Pediatrics - Intro Flashcards
(78 cards)
1
Q
What gestational age is considered full-term?
A
37 - 42 weeks
2
Q
What are the 3 stages of embyronic development?
A
- Germination (3 weeks)
- Embryonic (6 weeks)
- Fetal (8 weeks - Term)
3
Q
When is a child a neonate?
A
For the first few weeks of life
4
Q
When is a child an infant?
A
Upto 12 months of life
5
Q
What 5 qualities are measured in an APGAR score?
A
- Heart rate
- Respiratory rate
- Muscle tone
- Reflex irritability
- Color
6
Q
What are the 0 - 2 scorings of each APGAR element?
A
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
7
Q
What is considered a normal APGAR score?
A
Anything above 7
8
Q
What happens to primitive reflex as a child matures in a normally developing child?
A
Become integrated
9
Q
What is the rooting reflex?
When is it integrated normally?
What does it interfere with if not integrated?
A
- 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
10
Q
What is the sucking reflex?
When is it integrated?
What does it interfere with if not integrated?
A
- 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
11
Q
What is the moro reflex?
When is it integrated normally?
What does it interfere with if not integrated?
A
- 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
12
Q
What is the startle reflex?
When is it integrated normally?
What does it interfere with if not integrated?
A
- 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
13
Q
What is the palmar grasp reflex?
When is it integrated normally?
What does it interfere with if not integrated?
A
- 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
14
Q
What is the plantar grasp reflex?
A
- 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
15
Q
What are the 3 attitudinal reflexes?
A
- ATNR (Asymmetrical tonic neck reflex)
- STNR (Symmetrical tonic neck reflex)
- TLR (Tonic labyrinthine reflex)
16
Q
What is the ATNR?
When is it integrated normally?
What does it interfere with if not integrated?
A
- 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
17
Q
What is STNR?
When is it integrated normally?
What does it interfere with if not integrated?
A
- 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
18
Q
What is TLR?
When is it integrated normally?
What does it interfere with if not integrated?
A
- 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.
19
Q
What are the 4 protective extension responses?
A
- Parachute response
- Forward sitting
- Sideways sitting
- Backwards sitting
20
Q
What is the parachute response?
When is it present?
A
- Quick displacement of the trunk downward with the child suspended prone at 45 degrees causes arm extension
- Present at 4 months
21
Q
What is forward sitting protective extension?
When is it present?
A
- Pushing of child forward in sitting should result in shoulder extension to catch their weight
- Present at 6 - 7 months
22
Q
What is the sideways sitting protective extension reponse?
When is it present?
A
- 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
23
Q
What is the backwards sitting protective extension response?
When is it present?
A
- Pulling child backwards from sitting should cause arm extension to support weight
- Present at 9 - 12 months
24
Q
What are the 2 upright reflexes?
A
- Positive standing reflex
- Walking reflex/ stepping reflex
25
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
26
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
27
Who developed the dynamical systems theory of development? When?
- Thelen
| - 1990s
28
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
29
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
30
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)
31
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
32
What are 4 factors for motor development?
- CNS Maturation (cognition/ motivation)
- Musculoskeletal changes
- Cardiorespiratory changes
- Environment - opportunity to practice
33
Do cephalo or caudal motor skills develop first?
Cephalo
34
Do Fine Motor or Gross Motor skills develop first?
Gross
35
Do proximal or distal motor skills develop first?
Proximal
36
Do stable or mobile motor skills develop first?
Stable
37
Do mobility or flexibility develop first?
Flexibility
38
Are the stages of development fluid or stable?
Fluid
39
What is a sensitive period?
Periods when episodes of care are most effective
40
What is the sensitive period for early intervention?
0 - 3 years
41
When do babies typically progress to a new skill?
Before they have mastered the previously learned skill
42
What skills does a child learn in the 1st quarter of life? 2nd quarter? 3rd quarter? 4th quarter?
