peds Flashcards
APGAR score
q
range 0-10, each with a possible 0-2 points
A: appearance
P: pulse
G: grimace
A: activity, tone
R: respiration
what score is needed to get re-checked at 10 min for the APGAR test
less than 7 points, needs to be rechecked at 10 min
what is full term
40 weeks
peds milestones
months 2-3
- prone on elbows
- can lift head in prone
peds milestones
months 3-4
- supine to sidelying
- crawling - army crawl
peds milestones
months 4-5
- prone to supine
- pull to sit without head lag
- sitting with UE support
- feet to mouth
peds milestones
months 6-7
- supine to prone
- quadruped and assumes sitting from quadruped
- independent sitting
- trunk rotation in sitting
peds milestones
months 8-9
- quadruped creeping, siting better from quad
- cruises to sideways (furniture walking)
- can stand alone
- improving grasping skills
peds milestones
month 10-15
- begins to walk unassisted
- transitions in and out of squatting
- floor to stand
- pincer grasp
- stacks two cubes
POEM ABOUT MILESTONES
3 I lift my head
4 i lay to side
5 i go from prone to supine
and at 6, i sit upright
7 quadruped
and at 8 i take a cruise
i creep and stand along at 9
then walk and stack two cubes
early gait for babies
range at 10-15 months
- high gaurd position of arms
- abduction and ER
- hips and knees slightly flexed
- pronated feet (no heel strike)
- pincer grasp
- palmar grasp
- three jaw chuck grasp
- scissor grasp
- pincer grasp
10 months, thumb and index finger - palmar grasp
6 months but integrated by 10 months (should no longer be seen) - three jaw chuck grasp
10 months, like holding a pencil - scissor grasp
10 months, like holding scissors
neonatal reflexes
flexor withdrawal
onset: 28 weeks gestation
integrated: 1-2 months
stimulus: noxious stimulus (pinprick) to sole of foot
response: toes extend, foot dorsiflexes, LE flexes uncontrollably
neonatal reflexes
flexor withdrawal
noxious stimulus (pin prick) to sole of foot
response: toes extend, foot DF, LE flexes uncontrollably
onset- 28weeks gestation
integrated 1-2 months
neonatal reflexes
crossed extension
onset: 28 weeks gestation
integrated: 1-2 months
stimulus: noxious stimulus to ball of foot of LE fixed in extension
responses: opposite LE flexes then addcuts and extends
neonatal reflexes
rooting
onset: 28 weeks
integrated: 3 months
stimulus: stroking the side of babys cheek
responses: head turns toward stimulus and mouth opens
neonatal reflexes
traction
onset: 28 weeks
integrated: 2-5 months
stimulus: grasp forearm and pull up from supine into sitting position
responses: grasp and total flexion of the UE
neonatal reflexes
ATNR
onset: 28 weeks
integrated: 4-6 months
stimulus: rotation of the head to one side
responses: flexion of skull limbs, extension of the jaw limbs
bow and arrow pose
neonatal reflexes
palmar grasp
onset: birth
integrated: 4-6 months
stimulus: maintained pressure to palm of hand
neonatal reflexes
moro reflex
onset: 28 weeks gestations
integrated: 5-6 months
stimulus: drop the pt backward from sitting position
response: extension, abduction of UEs, hand opening and crying followed by flexion, adduction of arms acros chest
neonatal reflexes
symmetrical tonic labyrinthine (TLR/STLR)
onset: 28 weeks gestation
integrated: 5-6 months
stimulus: prone or supine position
response:
prone: increased flexor tone of all limbs (think calender baby pose)
supine: increased extensor tone of all limbs
neonatal reflexes
positive supporting
onset: birth
integrated: 6 months
stimulus: contact to the ball of the foot in upright standing position
if still present after 6 months, will have difficulty walking
neonatal reflexes
plantar grasp
onset: 28 weeks gestation
integrated: 9 months
stimulus: maintained pressure to ball of foot under toes
neonatal reflexes
STNR
onset: 4-6 months
integrated: 8-12 months
stimulus: flexion or extension of head
response:
head flexion: flexion of UEs and extension of LEs
head extension: extension of UEs and flexion of LEs
neonatal reflexes
startle
onset: birth
integrated: persists
stimulus: sudden loud or harsh noise
spastic CP
velocity dependent resistance of a mm to stretch
- syngergy patterns, contractures, crouched gait, toe walking
ataxic CP
disorder of coordination, force and timing, associated wit cerebellar involvement
- floppy baby/low tone, poor balance, wide BOS, nystagmus
hypotonic/dyskinetic CP
disorder of the basal ganglia, charavterised by movements that are slow and writhing (athetosis)
- poor stability, intention tremor, fluctuating tone, hypo becomes hyper
Level 1gross motor classification of CP
patient will walk without restrictions but will have limitations ine more advanced grossmotor skills
limited athletic skills
Level 2 gross motor classification of CP
patient will walk without AD with limitations in walking outdoors and in the community
Level 3 gross motor classification of CP
patient will walk without AD with limitations in walking outdoors and in the community.
will ocassionaly use wheelchair
Level 4 gross motor classification of CP
patient self mobility will be severly limited; children are transported or use power mobility outdoors and in the community.
may stand or take steps but primarily used wheelchair
Level 5 gross motor classification of CP
patient self mobility will be severly limited; even with the use of assistive technology; requires caregiver
difference betwen erbs and klumpke’s palsy
