Term
| what are the 3 distinct periods of the prenatal period |
|
Definition
| germinal, embryonic, fetal |
|
|
Term
| when is the germinal period |
|
Definition
|
|
Term
| when is the embryonic period |
|
Definition
|
|
Term
|
Definition
|
|
Term
| when is the critical period for CNS defects |
|
Definition
|
|
Term
| when is the critical period for heart defects |
|
Definition
|
|
Term
| when is the critical period for skeletal system defects |
|
Definition
|
|
Term
| of the 3 periods of prenatal period, which is the most critical period when most of the body is forming |
|
Definition
|
|
Term
| what are 2 other terms for the embryonic period |
|
Definition
| organogenetic or epigenetic period |
|
|
Term
|
Definition
| failure of anterior neural tube closure: no brain, not compatible with life |
|
|
Term
|
Definition
| failure of posterior neural tube closure |
|
|
Term
| where in the neural tube is most (80%) of myelomeningocele neural tube openings |
|
Definition
|
|
Term
| what does most myelomeningocele defects include |
|
Definition
| dorsal displacement of the neural tube, forming a sac |
|
|
Term
| what are causes of birth defects |
|
Definition
| genetic, environmental factors |
|
|
Term
| what are genetic causes of birth defects |
|
Definition
| chromosomal abnormalities or mutant genes |
|
|
Term
| what are environmental causes of birth defects |
|
Definition
| malnutrition, diseases, chemicals, drugs |
|
|
Term
|
Definition
| the scientific study of birth defects |
|
|
Term
|
Definition
| an agent that alters morphology or function |
|
|
Term
| what are some examples of teratogens |
|
Definition
| infection, chemical, drugs, deficiency |
|
|
Term
| what does damage from teratogen exposure depend on |
|
Definition
| amount of exposure, time of exposure, genetic makeup of the individual |
|
|
Term
| how many (%) infants bron to HIV infected mothers become infected during labor, delivery, or breastfeeding |
|
Definition
|
|
Term
| how to reduce HIV transmission from mother to baby |
|
Definition
| transmission can be reduced by 2/3 with maternal treatment in 2nd and 3rd trimesters as well as infant treatment for 6 weeks after birth. Don't breastfeed |
|
|
Term
| what is the clinical presentation of HIV in an infant |
|
Definition
| begins months-2 years: progressive or static encephalopathy; cognitive impairment; failure to thrive; enlarged spleen; recurrent diarrhea; persistent oral candida |
|
|
Term
| how many (%) women have group B strep colonized in their genitourinary tracts? |
|
Definition
|
|
Term
| how many (%) infants born to women with group B strep develop early onset invasive dsease |
|
Definition
|
|
Term
| what is the result of group B strep |
|
Definition
| shock, pneumonia, meningitis |
|
|
Term
| what is the outcome of meningitis in infants |
|
Definition
| 21% die. High rates of neurological impairments in survivors |
|
|
Term
| how is congenital cytomegalovirus infection transmitted from mother to infant |
|
Definition
| infected mother passes congenital cytomegalovirus to fetus through the placenta. |
|
|
Term
| is a mother infected with congenital cytomegalovirus always symptomatic |
|
Definition
|
|
Term
| what percentage of infants who have symptoms of congenital cytomegalovirus at birth will have neurologic abnormalities later in life |
|
Definition
|
|
Term
| what are possible complications of congenital cytomegalovirus |
|
Definition
| psychomotor retardation, deafness |
|
|
Term
| what does tetracycline affect in a developing fetus |
|
Definition
|
|
Term
| how do some anticonvulsants affect the fetus |
|
Definition
| heart disease, cleft lip, palate |
|
|
Term
| what can some antidepressants do to developing fetus |
|
Definition
| limb anomalies, cleft palate, withdrawal symptoms |
|
|
Term
| what can accutane do to a developing fetus |
|
Definition
| cause miscarriages and birth defects |
|
|
Term
| what can thalidomide do to developing etus |
|
Definition
|
|
Term
| what is wiedemann's dysmelia syndrome |
|
Definition
| limb malformations caused by thalidomide |
|
|
Term
| how does tobacco use by mother affect fetsu |
|
Definition
| reduces blood flow to the placenta and oxygen to the fetus |
|
|
Term
| what are risks caused by maternal tobacco use during pregnancy |
|
Definition
