
12-24
13
Q
Stepping reflex = in first __ months
A
2
14
Q
_______ ______ ______ = will flex UE and extend LE w/ neck flexion; when neck extended UE will extend and LE are flexed
A
symmetrical tonic reflex
15
Q
______ ______ reflex = stimulate pressure to base of toe and get toe flexion
A
plantar grasp
16
Q
Symmetrical tonic neck reflex = ___ months
A
3 months
17
Q
Plantar grasp reflex = present at __ weeks to __- __ months
A
28; 9-10
18
Q
____ reflex = stroke side of cheek, baby will open mouth and turn towards side of stimulation
A
rooting
19
Q
Rooting reflex = up to __ months
A
3
20
Q
______ reactions = no matter their position, head will orient to upright position
A
righting
21
Q
______ reactions = related to trunk stability
A
equilibrium
22
Q
______ reactions = extending arms w/ sudden displacement as not to fall
A
protective
23
Q
Developmental milestones: birth to 3 months
A
- able to turn head side to side
- brief head righting
- random kicks in supine
- maintain head midline
- hand fisted w/ reflex grasp
24
Q
Developmental milestones: 4 - 5 months
A
- able to prop w/ extended elbows
- head control
- rolls
- supported sitting
- WB in stating when supported
- grasp / hold small toys (3-5 months)
- release toys (3-5 months)
- increased frequency of reaching (3-5 months)
25
Developmental milestones: 5 months
head control in sitting
26
Developmental milestones: 6 months
1. sitting independently
2. uses hands for play
3. stands w/ support
4. radial palmar grasp (6-8 months)
5. rake to grasp (6-8 months)
6. reaching path is straight (6-8 months)
27
Developmental milestones: 7 months
1. anticipate and orient hand for reach and grasp
| 2. commando crawling
28
Developmental milestones: 8-9 months
1. 4 pt kneel
2. moves from sit to prone
3. pivots in sitting
4. may pull to stand
29
Developmental milestones: 9-11 months
1. points and pokes w/ index finger
| 2. uses PINCHER grip **
30
Developmental milestones: 10 - 11 months
1. can move out of prone or supine
2. sitting bum scoot
3. transfer from stand --> sit w/out falling
4. picks up objects from floor w/out support
5. stands hands free for a few seconds
6. ++ mobility (crawls up stairs, cruising, walking w/ hands held, can start walking independently)
31
Developmental milestones: 12 - 18 months
1. walks independently
2. transitions to stand at mid floor
3. squats
4. picks up toys w/out support
5. walks up stairs w/ hand held or rail
6. initiates ball kick / throws ball
7. walks backwards / sideways a few steps
8. opens books
9. handedness usually established
32
Developmental milestones: 2-2.5 years
1. propels or steers push toys
2. walks on tip toes
3. jumps
4. stands on one foot
5. kick ball
6. throw and catch
7. ascend and descend stairs independently
33
Developmental milestones: 3-5 years
1. climb stairs independently
2. run faster and more controlled
3. walk in straight line
4. throw under and over head
5. somersaults
6. gallop and skip
7. dress and eat independently
8. use mature tripod grasp (4.5 years)
34
Down syndrome = alteration of chromosome __
21
35
Name minimum 5 S/S of down syndrome
Any of ...
1. identifiable facial features
2. hypotonia
3. dec strength and ligament laxity
4. short arms and legs
5. heart defects
6. AA instability
7. scoliosis
8. pronated feet
9. hip dislocation
36
_______-_______ syndrome = related to disturbance in hypothalamus, genetic deletion of chromosome 15 usually
prader-willi
37
Name 5 S/S of prader-willi syndrome in infants
1. hypotonia
2. delayed motor and learning development
3. little spontaneous movement
4. resp difficulties
5. oral motor or feeding difficulties
38
3 Rx for Prader-Willi syndrome in infants?
1. gross motor development
2. compensatory postures
3. nutritionist
39
5 S/S of Prader-Willi syndrome in older kiddos?
1. hypotonia
2. intellectual impairment
3. short stature
4. hyperphagia
5. extreme obesity/behaviour problems
40
5 Rx for Prader-Willi syndrome in older children?
1. weight management
2. inc activity level
3. orthotics
4. improve postural control
5. behaviourist
41
Neonatal respiratory distress syndrome = < ___ weeks gestation due to lack of ______
37; surfactant
42
4 S/S of neonatal resp distress syndrome ?
1. tachypnea
2. in drawing
3. cyanosis
4. occurs soon after birth
43
Rx for neonatal resp distress syndrome ?
