Peds MS Flashcards
What does the peds neuro exam start with?
Observation (duh)
What is the normal tone for infants?
Flexion at the elbows, hips, and knees
Down syndrome neuromuscular tone = (more or less)?
Decreased tone
If one arm is not flexed, what are the two things on your differential?
Clavicle fracture
Brachial plexus impingement
What is the approach to examining the clavicle?
Move arm
Two finger palpation
If clavicle is normal, and decrease tone is present unilaterally, what should you suspect?
Brachial nerve palsy
Clavicle fractures are more common with large or small babies?
Large
How do you asses the muscular tone of an infant?
Grab arms and legs, pull towards you.
Assess the degree of flexion when you release
What is the pull test?
Pick up the baby by both arms, and see what tone is present, what does the head do?
What is ventral suspension?
Place baby prone on your hand, should wrap around your hand
What is Barlow’s maneuver?
Grasp thigh and see if you push the hip out of the joint by adducting the thigh and applying downward pressure
What is Ortolani’s maneuver?
Slowly adduct the thigh while maintaining axial pressure, and exert a LEVER movement in the opposite direction so the you push the head of the femur back toward the acetabulum ceter.
What is Allis sign?
Baby supine, flex hips and knees. If one knee is higher than the other, sign is positive for a femur dislocation (or short femur)
What is Talipes equinovarus?
Clubfoot (in-turning at the mid and hindfoot)
What is metatarsus adductus?
In-turning at the midfoot
What are the three reflexes you test with every baby?
- Suck reflex
- Plantar and palmar grasp reflexes
- Moro reflex
How do you test the suck reflex?
Place gloved finger in the mouth and see if it sucks
How do you test the plantar/palmar reflex?
Place finger in the palm/plantar aspect of the hand/foot, should grasp both sides equally
How do you test the moro reflex?
Releasing the baby, seeing if the hands reach out and grab the air
How do you test CN II, III, IV and VI?
Shine light. should blink
Tracking
How do you test CN V?
Touch side of an infant’s mouth. Should move face toward (like to suck)
How do you test CN VII?
Baby’s head should wrinkle when crying or symmetry of the smile
How do you test CN VIII?
Clap hand 30 cm away from baby’s head, should blink
OR
Moves in direction of sound
How do you test CN IX and X?
Swallowing and gag reflex
Test CN XII?
Pinch infants nose, mouth will open and tongue will rise midline
Motor control develops how (head to toe or toe to head)?
Head to toe
What is Gower’s sign?
Test for Duchenne’s muscular dystrophy
What is vertical suspension?
Hold the baby upright with two hands around the chest and assess flexion
When can a child lift head
1 mo
When can a child sit up
6 mo
When can a child walk?
12 mo
When can a child track with eyes?
1 mo
When can a child exert a raking grasp?
6 mo
When can a child use a 2 finger grasp?
12 mo
When can a child coo?
1 mo
When can a child babble?
6 months
When can a child say mama/dada?
12 mo
When can a child recognize parents?
1 mo
When does a child develop stranger anxiety?
6 mo
When can a child imitate parents?
12 mo
When can a child walk with assistance
9 mo
When can a child exert a 3 finger grasp?
9 mo
When can a child wave bye-bye or play pat a cake
9 mo
What are the developmental milestones for a 2 year old?
2 steps
2 word phrases
2 step commands
6 blocks
When can a child ride a tricycle?
3 years
When can a child say three word sentences?
3 years
When can a child say two word sentences?
2 years
When can a child brush their teeth?
3 years
When can a child draw a circle?
3 years
When can a child play hop scotch?
4 years
When can a child copy a cross?
4 years old
When can a child play with kids their own age?
4 years