Week 108: The Normal Child Flashcards
What are the primitive reflexes?
- Suck
- Swallow
- Grasp
- Moro
What is the plantar reflex?
Reflex elicited when the sole of the foot is stimulated with a blunt instrument
What is the Babinski response in an infant?
The big toe moves upwards or towards the tops surface of the foot and the other toes fan out
If this happens in adults or children older than 2, it is a sign of brain or nervous system disorder
What is a term pregnancy?
40 weeks
What is a term pregnancy embryologically?
38 weeks
What is proliferation?
An increase in the number of cells
What is hypertrophy?
An increase in cell size
What is accretion?
Increase in the extracellular content
What does the ectoderm produce?
- Hair
- Retina
- Outer layer of skin
- Central nervous system
- Outer lining of everything
What does the endoderm produce?
- Lining of the gut
- Secretory cells of the GI tract
- Inside of the respiratory tract
- Inner lining of everything
What does the mesoderm produce?
- Muscle
- Bone
- Organs (kidneys, reproductive, some of lungs, GI tract)
What is vernix?
The things covering a baby when it is first born
What is meconium?
The first poo
- Greenish brown colour
- Bad smelling
- Secretory things in digestive tract - bile salts
- System started operating but nothing to digest
What is the normal heart rate of a newborn?
110-150
What is the normal respiratory rate of a newborn?
40-60
What is a normal blood pressure for a newborn?
65/40
What is a normal weight for a newborn?
3.5kg or in the range of 2.7kg - 4.6kg
What is the ductus venous?
Allows half of blood straight into the inferior vena cava rather than going to the liver first
What is the foramen ovale?
Becomes the fossa oval in adults
- Hole between two atria
- Normal in babies
What is the ductus arteriosus?
Pulmonary artery goes to the aorta - reduced blood flow to lungs compared to adults
- In adult it is the ligamentum arteriosum
How does temperature maintenance work in young children?
- Difficult as large surface area to weight ratio
- Unable to sweat or shiver
- Abundant brown fat deposits to produce heat to compensate
- Cutaneous blood flow very sensitive to temperature change to keep cool
- Heart murmurs quite common in newborns though tend to go quite quickly
- Abnormal breathing: grunting, nasal flaring, chest recession, tachypnoea, bradypnoea
How does nutrition work in the first few days of life?
- Large glycogen store in the liver
- Can use ketone bodies from fat breakdown
- Overly hydrated at birth
- Colostrum in initial breast milk (low volume, high energy, rich in protein, rich in immune cells)
How much milk per day is normal?
150ml/kg/day
Why is jaundice common in the first week?
Liver has not developed sufficiently
- 10% require phototherapy
- Premature child has high likelihood of jaundice and is more likely to need treatment
What is physiological anaemia?
High oxygen saturation at birth
- EPO undetectable
- Anaemia at 5-8 weeks of life
- EPO begins again
How much birthweight is lost in the first week and why?
10 %
- Birthweight is mainly water
What is erythema toxicum?
Rash of term infants: migratory rash, starts at foot then goes to ankle after leaving foot
Normal condition in first few years
What is milia?
White dots round the face
Normal condition in first few years
What is molluscum contagiosum?
Common condition where small, warty bumps appear on the skin
Normal condition in first few years
Which hormones are used pre-pubertely?
Growth hormone
Thyroid hormone
Which hormones are used in pubescence?
Sex hormones
What are key factors for growth in an infant?
Nutrition
Lifestyle
Happiness
Environment
What is adrenarche?
6-8 years
Pubic hair growth
What is gonadarche?
Development of gonads and breasts
What causes epiphyseal plate fusion?
Oestrogen
- Hence height difference between girls and boys
What is an expected height?
Mid-parental height +/- 8.5cm
What happened in Pavlov’s Dog experiment?
Conditioning
- Drooling with food and bell
- Rang bell on serving food then only had to ring the bell and the dog started salivating
⇒ Association between something and something else
What happened in the Little Albert experiment?
Conditional emotional response
- Fear of toy through scary noise
What happened in the Milgrim Emotional Study?
Person in position of authority has lots of power
- Participant was told to give someone an electric shock and was told to keep going even when the person sounded like they were about to die
How does Huntington’s disease present?
- Lack of emotions and lack of recognition of needs of others
- Alternating periods of aggression, excitement, depression, apathy, antisocial behaviour, anger,
- Memory, orientation, concentration difficulties
- Depression
- Uncontrollable movements of the face
Jerking, flicking or fidgety movements in limbs - Generally diagnosed between 35-55
How does cystic fibrosis present?
- Thick sticky mucous in the body covers a number of organs
- Persistent coughing and wheezing to try to shift the mucous
- Recurring chest and lung infections
- Large smelly stools (digestive enzymes are not produced)
- Malnutrition
- Sinusitis
- Arthritis
- Osteoporosis
- Meconium illus (stuck poo)
- Life expectancy now to live into 40s
- Generally diagnosed within first year
How does Duchenne Muscular Dystrophy present?
- Have difficulty walking, running, jumping
- Have difficulty standing up
- Learn to speak later than usual
- Be unable to climb stairs without support
- Have behavioural or learning difficulties
- Usually only live until 30s due to respiratory and heart failure
- Boys generally affected more than girls
- Diagnosed between the ages of 1 and 3
Why is folic acid given to expectant mothers?
To prevent neural tube defects
What does autosomal recessive mean?
That you need two genes to have the disease, but only one to carry
What does autosomal dominant mean?
That you need one gene to have the disease or carry it
What does x-linked recessive mean?
That you need 1 gene in men to have or carry the disease
That you need 2 genes in women to have the disease, 1 gene to carry it
What does x-linked dominant mean?
That you need 1 gene to have or carry the disease
Give 7 examples of autosomal dominant disorders
Acute Intermittent Porphyria Huntington's Disease Marfan's Syndrome Von Willebrand Disease Long QT Syndrome Hypercholesterolaemia Autosomal Polycystic Kidney Disease
Give 6 examples of autosomal recessive disorders
Cystic fibrosis Phenylketonuria Sickle-Cell Disease Spinal Muscular Atrophy Tay-Sachs Disease Haemochromatosis
Give 1 example of an x-linked dominant disorder
Klinefelter Syndrome
Give 3 examples of x-linked recessive disorders
Duchenne Muscular Dystrophy
Fragile X Syndrome
Haemophilia (A)
