NCS > Pediatrics > Flashcards

Pediatrics Flashcards

(67 cards)

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1
Q

Gross Motor Development features (6)

A
  • primitive reflexes dominant movement before cortical control
  • general before localized responses
  • flexor tone before extensor tone (once antigravity/upright: extensor tone progresses before flexor tone)
  • cephalic to caudal development
  • proximal to distal development
  • gross motor before fine motor control
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2
Q

PED Milestones - month 3

A
  • prone on elbows
  • can lift head in prone
  • belly crawl (3-9 mo)
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3
Q

PED Milestones - months 3-4

A
  • supine to sidelying
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4
Q

PED Milestones - months 5-6

A
  • prone to supine
  • pull to sit without head lag
  • sitting w/UE support
  • feet to mouth
  • propped or ring sitting high guard
    “sit = six”
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5
Q

PED Milestones - months 6-7

A
  • supine to prone
  • quadruped
  • transfer objects between hands
  • trunk rotation in sitting
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6
Q

PED Milestones - months 9-10

A
  • quadruped creeping
  • cruises to sideways
  • plantigrade, pulls to stand
  • upright, unsupported sitting (9 mo)
  • improving grasping skills, pincer, three jaw chuck (10 mo)
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7
Q

PED Milestones - months 10-15

A
  • begins to walk unassisted
  • transitions in and out of squatting (10 mo)
  • controls grasp AND release
  • stacks two cubes
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8
Q

What is crawling?

A

arm crawl, on belly

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9
Q

What is creeping?

A

Quadruped locomotion

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10
Q

Flexor Withdrawal Stimulus/Response

A

Noxious stimulus (pinprick) to sole of foot

Toes extend, foot dorsiflexes, LE flexes unconrollably

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11
Q

Crossed Extension Stimulus/Response

A

Noxious stimulus to ball of foot of LE fixed in extension

Opposite LE flexes, then adducts and extends

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12
Q

Rooting Stimulus/Response

A

Stroking the side of the baby’s cheek

Head turns toward stimulus and mouth opens

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13
Q

Traction Stimulus/Response

A

Grasp forearm and pull up from supine into sitting position

Grasp and total flexion of the UE

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14
Q

Asymmetrical Tonic Neck Reflex (ATNR) Stimulus/Response

A

Rotation of the head to one side

Flexion of skull limbs, extension of the jaw limbs, “bow and arrow” posture

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15
Q

Flexor Withdrawal Onset

A

28 weeks gestation

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16
Q

Flexor Withdrawal Integrated

A

1-2 months

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17
Q

Cross Extension Onset

A

28 weeks gestation

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18
Q

Cross Extension Integrated

A

1-2 months

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19
Q

Rooting Onset

A

28 weeks gestation

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20
Q

Rooting Integrated

A

3 months

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21
Q

Traction Onset

A

28 weeks gestation

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22
Q

Traction Integrated

A

2-5 months

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23
Q

ATNR Onset

A

Birth

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24
Q

ATNR integrated

A

4-6 months

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25
Palmar Grasp Stimulus/Response
Maintained pressure to palm of hand Maintained flexion of fingers
26
Moro Stimulus/Response
Drop patient backward from sitting position Extension, abduction of UEs, hand opening and crying followed by flexion, adduction of arms across chest
27
Symmetrical Tonic Labyrinthine (TLR/ STLR) Stimulus/Response
Prone or supine position Prone: Increased flexor tone of all limbs Supine: Increased extensor tone of all limbs
28
Positive Supporting Stimulus/Response
Contact to the ball of the foot in upright standing position Rigid extension (co-contraction of the LEs)
29
Palmar Grasp Onset
Birth
30
Palmer Grasp Integrated
4-6 months
31
Moro Onset
28 weeks gestation
32
Moro integration
5-6 months
33
TLR/STLR onset
birth
34
TLR/STLE intergrated
6 months
35
Positive supporting onset
birth
36
Positive supporting integrated
6 months
37
Plantar Grasp Stimulus/Response
Maintained pressure to ball of foot under toes Maintained flexion of toes
38
Plantar Grasp onset
28 weeks gestation
39
Plantar grasp integration
9 months
40
Symmetric Tonic Neck (STNR) Stimulus/Response
Flexion or extension of head Head flexion: flexion of UEs, extension of LEs Head extension: extension of UEs, flexion or LEs
41
STNR onset
4-6 months
42
STNR integration
8-12 months
43
Startle Stimulus/Response
Sudden loud or harsh noise Sudden extension or abuduction of UEs, crying
44
Startle onset
birth
45
Startle integrated
persists
46
What is cerebral palsy?
Group of permanent disorders of movement and posture - causes activity limitation - results from non-progressive disturbances in the developing fetal or infant brain Often associated with: - sensory, perceptual, cog, and communication impairments - seizures - secondary musculoskeletal problems
47
Who are at higher risk for CP?
- preterm infants - very low birth weight infants - multiple gestations (twins, triplets)
48
Risk factors for CP - Before Pregnancy
- maternal medical conditions - advances paternal age - previous fetal death
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Risk factors for CP - During Pregnancy
- preeclampsia - multiple gestation - poor intrauterine growth
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Risk factors for CP - Birth and Neonatal period
- low APGAR sores - neonatal seizures - sepsis - respiratory disease
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APGAR Scoring - First A
Appearance (Color) 0 - Blue 1 - Blue extremities 2 - No blue
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APGAR Scoring - P
Pulse 0 - absent 1 - < 100bpm 2 - 100-140bpm
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APGAR Scoring - G
Grimace (reflex irritability) 0 - no response 1 - grimace 2 - cry or withdrawal
54
APGAR Scoring - Second A
Activity (mm tone) 0 - flaccid 1 - some flexion 2 - active motion extremities
55
APGAR Scoring - R
Respiration 0 - absent 1 - weak cry, hypoventilation 2 - strong cry
56
When is APGAR score checked?
1 min 5 min 10 mins (only if needed)
57
General Movements (GMs) Assessment for Early Predictor of CP
Absence of fidgety movements = strong predictor *earlier abnormal GMs = more severe future motor limitations
58
Classifications of CP by Movement Disorder
- spastic (most common) - dyskinetic - ataxic - hypotonic
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Classifications of CP by Distribution
- monoplegic - hemiplegia - diplegia - quadriplegia
60
Classification of CP by Severity
By Gross Motor Function Classification System (GMFCS I-V)
61
Spastic CP
70-80%, most common form - mm appear stiff and tight - arises from motor cortex damage - commonly assessed using Mod Ashworth
62
Dyskinetic CP
6% - characterized by involuntary movements - arises from basal ganglia damage - cognition often normal or above normal - speech impairments may mask intelligence
63
Ataxic CP
6% - characterized by shaky movements - affects balance and sense of positioning in space - arise from cerebellum damage - WBOS and tremor - respond best to task-specific training
64
Distribution-Specific Characteristics - Hemiplegia
- UE more affected than LE - distance involvement common - milestones achieved but delayed
65
Distribution-Specific Characteristics - Diplegia
- LE involvement > UE - common gait patterns: equinus, crouch - cognition often normal
66
Distribution-Specific Characteristics - Quadriplegia
- severe involvement of all limbs and trunk - high equipment and caregiver needs - cognition varies widely
67
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