| premature rupture of membranes, premature birth, decreased fetal growth, placental abruptions/placenta previa, abnormal fingers/toes |
|
|
Term
| problems of fetal alcohol syndrome |
|
Definition
| growth deficiency, small head, epicanthic folds, mental retardation, hyperactivity, ADD, delayed growth and development |
|
|
Term
| what is fetal alcohol effect |
|
Definition
| less severe symptoms than FAS. Language delays, clumsiness |
|
|
Term
| is fetal alcohol syndrome or fetal alcohol effect more common |
|
Definition
|
|
Term
| how does cocaine use by mother affect fetus |
|
Definition
| cocaine causes blood vessel constriction, decreasing oxygen to the fetal brain and decreasing nutrition through the placenta leading to low birth weight |
|
|
Term
| how is risk of SIDS increased in babies who were exposed to cocaine prenatally |
|
Definition
|
|
Term
| what are non-specific features in babies who were prenatally exposed to cocaine |
|
Definition
| abnormal sleep, irritability, seizures, genitourinary anomalies, abnormal neonatal neurobehavior, modest effect on IQ |
|
|
Term
| what are problems in school age children who were exposed to cocaine prenatally |
|
Definition
| ADHD, disruptive behavior, anxiety, depression |
|
|
Term
| how does maternal malnutrition affect fetus |
|
Definition
| reduced fetal growth, premature rupture of membranes, increased risk of prematurity, increased morbidity |
|
|
Term
| what are risks on fetus caused by uncontrolled maternal diabetes |
|
Definition
| cardiac, spine, neural tube, limb abnormalities (these things don’t always happen, but they can) |
|
|
Term
| how does excessive radiation affect a fetus |
|
Definition
| microcephaly, mental retardation, skeletal deformities |
|
|
Term
| what types of paternal occupations are related to increased risk of birth defects |
|
Definition
| janitors, woodworkers, firemen, electrical workers, printers, painters |
|
|
Term
| what increased ridsks occur in infants of fathers who work in textile industires |
|
Definition
| stillbirth, preterm delivery, small for gestational age |
|
|
Term
| how can some cancer treatments in fathers affect offspring |
|
Definition
|
|
Term
| how many spontaneous abortions are caused by underlying chromosomal abnormalities |
|
Definition
|
|
Term
| what are common characteristics of trisomy 21 |
|
Definition
| typical facial profile; hypotonia and delayed motor development; moderate range of mental retardation; joint laxity; short limbs; nuchal fold; in adulthood: alzheimers, depression, obesity, leukemia; lifespan 40-50 years |
|
|
Term
| what are some inherited metabolic disorders |
|
Definition
| krabbe disease (globoid cell leuodystrophy), cerebral x-linked adrenoleukodystrophy, metachromatic leukodystrophy, hurlers synderome |
|
|
Term
| what is prader-willi syndrome |
|
Definition
| genetic/metabolic disroder |
|
|
Term
| functions of fetal movement |
|
Definition
| prevent stasis and adhesions to the uterine wall or between different parts of the fetus; position the fetus in preparation for birth; normal development of the structure of bones and joints |
|
|
Term
| what does APGAR stand for |
|
Definition
| Appearance (color); Pulse; Grimace (reflex irrritability); Activity/muscle tone; Respiration |
|
|
Term
|
Definition
| 1 minute, 5 minutes, then every 5 minutes up to 20 min if socre <7 |
|
|
Term
| what are ways of determining gestational age |
|
Definition
| date from last menstrual period, fetal heart tones, measurements of fundal height/crown rump length/femoral length, based on physical characteristics and neurological indicators after birth |
|
|
Term
| is a 22-23 GA infant more likely to have extensor posturing or flexed posturing |
|
Definition
|
|
Term
| is a 40 week GA infant more likely to have extensor or flexor posturing |
|
Definition
|
|
Term
| how do movements change between 22-40 weeks gestation |
|
Definition
| movements become purposeful and controlled |
|
|
Term
| what is the physical progression of muscle tone |
|
Definition
| legs to head: caudocephalic |
|
|
Term
| how do primary reflexes change from 22-40 weeks gestational age infant |
|
Definition
|
|
Term
| how to determine sequential patterns in premature infant |
|
Definition
| examine: resting posture, resistance to passive movement, amount and quality of active movements |
|
|
Term
