NURS653 Exam 3 Maryville | STUDY GUIDE
- Developmental eval
- Mental status -LOC, orientation
- Cranial nerves
neurologic exam
- Motor (muscle tone/strength)
components
- Reflexes
- gait/coordination/balance
- Sensory
Sucking reflex: The newborn sucks in response
to a nipple in the mouth; observed by 14 weeks’
gestation. Palmar grasp: Evident with the
placement of the examiner’s finger in the
newborn’s palm; develops by 28 weeks’
gestation and disappears by age 4 months.
Primitive reflexes
Moro (startle) reflex: Hold the infant supine
while supporting the head. Allow the head to
drop 1–2 cm suddenly. The arms will abduct
at the shoulder and extend at the elbow with
spreading of the fingers.
Adduction with flexion will follow. This reflex
develops by 28 weeks’ gestation (incomplete)
and disappears
by age 3 months.
appears at birth
Primitive reflexes-Palmar
disappears at 2-3
months
,Primitive reflexes- appears birth
Plantar disappears 10-12 months
grasp
appears at birth
Primitive reflexes-Moro
disappears 4-6 months
Primitive reflexes- appears at birth
stepping disappears 3-4 months
Primitive reflexes- tonic appears birth-6 weeks
neck disappears 4-6 months
appears birth
Primitive reflexes- disappears 3-4 months (except during sleep up
Rooting to 12 months)
sympathetic is fight of flight
increased heart rate, respiration,
sympathetic versus
vasoconstriction, stress effects digestion
parasympathetic
parasympathetic - slows and calms
twice as frequent in boys
2-5 million children seek medical tx each
Brain injury risks year Greatest incidence age 0-4 and 15-24
Young children more at risk due to large head and
less muscle control
What causes head abuse or falls
injuries
in infants?
what causes head injuries falls
in ages 1-4 years
what causes head sports/recreation, falls, car accidents
injuries in school age
kids?
, -Health history with focus on the immediate
injury, time, cause, and the direction and force
of the blow
-Baseline assessment
brain injury assessment -LOC—Glasgow Coma Scale
-Frequent and ongoing neurologic assessment
-Multisystem assessment- ha, irritability, tense
fontanel, unilateral head swelling
Otorrhea or rhinorrhea. CSF
Ecchymosis
Fight or Flight. Part of the autonomic nervous
Sympathetic Nervous
system that accelerates HR, constricts blood
System (SNS)
vessels, and ↑
BP.
parasympathetic nervous the division of the autonomic nervous system that
system calms the body, conserving its energy
1.Check for cephalohematoma (a swelling
over one or both parietal bones that is
contained within suture lines) and caput
succedaneum (edema of the scalp over the
presenting part that crosses suture lines).
2.Check for the presence and size of the
fontanelles. The anterior fontanelle varies
INfant neurologic from 1 to 4 cm in any direction; the posterior
fontanelle should be less than 1 cm. A third
fontanelle is a bony defect along the sagittal
suture in the parietal bones and may be seen
in genetic syndromes, such as trisomy 21.
Sutures should be freely mobile but are often
overriding just after birth.
3.Craniosynostosis, a prematurely fused
suture causing an abnormal cranial shape,
is more easily diagnosed a few days or
more after birth.
- Developmental eval
- Mental status -LOC, orientation
- Cranial nerves
neurologic exam
- Motor (muscle tone/strength)
components
- Reflexes
- gait/coordination/balance
- Sensory
Sucking reflex: The newborn sucks in response
to a nipple in the mouth; observed by 14 weeks’
gestation. Palmar grasp: Evident with the
placement of the examiner’s finger in the
newborn’s palm; develops by 28 weeks’
gestation and disappears by age 4 months.
Primitive reflexes
Moro (startle) reflex: Hold the infant supine
while supporting the head. Allow the head to
drop 1–2 cm suddenly. The arms will abduct
at the shoulder and extend at the elbow with
spreading of the fingers.
Adduction with flexion will follow. This reflex
develops by 28 weeks’ gestation (incomplete)
and disappears
by age 3 months.
appears at birth
Primitive reflexes-Palmar
disappears at 2-3
months
,Primitive reflexes- appears birth
Plantar disappears 10-12 months
grasp
appears at birth
Primitive reflexes-Moro
disappears 4-6 months
Primitive reflexes- appears at birth
stepping disappears 3-4 months
Primitive reflexes- tonic appears birth-6 weeks
neck disappears 4-6 months
appears birth
Primitive reflexes- disappears 3-4 months (except during sleep up
Rooting to 12 months)
sympathetic is fight of flight
increased heart rate, respiration,
sympathetic versus
vasoconstriction, stress effects digestion
parasympathetic
parasympathetic - slows and calms
twice as frequent in boys
2-5 million children seek medical tx each
Brain injury risks year Greatest incidence age 0-4 and 15-24
Young children more at risk due to large head and
less muscle control
What causes head abuse or falls
injuries
in infants?
what causes head injuries falls
in ages 1-4 years
what causes head sports/recreation, falls, car accidents
injuries in school age
kids?
, -Health history with focus on the immediate
injury, time, cause, and the direction and force
of the blow
-Baseline assessment
brain injury assessment -LOC—Glasgow Coma Scale
-Frequent and ongoing neurologic assessment
-Multisystem assessment- ha, irritability, tense
fontanel, unilateral head swelling
Otorrhea or rhinorrhea. CSF
Ecchymosis
Fight or Flight. Part of the autonomic nervous
Sympathetic Nervous
system that accelerates HR, constricts blood
System (SNS)
vessels, and ↑
BP.
parasympathetic nervous the division of the autonomic nervous system that
system calms the body, conserving its energy
1.Check for cephalohematoma (a swelling
over one or both parietal bones that is
contained within suture lines) and caput
succedaneum (edema of the scalp over the
presenting part that crosses suture lines).
2.Check for the presence and size of the
fontanelles. The anterior fontanelle varies
INfant neurologic from 1 to 4 cm in any direction; the posterior
fontanelle should be less than 1 cm. A third
fontanelle is a bony defect along the sagittal
suture in the parietal bones and may be seen
in genetic syndromes, such as trisomy 21.
Sutures should be freely mobile but are often
overriding just after birth.
3.Craniosynostosis, a prematurely fused
suture causing an abnormal cranial shape,
is more easily diagnosed a few days or
more after birth.
