Pregnancy and Pediatrics Week 3

Where is the dollar sign located in infants?

1" lateral and 2" inferior to the PSIS

What is a positive dollar sign?

Either a hypo or hypertonic gluteus convergence point

T or F: The positive dollar sign is taut in infants and hollow in toddlers

True

T or F: You palpate for both dollar signs bilaterally, simultaneously

False (one side at a time)

What should you do if the patient has a positive dollar sign?

Perform a more "meningeal" or light force adjustment

Where is crest sign

1" lateral to the iliac crest, above it at the level of L4

What is crest sign

When you squish against the lumbar spine, one side is wider

What muscles cause the crest sign?

QL and erector spinae

What muscles cause the dollar sign?

Glut max, med, min, and piriformis convergence

What should you do if the patient has a positive crest sign?

Perform a more "structural" or high force adjustment

Where do you place you hands to evaluate sacral occipital reciprocal motion?

One hand on the occiput parallel with the spine

One hand on the sacrum with the middle finger under the L5 spinous process and the flanking fingers on the sacral Ala (hand parallel to spine

T or F: You should be on the lambdoidal suture when you palpate for sacral occipital reciprocal motion

False (do not cross the lambdoidal suture

What motions should occur with inhalation with proper sacral occipital reciprocal motion?

Flexion of the sacral base moves superior and caudal

Occiput moves inferior and anterior, into flexion

What is the pivot point of the occiput?

Sphenoid

What is the rooting reflex?

Stroking the baby's cheek and baby moves head to side of stroking

What does an absent rooting reflex

Severe neurological problem

UMN

CNS problem

(baby was just fed* - bilateral)

What is the duration of the rooting reflex?

3-4 months

What is the sucking reflex?

Baby sucks on the pinky when placed in mouth

What does an absent sucking reflex indicate?

UMN lesion

What is the duration of the sucking reflex?

3-4 months

What is the AKA off the Moro reflex?

Startle reflex

What is the Moro reflex?

Making a loud noise or jiggling the exam table causes the baby to extend the extremities and then flex them

What does an asymmetric moro reflex indicate?

Injury/fracture

What does total absence or persistent moro reflex indicate?

Brain stem vestibular nucleus lesion

What is the duration of the moro reflex?

4-6 months

What is the AKA of the fencer reflex?

Tonic neck reflex

What is the fencer reflex?

Turn baby's head to one side, baby extends extremities on the side of head turn

What does persistent fencer reflex indicate?

Neurologic problems in the brain stem vestibular nucleus

What is the duration of the fencer reflex?

4-6 months

What is the grasp reflex?

Baby curls fingers around the examiners finger

What does an absent grape reflex indicate?

Cerebral insult in the vestibular nuclei

What is the duration of the grasp reflex?

4-6 months

T or F: The grasp reflex can be done on the sole of the foot

True

What is the babinski reflex?

Big toe extend and toes spread when the sole of the foot is stroked

What is the duration of the babinski reflex?

16-24 months

What is the AKA of the walking reflex?

Steppage reflex

What is the steppage reflex?

Baby lifts one foot and places it downward onto table when the baby is held upright over a table

What is the duration of the steppage reflex?

variable 2-4 months

What is the blink reflex?

Shining light into baby's eyes or tapping the glabella causes the baby's eyes to close

What does an absent blink reflex indicate?

Blindness or eyelid malfunction

What is the duration of the blink reflex?

8 months - 1 year

What is the galant reflex?

Examiner runs fingers down the spine

Baby is face down

Baby's butt torques toward the stimulated side

What does an absent galant reflex indicate?

Neurologic damage and paralysis

What is the duration of the galant reflex?

3-4 months

What is the Perez reflex?

Baby face down

Run fingers over spinous processes

Baby extends the head and brings knees to chest and may also urinate

What does absent Perez reflex indicate?

neurological deficit, including cerebral dysfunction

What is the duration of the Perez reflex?

2-4 months