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year 2 > peds: development > Flashcards

peds: development Flashcards

1
Q

grasp patterns.. when do these occur?
raking
pincer grasp

A

raking begins at 6 months - thumb curled against index finger

pincer grasp at 8-12 months - pad of thumb & pad of index finger

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2
Q

4 quarters of development (cephalocaudal direction)

A

first quarter: head control in all positions
second quarter: arms & upper trunk control
third quarter: lower trunk & pelvic control
fourth quarter: mobility & control of lower legs & upright postural control

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3
Q

when does hand preference come in?

A

starts around 2, established btwn 3 &4.

if it comes in before that, indicates motor impairment

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4
Q 
moro reflex 
 aka
 starts/ ends
 caused by...
 how to test & what happens
A

aka startle reflex

starts in utero by 28-32 weeks, integrates by 4-5 months

caused by loud noises, change in light or body position (hyperextension of neck)

to test: put neck in hyperextension they cry => abduction & extension of UE with palms up (trying to grab something)
followed by aDduction & flexion of UE and relxation

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5
Q

reasons moro reflex doesn’t integrate by 4-5 months

if it persists… (3)

A

it normally diminishes with head control, poor neck stability prolongs it

if persists:

  1. can throw baby off balance in upright positions
  2. excessive extensor tone develops
  3. associated with CP
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6
Q

absences of moro reflex on one side can suggest (3)

absence of moro reflex bilaterally can suggest

A

absences of moro reflex on one side can suggest

  1. fx of clavicle or humerus
  2. brachial plexus injury (BPI)
  3. hemiplegia

absence of moro reflex bilaterally can suggest damage to brain or spinal cord

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7
Q

rooting reflex
what it is
what absence can indicate

A
  1. tactile stimulation to cheek rotates head and opens mouth

absences seen in neurologically impaired infants

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8
Q 
sucking reflex
 begins & fully develops by...
 integrates by
 how to stimulate
 what it helps (2)
 how to test
A

begins around 32wks of gestation, fully developed at 36 weeks (so immature babies may have weak sucking reflex)
integrated by 2-5 months

to elicit response, stimulate roof of mouth

helps develop oral musculatures
sucking promotes flexion

test by removing bottle, if its easy, baby doesnt have strong suck

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9
Q

palmar grasp reflex
elicited & fully developed by…
asymmetrical response caused by (2)
no response =

A

elicited at 28 weeks, integrated around 6 months when baby can voluntarily release

asymmetrical response from:
BPI
humeral fx

no response = severe neurological deficit

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10
Q

plantar grasp reflex
begins and integrated by…
what it is

A

begins at 28 week of gestation & integrates when baby walks

when u apply firm pressure to base of toes, they flex

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11
Q

babinski
normal response in babies
when does it disappear

A

great toe DF and toes fan out

disappears btwn 12m -2 years

after 2 = UMN lesion

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12
Q

step or walk reflex
onset & integration
response
how to elicit

A

onset at 37 weeks of gestation, integration at 2 months

support infant upright with feet touching surface and incline infant forward to accompany stepping,
baby will alternate rhythmic and coordinated steps (walking on toes and scissoring is normal)

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13
Q

ATNR
seen from…
what it is

A

seen from 2-4 months

turn head to one side => extension, occiput side gets flexed

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14
Q

tonic labyrinthine
what it is
if it extends to______ suggests____

A

supine => extensor tone

if it lasts 12-24 months it indicates limited motor control and decreased possibility of walking

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15
Q

neck righting on body
begins and integration
test & normal response

A

begins at 34 weeks of gestation & integrates btwn 4-6 months

test baby in supine, head midline and turn head to one side. entire body turns to that side

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16
Q

body righting on body

test

A

rotate infants hips and log rolling occurs to re-align body

17
Q

landau reflex
onset & integration
test & normal response

A

onset at 3-4 months, integrates 12-24 months

testing: infant prone, place hands under chest and stomach. baby should extend head then trunk, hips and legs into full extension (superman)

