Peds Flashcards
1
Q
Myelodysplasia Functional Prognosis
Thoracic-L2
A
- THKAFO/Parapodium
- WC for all functional mobility, standing and walking for physiologic benefits
2
Q
Primary Walking
A
- 0-2 Months
- Hold infant in supported standing, tilt trunk forward slightly, reciprocal stepping motions in lower extremities.
3
Q
Protective Extension
A
- Quick displacement of trunk in downward direction while held or while sitting in forward, sideward, or backward direction results in extension of legs downward and extension of arms in sitting position to catch weight.
- Downward begins at 4 months
- Sideward sitting at 6 months
- Backward sitting at 9 months
- These reactions persist through life
4
Q
Neonatal neck righting
(Neck righting on body, NOB)
A
- 0-6 Months
- Turn head with infant in supine position; body log-rolls toward same side.
5
Q
Palamar Grasp
A
- 0-4 Months
- Pressure stimulus against palm results in grasping of object with slow release.
6
Q
Rooting
A
- 0-3 Months
- Stroking of perioral region results in head turning to that side with mouth opening.
- Important feeding reflex.
7
Q
Spina Bifida Occulta
A
- No spinal cord involvement
- May be indicated by tuft of hair, dimple, or sinus
8
Q
Moro Reflex
A
- 0-4 Months
- Sudden extension of neck results in flexion, abduction of shoulders, extension of elbows, followed by shoulder adduction and elbow flexion.
- Usually results in crying so test last!
9
Q
Symmetrical Tonic Neck Reflex
A
- 6-8 months
- Extension of cervical joints produces extension of upper extremities and flexion of lower extremities; flexion of cervical joints produces flexion of upper extremities and extension of lower extremities.
- If reflex persists, it may interfere with development of stable quadruped position and creeping.
10
Q
Dislocated Hip
A
- Asymmetrical gluteal folds, hip click
11
Q
Placing Reactions
A
- 0-6 Months
- Drag dorsum of foot or back or hand against edge of table, get placing of foot or hand onto table top.
12
Q
Primary Standing Reaction
A
- Infant held in supported standing position supports some weight and extends lower extremities.
- If this reflex persists, will intefere with walking by causing extension of all joints of the lower extremity and preventing disassociation of flexion and extension.
13
Q
Asymmetrical Tonic Neck Reflex
A
- 0-5 Months
- Rotation of head results in extension of face side extremities and flexion of skull side extremities.
- Stronger in lower extremities of neonates.
- If reflex persists, may result in scoliosis or hip dislocation and interfere with grasping and hand-mouth activities.
14
Q
Flexor Withdrawal
A
- 0-2 Months
- Sharp, quick pressure stimulus to sole of foot or palm of hand causes withdrawal of stimulated extremity.
15
Q
Athetoid Cerebral Palsy
A
- Generalized decreased muscle tone
- Floppy Baby Syndrome
- Poor functional stability especially in proximal joints
- Ataxia/incoordination when child assumes upright position, with decreae BOS and muscle tone flucuations
- Poor visual tracking, speech delay, and oral motor problems
- Tonic reflexes such as asymmetrical tonic reflex, STNR, TLR, may be persistent
16
Q
Talipes Equinovarus
A
- Clubfoot
- Ankle in plantar flexion
- Forefoot adduction and supination
17
Q
Sucking
A
- 0-6 Months
- Touch to lips, tongue palate results in automatic sucking.
- Important feeding reflex.
18
Q
Ataxic Cerebral Palsy
A
- Low postural tone w/ poor balance
- Stance and gait are wide
- Intention tremor of hand
- Uncoordinated movement
- Ataxia follows intial hypotonia
- Poor visual tracking, nystagmus
- Speech articulation problems
- May occur with spastic or athetoid CP
19
Q
Body-Right Reaction Acting on the Head (BOH)
A
- Begins at 4-6 months and persists through life.
- Contact of body with solid surface results in head righting with respect to gravity, interacts with labyrinthine righting reaction on head to maintain orientation to head in space.