| how long do we correct age for premature birth |
|
Definition
|
|
Term
| what is the corrected age of an 8 month chronological age infant who was born at 28 weeks? |
|
Definition
|
|
Term
| what are morbidity and mortality risk factors of premature infant |
|
Definition
| gestational age/brith weight, physiological/medical status, external factors |
|
|
Term
| what is the range of low birth weight |
|
Definition
| 1500-2500g (3.5-5.5 pounds) |
|
|
Term
| what is the very low birth weight range |
|
Definition
|
|
Term
| what is the extremely low birthweight range |
|
Definition
|
|
Term
|
Definition
| appropriate for gestational age |
|
|
Term
|
Definition
| small for gestational age |
|
|
Term
|
Definition
| large for gestational age |
|
|
Term
| what percentile is an AGA baby |
|
Definition
|
|
Term
| what percentile is an SGA baby |
|
Definition
|
|
Term
| what percentile is an LGA baby |
|
Definition
|
|
Term
| about how many infants are born annually in the US who weigh less than 1500g? |
|
Definition
|
|
Term
| about how many infants who weigh less than 1.5kg at birth survive? |
|
Definition
|
|
Term
| about how many infants who weigh less than 1.5kg at birth get CP? |
|
Definition
|
|
Term
| about how many infants who weigh less than 1.5kg at birth have behavioral and/or cognitive deficits |
|
Definition
|
|
Term
| what are problems that are seen in SGA infants that are full term |
|
Definition
| developmental problems such as behavioral and learning problems |
|
|
Term
| what are problems that are seen in preterm SGA infants |
|
Definition
| greater prevalence of developmental problems |
|
|
Term
| describe preterm and sick infants in the NICU |
|
Definition
| fragile, immature, have increased periods of behavioral disorganization |
|
|
Term
| what are immature systems and potential problems in preterm infants |
|
Definition
| CNS, pulmonary, cardiopulmonary, gastrointestinal, visual, auditory, increased infection ris |
|
|
Term
| what is the rate of neuron formation |
|
Definition
|
|
Term
| what is the volume of the brain at 24 weeks |
|
Definition
|
|
Term
| what is the volume of the brain at 40 weeks |
|
Definition
|
|
Term
| how many neurons in the brain at birth |
|
Definition
|
|
Term
| what are MRI differences in preterm and full term infants |
|
Definition
| cortical gray matter is decreased in premature; have greater frontal and sensorimotor vulnerability |
|
|
Term
| what are CNS impairments in preterm infants |
|
Definition
| germinal matrix interventricular hemorrhage; periventricular leukomalasia; encephalopathy of prematurity; later sensorimotor/cognitive/learning problems |
|
|
Term
|
Definition
| mild bleeding. Stays within the germinal matrix and doesn't reach the ventricles |
|
|
Term
|
Definition
| mild bleeding. Some blood enters the ventricles but doesn't enlarge them |
|
|
Term
|
Definition
| moderate. A lot of blood in the ventricles causes them to swell |
|
|
Term
|
Definition
| severe. The hemorrhage occurs beyond the ventricles in the substance of the brain |
|
|
Term
| what are problems associated with cardiopulmonary immaturity |
|
Definition
| respiratory distress syndrome, bronchopulmonary dysplasia |
|
|
Term
| what are problems associated with GI immaturity |
|
Definition
| necrotizing enterocolitis, gastroesophageal reflux |
|
|
Term
| what is retinopathy of prematurity |
|
Definition
| the growth and spread of abnormal blood vessels throughout the retina. These blood vessels are fragile and can leak, scarring the retina and pulling it out of position. |
|
|
Term
| how closely should an infant with retinopathy of prematurity be followed by an ophthalmologist |
|
Definition
| should be checked every 1-2 weeks |
|
|
Term
| what are some visual impairments that are often seen in premature infants after discharge |
|
Definition
| poor vision, strabismus, amblyopia, nystagmus, smaller field of vision |
|
|
Term
| when are premature infants screened for hearing impairments |
|
Definition
| when medically stable and 33 weeks gestation |
|
|
Term
| what happens if an infant gets abnormal results on hearing screen |
|
Definition
| checked again. If abnormal 2nd time, scheduled for an audiological evaluation after discharge for sensorineural and/or conductive loss |
|
|
Term
| what types of things to review when a preterm infant is referred for PT |
