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Flashcards in History and Examination of a Baby Deck (30)
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1

What should particular attention be paid to in neurological history taking?

- Age of onset
- Developmental history, including age of milestones and loss of any skills
- Deterioration in school performance
- Detailed family history
- Impact of the problem on family life and functioning

2

What categories do neurological presentations typically fall into?

- Developmental delay
- Developmental regression
- Weakness
- Abnormal movements
- Change in level of consciousness
- Paroxysmal events
- Headache
- Traumatic injury

3

Give an example of a condition causing developmental regression?

Rett's syndrome

4

Give an example of a condition causing weakness?

Muscular dystrophy

5

Give an example of a type of abnormal movement

Ataxia

6

Give an example of a condition causing a change in level of consciousness

Encephalopathy

7

Give an example of a condition causing paroxysmal events?

Epilepsy

8

Give an example of a condition causing headache?

Migraine

9

When is a full neurological examination required?

When a neurological disorder is suspected

10

In what positions should a baby be examined?

- Supine
- Sitting
- Standing
- Prone suspension

11

What should be looked for on examination when the baby is supine?

- General movements, posture, and alertness
- Birthmarks
- Measure and plot head circumference
- Assess fontanelles and head shape
- Lift head and do Moro reflex if necessary
- Individually assess tone, power, movement, and reflexes in each limb
- Observe response to sound
- Assess pupil responses, reaction to light, object fixation, and red reflexes/fundoscopy
- Take both hands
- Pull baby by hands to siting

12

Why is it important to check for birthmarks?

To look for neurocutaneous markers

13

Why is it important to assess fontanelles?

To look for hydrocephalus

14

Why is it important to assess head shape?

To look for craniosynotosis

15

How do you elicit the Moro reflex?

Allow head to fall back quickly supported in your hand by a short distance, and assess reaction of arms

16

Why should you not always do the Moro reflex?

Usually unnecessary and unpopular with parents

17

What will be found on assessing reflexes in babies?

Babinski will be positive

18

What are you looking for when you take both hands in babies?

Grasp reflex

19

What are you looking for when you pull a baby by hands to sitting?

Head lag

20

What should be looked for on examination when the baby is sitting?

- Degree of back rounding
- Ability to self support

21

What are you assessing when looking for the degree of back rounding in a sitting baby?

Tone

22

What are you assessing for when looking for the ability to self support in a sitting baby?

Tone and posture

23

What should be looked for on examination when the baby is standing?

- Are they 'slipping through your hands'
- Rigid legs
- Stepping and walking reflexes

24

What does it show if the baby is 'slipping through your hands'?

Hypotonia

25

What does it show if a standing baby has rigid legs?

Hypertonia

26

How should you hold a baby in prone suspension?

Lay infant prone across your hand/forearm

27

What should be looked for on examination when the baby is in prone suspension?

- Degree of drape/ability to lift head and legs
- Examine spine for abnormalities or defects
- Galant reflex
- Lay infant back down on bed, prone

28

What are you looking for when assessing degree of drape/ability to lift head and legs in a baby in prone suspension?

Tone

29

How do you elicit the Galant reflex?

Stroke side of spine to see if infant curls towards stimulus

30

What are you looking for when you lay the infant back down on the bed, prone?

- Head raise
- Rolling
- Attempt to crawl