corticosteroids
44
Sudden infant death syndrome = death of infant under __ year w/ unexplained cause, peaks at __ - __ months and usually occurs at night
1;3-4
45
Is SIDS more common in male or female infants ?
males
46
Risk factor for SIDS = _____ sleeping; may also be caused by ______
prone; infection
47
5 S/S of FAS?
1. facial changes
2. brain damage
3. hypersensitivity
4. poor concentration
5. poor feeders / eaters
48
_______ _______ ________ = rare NON progressive neuromuscular syndrome of unknown etiology; S/S can include joint contractors, muscle weakness, poor muscle development and fibrosis
arthrogryposis multiplex congenital (AMC)
49
The fibrosis seen in AMC can lead to what other 3 issues?
1. scoliosis
2. heart defects
3. resp problems
50
_____ ______ # = affects the growth plate in children
salter harris
51
Salter Harris # = immobilization usually between __ - __ weeks
3-6
52
_______ = developmental delay in social / language / motor and/or cognitive development, more common in M > F
autism
53
Average age of onset of autism = __ years
4
54
Name 5 S/S of autism
Any of ...
1. stereotyped and repetitive play skills
2. avoids eye contact
3. dislikes change in routine
4. strong sensory preferences
5. dyspraxia
6. gait = waddling, abnormal weight distribution
7. cerebellar involvement
55
3 outcome measures to use in autism ?
1. M-ABC
2. Bayley-3
3. PDMS -2
56
_____ disease = localized disorder of bone remodelling (excessive resorption followed by increase in bone formation) --> structurally disorganized mosaic of bone, weaker, larger, less compact, more vascular, more susceptible to #
paget's
57
Pagets disease normally involves multiple bones, especially _____ skeleton
axial
58
__ - __ % of pts with Pagets disease are asymptomatic
70-90!!!
59
5 S/S of Pagets disease?
1. bone pain
2. secondary OA
3. bony deformity
4. excessive warmth
5. neurologic complications
60
Name 5 points to touch on for education for pts w/ Paget's disease
1. proper posture
2. body mechanics
3. avoidance of trauma
4. precautions against falling
5. hazards of immobility
61
________= pituitary gland produces excess growth hormone during adulthood, = increased bone size
acromegaly
62
In children excess growth hormone leads to ______ rather than acromegaly
gigantism
63
S/S of acromegaly? (2)
1. enlarged hands and feet
| 2. gradual changes in shape of face (protruding jaw and brow, enlarged nose, thickened lips, etc)
64
Name 3 complication of acromegaly
Any of ...
1. HTN
2. cardiomyopathy
3. OA
4. precancerous growth on lining of colon
5. sleep apnea
6. carpal tunnel
7. hypopituitarism
8. uterine fibroids
9. SC compression
10. vision loss
65
_____ = short stature (4 foot 10" or shorter)
dwarfism
66
What are the two types of dwarfism?
1. proportionate
| 2. disproportionate
67
Dwarfism: may need ____ _____ if related to deficiency, or insertion of _____ to drain excess fluid and relieve pressure on brain
growth hormone; shunt
68
_____-______ syndrome = pain and swelling at insertion of patellar tenon to tibial tubercle
Osgood-Schlatter
69
Osgood-schlatter = self limited, caused by minor degree of _______ of tibial tubercle, associated with patella _____
separation; alta
70
Osgood-schlatters = usually in kids __ -___; more common in boys or girls?
10-15; boys
71
5 Rx for osgood schlatters?
1. ice
2. rest
3. decrease activity
4. avoid squatting and jumping
5. brace / cast in severe cases
72
Osgood-schlatters: generally resolves in __ weeks if following precautions; most cases within __ months
6;3
73
_______ ________ = lesion of subchondral bone and articular surface
osteochondritis dessicans
74
Common sites for osteochondritis dessicans?
