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DPT 762 - Pediatrics I > Test 2 Review > Flashcards

Test 2 Review Flashcards

1
Q

What is the role of motor control and CNS maturation in gait development?

A

Adequate motor control and CNS maturation are critical for gait initiation, with the development of central pattern generators supporting basic locomotion.

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2
Q

Why is adequate ROM and strength important for gait?

A

Sufficient range of motion and strength in the lower extremities are necessary for effective movement during the gait cycle.

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3
Q

How does bone structure and composition affect gait?

A

Proper bone alignment and composition facilitate balance and joint movement during walking.

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4
Q

What role does sensation and pelvic stabilization play in gait?

A

Sensation and muscle activation, especially around the pelvis, are necessary for maintaining stability and posture during gait.

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5
Q

What are the key characteristics of mature gait in children aged 3+?

A

Characteristics include

  • increased single-leg stance time
  • higher walking velocity
  • decreased cadence
  • increased step length
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6
Q

What are the characteristics of immature gait in children aged 2.5 and younger?

A

Immature gait has…

  • reduced postural stability
  • shorter single-leg stance time
  • rapid cadence
  • wide base of support
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7
Q

Describe skeletal alignment changes in newborns.

A

Newborns typically exhibit genu varum (bowlegs) due to intrauterine positioning.

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8
Q

What skeletal alignment changes occur at 6 months?

A

At 6 months, the legs begin to straighten, showing minimal genu varum.

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9
Q

How does skeletal alignment develop by 18 months?

A

By 18 months, or 6 months after walking independently, the legs are generally straight.

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10
Q

What alignment changes are seen in children aged 2.5 years to 4-6 years?

A

Between 2.5 and 4-6 years, genu valgum (knock-knees) develops, then alignment becomes straighter.

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11
Q

How do body structure and proportions change during gait development?

A

Body proportions change, with limb length increasing relative to head size, improving balance and stability.

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12
Q

What changes occur in base of support and stride length as gait matures?

A

The base of support narrows, and stride length increases as the child grows, leading to a more mature walking pattern.

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13
Q

How does the center of mass (COM) change from newborn to older child?

A

COM is higher in the trunk for newborns and toddlers, lowering as the child grows, improving stability.

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14
Q

What are the characteristics of gait from birth to 9 months?

A

Gait from birth to 9 months involves

  • reciprocal kicking
  • foot-to-foot contact
  • changes in body proportions
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15
Q

What are the gait characteristics observed between 9-15 months?

A
  • wide BOS
  • high COM
  • small steps
  • increased cadence
  • muscle activity focused on stability
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16
Q

What are the changes in body structure and alignment at 18-24 months?

A

At 18-24 months, legs are straight, hip abduction decreases, heel strike becomes consistent, and dynamic balance improves.

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17
Q

Describe the gait characteristics in children aged 3-3.5 years.

A

Tibiofemoral angle becomes valgus, femoral anteversion decreases, and gait pattern matures but remains narrow.

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18
Q

What are the key gait characteristics in children aged 6-7 years?

A

Gait is fully mature by age 7, with neutral tibiofemoral angles, decreased calcaneal eversion, and advanced postural control.

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19
Q

How does postural control develop in relation to gait?

A

Postural control develops with righting reactions and refined balance, supporting stable walking.

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20
Q

What is the role of visual and vestibular systems in gait development?

A

Visual and vestibular systems mature by age 10-12, enhancing balance and coordination during gait.

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21
Q

At what age is gait considered fully mature?

A

Gait is considered fully mature around 7 years of age.

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22
Q

What changes in muscle activity occur at 9-12 months during gait development?

A

Muscle activity increases in the lower extremities to support weight-bearing and postural control during walking.

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23
Q

What is the impact of body fat to muscle ratio on beginner walkers?

A

Beginner walkers have a higher body fat to muscle ratio, which impacts their ability to develop efficient gait patterns.

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24
Q

How does dynamic balance influence gait development in early walkers?

A

Dynamic balance is crucial for making postural adjustments during walking, improving as the child gains strength.

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25
Q

What are the key factors that limit gait development in infants?

A

Infants are limited by factors such as insufficient extensor strength, dynamic balance, and muscle coordination.

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26
Q

How do you correct for age in premature infants?

A

To correct for age, subtract the number of weeks the infant was born prematurely from their chronological age.

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27
Q

Provide an example of calculating corrected age for a premature infant.

A

Example: If an infant was born at 32 weeks (8 weeks premature) and is now 52 weeks old, their corrected age is 44 weeks.

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28
Q

What are the key differences between term and preterm infant development?

