Pediatrics Exam 1

The first synapse and neurons form around ________ weeks after conception.

7 weeks

The cerebral hemispheres and limbic system are in what portion of the brain?

forebrain

Spatial neglect and apraxia are both symptoms associated with damage to which lobe of the brain?

parietal lobe

Your patient who had a brain injury shows difficulty remembering how to tie their shoes and difficulty socializing. What lobe of the brain was likely damaged?

temporal lobe

Disinhibition is a symptom of damage to which lobe of the brain?

frontal lobe

Impulse control and cognitive function are both jobs of which lobe of the brain?

frontal lobe

The thalamus relays all sensory information except for:

smell

Which part of the limbic system controls sleep/wake cycles?

hypothalamus

What is the key brain site for central control of the ANS?

hypothalamus

Which portion of the limbic system is associated with spatial reasoning?

hippocampus

Emotional regulation and attachment are characteristics associated with which part of the limbic system?

amygdala

The cerebellum dramatically increases in growth during what part of gestation?

28 to 40 weeks of gestation

Which portion of the brain creates neural circuits for implicit learning?

cerebellum

True or false:

People with autism often have smaller cerebellums.

true

Which portion of the brain is responsible for breathing, HR, and BP and also controls reflexes?

brain stem

If a child has difficulty crossing midline, what part of their brain is likely not developed?

corpus callosum

What type of reflexes are triggered by the effects of gravity and begin to develop right after birth?

postural reflexes

What two categories are associated with postural reflexes?

righting reactions and equilibirum reactions

What is the difference between righting reactions and equilibrium reactions?

righting reactions: head misaligned

equilibrium reactions: body misaligned

Righting reactions are most distinguishable at ________ months.

10-12

Where are righting reactions controlled at?

midbrain

What level of head control is expected with a newborn?

no control, full head lag expected

What level of head control is expected with a 1 month old?

can lift head momentarily in prone

What level of head control is expected with a 2 month old?

they can maintain their head in midline in supported sitting with gaze downward

What level of head control is expected with a 3 month old?

prone prop on elbows, slight head lag expected with pull to sit with demonstration of chin tuck

What level of head control is expected with a 6 month old?

good control, prone prop on extended elbows, no head lag, anticipates pull to sit

Typically, how many months does it take for a child to show no head lag?

6 months

When do equilibrium reactions begin to appear?

6 months

What part of the brain controls equilibrium reactions?

cerebellum

What is the normal age of response of the asymmetrical tonic neck reflex (ATNR)?

birth to 6 months

What stimulus is used to elicit the ATNR?

head turning to one side

You turn a 4-month old's head to the left. If the ATNR is present, what response is expected?

left arm and leg extension

right arm and leg flexion

spine curved with convexity toward the left

What is the normal age of response of the symmetrical tonic neck reflex (STNR)?

6-12 months

What stimulus is used to elicit the STNR?

neck flexion or extension

A 9-month old's head flexes. If the STNR is present, what response is expected?

arms flex and legs extend

A 9-month old's head extends. If the STNR is present, what response is expected?

arms extend and legs flex

What is the normal age of response of the tonic labyrinthine reflex (TLR)?

birth to 6 months

What stimulus is used to elicit the TLR?

the head being positioned in supine or prone

A 5-month-old is laying in supine. If the TLR is present, what response is expected?

body and extremities are held in extension

A 5-month-old is laying in prone. If the TLR is present, what response is expected?

body and extremities are held in flexion

What is the normal age of response of the galant reflex?

30 weeks of gestation to 2 months

What stimulus is used to elicit the galant reflex?

touch to skin along spine from shoulder to hip

A 1-month-old is touched on skin along the left side of the spine from the shoulder to the hip. If the galant reflex is present, what response is expected?

lateral flexion of trunk to the left

What is the normal age of response of the palmar grasp reflex?

birth to 4 months

What stimulates the palmar grasp reflex?

pressure in palm on ulnar side of the hand

What is the normal age of response of the plantar grasp reflex?

28 weeks of gestation to 9 months

What stimulates the plantar grasp reflex?

pressure to base of toes

What is the normal age of response of the rooting reflex?

