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103 Cards in this Set
- Front
- Back
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How do children develop?
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1. cephalocaudally (first thing to develop is head control)
2. trunk--> out |
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What age do infants start to roll? How do you know they're capable of this?
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4-5 mo
hands can come together |
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Neonates have reflexes that disappear as they grow. Which reflex do they not lose?
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parachute
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What are 4 spontaneous movements you should look for in peds?
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1. symmetry
2. tremors 3. flexed position in full term baby 4. reflexes |
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How would you describe a floppy baby?
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hypotonic, not normal
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Name 5 types of reflexes you want to check in peds?
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1. rooting and suck
2. asymmetrical tonic neck reflex 3. moro reflex 4. parachute reflex 5. palmar/plantar grasp reflex |
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How do you induce the rooting reflex?
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touch the baby on the side of the cheek, and baby goes to suck (ie stroke the perioral region)
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Appearance and disappearance of the rooting reflex?
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appear: birth
disappear: 3-4 mo |
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How do you elicit the sucking reflex?
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place nipple in mouth 3-4cm away (important for teaching new moms to breastfeed)
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When does the sucking reflex appear/disappear?
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appear: brith
disappear: 3-4 mo |
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What is the asymmetrical tonic neck reflex?
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with the baby supine, rotate head to 1 side and hold for 15 sec, he'll flex (NORMAL)
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How do you illicit the grasp reflex in the hand and foot?
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put your finger in the palm of the hand [foot], baby will hold
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When does the asymmetric tonic neck reflex appear/disappear?
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appear: birth
disappear: 4-6 mo |
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When does the grasp reflex appear/disappear?
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appear: birth
disappear: 3-4 mo |
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What is a cortical thumb?
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abnormal: beyond 6 mo, it signifies a neuro problem (occurs when the thumb is inside the fist
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How do you illicit the moro reflex?
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hold supine baby's hands. When you let go, the baby's arms will be C-shaped.
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When does the moro reflex appear/disappear?
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appear: birth
disappear 3-6 mo (usually by 3) |
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How do you elicit the stepping reflex?
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hold the infant as thogh weigh bearing, with feet on surface
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When does the stepping reflex appear/disappear?
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appear: birth
disappear: 6-8 weeks |
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How do you elicit the plantar reflex?
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place fingers firmly against the base of toes
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When is the appearance/disappearance of the plantar reflex?
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appear: birth
disappear: 8-10 mo |
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What is anticipatory guidance?
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tell parent what they can expect
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When do kids start putting their foot to their mouth?
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~ 5 mo
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When can babies sit with assistance?
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5-6 mo
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What is the parachute reflex?
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when you fall, your hands go out to catch you
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When does the parachute reflex appear/disappear?
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appear: 6-8 mo
disappear: never |
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How do you elicit the parachute reflex?
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suspend the infant prone & lower quickly toward the table
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What is the purpose of sutures?
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allows the brain to grow
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What are the 5 sutures?
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1. coronal
2. frontal (metopic) 3. sagittal 4. lambdoid 5. temporal (squamosal) |
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Why does the baby need fat?
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brain myelination
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What is the last cortex to develop?
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prefrontal cortex-->risky behavior
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If a baby's head is 5th-95th percentile, he is..
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normocephalic
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If a baby's head is below the 5th percentile, he is..
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microcephalic
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What causes microcephaly?
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1. congenital disorders
2. chromosomal disorders (family genes) 3. sutures close too early |
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If the baby's head is above the 95th percentile, he is..
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macrocephalic (extra brain tissue; may be associated with autism)
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When does the posterior fontanelle close?
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2-3 mo
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When does the anterior fontanelle close?
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2-18 mo (upper limit of normal is 24 mo)
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Should infants have big pupils?
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no
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What is anisocoria?
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2 different sized pupils (more common in blue-eyed people)
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What size pupils are typical for adolescents?
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big
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What med causes pupil constriction?
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pain killers
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What is the sunsetting sign?
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a neuro abnormality: you shouldn't see the top of the iris
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What condition might cause the sunsetting sign?
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increased ICP from hydrocephalus
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When does a kid experience separation anxiety? How should you examine that patient?
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8 mo - 3 y/o: examine in mother's arms
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What 2 major assessments should you perform in the child?
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1. assess development as part of the neuro exam
2. assess the level of consciousness while in mom's arms during early childhood |
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What should you do if the child is preventing a reflex?
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distract: "wave bye bye" or "what tv show do you watch"
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What does the babinski reflex look like in a child that is not yet walking?
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upward going toes
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What does the babinski reflex look like in child who walks?
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toes only go downward
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Can you see translucent epiphyses on an x-ray?
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no, cartilage doesn't show
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What might a epiphyseal fracture interfere with?
