Cerebral Palsy Flashcards

1
Q

Components of muscle tone

A
Neural = innervation component
Mechanical = elastic component
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2
Q

Hypotonia

A

“Low muscle tone”

Decreased ability to generate voluntary muscle force

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3
Q

Hypotonia symptoms

A

Decreased strength, hypermobile joints, increased flexibility, rounded shoulders, delayed motor skills, leans on supports, poor attention and motivation, decreased activity tolerance, improvement with therapy

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4
Q

Hypertonia

A

“High muscle tone”

“Greater than normal resistance found with passive ROM of a limb”

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5
Q

Hypertonia symptoms

A

Neurally mediated stiffness (active and passive), increased resistance of muscle to stretch, tends to increase in age until 4 and then decreases till 12 and stabilizes

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6
Q

Spastic catch (R1/R2)

A
R1 = first point of resistance
R2 = last point you can reach (end of ROM)
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7
Q

Spasticity and reflexes

A

Absence of automatic postural reflexes

Persistence of primitive reflexes

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8
Q

Modified Tardieu Scale

A

Spasticity. ID’s the neural component.
Relationship of R2-R1:
- Large difference = neural component
- Small difference = mostly musculoskeletal component

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9
Q

APGAR acronyms

A
A = activity
P = pulse
G = grimace
A = appearance
R = respiration
*Scores range = 0-2
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10
Q

Before 2nd birthday Level I GMFCS

A

Minor amount of difficulty

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11
Q

Before 2nd birthday Level II GMFCS

A

Might need hands for support

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12
Q

Before 2nd birthday Level III GMFCS

A

Need for AD in later years

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13
Q

Before 2nd birthday Level IV GMFCS

A

Head control but needs trunk support

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14
Q

Before 2nd birthday Level V GMFCS

A

Difficulty holding head upright in anti-gravity position; assistance needed for rolling

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15
Q

Between 2nd and 4th birthday Level I GMFCS

A

Often walk as preferred mobility

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16
Q

Between 2nd and 4th birthday Level II GMFCS

A

Use AD or cruise

17
Q

Between 2nd and 4th birthday Level III GMFCS

A

Still walking indoors with AD

18
Q

Between 2nd and 4th birthday Level IV GMFCS

A

Less ambulatory capability. Still creeping, non-reciprocal hands and knees crawling

19
Q

Between 2nd and 4th birthday Level V GMFCS

A

No means of independent mobility. May use power mobility option

20
Q

Manual Ability Classification System

A

Same as GFMCS only for fine motor

21
Q

Motor milestones in children with CP

A

Sidelying with hands in midline > head and hands in midline while in seat > prone on elbows with head up > lifts feet off floor in supine and rolls over > plays in prone/belly crawls > sits propped up on both arms > attains quadruped > squat to stand > heel sits holding stable object > heel sits holding stable object with one hand free > heel sits with both hands free > creeps on hands and knees reciprocally > sits erect on bench > cruises > walks with reverse walker > walks with forearm crutches > stands without support > walks alone

22
Q

Other domains affected by CP

A

Cognitive delays/learning disabilities, speech delays, auditory impairments, seizure disorders, vision problems

23
Q

CP classification according to body area affected

A

Monoplegia (one limb) - rare
Diplegia (lower extremities)
Hemiplegia (unilateral)
Quadriplegia (entire body)

24
Q

CP classification according to movement abnormality

A

Spastic - abnormally increased tone
Athetoid (dyskinesia) - fluctuating tone
Ataxic - cerebellar lesion causing wild, uncontrolled movements
Hypotonic - low tone (no lesion found, just gross motor hypotonia)

25
CP classification according to severity
GMFCS
26
How common types of CP are
``` Spastic diplegia = most common (41.5%) Spastic hemiplegia = second most common (36.4%) Athetoid (dyskinesia) = 10% Spastic quadriplegia = 7.3% Ataxic = least common (5%) ```
27
CP causes
Coagulation disorders, intrauterine exposure to infection or inflammation, asphyxiating birth complications, intracranial hemorrhage
28
Types of CP neuropathic lesions ID'd
Neuropathy due to subdural hemorrhage (IVH) Encephalopathy caused by anoxia or hypoxia (HIE) Neuropathy due to malformation of the CNS Periventricular Leukomalacia (PVL)
29
CP is diagnosed when
Child does not meet gross motor milestones, exhibits abnormal muscle tone, or movement patterns with asymmetry. It should be diagnosed in all but the mildest cases by 6 mo AIMS, TIMP, GMA