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OT 533 Pediatrics > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

Visual system development

A

90% developed by 8 months

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2
Q

Prenatal disruption to visual system

A

Congenital cataracts
Congenital glaucoma

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3
Q

Perinatal disruption to visual system

A

Prematurity
Oxygen deprivation

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4
Q

Postnatal disruption to visual system

A

Tumors
Brain trauma

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5
Q

Albinism

A

Congenital lack of pigment
Oculocutaneous type:pigment is lacking in eyes,hair,skin
Ocular type: pigment lacking in eyes only (X-linked)

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6
Q

Cortical visual impairment

A

Loss of vision due to anomalies in cerebral cortex; defects in cortical function (occipital lobe)
Very specific characteristics, requires unique vision treatment plan.

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7
Q

Optic nerve hypoplasia

A

Optic nerve regressed during fetal formation, due to insult to CNS
Optic disc appears small, and has halo around it, visual acuity may range from normal to severely impaired
Inflammation of conjunctiva, eye looks red, has discharge, appears gritty, contagious, viral

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8
Q

Amblyopia

A

Loss of vision in one eye (lazy eye)
Brain suppression of one of two images it receives
Eyes that are not straight
Diagnosed around 2-3, by 8 its untreatable

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9
Q

Retinal detachment

A

Separation of the retina from the pigment epithelium, usually caused by a tear or hole in the retina but can be caused by pulling away, visual acuity is markedly reduced can result in total blindness, surgical treatment must be immediate

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10
Q

Nystagmus

A

Involuntary movements of the eyes, appears jumpy or jerky movements, can be horizontal, vertical, or undulating

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11
Q

Cataracts

A

Cloudiness of the lens
May be congenital, caused by trauma, or disease
Visual acuity will be reduced

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12
Q

Optic atrophy

A

Lack of poor functioning of the optic nerve
Eye report may say “pale disc”, results in reduced visual acuity, acuity may fluctuate

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13
Q

Retinitis pigmentosa

A

Retina deteriorates over time
Most types are hereditary
“Night blindness” may be first symptom followed by loss of peripheral vision, can result in tunnel vision
RP Diseases: Leber’s Disease, Usher’s Syndrome, Centro-peripheral dystrophy

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14
Q

0-3 months

A

Focus/fixate to black/white patterns
Fixate on mothers face
Fixate on reds, blues, greens
Focuses at 2-3 feet
Attachment behaviors develop

Implications:mother infant attachment may be impacted if cannot focus

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15
Q

3 months

A

Horizontal tracking 180 degrees
Fixates on all faces
Fixates on image in mirror
Starts to recognize familiar people
Shifts gaze between 2 objects

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16
Q

4-5 months

A

Shifts gaze near to far
Develops directed reach
Scans various objects to locate 1 object
Regards own hands
Gazes at toy they are holding

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17
Q

8-12 months

A

Tracks vertically upward
Detects small items at 10 inches
Recognizes familiar objects in pictures
Detects large objects at a distance
Plays peek-a-boo
Looks into cups, containers, spaces
Reaches and explores space around them
Increased body awareness
Imitates simple movements
Object permanence

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18
Q

1-2 years

A

Recognizes self and family in pictures
Recognizes pictures of common objects
Marks on paper
Imitates circle and line
Developers eye-hand coordination
Uses hands in a variety of ways to explore
Matches colors and shapes
Beginning of concept development
Identifies familiar toys by sound

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19
Q

3-5 years

A

Aware of finer details in pictures
Visual-motor development
Draws person with at least 2 body parts
Traces over a shape or outline
Imitates drawing T, H, X
Copies letters and shapes
Identifies missing parts
Draws more realistic people and objects
Cuts 2-4inch line approximately
Matches letters and numbers

