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Neuro > (8) Cerebral Palsy > Flashcards

(8) Cerebral Palsy Flashcards

1
Q

What is cerebral palsy?

A
  • involves a disorder of mvmt and posture
  • permanent but not unchanging
  • due to non progressive interference
  • interference in developing brain
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2
Q

What are the risk factors for CP (6)?

A
  • prematurity
  • low birth rate
  • TBI
  • infection
  • placenta complications
  • complications @ birth
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3
Q

What are causes of CP?

A
  • Periventricular Leukomalacia (PVL)
  • Intraventricular Haemorrhage (IVH)
  • Hypoxic-Ischaemic Encephalopathy (HIE)
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4
Q

What is Periventricular Leukomalacia?

A
  • damage to the white matter
  • damage to myelin, slowing and impeding nerve transmission
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5
Q

What are the major factors in periventricular leukomalacia?

A
  • decreased blood (ischaemia) or O2 (hyoxia) flow to PV region
  • Hypoxic-ischaemic incidents damage to the blood brain barrier (BBB)
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6
Q

What does the blood brain barrier do?

A
  • regulates flow of nutrients to brain
  • supports neurons throughout nervous sysetm
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7
Q

What are the risk factors for PVL (7)?

A
  • premature birth 26 weeks
  • low birth weight (1500g)
  • intrauterine infection
  • infection around time delivery
  • placental blood vessel conditions
  • vaginal bleeding
  • hypotension, hypoxaemia
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8
Q

When may an intraventricular haemorrhage occur?

A

PVL may be accompanied by a haemorrhage or bleeding in the periventricular-intraventricular area

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9
Q

What happens in the brain in a PVL?

A
  • enlarged ventricles
  • loss white matter
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10
Q

What happens in the brain in an IVH?

A
  • bleeding in ventricles
  • injury white matter
  • cell damage
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11
Q

How does an intraventricular haemorrhage occur?

A
  • most common 48hrs birth
  • changes BP cause delicate blood vessels rupture
  • results loss O2 to tissue
  • swelling & obstruction can lead to hydrocephalus
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12
Q

What are risk factors for IVH (6)?

A
  • premature birth
  • low birth weight
  • placental blood clots
  • weak blood vessels brain
  • maternal high BP or infection
  • shaken baby syndrome
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13
Q

What causes hypoxic-ischemic encephalopathy?

A
  • O2 deprivation to the brain
  • if lasts too long, brain tissue destroyed
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14
Q

What are impairments that can be seen as a result of hypoxic-ischemic encephalopathy (5)?

A
  • epilepsy
  • developmental delay
  • motor impairment
  • neurodevelopmental delay
  • cognitive impairment
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15
Q

What areas of the brain will mild hypoxia affect?

A

parasagittal white matter

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16
Q

What areas of the brain will severe hypoxia affect?

A
  • putamen
  • thalamus
  • paracentral white matter
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17
Q

What are the risk factors for hypoxic-ischemic encephalopathy?

A
  • acute maternal hypotension
  • blood containing less O2
  • cardiac complications
  • pressure to cranium changing its shape
  • impaired blood flow to brain
  • injury from umbilical cord complications
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18
Q

How is CP diagnosed?

A
  • MRI
  • Medical Hx
  • Reflexes
  • Motor skills Ax
  • Differential diagnosis
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19
Q

What are the two types of spastic CP?

A
  • Bilateral spastic CP
  • Unilateral spastic (hemiplegia) CP
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20
Q

What are features of Spastic CP?

A
  • increased tone
  • increased reflexes
  • pyramidal signs (Babinski)
  • abnormal pattern movement & posture
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21
Q

What are the two types of Dyskinetic CP?

A
  • Dystonic
  • Choreo-athetotic
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22
Q

What are features of dyskinetic CP?

A
  • involuntary, uncontrolled, recurring movements
  • primitive reflex patterns
  • muscle tone varying
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23
Q

What are features of ataxic CP?

A
  • loss ordinal muscular coordination
  • movements performed with abnormal force, rhythm & accuracy
24
Q

What is the GMFCS used for?

A

Classification tool for predicting outcomes in people with CP

25
Q

What are the 5 different grades of GMFCS?

A

I - walk & climb stairs w/o limitations
II - walk & climb stairs using handrails w some limitations
III - assistive mobility device
IV - walker or wheeled mobility
V - restricted voluntary control of movement

26
Q

What is the Manual Ability Classification System?

A

highlights the child’s ability to handle objects in important daily activities

27
Q

What is the Communication Function Classification System (CFCS)?

A
  • used to assess everyday communication and focuses on how info is expressed and received
  • can be used assess all methods of comms
28
Q

What are the 5 grades of CFCS?

A

I - effective sender & receiver with familiar & unfamiliar
II - effective sender & receiver but slower paced
III - effective sender & receiver with familiar
IV - inconsistent sender/receiver w familiar
V - seldom effective sender/receiver w familiar

29
Q

What are some characteristics of hypertonia (6)?