A

Term infants have better physiological flexion and developed reflexes, while preterm infants often have hypotonia and immature systems.

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29
Q

What are the primary characteristics of a Level III NICU?

A

Level III NICUs provide life support, full respiratory support, and manage critically ill infants under 32 weeks.

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30
Q

What are the primary characteristics and differences of a Level IV NICU?

A

Level IV NICUs offer all Level III capabilities plus complex surgeries and subspecialty care for severe cases.

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31
Q

What is Bronchopulmonary Dysplasia (BPD), and what are its symptoms?

A

BPD is a chronic lung condition in premature infants, characterized by rapid breathing, shortness of breath, and bluish skin.

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32
Q

What are the key PT considerations when working with infants with BPD?

A

PT considerations include reducing environmental stimulation, supporting respiration, and using gentle handling techniques.

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33
Q

What are the potential consequences of BPD on infant development?

A

BPD can lead to developmental delays, limited tolerance to physical activity, and prolonged hospitalization.

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34
Q

What are the key physiological differences in full-term infants compared to preterm infants?

A

Full-term infants exhibit physiological flexion, larger head-to-body ratio, and spontaneous movements compared to preterm infants.

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35
Q

What are the common characteristics of premature infants?

A

Premature infants often have hypotonia, underdeveloped reflexes, lanugo, and a lower body temperature.

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36
Q

What is the APGAR score, and what are its five components?

A

The APGAR score assesses newborn health based on Appearance, Pulse, Grimace, Activity, and Respiration.

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37
Q

How is the APGAR score interpreted, and what do the scores indicate?

A

Scores 7-10 are normal; below 7 may indicate the need for medical intervention or monitoring.

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38
Q

What are some techniques to reduce pain and stress in neonates in the NICU?

A

Pain reduction techniques include dimming lights, swaddling, and using non-nutritive sucking methods.

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39
Q

What are the signs of stress in a neonate?

A

Signs of stress in neonates include color changes, grimacing, irregular breathing, and frantic movements.

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40
Q

What are the key principles of family-centered care in the NICU?

A

Family-centered care emphasizes involving families in decision-making and highlighting their strengths.

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41
Q

How does the L.E.A.R.N. model apply to family-centered care?

A

The L.E.A.R.N. model involves listening, eliciting the family’s perspective, assessing needs, recommending actions, and negotiating care plans.

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42
Q

What cultural aspects should be considered in family-centered care in the NICU?

A

Cultural aspects include respecting the family’s beliefs, communicating openly, and adapting care to meet cultural needs.

43
Q

What is the definition of a reflex?

A

A reflex is an involuntary motor response to a sensory stimulus originating from the brainstem and occurring without conscious thought.

44
Q

What is the purpose of neonatal reflexes?

A

The purpose of neonatal reflexes includes protection (e.g., Moro reflex), nutrition (e.g., sucking and rooting reflexes), and survival.

45
Q

How are neonatal reflexes tested?

A

Neonatal reflexes are tested by stimulating specific areas to observe automatic responses.

46
Q

What is the expected response when testing primitive reflexes?

A

The expected response for primitive reflexes varies but typically includes specific automatic movements or postural adjustments.

47
Q

What is the typical onset and integration timing for primitive reflexes?

A

Primitive reflexes usually have specific onset and integration times, helping to assess neurological development.

48
Q

What is the Moro Reflex (Startle Reflex) and its function?

A

The Moro Reflex is a startle response that helps infants react to sudden stimuli like loud noises or falling.

49
Q

What is the Asymmetrical Tonic Neck Reflex (ATNR) and its function?

A

The Asymmetrical Tonic Neck Reflex (ATNR) causes the infant to turn their head to one side, extending the arm on that side while flexing the opposite arm.

50
Q

What is the Symmetrical Tonic Neck Reflex (STNR) and its function?

A

The Symmetrical Tonic Neck Reflex (STNR) assists in postural control and helps the infant achieve a quadruped position essential for crawling.

51
Q

What is the Tonic Labyrinthine Reflex (TLR) and its function?

A

The Tonic Labyrinthine Reflex (TLR) supports the development of muscle tone and postural control in prone and supine positions.

52
Q

What is the Landau Reflex and its role in development?

A

The Landau Reflex is observed when an infant held in a horizontal position lifts their head, extending their legs and trunk.

53
Q

What is the Babinski Reflex and its typical response in infants?

A

The Babinski Reflex involves the big toe extending upward while the other toes fan out when the sole of the foot is stroked.

54
Q

What is the impact of a retained Moro Reflex on motor development?

A

A retained Moro Reflex can lead to motion sickness, poor balance in sitting, and decreased protective responses.