18
Q

STNR
onset
test

A

active from 4-7 months

flex neck => flexed uppers & extended lowers

19
Q

parachute
appears…
test

A

last to develop*

appears from 6-9 months. face baby face down and arms extend as if trying to catch himself.

this lasts throughout life

20
Q

physiological flexion

A

occurs in utero during last trimester, so premies don’t do this

after birth occurs in all positions the first month

promotes calming

21
Q

swaddling benefits (5)

A
  1. promotes physiological flexion
  2. self calming by hand to mouth sucking
  3. increased proprioception & kinesthetic stimulation
  4. increases midline orientation
  5. helps infants sleep better in supine
22
Q

summary of first month (4)

A
  1. more extended (less physiological flexion)
  2. proximal tightness in shoulders & hips decreasing to allow aB, ER & extension
  3. in prone- can lift and turn head to either side
  4. follows with eyes to midline*
23
Q

summary of second month (5)

A
  1. visual tracking past midline*
  2. continues to extend (gravity continues to elongate flexors)
  3. asymmetrical head & extremities predominates
  4. which means asymmetrical WB in prone on elbows
  5. bilateral symmetrical kicking * can’t dissociate yet* (this is important because if its not symmetrical its spasticity)
24
Q

summary of third month (6)

A
  1. symmetry and midline orientation dominate (baby can keep head in midline)
  2. in supine baby can turn head side to side or maintain in midline
  3. in prone can lift head 45-90 degrees
  4. accidental rolling
  5. frog-legged
  6. unsupported sitting => falling forward (but head righting occurs and extends hands)
25
Q

indications of possible disturbances in motor development by 3 months (2)

A
  1. inability to assume & maintain head in midline (can’t break ATNR)
  2. inability to WB on forearms
26
Q

which 3 reflexes emerge during infancy

A

STNR
Landau
parachute

27
Q

which develops first?
medial or lateral?
extensor or flexor antigravity?
WB on flexed or extended extremities?

A

medial before lateral
3 ulnar finger grasp > thumb and index grasp

extensor (lift head in prone at 4 m) > flexor (5 m)

prone on elbows > prone on extended arms

28
Q

order of movement by plane

A

saggital -> frontal -> transverse

29
Q

order to teach new skill/ movement

A
  1. assume (or place baby)
  2. maintain
  3. rock
  4. reach
30
Q

how long does a baby need each day to spend in tummy time?

A

81 minutes

31
Q

3-5 month developmental milestones (2)

A

3-5 months:

  1. hand to midline
  2. prone on elbows
32
Q

4-6 month developmental milestones (10)

A

4-6 months

  1. prone unilateral reaching
  2. prone extended arms
  3. pivot prone
  4. segmental rolling prone -> supine
  5. supine head lifting
  6. supine bridging
  7. supine hands -> knees
  8. supine hands -> feet
  9. supine feet -> mouth
  10. propped sitting
33
Q

5-7 month developmental milestones (2)

A

5-7 months

  1. unsupported ring sitting
  2. segmental rolling supine -> prone
34
Q

6-10 month developmental milestones

A

6-10 months

assumes sitting independently

35
Q

7-9 months developmental milestones (2)

A

7-9 months

  1. independent sitting
  2. quadruped
36
Q

9-11 month developmental milestones (2)

A
  1. crawling/ creeping

2. cruising sideways

37
Q

10-12 month developmental milestones (4)

A
  1. bear walking
  2. pull to stand
  3. pull to stand & lower
  4. walks with both hands held
38
Q

11-13 month developmental milestone
11-14 month
11-15 month

A

11-13 months
pull -> stand via 1/2 kneel

11-14 months
stand alone

11-15 months
walk alone

39
Q

5 clinical signs or red flags for ASD

A
  1. no babbling by 12 months
  2. no back and forth gestures such as pointing, showing, reaching by 12 months
  3. no words by 16 months
  4. no 2 word meaningful phrases by 24 months
  5. any LOSS of speech, babbling or social skills at any age*

year 2 (24 decks)

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