A
  • stiffness
  • restricted movement
  • associated reactions
  • unreliable balance
  • abnormal co-contraction
  • poor alignment
30
Q

What are some characteristics of hypotonia?

A
  • difficulty moving against gravity
  • poor head & trunk control
  • ligamentous laxity
  • hypermobile joints
  • spasticity, ataxia & athetosis
31
Q

What are some characteristics of Ataxia (7)?

A
  • tone low to normal
  • poor grading & coordination
  • excessive small movements
  • poor selectivity
  • poor proximal stability
  • unreliable balance reactions
  • speech difficulties
32
Q

What are some characteristics of dyskinetic CP athetosis (4)?

A
  • involuntary movements
  • fluctuating tone
  • poor muscle control
  • unreliable balance reactions
33
Q

What are some characteristics of dyskinetic CP dystonia? (4)

A
  • fluctuating tone from high to low
  • fast movements
  • torsional element
  • wide range of movements
34
Q

What are the subtypes of dyskinetic CP (4)?

A
  • Pure athetosis
  • choreo
  • athetosis with spasticity
  • dystonic athetosis
35
Q

What are factors that impact muscle tone in CP (6)?

A
  • lack movement
  • repetition abnormal movements
  • type of stimulation
  • effort
  • illness
  • height/weight gain
36
Q

What are additional impairments of CP?

A
  • intellectual
  • speech and language
  • visual & hearing
  • sleep
  • epilepsy
  • perceptual & motor planning
37
Q

What are secondary musculoskeletal deformities of CP?

A
  • muscle/tendon contractures
  • bony torsion
  • hip displacement
  • spinal deformity
38
Q

What are the secondary musculoskeletal deformities of CP related to (6)?

A
  • physical growth
  • muscle tone
  • ageing
  • motor activity
  • distribution
  • types of CP
39
Q

What are activity limitations that patients with CP have?

A

difficulties an individual may have when executing a task or action

40
Q

What are participation limitations that patients with CP have?

A

problems an individual may have in involvement in life situations

41
Q

What according to the ICF are some body functions and structures that may be affected in an individual with CP?

A
  • muscle tone, power, length
  • reflexes
  • postural control
  • joint ROM
42
Q

What during assessment according to the ICF are some Activities that may be affected in an individual with CP?

A
  • gait observation
  • gross and fine motor development
  • sports
43
Q

What during assessment according to the ICF is participation that may be affected in an individual with CP?

A
  • community and social events
  • school and life after school
  • home life
  • learning and applying knowledge
44
Q

During assessment, what are some environmental and personal factors that may be investigated in a patient with CP?

A
  • environmental mods
  • family dynamics/considerations
  • family disability journey
45
Q

What is involved in an objective Ax for an individual with a GMFCS score of 1-3?

A
  • developmental infant Ax
  • GMFM 66
  • functional walk test
  • 6MWT
  • orthopaedic Ax
  • postural Ax in lying, sitting & standing
  • gait Ax
46
Q

What is the gross motor function measure (GMFM)?

A
  • standardised test used to assess gross motor skill development
  • 88/66 items examine
  • lying, sitting, crawling, kneeling, standing, walking etc
47
Q

What is involved in an objective Ax for an individual with a GMFCS score of 4-5?

A
  • developmental infant Ax
  • GMFM 66/88
  • Orthopaedic Ax
  • Postural Ax in lying, sitting & standing
48
Q

What is meant by the term postural management?

A

used to describe everything that has an impact on a childs postural ability

49
Q

What is 24 hour postural management?

A

should consist of a program which is incorporated into the lifestyle/activities of the individual and is applied throughout 24 hours

50
Q

What is involved in 24 hour postural management?

A
  • postural management equipment
  • individual therapy sessions
  • active exercise
  • orthotics
  • medication
  • surgery
51
Q

What are important things for individuals with CP to avoid when sleeping?

A
  • sleeping curled
  • lying with knees together
52
Q

What is the Bobath Concept Framework?

A
  • based on clinical observation & analysis
  • holistic
  • a way of thinking, observing, & interpreting what a client is doing, then adjusting what we do in the form of techniques
  • Dont teach them how to move, facilitate them to move
53
Q

What does an intervention for an individual with CP involve (6)?

A
  • handling to promote function
  • hands on when child learning activity, hands off when they can do it
  • start generally then move more specific treatment
  • Developmental function in early years
  • muscle strength training
  • orthosis
54
Q

What are the integral parts of an intervention for an individual with CP?

A
  • Parent, family, child involvement
  • education
  • self management
  • needs and goals
55
Q

What are additional services for individuals with CP?

A
  • Spasticity management clinic
  • hip surveillance programme
  • spinal surveillance programme
  • orthopaedic conditions
  • orthotics clinic
56
Q
A

Neuro (11 decks)

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