Pediatrics - Intro Flashcards
What gestational age is considered full-term?
37 - 42 weeks
What are the 3 stages of embyronic development?
- Germination (3 weeks)
- Embryonic (6 weeks)
- Fetal (8 weeks - Term)
When is a child a neonate?
For the first few weeks of life
When is a child an infant?
Upto 12 months of life
What 5 qualities are measured in an APGAR score?
- Heart rate
- Respiratory rate
- Muscle tone
- Reflex irritability
- Color
What are the 0 - 2 scorings of each APGAR element?
HR; 0:Absent, 1: <100, 2: greater than 100
RR: 0: Absent, 1: Slow and Irregular, 2: Good, crying
MT: 0: Limp, 1: Some flx/ext, 2: Active movement
RI: 0: No response, 1: Grimace, 2: Cough or sneeze
C: 0: Blue, 1: Pink, blue extremities, 2: Pink
What is considered a normal APGAR score?
Anything above 7
What happens to primitive reflex as a child matures in a normally developing child?
Become integrated
What is the rooting reflex?
When is it integrated normally?
What does it interfere with if not integrated?
- Touched cheek results in a turn of the head to the same side with mouth open
- Integrated by 3 motnhs
- Interferes with: Motor development, midline control of head, optical righting, visual tracking, and social interaction
What is the sucking reflex?
When is it integrated?
What does it interfere with if not integrated?
- Touch to lips, tongue or palate results in automatic sucking allowing the infant to take in food
- Integrated by 6 months
- Interferes with progression of oral motor food and solid intake
What is the moro reflex?
When is it integrated normally?
What does it interfere with if not integrated?
- Head drop into/ suddenly results in shoulder abduction, then adduction
- Integrated by 5 months
- Interferes with: balance reactions, protective responses in sitting, eye-hand coordination, visual tracking
What is the startle reflex?
When is it integrated normally?
What does it interfere with if not integrated?
- Loud, sudden noises result in Moro response (shoulder abudction –> adduction) with elbows flexed and hands closed
- Integrated by 5 months
- Interferes with: balance reactions, protective responses in sitting, eye-hand coordination, visual tracking, social interaction, and attention
What is the palmar grasp reflex?
When is it integrated normally?
What does it interfere with if not integrated?
- Pressure in infant’s palm results in fist grip with slow release
- Integrated by 4 months
- Interferes with: ability to grasp and release objects voluntarily, and weight bear on open hand
What is the plantar grasp reflex?
- Pressure to base of toes results in toe flexion
- Integrated by 9 months
- Interferes with ability to stand with flat feet, balance reactions, and weight shifting in standing
What are the 3 attitudinal reflexes?
- ATNR (Asymmetrical tonic neck reflex)
- STNR (Symmetrical tonic neck reflex)
- TLR (Tonic labyrinthine reflex)
What is the ATNR?
When is it integrated normally?
What does it interfere with if not integrated?
- Head turned t one side resulting in arm and leg extension on the face side and flexion of the scalp side
- Integrated by 6 moths
- Interferes with: feeding, tracking, midline use of hands, B hand (?) use, rolling, crawling, and can cause skeletal deformities
What is STNR?
When is it integrated normally?
What does it interfere with if not integrated?
- Neck flexion produces UE flexion and LE extension
- Neck extension produces UE extension, and LE flexion
- Integrated by 6 - 8 months
- Interferes with prone on elbows position, quadriped position, sitting, balance, looking, and use of hands in neck FLX or EXT
What is TLR?
When is it integrated normally?
What does it interfere with if not integrated?
- Supine causes body and extremities extension
- Prone causes body and extremity flexion
- Integrated by 6 months
- Interferes with: ability to initiate rolling, prone on elbows position, supine to sit, balance in sitting or standing.
What are the 4 protective extension responses?
- Parachute response
- Forward sitting
- Sideways sitting
- Backwards sitting
What is the parachute response?
When is it present?
- Quick displacement of the trunk downward with the child suspended prone at 45 degrees causes arm extension
- Present at 4 months
What is forward sitting protective extension?
When is it present?
- Pushing of child forward in sitting should result in shoulder extension to catch their weight
- Present at 6 - 7 months
What is the sideways sitting protective extension reponse?
When is it present?
- Displacement of trunk to each side should result in shoulder and arm extension to the same side to catch their weight
- Present at 6 - months
What is the backwards sitting protective extension response?
When is it present?
- Pulling child backwards from sitting should cause arm extension to support weight
- Present at 9 - 12 months
What are the 2 upright reflexes?
- Positive standing reflex
- Walking reflex/ stepping reflex
What is the positive standing reflex?
When is it integrated?
What does it interfere with if not integrated?
- When weight is placed onto the balls of the feet of a child, they stiffen their legs and trunk into extension
- Integrated at 2 months
- Interferes with standing, walking, weight shift in standing, and can cause plantarflexion contracture
What is the walking/ stepping reflex?
When is it integrated?
What does it interfere with if not integrated?
- Supported upright on soles of feet causes flexion and extension of the lower extremities
- Integrated at 2 months of age
- Interfers with standing, walking, balance reactions, weight shift in standing, development of smooth coordinated reciprocal LE movements
Who developed the dynamical systems theory of development? When?
- Thelen
- 1990s
How are stages viewed by the dynamical systems model?
- They are actually states of relative stability that become apparent through self-organizing, and emergent properties of a number of different systems that develop independently, at their own rate
What is the driving force for development in the dynamical systems model?
Organism develops by recognizing the affordances of the environment, and selecting the appropriate available responses to tasks
What are the building blocks of developments according to dynamical systems?
- Multiple cooperating systems developing independently along with self-motivated exploration of environment drives development (no specific building blocks)
List the 8 steps of the dynamic systems theory of motor control.
- Pattern generation of the coordinative structures leading to reciprocal LE activity, consisting primarily of alternating flexor muscle activation
- Development of reciprocal muscle activity of flexor and extensor muscles
- Strength of extensor muscles needed for opposing the force of gravity
- Changes in body size and composition
- Antigravity control of upright posture of the head and trunk
- Appropriate decoupling of the tight synchronization of characteristics of early reciprocal LE movements, such that the knee moves out of phase with the hip and ankle
- Visual flow sensitivity required to maintain posture while moving through the environment
- Ability to recognize the requirements of the task and be motivated to move toward a goal
