peds Flashcards
vernix
waxy stuff on newborns
when are fontanelles closed
2 years
incomplete breech
one leg in extension
frank breech
both legs extended
complete breech
both legs flexed
not all breach babies have atypical hip joint T/F
TRUE
typical ROM for newborns
excessive flexion, limited ext
writhing
overall pattern of infant motion
asymmetric tonic neck reflex (ATNR)
look toward extended arm
creeping
on their hands and knees (belly and pelvis off)
plantigrade, bear walking
hands and feet
high guard
arms up
cruising
on feet, but using hands on elevated surface
assessment components
- weight bearing position
- antigravity movement
- symmetrical or asymmetrical
neuromaturational theory
development tightly tied to CNS development, motor development is cephalocaudal and proximal to distal
dynamic systems theory
individual, task, and environmental constraints, motor behavior is made up of periods of stability and instability
most common childhood motor disability
CP
what does W-sitting mean?
not necessarily abnormal
can also be seen with hypo (wides BOS) or hypertonia (limited ROM)
capacity
the best the child can do in a standardized setting
performance
what the child can typically do
AIMS subscales
prone, supine, sitting, standing
scoring AIMS
determine window (least-most mature observed items) and score each as observed or not observed, 1 pt. each
5 domains of development
- physical motor
- social/emotional
- communication/language
- cognitive
- adaptive
joint attention
looking where someone is pointing, more likely after there is locomotor ability
encephalocele
NT defect, in occipital region, brain damage is typically focal
anencephaly
absence of most of the brain, die within a few hours
hydranencephaly
absence of cerebral cortex, can live a few years
x-linked disorders
muscular dystrophy
fragile x
rett syndrome
hemophilia
chronological age
time elapsed since birth
corrected age
chronological age - # of weeks born before 40 weeks gestation
used up to age 3
conceptional age
time elapsed from fertilization and day of delivery (shouldn’t be used clinically unless IVF or something)
gestational age
time between first day of last menstrual period and day of delivery
also conceptional age + 2 weeks
post-menstrual age
gestration + chronological age (used for preterm before due date)
full-term birth
37-42 weeks
birth weight
low BW: 2,500g
very low BW: less than 1500g
extremely low BW: less than 1000g
small for gestational age
below 10th percentiale
large for gestational age
above 90th percentile
Apgar stands for
appearance, pulse, grimace, activity, respiration
get two points each
normal Apgar score
8-10
critically low Apgar score
0-3, needs resuscitation
when does surfactant develop
between 24-34 weeks
common brain injuries of premies
intraventricular hemorrhage (IVH): bleeding into ventricles periventricular leukomalacia (PVL): ischemia of white matter near ventricles, increases rate of CP
subsystems of behavioral development
- autonomic
- motor
- state
- attention/interaction
- self-regulatory
GMFC levels
Level I: walks without restrictions; limitations in more advanced gross motor skills
Level II: walks without assistive device; limitations in community mobility
Level III: walks with device; limitations in community mobility
Level IV: limited ambulation or self-mobility; primary mode of mobility is a wheelchair
Level V: severe limitations in self-mobility and function even with use of assistive technology
who can use GMFM-66
cerebral palsy or acute TBI
when does an arch in the foot develop
4 years old
motor performance
temporary change in motor behavior
motor learning
relatively permanent change
motor control
ability to regulate or direct the mechanisms essential to movement
neuromaturational model for motor control
unfolding of predetermined patterns, SUPPORTED by the environment
more complex behaviors = higher levels of neurological systems
cephalocaudal direction
Rood treatment approach
really heavy on sensory
should you fade feedback with children?
can be detrimental if done too quickly
purposes of behaviors
escape
attention
tangible
sensory
behavior ABCs
Antecedent
Behavior
Consequence
dyspraxia vs. apraxia
apraxia is due to a lesion, dyspraxia is developmental
somatodyspraxia
sensory impairments based in tactile, vestibular and proprioceptive discrimination
four phases of swallow
- oral predatory phase
- oral phase
- pharyngeal phase
- esophageal phase
true sucking develops by ___ months
4 months
can begin introducing solid foods at ____ months
6 months
types of tone in CP
spastic
athetoid - writhing
ataxic
hypotonic
GMFM-88 can be used for children with other diagnoses (T/F)
TRUE
Down syndrome and osteogenesis imperfecta (also acute TBI which is true for 66)
GMFM is based on how much of a task the child can complete, not how well (T/F)
TRUE
GMFM-66 can be used to determine impact of orthoses (T/F)
TRUE
what tract controls muscle tone?
vestibulospinal tract
anteversion
head of femur anteriorly in acetabulum –> toeing out
retrotorsion
femur bone is twisted outward–> toeing out
anteversion and retrotorsion cause
toeing out
retroversion and antetorsion cause
toeing in
what age do we see developed arches?
4 years
tarsal coalition
fibrous, cartilaginous, or osseous fusion of midfoot or hind foot
limited STJ motion, recurring lateral ankle sprain
ASD Drugs
risperidone and aripiprazole
which shunt direction causes cyanosis
right to left (supposed to go to lungs, but goes to body instead)
atrial septal defect
foramen ovale persists
ventricular septal defect
opening in intraventricular septum
atrioventricular septal defect
parts of atrial and ventricular septum remain open
transposition of the great arteries
the aorta and pulmonary arteries are switched, PROFOUND CYANOSIS, surgical intervention needed
surfactant production begins at
32 weeks
respiratory distress syndrome
insufficient surfactant in lungs
bronchopulmonary disease (BPD)
chronic lung disease
results from prolonged exposure to mechanical ventilation
asthma
bronchi overreact to trigger, extreme prematurity –> increased risk
cystic fibrosis
inherited disease where body produces unusually thick, sticky mucus
arthrogryposis
congenital joint contracture in two or more areas of the body
