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PT 641 Peds > Cerebral Palsy > Flashcards

Cerebral Palsy Flashcards

1
Q

a group of permanent disorders of the development of movement and posture, causing activity limitations that are attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain.

A

CP

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2
Q

what is the most common motor disability in children

A

CP (1-4/1000)

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3
Q

what factors increase prevalence of CP in children

A

low birth weight and those born before 28 weeks gestation

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4
Q

common risk factors for prenatal CP (most common)

A

vascular events, congenital brain malformations, maternal infections, multiple gestations

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5
Q

common risk factors perinatal (during birth)

A

umbilical prolapse, obstructed labor, placental abruption

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6
Q

common risk factors postnatal

A

infections, blood disorders, injuries

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7
Q

are low or high APGAR scores associated with CP

A

Low (0-3)

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8
Q

what is the cutoff age to begin to worry about asymmetry

A

4 m/o

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9
Q

what are the key elements in diagnosing CP

A

Motor skills/development
Non-progressive sx
Neuroimaging

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10
Q

bleeding into the ventricles only

A

Intraventricular Hemorrhage (IVH)

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11
Q

bleeding into the tissue around the ventricles only

A

Germinal Matrix Hemorrhage (GMH)

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12
Q

bleeding into both the ventricles and tissues around the ventricles

A

Periventricular Intraventricular Hemorrhage (PIVH)

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13
Q

may develop in these areas as the hemorrhage resolves

A

Periventricular Cyst (PVC)

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14
Q

grading for hemorrhages

A

I-IV (least to most severe)

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15
Q

Ischemic lesion in areas adjacent to the lateral ventricles

A

Periventricular Leukomalacia (PVL)

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16
Q

major cause of CP in infants born preterm (<32 weeks)

A

Periventricular Leukomalacia (PVL)

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17
Q

Focal periventricular necrosis and more diffuse white matter cerebral injury

A

Periventricular Leukomalacia (PVL)

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18
Q

where is there damage to in PVL

A

cortical spinal tracts

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19
Q

are the LE or UE more affected in PVL and why

A

LE (spastic diplegia) because LE cortical tract is closest to the ventricles

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20
Q

what are the 3 ways to classify CP

A

type of movement abnormality related to tone
anatomical distribution of involved areas
functional abilities (GMFCS)

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21
Q

3 types of tone related to CP

A

spastic, ataxic, dyskinetic

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22
Q

one extremity involved

A

monoplegia

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23
Q

UE and LE on same side and trunk involved

A

hemiplegia

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24
Q

all extremities and trunk involved with LE more involved than UE

A

diplegia

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25
Q

equal involvement of all extremities and trunk

A

Quadriplegic

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26
Q

Classification based on gross motor function in kids with CP
Standardized system to measure severity of movement of the disability

A

gross motor function classification system (GMFCS)

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27
Q

what is the most prominent type of CP

A

spastic

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28
Q

velocity dependent hypertonicity characterized by resistance to passive stretch that increases with increased speed of movement; hyperactive stretch reflex

A

spasticity

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29
Q

how can spasticity lead to histological muscle tissue changes

A

Decreased longitudinal growth of muscle fibers
Decreased muscle volume
Change in muscle unit size

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30
Q

most common form of spastic CP

A

diplegia

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31
Q

White matter infarct in periventricular area caused by hypoxia
Primarily affects b/l LE

A

spastic diplegia

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32
Q

Increased lordosis
Anterior pelvic tilt
B/L hip IR
B/L knee flexion
Toe in
Equinovalgus foot position

A

spastic diplegia

33
Q

Large range of motor function/gat abilities
Cognition is usually typical
May have social/emotional issues

A

diplegia

34
Q

Periventricular white matter abnormalities most common cause
UE and LE on same side of the body are affected
(UE>LE )

A

Spastic Hemiplegia/Unilateral

35
Q

Scapular protraction
Elbow flexion
Forearm pronation
Wrist flexion
Ulnar deviation
Posterior pelvic rotation
Hip IR and flexion
Knee flexion
Ankle plantar flexion

A

Spastic Hemiplegia/Unilateral

36
Q

Usually able to achieve all developmental milestones but with delays
Delay of bimanual skills depending on severity of UE involvement
Usually have typical cognition/intelligence, may have social/emotional deficits

A

Spastic Hemiplegia/Unilateral

37
Q

Impairment of voluntary muscle control of UE, LE, neck/trunk muscles
Wide range of cognitive abilities from typical to severe impairment
Gross and fine motor delays

A

Spastic Quadriplegia

38
Q

PVL lesions most often seen, or lesion of basal ganglia or occipital region&raquo_space; seizures, visual impairments
Function: Wide range from household ambulation or complete dependent care