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growth
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If there is a lump at the base of a newborn's neck, what might that indicate?
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the callous of a broken clavicle
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Do peds have more or less radiolucent cartilage?
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more
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Wht do growth plates do before a joint ligament tear?
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more likely to separate
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Describe ped bones.
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porous, less dense, prone to bow when bent
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Kids have a thicker periosteum. How is this beneficial?
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reduces fracture displacement;
produces more callous for rapid healing |
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Describe the ped ability to remodel bones.
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bone formation potential is greater.
Non-unions are rare potential for overgrowth in shafts of long bones |
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How does muscle mass in kids compare to adults?
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25% of body weight in kids, 40% in adults
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Which types of fractures occur in children?
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Salter Harris (fractures through the growth plate?)
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What influences the shape of legs and feet of infants and young children?
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intrauterine position
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What does intrauterine position cause?
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1. hip flexion contractures of 20-40 degrees
2. hamstring tightness |
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What shape is a fetal spine?
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C
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When does the normal cervical curve develop?
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as the child holds his head erect
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When does the normal lumbar curve develop?
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As the child sits
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Describe toddler height at age 2
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50% of adult height
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Describe the tissue changes in a toddler.
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fat storage decreases and muscle development becomes more apparent
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What is hyperlordosis?
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a swayback look when the bottom sticks out…seen in toddlers
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What does the toddler's belly look like?
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pot bellied
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Is intoeing normal in the infant and toddler years?
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yes
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What are 3 types of intoeing seen in infant and toddler years?
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1. Metatarsus adductus
2. internal tibial torsion 3. femoral anteversion **occur from untrauterine position |
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When does femoral anteversion peak and correct?
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peaks: later preschool years
corrects: spontaneously by age 8 |
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What feature of the musculoskeletal system is important in infant and toddlers?
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symmetry
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Are flat feet normal in infants/toddlers?
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yes
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When are bow legs common in infants/toddlers?
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at 1 year of age
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When does the muscular system have the largest amount of growth?
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during toddler years
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Describe a toddler's gait.
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wide-based
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What is genu varum and when is it commonly seen?
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Genu varum is when the legs appear bowed. It is seen until a child has been walking for a year.
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What is genu valgum and when is it abnormal?
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Genu valgum is when the legs appear knock kneed. It is abnormal if the child has been walking for LESS than a year
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When does genu valgum occur normally?
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in 3-5 y/o toddlers
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Which sex has more frequent developmental hip dislocations?
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females
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What type of developmental hip dislocation is most common?
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unilateral
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What are 3 risk factors for having a developmental hip dislocation?
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1. female sex
2. being first-born 3. breech positioning 8% of hip dislocations, need ultrasound |
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What causes a developmental hip dislocation?
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When the femoral head doesn’t sit in the hip socket, it doesn't develop
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How should you examine the hip?
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One hip at a time while stabilizing the unexamined leg
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How do you do the Ortolani maneuver?
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the contralateral hip is held still while the thigh of the hip being tested is abducted and gently pulled anteriorly
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What does the Ortolani maneuver test for?
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hip dislocation
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What tests do you use for hip dislocations in the first 4 mo?
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1. Ortolani maneuver
2. Barlow maneuver |
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How do you do the Barlow maneuver?
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ADDUCT the hip while pushing the thigh POSTERIORLY
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What is a positive barlow maneuver?
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if the hip goes out of the socket, it is called "dislocatable" and positive
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How do you confirm the hip dislocation?
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perform the Ortolani maneuver to reduce or relocate the hip
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After 4 mo, which test do you perform?
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Allis's sign: bend the legs to see if the knee heights are the same
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What test do you perform at 1-2 years to test for hip dislocation?
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Galeazzi test (same as alias's sign)
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When one leg has weak hip abductors, where does the pelvis tilt?
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pelvis tilts toward the normal hip when the weight is on the affected side
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3 benign causes of toeing in?
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1. metatarsus adductus (foot)
2. internal tibial torsion (tibia) 3. femoral neck anteversion (hip) |
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What is a metatarsus adduction?
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deformity of the upper one half of the forefoot
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Where might the skin crease be located in metatarsus adductus?
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the medial aspect of the longitudinal arch
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What causes internal tibial torsion?
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it's a remnant of intrauterine positioning
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When should internal tibial torsion improve?
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age 3
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In preschoolers, is genu valgum normal in most cases?
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yes
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What is the maximum correction age for genu valgum?
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age 8
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If a normal foot is flat, but flexible, is it a problem?
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no
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What is flat foot?
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a "variation of normal", found in 10% of the population
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When do girls stop having open epiphyses?
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until 2 years after menses
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When do boys stop having open epiphyses?
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until adolescence
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