55
Q

What challenges can arise if the Asymmetrical Tonic Neck Reflex (ATNR) is retained?

A

If the ATNR is retained, it can cause delays in hand-eye coordination, difficulty bringing hands to midline, and poor bilateral development.

56
Q

How does the retention of the Tonic Labyrinthine Reflex (TLR) affect motor skills?

A

Retention of the TLR can result in difficulties with initiating rolling, propping on elbows, and balance in sitting or standing.

57
Q

What are the effects of a retained Symmetrical Tonic Neck Reflex (STNR) on movement?

A

A retained STNR can cause issues with posture, such as ‘W’ sitting, and challenges in transitioning to quadruped position.

58
Q

What motor development issues can result from a retained Landau Reflex?

A

Retained Landau Reflex may cause poor muscle tone, chronic back and neck pain, and difficulty with hopping and jumping.

59
Q

How does a retained Babinski Reflex impact gait and balance?

A

A retained Babinski Reflex can impact gait, causing a person to walk on the outside of their feet, leading to balance issues.

60
Q

How do reflexes support the early stages of motor development?

A

Reflexes play a foundational role in initiating movement patterns, supporting postural control, and facilitating coordination and balance.

61
Q

What is the definition of family-centered care?

A

Family-centered care is a philosophy recognizing that families play a vital role in the health and well-being of children, focusing on empowering families and incorporating their values into care.

62
Q

What are the key principles of family-centered care in pediatric physical therapy?

A

Key principles include involving the family in decision-making, building on their strengths, and promoting collaboration between healthcare providers and families.

63
Q

What is the L.E.A.R.N. model in family-centered care?

A

The L.E.A.R.N. model is a framework that guides healthcare professionals in providing family-centered care by focusing on listening, eliciting, assessing, recommending, and negotiating with families.

64
Q

What does the ‘Listen’ component of the L.E.A.R.N. model involve?

A

The ‘Listen’ component involves actively listening to the family’s concerns and understanding their perspective without interrupting.

65
Q

What does the ‘Elicit’ component of the L.E.A.R.N. model involve?

A

The ‘Elicit’ component focuses on understanding the family’s beliefs, expectations, and goals for their child’s care.

66
Q

What do the ‘Assess’ and ‘Recommend’ components of the L.E.A.R.N. model entail?

A

The ‘Assess’ component evaluates the situation and needs, while the ‘Recommend’ component proposes a care plan with clear explanations.

67
Q

What does the ‘Negotiate’ component of the L.E.A.R.N. model involve?

A

The ‘Negotiate’ component involves collaborating with the family to agree on a care plan that considers their preferences and input.

68
Q

Why are cultural awareness, desire, and knowledge important in family-centered care?

A

Cultural awareness, desire, and knowledge help healthcare providers understand and respect a family’s values, beliefs, and practices in care decisions.

69
Q

How can cultural skills be applied in family-centered care?

A

Cultural skills involve asking appropriate questions, listening without judgment, and adapting care to be culturally relevant for each family.

70
Q

What are typical family responses to disability and illness in a child?

A

Families often experience a range of emotions including shock, denial, guilt, and grief when faced with a child’s disability or illness.

71
Q

What factors influence a family’s response to their child’s condition?

A

Factors influencing a family’s response include past experiences, cultural beliefs, support systems, and perceptions of illness or disability.

72
Q

What recent changes have occurred in pediatric care, emphasizing family-centered care?

A

Recent changes in pediatric care include a shift toward a family-centered approach, emphasizing natural environments and active family involvement.

73
Q

What are the three primary germ layers in embryonic development?

A

The three primary germ layers are ectoderm, mesoderm, and endoderm.

74
Q

What does each germ layer develop into?

A

The ectoderm develops into the nervous system and skin, the mesoderm into muscles and bones, and the endoderm into the digestive and respiratory systems.

75
Q

Why are the germ layers significant in embryonic development?

A

Germ layers are significant because they give rise to all tissues and organs of the body.

76
Q

What are the stages of embryo development from ovulation to implantation?

A

Embryo development stages include ovulation, fertilization, zygote formation, cell division, and implantation.

77
Q

What is the role of the blastocyst, and what are its components?

A

The blastocyst consists of the inner cell mass (forms the embryo) and trophoblast (forms the placenta).

78
Q

What is the importance of the bilaminar and trilaminar disc in development?

A

The bilaminar disc transitions to a trilaminar disc, forming the three primary germ layers essential for further development.

79
Q

What is the significance of the notochord and the process of neurulation?

A

The notochord guides the formation of the neural tube, which eventually develops into the brain and spinal cord.

80
Q

What are the critical periods in embryonic and fetal development?

