what is ICD?
.made by WHO
.stands for International classification of disease
.used in billing to classify disease.
Who is ICF?
.made by WHO
.stands for international classification of function
. focus on health condition and contextual factors
.ICF defines components of health and related quality of life
Intrinsic vs extrinsic contextual factors
.(intrinsic) :attributes of the individual that impact health, personal
-motivation and cultural perspectives
.(extrinsic) :context in which an individual lives, environmental
-physical, social and attitudinal environment
week 1 prenatal development
▫Zygote becomes multicellular blastocyst
▫Development of fetal membranes and placenta
▫Atypical implantation may occur
2nd week of prenatal development
.Amnioblasts form within blastocyst
.Embryonic disc forms
.Primitive circulation
.By day 12: blastocyst will have penetrated fully into uterine wall
.By end of second week: completion of implantation
.▫Embryo has flattened appearance with thickening of small area of embryonic disc
week 3 prenatal development
▫Embryonic disc forms three layers
-Endoderm- germ layer for the digestive system, many glands, and parts of the respiratory
-Mesoderm- germ layer that forms many muscles, circulatory ,excretory, dermis, skeleton, and connective tissues
-Ectoderm-Nervous system and epithelium
.Primitive streak forms
Mesodermal Structures
▫Middle layer of embryonic disc
▫Form muscle, bone, cartilage, and connective tissues, cardiovascular, reproductive, and other internal organs
▫Notochord- rod like structure around which the vertebral column will form
▫Cephalocaudal direction- where the bead shaped buds called somite's go in to a head to tail direction along the long axis of the body
Ectodermal Structures
▫Outermost layer of embryonic disc
▫Form nervous system, skin, and teeth
▫Form neural plate, neural groove, neural tube, and neural crest
▫Form digestive, urinary, and respiratory systems
Endodermal Structures
▫Form digestive, urinary, and respiratory systems
-By the end of this period the embryo will have a distinguishable human resemblance as it begins to curl .
week 4 prenatal development
▫Beginning of organogenesis
▫Brain tissue
▫Peripheral nerves
▫Limbs
▫Cardiorespiratory structures
▫Beginning of spinal cord formation
▫Neural tube defects can occur such as spina bifida
▫Limb development will progress in cephalocaudal and proximodistal (from the center, or midline, moving outward
weeks 5 +6 prenatal development
▫Critical changes in most body organs and systems
▫Significant changes to head
-Primitive eyes covered by eyelids
-Auricular hillocks and primitive external ear canals
-Initiation of the division of the heart into atrial and ventricular chambers
-Brain waves can be recorded
weeks 7 +8 prenatal development
▫Formation of cartilage and beginning of ossification
▫Heart has primitive aorta, carotid, subclavian, and pulmonary arteries
▫Cloaca separates into urogenital and anorectal tubes
▫Craniofacial bones will emerge
▫Most sensitive period in the development of the limbs, exposure to teratogens during this period will affect the limbs
▫Embryo will be approximately 5cm long with a well defined head
weeks 9 to 12 prenatal development
▫Grows; body parts become more detailed
▫Systems become functional
▫Cartilaginous skeleton visible
▫Vascularization (growth of blood cells) continues
weeks 13 to 16 prenatal development
▫Enhanced coordination as a result of neuromuscular system refinement
▫The entire body will be more proportional
▫Ossification will be very active identifying many of the bone through ultrasound
▫Blood will begin to reach the lung epithelium as a result of ongoing capillary proliferation
weeks 17 to 20 prenatal development
▫Enhanced coordination as a result of neuromuscular system refinement
▫The entire body will be more proportional
▫Ossification will be very active identifying many of the bone through ultrasound
▫Blood will begin to reach the lung epithelium as a result of ongoing capillary proliferation
weeks 21 to 25 prenatal development
▫Enhanced probability of survival for infants born prematurely
▫Oligohydramnios –Decreased amniotic fluid secondary to decreased production of urine by obstruction of the urinary tract
▫ Polyhydramnios – Any problem that interferes with the fetus’s ability to swallow
weeks 30 to 34 prenatal development
▫Reaches 2500g (5 ½ lb) mark
▫Born after this point:
-No longer considered premature by weight
-Requires minimal transitional temperature support
Some born around this time will have frequent respiratory difficulties
weeks 35 to 38 prenatal development (full term)
.From deep sleep to crying; smooth transitions between states
.Gain approximately 2lbs
.Fat will accumulate at a rate of 14g per day in the final weeks of pregnancy
MORO REFLEX
Onset: prenatal
Integration: 5-6 mths
Position: supine w/ head midline
Procedure: support infants head & shlds w/ hands and allow head to drop back 20-30°
Response: Abduction of the UEs w/ ext of elbows, wrists, & fingers followed by adduction of arms at shoulders & flex at the elbows
ROOTING REACTION
Onset: prenatal
Integration: 5-6 mths
Position: supine w/ head midline
Procedure: support infants head & shlds w/ hands and allow head to drop back 20-30°
Response: Abduction of the UEs w/ ext of elbows, wrists, & fingers followed by add of arms at shlds & flex at the elbows
Plantar Grasp Reflex
Onset: birth-2mths
Integration: 4-11 mths
Position: supine
Procedure: place firm pressure on volar aspect of foot directly below the toes
Response: plantar flexion of toes
PALMAR GRASP REFLEX
Onset: birth-2 mths
Integration: 4-11 mths
Position: supine w/ head midline
Procedure: Place index finger into hand w/ pressure over MCPs
Response: Fingers will flex over the examiner’s.
Asymmetric Tonic Neck Reflex
Onset: Birth- 2 mths
Integration: 4-6 mths
Position: supine
Procedure: Turn child’s head to the side
Response: Extension of the arm and leg to which the face is turned along w/ flex of the opposite limbs, producing a “fencing” position
TONIC LABYRINTHINE REFLEX (PRONE)
Onset: Prenatal
Integration: 6 mths
Procedure: observe posture in prone
Response: prone: flexor tone dominates, child will not lift head
Supine: extensor tone dominates (child will not flex in pull to sit)
GALANT’S RESPONSE
Onset: Prenatal
Integration: 4-6 mths
Position: Place infant prone over your hand
Procedure: stroke w/ pressure along a paravertebral line
Response: Trunk curves w/ shortening on the stimulated side
PLACING REACTIONS
Onset: Arms=birth
Legs=prenatal
Integration: end of first postnatal mth
Position: Hold child upright
Procedure: brush dorsum of hand/foot against tabletop
Response: limb will lift in flex and then extend as if to place it on the table
behavioral state stages
Behavioral State I – deep sleep
Behavioral State II – active, or REM, sleep
Behavioral State III – from sleep to wakefulness
Behavioral State IV – quiet alert. Infant does not have a lot of movement. Extremely imp in establishing social relationships and early learning.
Behavioral State V – active alert
Behavioral State VI– crying. Infant is aroused by crying so does not engage interaction