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69 Cards in this Set
- Front
- Back
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How do children develop?
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Cephalocaudally and from trunk out
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What is the difference between adult reflexes and neonate reflexes?
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Neonates have some reflexes that eventually go away as they grow
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What should you look for when examining the spontaneous movements of a baby?
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Symmetry and tremors
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What type of body position should a full term baby have when lying on her back?
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Flexed position (arms and legs)
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Babies have what five reflexes?
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1. Rooting and sucking
2. Asymmetrical tonic neck reflex 3. Moro reflex 4. Parachute reflex 5. Palmar and plantar grasp reflex |
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When does rooting and sucking appear? Disappear?
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Appears at birth
Disappears by 3-4 months |
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How can you elicit the rooting reflex?
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Stroke the perioral skin at the corners of the mouth
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How can you elicit the sucking reflex?
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Place nipple in mouth 3-4 cm
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How can you assess the asymmetric tonic neck reflex?
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With baby supine, turn head to one side, holding jaw over shoulder.
The arms/legs on side to which head is turned extend while the opposite arm/leg flex. Repeat on other side. |
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When does the asymmetric tonic neck reflex appear? Disappear?
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Appears at birth
Disappears by 2 months old |
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When does the palmar grasp reflex appear? Disappear?
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Appears at birth
Disappears by 3-4 months |
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What is the cortical thumb?
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Clenched hand in which the fingers overlap the thumb (i.e., baby tucks thumb inside fist).
Persistence beyond 6 months signals a neurological problem |
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How do you elicit the moro reflex?
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Hold the baby supine, supporting the head, back, and legs. Abruptly lower the entire body about 2 feet.
Arms abduct, hands open, and legs flex. Baby may cry. |
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What is the moro reflex also known as?
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Startle reflex
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When does the moro reflex appear? Disappear?
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Appears at birth
Disappears by 3-6 months |
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What is the stepping reflex?
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When the baby is held in an upright position and one foot touches a tabletop, the baby will take alternating steps.
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When does the stepping reflex appear? Disappear?
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Appears at birth
Disappears by 6-8 weeks |
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How do you elicit the plantar grasp reflex?
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Place finger firmly against base of toes.
Toes will curl |
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When does the plantar grasp reflex appear? Disappear?
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Appears at birth
Disappears by 8-10 months |
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What is the parachute reflex?
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When the baby is lowered head first, he will extend his arms and legs in a protective fashion (as if to brace against a fall)
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When does the parachute reflex appear? Disappear?
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Appears at 6-8 months
NEVER disappears |
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At what age do babies start to eat their feet?
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5 months old
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At what age do babies start to crawl?
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Around 9 months old
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What is a milestone that appears around 5-6 months of age?
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Babies can sit up with assistance
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What sutures are in the baby's skull?
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1. Coronal
2. Lambdoidal 3. Sagittal 4. Squamosal (above ears) 5. Metopic (midline, extends toward forehead) |
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What is the purpose of sutures?
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They allow for brain growth
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At what age does the posterior fontanelle close?
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By 2-3 months old
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At what age does the anterior fontanelle close?
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Usually by 18 months
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What is microcephaly?
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Abnormally small head size
May be caused by premature closure of the sutures or congenital infections |
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What is macrocephaly?
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Abnormally large head size. Indicates extra brain tissue.
May be caused by autism, neurofibromatosis |
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Which is worse, microcephaly or macrocephaly?
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Microcephaly
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What is the difference in pupil size between infants and adults?
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Pupil size is small
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At what age are the pupils larger?
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Adolescence
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What is anisocoria?
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Unequal pupil size
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What is the sunsetting sign?
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You can see the tops of the baby's irises. This is an abnormal finding during an neuro exam.
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What are some differences in assessing the infant during the neuro exam?
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1. Use of distraction
2. Assess development as part of neurological exam 3. Level of consciousness is assessed in mother's arms when the child is in early childhood |
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When is a positive Babinski reflex normal?
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Before the baby can walk (no later than 18 months)
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What are the differences in pediatric musculoskeletal anatomy?
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1. More radiolucent cartilage
2. Growth plates likely to separate before joint ligament tear 3. Bones are porous & less dense 4. Bones are prone to bow when bent 5. Thicker periosteum 6. Bone formation potential greater, non-unions are rare, potential for overgrowth in shafts of long bones 7. Ability to remodel bones |
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What is the advantage of thicker periosteum?
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Reduces fracture displacement and produces more callus, rapid healing
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What is the difference in muscle composition between infants and adults?
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Infants: 25% of body weight
Adults: 40% of body weight |
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What are Salter-Harris fractures?
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Fractures of the bone at the epiphyses (growth plates). These are problematic because they can affect growth.
Fractures occur in children and into adolescence for boys. |
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At birth, what influences the shape of the legs and feet?
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Intrauterine position
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What shape is the spine at birth?
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C-shaped
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When does the normal cervical curve develop?
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As the child learns to hold the head erect
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When does the lumbar curve develop?
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As the child learns to sit upright
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By age 2, how does a toddler's height compare to his adult height?
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About 50% of adult height
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What is hyperlordosis?
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Increased lumbar concavity. This is normal for toddlers.
Toddler takes on a pot-bellied appearance (protuberant abdomen), especially when walking |
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Is intoeing normal or abnormal in infants and toddlers?
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Normal finding
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What are some possible reasons for intoeing?
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1. Metatarsus adductus
2. Internal tibial torsion 3. Femoral anteversion |
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When does femoral anteversion peak?
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Later preschool years
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Does femoral anteversion go away?
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Yes, spontaneous correction by age 8
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What characteristic of the feet is normal in infants and toddlers?
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Flat feet until age 6
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What is genu varum?
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Severe bowing of the legs
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Are bow legs ever considered normal?
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Yes, bow legs are common at one year of age
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How long might genu varum last?
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Typically seen until child has been walking for one year
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What is genu valgum?
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Knees angle in and touch each other (knock-kneed)
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When is genu valgum abnormal?
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If the child has been walking less than one year
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When is genu valgum a normal finding?
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Between 3 to 5 years old
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What is the most important thing to note when assessing the child's musculoskeletal system?
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Symmetry
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What are the risk factors for dislocation of the hip in peds patients?
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1. Female patients
2. First-born child 3. Breech birth |
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How is the Barlow maneuver performed?
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Adduct the hip while pushing the thigh posteriorly
If the hip goes out of socket, it is called "dislocatable" and the test is termed positive |
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How can you confirm that the hip has been dislocated?
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Perform the Ortolani maneuver to reduce or relocate the hip
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How is the Ortolani maneuver performed?
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Examine one hip at a time, stabilizing the unexamined leg
Hold the contralateral hip still while the thigh of the hip being tested is abducted and gently pulled anteriorly |
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How often should you assess for hip dysplasia?
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Regularly assess using the Barlow and Ortolani maneuvers in the first four months
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What is metatarsus adduction?
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Deformity of the upper one half forefoot
May present with skin crease located on the medial aspect of the longitudinal arch |
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Is internal tibial torsion normal or abnormal?
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Normal; remnant of intrauterine positioning
Should improve by age 3 |
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Is a flat foot in the preschool years bad?
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A flat foot is okay if the foot is flexible.
To assess, have the child walk on tip toes and try to locate the arch |
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After 4 months of age, how can you assess for hip problems?
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Galeazzi or Alice test
Place the child's feet together with knees bent and observe any difference in knee height. |
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What does a positive Galeazzi or Allis test tell you?
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Hip dysplasia
Evident by femoral shortening (the knee on the weak side of the hip will be lower) |