|
Definition
| pregnancy complications, labor/delivery complications, apgar scores, significant diagnosis during hospitalization: RDS, BPD, IVH, PVL, NEC, infections, GER, ROP, hearing impairment; significant procedures: ventilator, PDA ligation, hernia repair, surgery for NEC or perforated bowel |
|
|
Term
| what body functions and structures should a PT look for in a preterm infant |
|
Definition
| skeletal alignment, ROM, postural control, muscle performance, ventilation/respiration, sensory organization |
|
|
Term
| what activities might be affected in a premature infant |
|
Definition
| physiological tolerance to routine care; feeding (respiration); self-regulation; movement; changing positions; sensory responsiveness |
|
|
Term
| what participation might be changed in a perterm infant |
|
Definition
| attention/interaction with parents/caregivers/siblings |
|
|
Term
| what environmental aspects affect a preterm infant |
|
Definition
| NICU; physical/social/cultura |
|
|
Term
| what personal factors affect a preterm infant |
|
Definition
| limited family transportation, infant's medical condition |
|
|
Term
| what are the PT aims for preterm infants |
|
Definition
| enhance movement and postural control; support symmetry and alignment; minimize contractures and deformities; promote respiratory/feeding performance; foster caregiver confidence and attachment; support regulatory behaviors and social interactions |
|
|
Term
| what PT interventions can be done in the NICU |
|
Definition
| environmental modifications, positioning for containment, alignment, self-regulation, and promotion of appropriate behavioral state and autonomic stability; direct therapy; family centered care; family education/guidance/support |
|
|
Term
| what is family centered care |
|
Definition
| supporting and assisting families in: understanding the nursery and their infant's specific physiological behavioral issues; understanding their infant's signals and cues; developing confidence in all areas of caregiving; facilitating infant's ability to interact with parents and caregivers; support for discharge including follow-ups, referrals, and community environments |
|
|
Term
| what direct handling PT interventions can be done for preterm infants in the nicu |
|
Definition
| positioning, therapeutic handling, ROM/taping/splinting/hydrotherapy, contingent sensorimotor stimulation, oral-motor intervention |
|
|
Term
| what are examples of therapeutic handling |
|
Definition
| bring head/hands to midline, symmetry, head/trunk control, axial rotation, movement/postural experience |
|
|
Term
| what are postural/movement issues for preterm infants |
|
Definition
| extensor posturing often dominant; lateral rotation of legs, external tibial torsion, everted feet; positional deformities leading to functional limitations in midline head control, visual orientation, movement transitions |
|
|
Term
| what is the influence of extensor dominance |
|
Definition
| hyperextended neck, retracted shoulders, decreased trunk/pelvic mobility, frog legged, toe walking |
|
|
Term
| what does a hyperextended neck interfere with |
|
Definition
| interferes with development of graded head control |
|
|
Term
| what do retracted shoulders interfere with |
|
Definition
| upper extremity self-regulation, hands to midline, prone propping |
|
|
Term
| what does decreased trunk/pelvic mobility interfere with |
|
Definition
| weight shifting, rolling, pivoting, transitional movements, limits hands to feet play |
|
|
Term
|
Definition
| shortened hip abductors and IT Band |
|
|
Term
| what are the problems of frog leg |
|
Definition
| interferes with crawling, wide base of support, prolonged toeing out gait |
|
|
Term
| what are the problems of toe standing |
|
Definition
| walking, delays heel-toe gai |
|
|
Term
| what to do in developmental examinations and evaluations |
|
Definition
| assess CNS integrity; determine a baseline; target babies who may benefit from intervention; formulate treatment plan |
|
|
Term
| what is the Test of Infant Motor Performance |
|
Definition
| describes the evolution of functional motor skills in early infancy in order to plan intervention programs in infants with motor delays. Documents motor performance over time and evaluates effectiveness of treatment. |
|
|