A

The critical periods in development are the embryonic period (first 8 weeks) and fetal period (weeks 9-38).

81
Q

Why is it important to avoid teratogens during these critical periods?

A

Exposure to teratogens during critical periods can lead to significant birth defects or developmental issues.

82
Q

What role does folic acid play in neural tube development?

A

Folic acid is crucial for preventing neural tube defects like spina bifida and aiding in proper neural tube closure.

83
Q

What is the process of neural tube formation, and when does it occur?

A

Neural tube formation begins with the neural plate, folding into the neural groove, and then closing to form the tube by the end of week 4.

84
Q

What are the consequences of neural tube defects, and how can they be prevented?

A

Neural tube defects can cause conditions like spina bifida; taking folic acid before and during pregnancy can help prevent these defects.

85
Q

What is the role of the mesoderm, ectoderm, and endoderm in development?

A

The ectoderm forms the nervous system and skin, the mesoderm forms muscles and the circulatory system, and the endoderm forms the digestive and respiratory systems.

86
Q

What happens in the development of major organs by 8 weeks?

A

By 8 weeks, all major organs have started to form, making this a crucial stage for avoiding harmful substances.

87
Q

Why is the early development of the heart significant in embryology?

A

The heart starts beating by day 22-28, providing necessary circulation for the developing embryo.

88
Q

What is the importance of folic acid for neural development?

A

Folic acid supports the development of the brain and spinal cord by ensuring proper neural tube closure.

89
Q

How can drugs or alcohol impact development during early pregnancy?

A

Drugs or alcohol during early pregnancy can disrupt organ formation and lead to developmental defects or growth issues.

90
Q

Which germ layers give rise to different body systems?

A

The ectoderm develops into the nervous system and skin, the mesoderm into muscles, bones, and the cardiovascular system, and the endoderm into the digestive and respiratory systems.

91
Q

How does the axial skeleton develop from the germ layers?

A

The axial skeleton develops through the process of ossification, starting with the formation of the notochord, followed by vertebral and rib development.

92
Q

How does the muscular system develop from the germ layers?

A

The muscular system arises from the mesoderm, with differentiation into skeletal, cardiac, and smooth muscles during development.

93
Q

When does ossification begin and end in the axial skeleton?

A

Ossification begins around the 6th or 7th week of embryonic development and continues until about age 25.

94
Q

What are the key characteristics of achondroplasia?

A

Achondroplasia is a genetic condition characterized by short stature, large skull, and spinal curvature, primarily affecting long bones.

95
Q

What is the difference between pectus excavatum and pectus carinatum?

A

Pectus excavatum is a sunken chest wall deformity, while pectus carinatum is a protruding sternum, both impacting physical appearance.

96
Q

What is Duchenne Muscular Dystrophy (DMD) and how does it progress?

A

Duchenne Muscular Dystrophy (DMD) is an X-linked disorder causing progressive muscle wasting, with onset in early childhood and progression to loss of ambulation by adolescence.

97
Q

What are the characteristics and progression of Spinal Muscular Atrophy (SMA)?

A

Spinal Muscular Atrophy (SMA) is characterized by degeneration of motor neurons, with varying severity depending on the type, affecting motor function and respiratory health.

98
Q

What are the key features of limb development, including conditions like clubfoot and congenital hip dysplasia?

A

Limb development can be affected by conditions like clubfoot, where the foot is twisted inward, and congenital hip dysplasia, where the hip joint is improperly formed.

99
Q

What is the development timeline of the heart in embryology?

A

The heart begins to develop and starts beating between days 22-28 of embryonic development, essential for circulation.

100
Q

What is the significance of Patent Ductus Arteriosus (PDA) in the cardiovascular system?

A

Patent Ductus Arteriosus (PDA) is a condition where the ductus arteriosus fails to close after birth, leading to abnormal blood circulation.

101
Q

What role does surfactant play in respiratory system development?

A

Surfactant reduces surface tension in the lungs, preventing alveolar collapse and aiding in proper lung function, especially in preterm infants.

102
Q

What is hydrocephalus and how does it relate to CNS development?

A

Hydrocephalus is a condition of excess cerebrospinal fluid in the brain, causing increased pressure and requiring shunt placement for management.

103
Q

What are the key milestones in eye development and related conditions?

A

Eye development milestones include the formation of optic structures, eyelid fusion, and the maturation of the pupillary reflex.

104
Q

What are the significant points in ear development and causes of congenital hearing loss?

A

Ear development includes the formation of structures like the cochlea and pinna, with congenital hearing loss caused by genetic or environmental factors.

DPT 762 - Pediatrics I (21 decks)

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