WK2- paeds intro Flashcards
what condition is the most prevelent in children
asthma, hay fever and alergic rhinitis
when does the greatest developmental changes occur in a persons life
what happens?
first 4 weeks after fertilisation
when does foetal period begin?
what happens in this stage
8th embryonic week
during this stage,
foot is 90deg of equinas and adducted.
foot is supinated and externally rotated
ossification begins during this stage also
when is embryonic period
3rd week post conception and finishes at the end of week 8 (foetal period begins)
tetragens (things that can cause birth defects)
- alochol: affects growth, CNS dysfunction, facial abnormalities, fetal alcohol syndrome
- tobacco: risk of miscarriage, low birth weight, fetal hypoxia
- cannabis: low birth weight
- cocaine: brain damage
3 main stages to forming the skeleton
- mesenchymal
- cartilaginous
- osseous
what happens in week 3 embryonic period
- nervous system begins developing
-lower limb buds begin to develop
what happens in week 4 embryonic period
-spinal cord develops
what happens in week 5 embryonic period
-femoral, tibial and common peroneal nerves branch to their areas of limb bud
what happens during week 6 of embryonic period
-foot is in full equinas and inverted
-plantar surface of feet face eachother
-bud webbing begins to notch and regress to form digits
(webbed feet may result from incomplete regression)
what happens during week 7 embryonic period
-muscles of gastroc and soleus are apparent and myogenous zones for other muscles but ill defined
-nerves have branched to supply and innervate the future muscle groups
when do many congenital foot deformities occur
before 7 weeks embryonic period
what happens during foetal period (week 8) and term (37-40 weeks)
-foot is in equinas, supinated and adducted
-muscles, vessels, nerves and digits are differentiated
when does calc ossify
week 21
first tarsus bone to ossify is
calc at 21 weeks foetal period
whats the first bone to ossify and when
distal phalanx of great toe, week 9 foetal period
when does the talus ossify
week 24 (second tarsus bone to ossify)
when does cuboid ossify
37 weeks feotal period
primary ossification centre is what
where does it occur in long bones, where does it occur in irregular bones
first area of bone to start ossifying
long bones: occurs in diaphysis/shaft
irregular bones: body of bone
secondary ossification centre
when do they occur, where do they occur in long bones
typically appears during postnatal and adolescent years
most bones have more than one secondary centre
long bones: epiphyses
what is the angle of inclination for femur (frontal plane) for newborn and adulthood
newborn 135-140deg which reduces to 125deg in adulthood
femoral torsion angle (transverse plane)/ femoral neck anteversion angle
internal rotation (anteversion) of femoral neck
newborn 31degs and decreases until teenage years when they reach:
little less than 15deg males,
18deg females
FNA angle at 5
26 degrees anteversion
FNA angle at age 9
21 degrees anteversion
tibia shape in newborns
varus bowing (tibial varum) of 15-20deg
retrotorsion of tibia/fibula
what is it and what is it likely caused by
not a true torson
backward deflection of the tibia, most probably due to tension of the hamstring muscles ( usually biceps femoris)
retroflexion of tibia/fibula
what is it and what is it likely caused by
tibia bent to be concave posteriorly (possibly due to the pull of
the posterior leg muscles with attachments proximally)
retroversion fo tibia/fibula
angle at birth
angle at 19
at birth 27 degs posterior angulation, gradually changing to 5 degress by 19 years of age
malleoli changes
at birth, both medial and lateral malleoli are in the same plane
they begin to externally rotate until age 6
foot dorsiflexion/plantarflexion at birth
foot can dorsiflex 45 deg and plantarflex 50 deg
what bones are visible on an x ray at birth
-talus
-calc
-cuboid
-all 5 mets
-phalanges but not intermediate/distal on 5th toe
milestones are very consistent up until
2 years of age
what are good and concerning signs
progression - good
plateau - concerning
regression- very concerning
milestones for 1 month
-spontaneous motor acitvity
-lifts head when prone, poor supine head control
-takes in surroundings
-follows objects to midline
milestones for 2 months
-motor activity generalised
-smiles and coos socially
-follows objects past midline
miletones for 3 months
-follows well with eyes
-uses hands
-controls head in prone
-moro’s reflex disappearing
-smiles/coos
milestones for 4 months
-toy use
-control of head good when sitting
-plays with hands
-laughs
milestones at 6 months
-rolls over
-can sit briefly
-laughs and interacts
milestones at 8 months
-grasps with hands
-independent sitting
-babbles
-regards self in mirror
milestones at 10 months
-crawls
-kneeled play
-self feeds
-may say words
1 year milestones
-walks with support
-stands alone
-plays with toys
-may know some words
-begins to self feed with fingers
milestones at 15 months
-walks alone
-4-5 words
-drinks
-can feed self with spoon
-points/vocalises
milestones at 18 months
-walks well
-sits on chair
-throws balls
-climbs
-10 word vocabulary
-identifies pictures
-may be toilet trained
milestones at 2
-runs well
-uses 3 word sentences
-feeds self
-knows name
-toilet trained during day
-interacts with surroundings and people
walking milestone
12-13months
jumping milestone
2 years
crawling milestone
6-7 months
sitting milestone
6-7 months
3 years old
-single leg stance (eyes open) 5-7 secs
4 years old
-single leg hops
-coordinated skipping
-throws balls
5 years
skips, alternating feet
6 years
single leg stance longer than 15 seconds