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20
Q

Strategies to address visual impairment

A

-tactile modeling introduces one part of activity at a time
-hand-under-hand guidance
-utilize color preferences to highlight important aspects of toy or objects
-use tactile markings
-attach suction cups to toys for stabilization
-place materials on tray
-attach strings to toys
-add sound to toys
-relate task to functional activity

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21
Q

Sarcomere

A

Basic contractile unit in the muscle fiber

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22
Q

Hypotonia symptoms

A

Delays in developmental milestones
Increase or lack of growth in head size
Changes in activity, reflexes, or movements
Lack of coordination
Muscle rigidity, tremors, or seizures
Muscle wasting and slurred speech

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23
Q

Muscular dystrophy

A

Hereditary disorder characterized by progressive muscle weakness and wasting of the skeletal and or voluntary muscles that control movement
Diagnosis: Elevated CPK, biopsy, EMG, ECG
No effective treatment

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24
Q

Gowers maneuver

A

Helps get up off the floor with muscular dystrophy
-first children turn to face the floor
-then they use their hands on the floor to push themselves up
-finally they walk their hands up their thighs to regain an erect posture

25
Q

Duchenne Muscular Dystrophy

A

Most common and most severe
Affects males almost exclusively
deficiency of muscle protein dystophin
Symptoms occur between ages 2-6 with difficulty getting up from prone or supine
Hypertrophy especially of calves with weakness
Ability to walk last by age 12
Fatigue, low endurance, muscle weakness

26
Q

Osteogenesis Imperfecta (Brittle Bone Disease)

A

Genetic disorder of brittle bones, bowing of long bones, thin skin, fascia involvement, blue sclera of the eyes
Caused by improper formed bone collagen
May become osteporotic, frequent fractures, short stature

27
Q

Osteogenesis Imperfecta Types

A

Type 1: most common; mildest form characterized by bone fractures, blue sclera and dental issues. Hearing loss in 20-30s, near normal stature, normal lifespan

Type 2: newborns are severely affected, with a small stature, small chest, and underdeveloped lungs. Born with broken bones at birth, pass away shortly after birth

Type 3: fractures common at birth, small stature, joint laxity, poor muscle development in arms/legs, severe hearing loss, physical disabilities, short lifespan

Type 4: bones fracture easily, scoliosis, joint laxity, normal sclera, mild bone deformity, short life span

28
Q

Arthrogryposis Multiplex

A

Characterized by the formation of multiple non-progressive congenital contractures (flexor/extensor, symmetrical/asymmetrical, one/several joints)
Muscle development is poor, average intelligence
UE: shoulder adduction, internal rotation, elbow extension, wrist flexion, stiff extended fingers
LE: hip dislocations, knee contractures, severe clubfeet

29
Q

Juvenile Rheumatoid Arthritis

A

Most common peds rheumatoid disease, affecting girls
Chronic synovial inflammation, unknown cause
Diagnosis through rheumatoid factor and ANA, MRI identification of joint damage
Recovery within 1-2 years onset

30
Q

Systemic (Still’s Disease) Juvenile Arthritis

A

Onset at any age, affects both males and females
10% of JRA cases, 50% develop chronic arthritic
May involve other organs including spleen and lymph nodes; growth retardation and delayed development of sexual characteristics

31
Q

Polyarticular Juvenile Arthritis

A

40% of cases
Onset at any age, usually 1-3 years, 3:1 ratio males to females, 5 or more joints affected,usually symmetrical

32
Q

Pauciarticular Juvenile Arthritis

A

50% of cases, onset under age 10
Male to female ratio 1:10
4 or fewer joints, most commonly the knee, followed by ankle and elbow
Side effects: chronic eye inflammation, can develop functional blindness
Good prognosis

33
Q

Types of Scoliosis

A

Idiopathic: 80% of all cases, more common in girls, unknown cause, genetic
Structural: 20% of cases, due to vertebral anomalies or other disease processes such as CP
Functional: spine rests in an asymmetrical position due to the muscle imbalance or poor positioning, but the sine is still straight when it is in alignment
Structural: misalignment doesn’t go away when bending forward
Curves greater than 40 degrees have shorter lifespan due to compromised respiration
Curves less than 20 degrees not treated
Curves 20-40 degrees require treatment

