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Child Health > Week 1 L 6-10 > Flashcards

Week 1 L 6-10 Flashcards

1
Q

List some factors that can influence development.

A

Genetics
nutrition
environmental factors

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2
Q

What are the 5 main prinicples of development?

A

Continous process
requires maturation of the nervous system
sequence same but rate varies
cephaloaudal direction
generalised mass activity changing to more specific controlled movements

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3
Q

List the 4 areas of development.

A

Gross motor
Fine motor and vision
Language and hearing
Social behaviour and play

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4
Q

Give some examples of primitive reflexes.

A

Sucking and rooting
Palmar and plantar graap
Asymmetric tonic neck reflex (ATNR)

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5
Q

Describe the ATNR and why is it used?

A

One arm beside head and other strecthed out.

To stop baby rolling off unstable surface

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6
Q

When does the ATNR disappear and why?

A

3-4 months

need to lose this to develop voluntary movement

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7
Q

Define developmental delay.

A

Failure to attain appropriate developmental milestones for child’s corrected chronological age.

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8
Q

What are the red flags of development?

A 
Asymmetry of movement 
Not reaching for objects by 6 months 
Unable to sit unsupported by 12 months 
Unable to walk by 18 months 
No speech by 18 months 
concerns re vision or hearing 
Loss of skills (regression)
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9
Q

Define Global developmental delay.

A

Significant delay in 2+ of:
gross/ fine motor, speech/ language
cognition, social/ personal, ADL

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10
Q

What is a globa developmental delay called in shool age children?

A

Learning disability

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11
Q

Give an example of a global developmental delay condition.

A

Down’s syndrome

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12
Q

Give examples of a developmental delay that is specifically a motor delay.

A

Duchenne Musculaar Dystrophy

Cerebral Palsy

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13
Q

Treacher- Collins syndrome is an example of what?

A

A specific sensory deficit and associated delay

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14
Q

Give an example of a specific sensory deficit and associated delay.

A

Oculocutaneous albinism

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15
Q

ASD is an example of what?

A

Developmental deviation

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16
Q

Developmental regression is seen in what syndrome?

A

Rett’s syndrome

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17
Q

What % of the UK child population has is on the autistic spectrum?

A

1%

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18
Q

What % of the UK child population have a specific learning disability?

A

5-10%

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19
Q

What causes Down’s syndrome?

A

Trisomy 21

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20
Q

Give some causes of Down’s syndrome.

A 
prematurity 
hypoxia 
intrauterine infection 
kernicterus 
many cases no specific cause is found
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21
Q

What is the triad of disorders of ASD?

A

Communication
Social interaction
Flexibility of thought

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22
Q

What else can affect someone on the autistic spectrum?

A

Restictive/ repetitive behaviours

sensory difficulties

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23
Q

What investigations may be carried out if you were concerned a child had a developmental delay?

A

Chromosomes, FRAX, Oligoarray CGH
Neonatal PKU
Thyroid studies
CK

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24
Q

When does human brain development start?

A

The 3rd post-conception week

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25
Q

What intrauterine environmental factors may influence brain development?

A

Maternal health and disease
alcohol exposire
placental function and foetal nutrition

26
Q

Give some extrauterine factors which may influence brain development.

A

Nutrition and environmental toxins

Emotional and social factors (neglect and lack of stimulation)

27
Q

How long is the embryonic period?

A

Conception to week 9

28
Q

What appears during the embryonic period?

A

Primitive streak and primitive node

29
Q

What does gastrulation result in?

A

The development of a 3 layered embryo: ectoderm, mesoderm and endoderm

30
Q

Before gastrulation occurs, the embryo is made of 2 layers, What are these called?

A

epiblast and hypoblast

31
Q

What does the ectoderm go on to create?

A

skin, hair, nails and neura tissue

32
Q

The mesoderm goes on to create what?

A

Muscle bone cartilagea nd vascualr system

33
Q

What does the endoderm create?

A

gut and respiratory system

34
Q

When does the neural tube form?

A

day 27

35
Q

The anterior/ rostral end of the neural tube forms what? and what does the posterior/ caudal end form?

A

Anterior - motor cortex

Posterior - visual cortex

36
Q

When does the foetal development occur?

A

week 9 - term (week 40/42)

37
Q

Do the neuronal progenitor cells in the VZ divide asymmetrically first?

A

No symmetrically then asymmetrically

38
Q

What process occur during neuronal migration to create the 6 layered brain cortex?

A

Some translocations
radial glial guides
tangeital migration and signalling pathways

39
Q

Briefly describe myelination.

A

Oligodendrocyte progenitor cells develop processes which wrap around axon giving a myelin sheath whihc allows faster conduction of APs

40
Q

When does the majority of myelination occur?

A

first 2 years but is ongoing into twenties

41
Q

What happens when the posterior neural tube fails to close?

A

Spina bifida

42
Q

Where is 2/3rds of the CSF produced?

A

By the choroid plexus located in he lateral, 3rd and 4th vetricles

43
Q

Where else produces CSF?

A

Result of interstitial fluid movement

secreted by the lining of the subarachnoid space

44
Q

What is the total CSF volume of an adult and neonate?

A

Adult 150mls

neonate 10-60mls

45
Q

What are the functions of CSF?

A

Cushions the brain
maintains ICP at a constant level
transports metabolic waste products, antibodies and chemical away from the brain

46
Q

Name the foramens the CSF flows through to get to the subarachnoid space?

A

Foramens of Magendi and Luschka

47
Q

How is the CSF absorbed from the subarachnoid space?

A

Through the arachnoid villi into the venous drainage system of the brain

48
Q

What coour should the CSF be?

A

Clear colourless and the same viscosity of water

49
Q

If blood is in the CSF, what colours may it be?

A

Yellow, ink or straw coloured

50
Q

If the CSF is turbid and cloudy what might this indicate?

A

Inflammatory cells, presence of micro-organisms or raised protein

51
Q

What chemicals are most commonly measured in CSF and what would an increase in them indicate?

A

Protein - inflammation or infection

Glucose - raised blood glucose

52
Q

What detremines intracranial pressure?

A

The brain and CSF volume

53
Q

What does the brain require to get enough oxygena nd glucose delivered and how is this calculated?

A

Normal cerebral perfusion pressure (CPP)

CPP= MABP - ICP

54
Q

What will cause the CPP to fall?

A

MAP drops or ICP rises

55
Q

What can cause increased ICP?

A

Intracranial mass lesion/ tumour
excessive intracranial fluid or blood
faulty CSF circulation

56
Q

What is the most important sign in a hydrocephalus?

A

Enlarging head circumference

57
Q

What later signs may present in a hydrocephalus?

A

Setting sun sign
prominent scalp veins
splaying of the sutures
enlarged fontanelles

58
Q

How may a hydrocephalus present in an adult?

A 
Slowing mental capacity 
headaches
blurred vision 
drowsiness 
difficulty walking secondary to spasticity
59
Q

What is the treatment for a hydrocephalus?

A

Ventriculoperitoneal shunt

60
Q

What are the indications for a lumbar puncture?

A

Suspected CNS ifection
Suspected subarachnoid haemorrhage
Therapeautic reduction of CSF pressure
Sampling of CSF for any other reason

61
Q

What are the contraindications to lumbar pucture?

A 
local skin infection 
raised ICP 
susected spinal cord mass or intracranial mass lesion 
uncontrolled bleeding diathesis 
spinal cord deformities 
lack of patient cooperation

Child Health (3 decks)

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