A

Spastic Quadriplegia

39
Q

movement is uncontrolled and involuntary

A

dyskinetic

40
Q

dyskinetic typically has abnormalities in the deep gray matter such as

A

basal ganglia and thalamus

41
Q

what is the hallmark sign of dyskinetic CP

A

hypotonia

42
Q

Infants show little to no antigravity movements in first few months
Movement characterized by bursts of activity

A

dyskinetic

43
Q

what are the 3 subtypes of dyskinetic CP

A

athetosis, dystonia, choreoathetosis

44
Q

means without fixed posture (constant, slow movements)

A

athetosis

45
Q

Involuntary movements that are slow and writhing, continuous and prevent sustaining of stable posture
Posture is asymmetric extension of trunk
Movements are abnormal in timing and direction
Often unable to produce speech due to unable to control breathing
Cognition is often normal to above-normal intelligence

A

athetosis

46
Q

Global decrease in stiffness/tone proximal to distal
Inability to grade muscle activation
Muscle termination tends to be passive

A

athetosis

47
Q

Asymmetry of spine and hips
Joint hypermobility
Poor ability to produce force (decreased strength)

A

athetosis

48
Q

Fluctuations in respiration rate and rhythm
Poor breath support

A

athetosis

49
Q

Movement disorder characterized by sustained muscle contraction with twisting, repetitive movements and abnormal postures
Sustained muscle contraction when trying to move
Low tone at rest
Often resembles spasticity due to co-contraction and overflow into extraneous muscles
Large variability in body position and movement

A

dystonia

50
Q

means dance

A

Choreoathetosis

51
Q

Involves brief, jerky, random movements
Differs from athetosis in duration and continuity of movements
In CP, almost never seen in isolation, will usually be classified along with another type of dyskinetic CP

A

Choreoathetosis

52
Q

A disorder of balance and control in timing and coordination movements

A

ataxia

53
Q

where due lesions occur with ataxia

A

cerebellum

54
Q

Often in combination with spasticity and athetosis
Often use musculoskeletal system to extremes to support posture
Poor processing of sensory information

A

ataxia

55
Q

common characteristics of ataxia

A

weakness, incoordination, wide based gait, tremor, dysmetria, hypotonia

56
Q

Often correlated to congenital abnormalities
Wide range of functional abilities
Can be main form of motor dysfunction or as a precursor to athetosis or spasticity

A

hypotonia

57
Q

Decreased stiffness/tone throughout trunk and extremities
Difficulty sustaining most muscle groups
Passive termination of muscle activity

A

hypotonia

58
Q

Joint hypermobility
Muscle contractures
Poor force production

A

hypotonia

59
Q

Decreased breath support
Poor cough
Decreased cardiovascular fitness

A

hypotonia

60
Q

Origin in weakness in CNS dysfunction

A

Force Production Deficit

61
Q

Inability to fractionate/isolate movement associated with moderate or greater hyperexcitability

A

Fractionated Movement Deficit

62
Q

fractionated movement deficit is always associated with what type of deficit

A

CNS

63
Q

Slowness in initiating and executing movement

A

hypokinesia

64
Q

Inability to grade forces appropriately for the distance and speed aspects of a task
Associated with cerebellar dysfunction

A

Dysmetria

65
Q

Systemic effect on muscle tone
Inhibit the release of excitatory neurotransmitters or increase release of inhibitory neurotransmitters

A

Oral anti-spasticity medications

66
Q

Diazepam (Valium) and Baclofen effect the binding and transmission of GABA receptors at what level

A

spinal level

67
Q

Dantrolen is an anti-spasticity medication that acts directly on

A

skeletal muscle

68
Q

Regional effect on spasticity
Neurosurgical implantation of pump into abdomen with catheter inserted intrathecally

A

Intrathecal Baclofen Pump

69
Q

ways to treat spasticity

A

oral medications, intramuscular injections, neurosurgical interventions, botox, selective dorsal rhizotomy (SDR)

70
Q

increased resting muscle tension

A

hypertonia

71
Q

Toe curling, fisting hands, difficulty moving a body part (actively or passively), asymmetric posture, arching

A

hypertonia

72
Q

decreased resting muscle tension

A

hypotonia

73
Q

Collapse of body segments, loss of postural alignment, inability to sustain a posture against gravity

A

hypotonia

74
Q

resistance to passive movement at 2 speeds

A

tardieu scale

75
Q

angle of muscle reaction, point of first catch, functional ROM

A

R1

76
Q

full PROM

A

R2

77
Q

17 parameters assessed on each LE at foot, knee, hip and trunk in sagittal, frontal, and transverse planes

A

Edinburgh Visual Gait Score (EVGS)

78
Q

Assesses ability to perform isolated joint movement without using mass flexor/extensor patterns or undesired movement at other joints
Selective motor control is a predictive factor of functional ability in children with CP
Tests hip, ankle, knee, subtalar joint and toes

A

Selective Control Assessment of the LE (SCALE)

PT 641 Peds (16 decks)

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