28 weeks of gestation to 3 months

How can you stimulate the rooting reflex?

touch their cheek

You touch a 2-month-old's right cheek. If their rooting reflex is present, what response would occur?

They would turn their head to the right with their mouth open

What is the normal age of response of the moro reflex?

28 weeks of gestation to 5 months of age

How is the moro reflex stimulated?

head dropping into extension suddenly for a few inches

What is the response associated with the moro reflex?

arms abduct with fingers open, then cross trunk into adduction; cry

What is the normal age of response of the startle reflex?

28 weeks of gestation to 5 months

How is the startle reflex different from the moro reflex?

the elbows remain flexed and the hands are closed in the startle reflex response

What is the normal age of response of the positive support reflex?

35 weeks of gestation to 2 months

What stimulates the positive support reflex?

weight placed on balls of feet when upright

What is the response expected from the positive support reflex?

stiffening of legs and trunk into extension

What is the normal age of response of the walking (stepping) reflex?

38 weeks of gestation to 2 months

Which postural reflex can cause a high steppage gait?

walking (stepping) reflex

How is the walking (stepping) reflex stimulated?

child supported in an upright position with soles of feet on firm surface

What response is associated with the walking (stepping) reflex?

reciprocal flexion/extension of legs

What is the average age for a child to be able to sit with support?

newborn to 2 months

What is the average age for a child to be able to kick in supine?

newborn to 2 months

What is the average age where prone on elbows emerges?

3-4 months

What is the average age for a child to be able to perform reciprocal kicking?

3-4 months

When does depth perception regularly emerge for a child?

3-4 months

At 8 weeks, how many minutes of tummy time should the child get per day?

15 minutes/day

At 4 months, how many minutes of tummy time should the child get per day?

80 minutes/day

At what age does prop sitting usually emerge for a child?

5 months

What is the average age for a child to be able to roll prone to supine?

5 months

What is the average age for a child to be able to babble?

5 months

What is the average age for a child to be able to start pivoting in prone?

5 months

What is the average age for a child to begin reaching?

5 months

What pre-requisites should a child have before rolling prone to supine?

shoulder stability, neck extension, and neck rotation

What pre-requisites should a child have before pivoting in prone?

visual stimulation, weight shifts, shoulder stability, neck extension, neck rotation

What is the average age for a child to be able to start rolling in all directions?

6 months

What is the average age for a child to be able to start pulling to sit without head lag?

6 months

What is the average age for a child to be able to start recognizing strangers/family?

6 months

What is the average age for a child to be able to start reaching across midline?

6 months

What pre-requisites should a child have before rolling supine to prone?

ability to lift legs, reach across midline, head righting (weight shifts), and neck rotation

What is the average age for a child to be able to start crawling?

7-9 months

(army crawl: ~6.5-7 months, quad crawl: ~8-9 months)

You see a child holding their own bottle. When does this ability begin to emerge for children, on average?

7-9 months

What is the average age for a child to be able to start standing with assistance?

7-9 months

What prerequisites are needed to be able to perform quad crawling?

maintaining 4 point

glute strength

reaching in 4 point

rocking

transition in/out of 4 point

What is the average age for a child to be able to start standing independently?

10-12 months

What is the average age for a child to be able to start cruising?

10-12 months

What is the average age for a child to be able to start squatting?

10-12 months

What is the average age for a child to be able to start assisted walking?

10-12 months

What is the average age for a child to be able to understand up to 10 words, including their name?

10-12 months

What prerequisites are needed before a child can begin cruising?

standing, weight shifts

What prerequisites are needed before a child can begin assisted walking?

standing, weight shifts

(but in a forward direction)

What is the average age for a child to be able to start independent walking?

12-18 months

What is the average age for a child to be able to start pointing to ask for help?

12-18 months

What is the average age for a child to be able to start feeding themselves with a spoon?

12-18 months

What is the average age for a child to be able to start creeping up stairs?

12-18 months

What is the average age for a child to be able to start squatting to play or for transitions?

12-18 months

What is the average age for a child to be able to start walking backwards, fast walking, and running?

18-24 months

What is the average age for a child to be able to start walking up steps with handheld assistance?

18-24 months

You notice a child propelling on a toy with wheels in the clinic. What age range does this skill usually start in?

18-24 months