34
Q

Erb’s Palsy

A

Temporary or permanent paralysis of the arm caused by trauma during vaginal delivery or direct trauma to the plexus, waiters tip
Symptoms: numbness, weakness, lack of motion, pain, inability to weight bear on extended arms, postural asymmetry

35
Q

Pediatric Cancers

A

Bone cancers (osteosarcoma): in long bones
Brain cancers & brainstem tumors: named for both the type of cell from which the tumor originated and the location of the tumor
Leukemia: cancer of blood-forming tissues, bone-marrow
Hepatoblastoma: liver cancer
Lymphoma: Hodgkins vs Non-hodgkins; rare in children under 5, more common in boys
Neuroblastmoma: solid cancer of the nerve tissue of the sympathetic nervous system

36
Q

4 types of Burns

A

Thermal: burn caused by outside heat source
Chemical: caused by strong acids
Electrical
Radiation: can be a side effect of external beam radiation therapy to treat some forms of cancer

37
Q

Classification of Burns

A

Superficial (1st degree): epidermis, dry/blanching erythema, painful, heals without scarring 5-10 days

Superficial Partial-thickness (2nd degree): upper dermis, blisters/wet/blanching erythema, painful, heals without scarring in 3 weeks

Deep Partial-thickness (2nd degree): lower dermis, yellow or white, dry, no blanching, decreased sensation, heals in 3-8 weeks likely to scar

Full-thickness (3rd degree): subcutaneous structures, white or black/brown, no blanching, decreased sensation, heals by contracture >8 weeks, will scar

38
Q

Glaucoma (buphthalmos)

A

Increase in the intraocular pressure of the eye, if untreated can cause blindness by damaging the retina through excess pressure on the optic never and retinal tissue

39
Q

Leber’s Congenital Amaurosis

A

A rare inherited eye disease affected retinal functioning, often resulting in severely reduced visual acuity
May be accompanied by nystagmus, photophobia

40
Q

Microphthalmos

A

Abnormally small eyeballs

41
Q

Developmental Coordination Disorder

A

Classified as discrete motor disorder under neurodevelopmental disorders in DSM-V
Greater in boys than girls; 4;1
Increased incidence in preterm infants
Aka. Developmental clumsiness, In-coordination, Minimal Brain Dysfunction

42
Q

DCD DSM Criteria

A

A. Acquisition and execution of coordinated motor skills is substantially below expected at chronological age (clumsiness, slowness, inaccuracy)
B. Deficits significantly interfere with ADLs appropriate to chronological age and impacts academic productivity, leisure, play
C. Onset of symptoms in early developmental period
D. Motor skills deficit is not explained by intellectual disability or visual impairment or neurological condition affecting movemy

43
Q

Processes for Coordination Difficulties

A
  1. Child has difficulty interpreting and integrating information (visual, tactile, balance, proprioception)
  2. Child has difficulty choosing the type of motor action that is appropriate for the situation
  3. Child has difficulty forming a plan of action in the proper sequence
  4. Message sent to the muscles must specify speed, force, direction, distance to be moved
44
Q

Apraxia

A

Usually seen in adults
Loss of praxis (able to plan and coordinate a motor skill)
Neurological basis for problem as seen on CT or MRI
Basis not usually tied to somatosensory dysfunction

45
Q

Dyspraxia

A

Usually seen in children
Dysfunctional praxis (able to plan and coordinate a motor skill)
Neurological basis for problem NOT noted on CT or MRI
Thought to have tactile proprioceptive basis
Learning activities for first time, can’t build on previous skills
Ex. Poor motor planning, clumsiness, low muscle tone, problems with ADL, weight shifting problems, decreased rotation, shuffling, toe walking, high stepping, must give full attention to task, decreased postural reactions, poor synergy, problems with unconscious movements, difficulty organizing self, emotionally sensitive, self-image problems, poor proprioception, vestibular impairments, oculomotor deficits