1st: Head control
2nd: Trunk stability
3rd: Balance and coordination
4th: Movement
43
What gross motor milestones occur at months 13 - 15?
- High Kneel
- Walking I
- Creep Up Stairs
44
What gross motor milestones occur at months 16 - 18?
- Rise to stand
| - Walk up and down stairs with HHA1
45
What gross motor milestones occur at months 19 - 21?
- Kicking a ball
| - Side stepping
46
What gross motor milestones occur at months 22 - 24?
- Throwing tennis ball
- Jumping up
- Walking up stairs I
47
What fine motor milestones occur at months 13 - 15?
- Place peg in board
- Circle in puzzle
- Release raisin
- Scribble
48
What fine motor milestones occur at months 16 - 18?
Separate pop bread
49
What fine motor milestones occur at months 19 - 21?
- Build 5 block tower
- Turn pages of cardboard book
- 3 puzzle piece puzzle
50
What fine motor milestones occur at months 22 - 24?
- 6 block tower
| - Imitate vertical stroke
51
What gross motor milestones occur at months 25 - 27?
- Walk down stairs I
52
What gross motor milestones occur at months 28 - 30?
- Walk on tip toes
| - Few alt. steps on beam/ line
53
What gross motor milestones occur at months 31 - 33?
- SLS 3 seconds
| - Jump forward 2 feet
54
What gross motor milestones occur at months 34 - 36?
- Catches a ball
- Rides a tricycle
- Walks heel-toe gait
- Narrow BOS
- Reciprocal arm swing
55
What fine motor milestones occur at months 25 - 28?
- Snips with scissors
- Imitates horizontal stroke
- Circular scribble
- String 2 beads
56
What fine motor milestones occur at months 29 - 30?
- 4 block train
| - 10 block tower
57
What fine motor milestones occur at months 31 - 36?
- Block designs
- Copies a circle
- Shows hand preference
58
What may a 3 year old child do?
- Alternate feet when ascending stairs
- Ride a tricycle
- Hop briefly
- Feed themselves
- Hold cup with one hand
- Toilet trained
- Behaviors vary
59
What may a 4 year old child do?
- Walk down stairs alternating feet
- Catch ball with hands only
- Roller skate/ ride small bike
- Enjoy athletic activities
- Button large buttons
- Lace shoelaces
- Dress I
- Self-confident
60
What may a 5 year old child do?
- Skip
- Jump forward 2 feet
- Climb well
- Jump rope
- Acrobatics
- Play blocks
- Enjoy helping at home
61
What may a 6 year old child do?
- Constantly moving
| - Awkwardness with motor skills
62
How does a 14 month old child eat?
With fingers
63
How does a 15 month old child eat?
With a spoon
64
What may be a sign of concern in a child who is having problems eating?
- Coughing/ choking during or after eating
- Change in vocal quality
- Loss of food/ liquid from mouth
- Food remains in mouth after swallow
- Difficulty transitioning between food stages
65
At what age will children localize sounds?
6 months
66
At what age can children understand 25 - 50 % of words?
2 years
67
At what age can children produce 20 words?
18 months
68
At what age can children produce 50 words?
24 months
69
At what age can children understand 75 % of words?
3 years
70
At what age can children ID common objects and produce single words?
12 months
71
At what age can children imitate the body action with a doll?
15 months
72
At what age can children match 2 sets of objects by color?
31 months
73
At what age can children match 2 sets of objects by item and imitate a model from memory?
27 months
74
At what age do children perform for social attention?
12 months
75
At what age do children begin smiling?
4 months
76
At what age do children imitate actions, and pretend play?
24 months
77
What are 5 signs of concern for children in terms of social/ emotional/ play skills?
- No contact with peers or adults
- Fixation on toys that spin
- Not demonstrating appropriate play with toys
- Overly upset with change or transitions
- Significant difficulty attending to tasks
78
What is a child's main functional activity?
Play