20
Q
Spina Bifida Cystica
A
- Visible or open lesion
- Meningocele
- Cyst includes cerebrospinal fluid
- Cord intact
- Myelomeningocele
- Cyst includes CSF and herniated cord tissue
21
Q
Myelodysplasia Functional Prognosis
L1-L3
A
- Reciprocating Gait Orthosis (RGO)/HKAFO
- WC for most functional mobility
- Short household ambulation possible
- Standing/walking for physiologic benefits
22
Q
Traction or Pull-to-Sit
A
- 4-5 Months
- Pull Infant to sitting from supine position; upper extremities will flex, and head will lag until 4-5 months.
23
Q
Klumpke’s Paralysis
A
- C8-T1
- Involves:
- Intrinsic muscles of hand
- Flexors/Extensors of wrist/fingers
24
Q
Plantar Grasp
A
- 0-9 Months
- Pressure stimulus to sole or lowering of feet to floor results in curling of toes.
- Must be integrated before walking occurs.
25
Q
Babinski Reflex
A
- 0-12 months
- Stroke lateral aspect of the plantar surface of foot, get extension and fanning of toes
26
Q
Body-Righting Reaction Acting on the Body (BOB)
A
- Begins at 6-8 months and persists.
- Rotation of head or thorax results in rolling over, with rotation between trunk and pelvis.
27
Q
Waiter’s Tip Deformity
A
- Shoulder Adductor/IR
- Elbow Extension
- Pronation
- Wrist Flexion
- Common in Erb’s Paralysis
28
Q
Crossed Extension
A
- 0-2 Months
- Sharp, quick pressure stimulus to sole of foot results in withdrawal of stimulated lower extremity and extension of opposite leg.
29
Q
Myelodysplasia Functional Prognosis
L3-L4
A
- KAFO
- WC for community mobility
- Household ambulation possible
30
Q
Myelodysplasia Functional Prognosis
L4-S1
A
- AFO/Ground-Reaction AFO
- Household/community ambulation
- May be limited
31
Q
Landau’s Reaction
A
- 4-18 months
- Infant held in ventral suspension will extend neck, trunk, and hips.
32
Q
Preterm Postural and Movement Profile
A
- Do not develop physiological flexion
- May exhibit hyperextended neck and trunk
- Shoulders may be elevated, abducted, extended, w/ scapular retraction
- Hips abducted/extended
- Pelvic tipped anteriorly
- Decreased midline arm movement
- May bear weight on toes when in supported/standing position
33
Q
Myelodysplasia Functional Prognosis
S1
A
- Foot Orthosis (FO)/Supramalleolar (SMO)
- Community ambulation
34
Q
Total or Whole Arm Paralysis
A
- C5-T1
35
Q
Erb’s Paralysis
A
- Involves C5-C6
- May involve
- Rhomboids
- Levator Scapulae
- Serratus Anterior
- Deltoid
- Supraspinatus
- Infraspinatus
- Biceps
- Brachioradialis
- Brachialis
- Supinator
- Long Extensors of wrist, fingers, and thumb
36
Q
Startle
A
- 0-6 Months
- Loud noise, sudden light or cold stimulus causes a sudden jerking of whole body or extension and abduction of upper extremities, followed by adduction of shoulders.
37
Q
Optical and Labyrinthine Righting
A
- 1 Month-Throughout Life
- Head orients to a vertical position when body is tilted.
- Test labyrinthine righting with the eyes blindfolded.
38
Q
Spastic Cerebral Plasy
A
- Increased muscle tone in antigravity muscles
- Abnormal postures and movements w/ mass patterns of flexion/extension
- Imbalance of tone acorss joints may cause contractures/deformities, especially hip flexors, adductors, IR, knee flexors, ankle plantarflexors, scapular retractors, glenohumeral extensors, and adductors, elbow flexors, forearm pronators
- Visual, auditory, cofnitive, and oral motor deficis may be present
- Crouched Gait
- Hip Flexion, IR, and knee flexion, may toe walk
39
Q
Galant or Trunk Incurvation Reaction
A
- 0-2 Months
- Sharp stoke along paravertebral line from scapula to top of iliac crest results in lateral trunk flexion toward stimulated side.
40
Q
Tilting Reactions
A
- Slow shifting of base of support or slow displacement of body in space will result in lateral flexion of spine toward elevated side of support, abduction of extremities on elevated side, and sometimes trunk rotation toward elevated side.
- Prine begins at 5 months
- Supine begins at 7 months
- Sitting at 8 months
- Quadruped at 12 months
- These reactions persist throughout life.