46
Q

Movement ABC

A

Norm based assessment of fine and gross motor performance for children 4-12
Contains 3 categories: Manual Dexterity, Ball Skills, & Dynamic Balance
Percentile scores < 5% indicate definite motor problem, 5-15% considered borderline motor problem

47
Q

DCD Treatment Procedures

A

Active participation of the child
Child directed
Individualized treatment
Purposeful activity (activity rich in proprioceptive, vestibular, and tactile input)
Just Right Challenge
Need for an adaptive response

Therapist Responsibility: Choose skill, modify environment, feedback (immediate, constant, random, delayed -best for advanced kids)

48
Q

Diagnostic Criteria DSM vs. ASD

A

Autism Disorder:
Diagnosed as early as 2, typically closer to 4
Impaired development of social interaction and communication
Inability to initiate or sustain conversation
Lack of spoken language
Repetitive speech/echolalia
Absence of pretend or spontaneous play
markedly restricted repertoire of interested
Symptoms before age 3

Asperger Syndrome:
Delays in social interaction
Repetitive behaviors, interests, activities
No delays in language speech, cognition, or curiosity

PDD
Does not meet specific criteria for autism

49
Q

Sensory Processing Disorder

A

Difficulties processing tactile, vestibular, and proprioceptive input coming from various senses.
Not in the ICD or DSM

50
Q

Rest Syndrome

A

Genetic
Females only
Typical first 5 months
Brain growth decelerates skills lost starting around 5 months
Stereotypical arm movements
Loss of social engagement
Poorly coordinated gate and trunk movements
Severe delay or absence of language
Loss of previous acquired hand skills between 5-30months

51
Q

Childhood Disintegrative Disorder

A

Typical development
Sudden loss of language, bowel & bladder control after 2 years or older

52
Q

Fragile X Syndrome

A

Genetic
Males only
Presentation very similar to ASD

53
Q

Social communication disorder

A

Limitations in the social use of language
Absence of restricted interests and repetitive behaviors

54
Q

ASD Levels of Severity

A

Level 3: Requires Very Substantial Support
Severe deficits in verbal and nonverbal communication skills causing severe impairments in functioning
Level 2: Requires Substantial Support
Marked deficits in verbal & nonverbal social communication skills, limited initiation of social interactions and reduced responses
Level 1: Requires Support
Without supports in place, deficits in social communication cause noticeable impairments

55
Q

Executive Function

A

Series of cognitive skills, allows us to plan, focus attention, remember and attend to different tasks at the same time
Includes self-regulation & metacognition
3 main areas:
Working Memory: ability to briefly hold and integrate info important for reasoning of decision making
Inhibitory Control: ability to resist distraction/impulse
Cognitive Flexibility: ability to adjust to the demands and change in the environment or switch attention

56
Q

EF Development

A

By age 3:
Tasks involving two rules (if its red, put here)
Redirect their attention to the bin (cog flexibility)
Remember what they’re doing and why
By age 5:
Conscious problem solving, multistep commands
Can inhibit responses (waiting for candy for bigger reward)

57
Q

Applied Behavioral Analysis ABA

A

Each skill is broken down into components
Discrete Trials
Instruction: clear and concise
Prompt: verbal or physical, not always needed
Opportunity for response
Immediate feedback
Intense carryover at home is needed

58
Q

Developmental Individual Difference Relationship Based Model (“Floor Time”)

A

Promotes social interaction
Adult follows the child’s lead: child may instruct adult, adult may join the child’s activity, child sets the tone and directs interaction
Observe —> Approach —> Follow the child’s lead —> child expresses ideas —> child feels understood

OT 533 Pediatrics (4 decks)

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