pediatrics

Question 1

APGAR table

Answer 1

go over it

Question 2

apgar scoring

Answer 2

8-10 - normal
5-7 - need O2
<5 - may need resuscitation

Question 3

does cephalic or caudal develop first?

Answer 3

cephalic - shoulder and head stability before hip

Question 4

when is flexor vs extensor tone first

Answer 4

flexor tone - when first born
extensor tone - when first standing

Question 5

pedes reflexes

Answer 5

go over quizlet

Question 6

early gait position

Answer 6

high guard, hip abduction/ER, crouched, wide BOS, pronated feet, hips and knees flexed, no heel strike

Question 7

reflexes integrated 1-2 months

Answer 7

flexor withdrawl and crossed extension

Question 8

reflexes integrates 3 months

Answer 8

rooting

Question 9

reflexes integrated 2-5 months

Answer 9

traction

Question 10

reflexes integrated 6 months

Answer 10

PAMS TP
palmar, ATNR, MORO, sucking, TLR, positive support reflex

Question 11

reflexes integrated at 9 months

Answer 11

plantar grasp

Question 12

reflexes integrated by 12 months

Answer 12

BS
babinski, STNR

Question 13

ataxic CP

Answer 13

• always hypotonic
• from cerebellum
• decreased coordination, decreased balance, nystagmus
• wide BOS

Question 14

spastic CP

Answer 14

• velocity dependent spasticity
• synergy patterns
• scissoring gait, crouched gait, toe walking
• contractures

Question 15

hypotonic/dyskinetic CP

Answer 15

• fluctuating tone: start hypotonic - go into hypertonicity
• from basal ganglia
• intention tremor
• involuntary slow writhing movements
• poor stability

Question 16

plagiocephaly

Answer 16

• ipsilateral occipital flattening, and frontal bossing and anterior displacement of ear
• contralateral occipital bossing and frontal flattening
• fron prolonged asymmetrical pressure on premature skull
• treatment: helmet

Question 17

torticollis

Answer 17

• named for tight SCM side (side of bend)
• opposite side to plagiocephaly
• treatment:
  stretching, football hold with ipsi side down so they try to do head righting, visual tracking

Question 18

down’s syndrome

Answer 18

• result from extra full or partial copy of 21st chromosome (aka trisomy 21)
• increased risk with age of mother
• forceful neck flexion and rotation should be avoided due to laxity of odontoid ligament and potential for subluxation of atlanto-axial joint
• encourage motor function
• avoid hyperextension of elbows and knees during WB
• hypermobile, hypertonic, tend to be in extension, ligamentous laxity
• delayed motor milestones (esp. running and jumping)
• deficits in memory and expressive language
• postural control and coordination impairments
• decreased quad and hip abd strength

Question 19

dyspraxia

Answer 19

inability to imitate movement
- seen with autism

Question 20

duchenne muscular dystrophy

Answer 20

• only in males, x linked recessive gene
• dystrophin gene is missing
• gowers sign
• proximal to distal weakness, core weakness
• weakness starts at 3 y/o
• lordosis, kyphoscoliosis
• decreased cardiopulm function

Question 21

DMD treatment

Answer 21

• maintain mobility and ROM as long as possible
• dont overfatigue

Question 22

Schuermann disease

Answer 22

• shmorl’s nodes - cracks in vertebrae - lead to back pain
• make wedged t/s which lead to kyphosis
• pain with thoracic extension/rotation and prolonged sitting/standing/physical activity
• increased thoracic kyphosis, lumbar lordosis
• PT interventions: Schroth method: stretch ant mm, strengthen post mm

Question 23

Erb’s palsy
Nerve roots:
MOI:
Loss of movement:
Deformity:

Answer 23

Nerve roots: C5-C6
MOI: stretching head downward
Loss of movement: loss of abduction and shoulder ER
Deformity: waiters tip

Question 24

Klumpke’s palsy
Nerve roots:
MOI:
Loss of movement:
Deformity:

Answer 24

Nerve roots: C8-T1
MOI: stretch of arm overhead
Loss of movement: paralysis of intrinsic hand mm
Deformity: claw hand (pull KLUMP of grass out of ground