1. distal femur MOST common
2. lateral surface of medial femoral condyle
3. femoral capitate epiphytes
4. talus
75
Osteochondritis dessicans = due to ischemic ______, cause ______
necrosis; unknown !
76
S/S of osteochondritis dessicans?
1. pain
2. swelling around knee
3. antalgic gait
4. locking (if fragment separates)
77
Osteochondritis dessicans is often asymptomatic (T/F)
TRUE
78
4 Rx for osteochondritis dessicans?
Mostly SELF LIMITING!
1. immobilization
2. gradual activity w/ quads strengthening
3. Sx if separation and intra-articular fragment
79
______ ____ ______ = walking milestones normal but up on toes; child others appears completely normal
idiopathic toe walking
80
3 S/S of idiopathic toe walking?
1. childs walks and runs on toes
2. variable degree of tightness in PF's
3. always SYMMETRICAL!
81
4 Rx for idiopathic toe walking?
1. AFO'S
2. PT (ROM and strength)
3. serial casting
4. botox
82
_______= rotational deformity of the C spine with secondary tilting of head
torticollis
83
Torticollis = _____ head tilt w/ ______ rotation
lateral; contralateral
84
______ ______ torticollis = unilaterale shortening or fibrosis of SCM at birth or shortly after
congenital muscular
85
Torticollis = increased risk w/ prolonged time on _____
back
86
Associated conditions w/ torticollis?
1. plagiocephaly
2. facial asymmetry
3. hip dysplasia
4. MSK abnormalities (metatarsus adducts, etc)
5. brachial plexus injury
6. TMJ dysfunction
7. developmental delay
87
3 typical presentations of congenital muscular torticollis?
1. SCM "tumor" (palpable mass in SCM; not a neoplasm but scar tissue)
2. muscular torticollis (without palpable tumour but thickening and / or shortening of SCM)
3. postural torticollis (where clinical features present without tumour or muscle tightness)
88
Other causes of torticollis may include ocular torticollis where the ____ ____ mm is weak and bb head tilts to correct double vision; OR space occupying lesion (______ _____ tumour)
superior oblique; post fossa
89
5 aspects of Ax of congenital muscular torticollis?
1. Hx
2. observation
3. ROM
4. strength + tone
5. development
90
Should see lateral head righting reflex > __ months in bbs
4
91
5 Rx for congenital muscular torticollis?
1. stretching
2. strengthening
3. positioning
4. environmental adaptations
5. parental education
92
_______ = the misshaping and flattening of an infants head through sustained external directional force
plagiocephaly
93
4 main components of a paediatric examination ?
1. Hx
2. systems review
3. intervention
4. re-examination
94
6 aspects of Hx component of paediatric exam?
1. prenatal
2. birth
3. general health
4. milestones
5. procedures / interventions
6. goals
95
4 outcome measures to assess paediatric intervention?
1. FMS
2. GMFCS
3. GMFM
4. COPM
96
____ = ages 4-18 w. CP; rates walking ability at 5, 50, and 500m; questions not observation; used to figure out what devices you will need
FMS (functional mobility scale)
97
Scoring of the FMS?
N - 6
| You want a high score
98
_______ = 5 levels for kids w/ CP, based on self initiated movement, good for communication b/w families and health care professionals and goal planning
GMFCS (gross motor functional classification system)
99
______ = standardized test for gross motor function for children w/ CP, all items that a 5 year old (normal development) would do, can measure over time to see change and set realistic goals
GMFM (gross motor functional measure)
100
Scoring of the GMFCS?
5 levels, 1 = high function, 5 = very limited
101
_____ = identifies goals in self care, productivity and leisure ; family centred!
COPM
102
4 aspects of measuring tone in peds?
1. mm palpation
2. PROM
3. quantifying tone
4. primitive reflexes
103
When measuring tone using modified Tardieu, assses ROM at ___ (high velocity) and ___ (end ROM and slow sleep)
R1; R2
104
Scoring of the modified Tardieu?
0-5, want lower score
105
What is the modified Ashworth scale used for? What is the scoring?
Tone Ax; 5 point scale, 0-4
