pediatrics 5

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pediatrics 5
2013-03-01 22:12:07

spring 2013
Show Answers:

  1. for the principel of "reflex before cortical control" what's the early and matured responses?
    • early: ATNR, Moro
    • matured: limbs move indep of head
  2. ATNR
    • asymmetrical tonic neck reflex
    • turn head to side, and the limbs on nose-side extend while those on occiput side flex
  3. for the principel of "total body movement before issolted movement (dissociation)" what's the early and matured responses
    • early: upper extremity swiping; prone kicking w both legs
    • matured: grasping skills; prone flex/ext knee
  4. for the principel of "proximal control before distal control" what's the early and matured responses
    • early: shoulder and hip stabilility
    • matured: elbow, wrist, hand, knee ankle stability
  5. for the principel of "cephalic before caudal" what's the early and matured responses
    • early: shoulder control & stability
    • mature: hip control & stability
  6. cephalocaudal direction of body control by quarters (quarters of the first year???)
    • first quarter: head control
    • second: arms & upper trunk
    • 3rd: lower trunk & pelvis
    • last: mobility & control of lower legs, and upright postural control
  7. which antigravity control comes first?
    extensor before flexor (can lift head in prone before in supine)
  8. wt bearing on flex/ext extremities - which comes first?
    flexed - prone on elbow comes before prone on extended arms
  9. which part of hands get control first?
    • med then lat
    • ulnar fingers before index and thumb
  10. raking emerges when?
    6 months
  11. pincer grasp emerges when?
    8-12 months
  12. when does handedness appear?
    • around 2 yrs old, gets established at 3-4 yrs
    • - if it comes in before 1 yr, indicates motor impairment of opp arm
  13. 7 reflexes present at birth
    • Moro
    • suck
    • rot
    • palmar
    • plantar
    • ATNR
    • babinski
  14. Moro reflex - when does it appear? when does it disappear
    • 28-32 weeks gestation
    • 4-5 months
  15. Moro/Startle reflex - what triggers it?
    being startled - noise, change in light, change in body pos, falling
  16. Moro/Startle reflex - what is it?
    • UEs abd, extend, supinate
    • cry
  17. 3 troubles if the Moro/Startle reflex persists (past it's usual time for integration at 4-5 months)
    • throws infant off balance
    • excess extensor tone developmen
    • associated w CP
  18. rooting reflex - what is it?
    tactile stim to cheek makes head turn to that side and mouth opens

    prepares the baby to suck
  19. sucking reflex - begins when?
    32 week gestation, fully developed by week 36
  20. sucking reflex - integrates when?
    2-5 months
  21. how to trigger the sucking reflex?
    • stim the top of the mouth
    • fyi - sucking promotes flexion of body
  22. palmer grasp reflex, begins when?
    28 weeks gestation
  23. palmer grasp reflex - what is it?
    stim the palm and the baby grasps, can't volitionally release
  24. when is palmar grasp integrated?
    when vol grasp develops - by 6 months
  25. plantar grasp reflex - appears when?
    28 weeks gestation
  26. plantar grasp reflex - what is it?
    apply firm pressure to base of toes, and the toes will flex down
  27. when does the plantar grasp reflex integrate?
    when kid starts walking
  28.  babinski - normal response in babies?when does it integrate?
    • toe fanning & big toe dorsiflexing
    • normal up to 2 years, may disappear by 1 year
    • (it disappears when the system becomes more myelinated)
  29. step or walk reflex - begins when? integrated when?
    • begins at 37 weeks gestation
    • integrated at  months
  30. what is the step/walk reflex?
    • alternating, rhythmical, coordinated steps
    • elicit it by supporting infant upright with feet on ground - support it and guide it forward
  31. ATNR - appear when? integrates when?
    • 2 weeks
    • 4 months
  32. what do you think of persisten neck reflexes at 12-24 months?
    • bad!
    • suggests limited motor control and possibly decreased indep amb
  33. "neck righting on the body" - appears when? integrated when?
    • 34 weeks gestation
    • 4-6 months
  34. neck righting on the body - what is it?
    • pt supine, head midline - turn the head to side, and entire body will turn in this direction
    • (sounds like it's really body righting on the head)
  35. landau reflex - appears when? integrates when?
    • 3-4 months
    • 12-24 months
  36. what's the Landau reflex?
    hold an infant prone w yr hands under chest and stomach, and the head, neck, arms should extend so the kid's in a superman pose, everything raised above the stomach's horizontal
  37. symmetrical tonic neck reflex - what is it?
    flex/ext neck, legs move you away from where you're looking, arms do the opposite

    • flex neck: LE ext, UE flex
    • ext neck: LE flex, UE ext
  38. when is the symmetrical tonic neck reflex (STNR) present?
    4th - 7th month
  39. parachute reflex - present when?
    • appear 6-9 months
    • stays forever
  40. cortical thumb - appears and disappears when?
    • found in normally developing infants
    • resolves 1.5-7 months
  41. 9 skeletal characteristics of neonates
    • medial femoral torsion
    • femoral anteversion
    • femoral coxa valga
    • shallow acetabulum
    • genu varum
    • tiba varum
    • tibial torsion
    • calcaneal & forefoot varus
    • metatarsus adductus