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Pediatrics > Cerebral Palsy > Flashcards

Cerebral Palsy Flashcards

1
Q

Cerebral Palsy: defenintion

A

“A group of permanent disorders of the development of movement and posture, causing activity limitations that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain”

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2
Q

Comorbidities often occurring with CP

A

Sensation and sensory processing involvement
Perception
Cognition
Communication and speech issues

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3
Q

Issues with diagnosis of CP

A

Difficult due to the plasticity of the developing brain
Can use MRI and cranial ultrasound
Often won’t be diagnosed until age 3

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4
Q

Presentation of CP

A

Abnormal muscle tone
Atypical posture
Movement with persistent reflexes
Non-progressive lesion

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5
Q

Diagnoses which mimic CP

A

Metabolic disorders
Mitochondrial disorders
(rule out with family history)

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6
Q

Intraventricular hemorrhages (IVH)

A

bleeding INTO the ventricles

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7
Q

Germinal matrix hemorrhages (GMH)

A

bleeding into the tissues AROUND the ventricles

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8
Q

Periventricular Intraventricular hemorrhages (PIVH)

A

bleeding into ventricles AND surrounding tissue

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9
Q

Periventricular cyst (PVC)

A

may form in the area where the bleed occurred once the acuteness has resolved

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10
Q

Known risk factors for development of CP

A

Injury during critical periods of brain development

Periventricular white matter is most sensitive to insult/injury between 24-34 wks of gestation

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11
Q

Spastic CP

A

Increased resistance to passive movements, spasticity increases with increased velocity and movement
Associated with lesion in cerebral cortex
Hemi, Di, and Quad

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12
Q

Hypotonic CP

A

Infants can present with hypotonia and transition to spasticity or ataxia

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13
Q

Dyskinetic CP

A

Uncontrolled movement
Athetoid and Dystonic
Deep gray matter lesions
Sometimes periventricular white matter lesions

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14
Q

Athetoid CP

A

Slow, writhing movement

Associated with lesion in basal ganglia

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15
Q

Ataxic CP

A

Balance and control disorder
Weakness, incoordination, wide based gait, noted tremor
Associated with cerebellar infarct

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16
Q

Diplegia

A

Most common form of spastic CP
Primarily affects LEs
Infarct in white matter of periventricular area caused by hypoxia
Usually normal cognition

17
Q

Hemiplegic

A

UE and LE on same side of body affected
Cognitive function normal
Social and emotional deficits
Minimal equipment requirements

18
Q

Quadriplegic

A

Volitional muscle control of 4 extremities severely impaired
Periventricular white matter lesions
Variable cognitive affects
Requires significant equipment through life span

19
Q

GMFC level I

A

Independent

20
Q

GMFC level II

A

Walks without assistive devices

Limited in outdoor and community level ambulation

21
Q

GMFC level III

A

Walks with assistive devices

Limited in outdoor and community level ambulation

22
Q

GMFC level IV

A

Self-mobility with limitations

Children are transported or use power mobility outdoors and in community

23
Q

GMFC level V

A

Difficulty controlling all movements

Self mobility severely limited even with use of assistive technology

24
Q

4 main brain lesions resulting in hemiplegic CP

A

Periventricular white matter abnormalities
Cervical-subcortical lesions
Brain malformations
Nonprogressive postnatal injuries

25
Q

4 components of comprehensive assessment

A

Motor attainments
Neurologic signs
Primative reflexes
Postural reactions

26
Q

Gait abnormalities in Spastic Diplegia

A

Limited mobility in L-spine and pelvic girdle
Compensate with more movement of trunk, head, neck and UEs.
Feet can be in valgus outside lateral dimensions of trunk or in narrow BOS with heels off floor in plantarflexion

27
Q

Gait abnormalities in Hemiplegia

A

Asymmetry! Brief/incomplete weight shift on uninvolved LE
UE swing on uninvolved side, Involved shoulder in hyperextension and elbow flexion
Toe walking common, tight gastroc

28
Q

Gait abnormalities in Athetosis

A

Initiates gait with head
High flexion of hip initially during stepping
LE placed into extension with adduction, IR and PF
Thoracic spine excessively flexed with rotation of cervical spine

29
Q

Gait deviations in Diplegia

A 
Equinovarus 
Planovalgus
Crouch
Jump knee
Stiff knee
Recurvatum
Idiopathic toe walking
30
Q

Quadriplegic gait

A

usually not community ambulators

Encourage gait/standing

31
Q

Ataxic gait deviations

A

Widened BOS
Increased double-limb support time
Balance is primary goal in PT

Pediatrics (8 decks)

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