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Pediatrics > Cerebral Palsy > Flashcards

Cerebral Palsy Flashcards

1
Q

Can occur in utero, during or shortly after birth and produces motor as well as other impairments

A

Cerebral Palsy

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2
Q

____________ refers to a constellation of disorders and impairments. It is not a homogenous pattern of dysfunction.

A

Cerebral Palsy

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3
Q

Is CP progressive or non-progressive?

A

A non-progressive neuromotor/neuodevelopmentaldisorder caused by anon progressivedefect or lesion in a single or multiple locations in the immature brain.

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4
Q

Infants with very low birth weight and are very premature are at highest risk of _____

A

CP

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5
Q

In pre-terms can be related to many factors including _______

A
  • anoxia & IVH (Intraventricular Hemorrage) .
  • Lower weight and very pre-mature.

(anoxia from meconium inspiration)

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6
Q

C.P. can be classified or described by the types of impairment or motor disturbance seen

A
  • Spastic
  • Dyskinetic or Athetoid
  • Ataxic
  • Hypotonic
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7
Q
A

Hemiplegia CP

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8
Q

In which type of CP many children may have seizures disorders (35-43%)?

A

Greatest in spastic quadriplegic and hemiplegic

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9
Q

Most common form of CP

A

Spastic Diplegia

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10
Q

In spastic diplegia CP, _____ of the cases are caused by prematurity

A

2/3

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11
Q
A

Spastic Diplegia

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12
Q

In spastic diplegia CP, the Prognosis for independent ambulation is _____

A

good

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13
Q
A

Spastic Quadriplegia

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14
Q

A 5 level system based on descriptions of functional motor abilities with focus on posture and mobility

A

The Gross Motor Function Classification System

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15
Q

These are slow, wriggly, or sudden quick movements of the child’s feet, arms, hands, or face muscles

A

ATHETOSIS

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16
Q

Walks without restrictions; limitations in more advanced gross motor skills i.e.. balance, coordination.

A

Level 1 GMFCS

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17
Q

Walks without assistive devices; limitations in walking outdoor and in the community

A

Level II (GMFCS)

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18
Q

Walks with an assistive mobility devices (including crutches and wheelchairs); limitations walking outdoors and in the community

A

Level III of GMFCS

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19
Q

Self-mobility limitations; walk short distances, are transported or use power mobility outdoor and in the community.

A

Level IV GMFCS

20
Q

Self-mobility is severely limited, even with the use of assistive technology

A

Level V GMFCS

21
Q

intellectual disability and learning problems in CP:

A
  • 50-75%
  • Communication disorders: 25%, related to oral-motor function, central language dysfunction, hearing and cognitive deficits
22
Q

Cerebral palsy children will show classic UMN lesion or LMN?

A
  • Classic UMN lesion
  • Spasticity
  • Clonus
  • BabiskBabinski
  • Increased DTR
23
Q

Babinski sign:

A

where the big toe is raised (extended) rather than curled downwards (flexed) upon appropriate stimulation of the sole of the foot. The presence of the Babinski sign is an abnormal response in adulthood.

24
Q

Selective Motor Control in children with CP:

A

is impaired

e.x. can’t dorsiflex the ankle with the knee extended

25
Q

Strength in children with cerebral palsy:

A
  • WEAKNESS
  • Must do strengthening exercises
26
Q

Neuromotor impairments in children with CP:

A
  • Muscle tone (spasticity)
  • Selective motor control
  • Balance
  • Strenght (weakness)
  • Alignment and WB
27
Q

Major musculoskeletal impairments in children with CP:

A
  • Contractures
  • Hip subluxation / dislocation
  • Torsional Deformities: femoral anteversion, tibial torsion
  • Scoliosis
  • Back Pain
  • Patello-femoral dysfunction
28
Q 
Therapeutic Interventions for CP treatment includes 
Neurodevelopmental Therapy (NDT).

What are the NDT treatment principles?

A
  • Use of Facilitation of effect “Tone”
  • Use of Reflex Inhibiting Postures
  • Use of Key Points of Control
29
Q

Currently ____________ regimes for
individuals with CP have been proven to
be highly effective and have been shown
not to increase spasticity (Daminano)

A

Strengthening

30
Q

Currently in NDT there is a greater focus on:

A 
function and acquisition of skills in a
functional context
31
Q

________________ is an orthosis commonly prescribed for ambulatory children who walk with excessive dorsiflexion and knee flexion (crouched gait) during the stance phase of gait

A

The ground-reaction (also known as floor-reaction) AFO

GRAFO

32
Q
  • Moderate to severe crouched gait
  • Heavier child that solid AFO does not provide enough stability
A

GRAFO

Ground Reaction

33
Q
A

Posterior Leaf Spring AFO

PLS

Hemiplegia (some flexibility for DF)

strong enough to prevent plantar flexion during swing and stance but flexible enough to allow some anterior tibial translation and dorsiflexion from midstance to the beginning of terminal stance

34
Q
A

Supramalleolar Orthoses

SMO

The SMO is typically indicated for the child with good ankle plantarflexion and dorsiflexion control but who needs control of planovarus or planovalgus foot position

35
Q
A

SAFO

A solid AFO with anterior tibial strap and anterior ankle strap is a common orthotic design to provide ankle and foot stability , giving a stable base for children to stand.

36
Q

KAFO

A

Knee Ankle FO

37
Q

HKAFO

A

Hip Knee AFO

not used anymore

38
Q

Interferes with release of acetylcholine at the neuromuscular junction

A

Botulinum Toxin
local dynamic contractures

(not structural)

39
Q

Intrathecal Delivery of Baclofen

A
  • Acts as GABA receptor agonist
  • GABA (gamma-amino butyric acid) is an inhibitory CNS neurotransmitter
  • impedes release of excitatory neurotransmitters
40
Q

Intrathecal delivery of baclofen vs. Oral

A
  • Intrathecal:
    • Lower doses
    • fewer SEs
  • Oral:
    • Low BBB penetration
    • SE
    • Lack of preferential SC distribution
41
Q

Selective Dorsal Rhizotomy (SDR)

A
  • Dorsal sensory nerve roots are severed
  • Often performed on children between ages of 7 and 10 years
42
Q

Selective Dorsal Rhizotomy (SDR) complications

A

possible sensory loss

43
Q

Selective Dorsal Rhizotomy selection and exclusion criteria

A
  • Spastic CP, at least 2 years of age
  • Adequate strength
  • Motivation and ability to participate in P
  • Exclusion: Non-CP, Mixed tone, Rigidity, Severe scoliosis, no potential for functional gains
44
Q

Treatment Options for Patients with Spasticity:

A
  1. Intrathecal Baclofen Therapy
  2. Oral medications: SEs
  3. Injection therapy: botox
  4. Neurosurgery: SDR
  5. Orthopedic surgery
  6. Rehab Therapy
45
Q

GROSS MOTOR FUNCTION MEASURE (GMFM)

A
  • around 5 y/o children with cerebral palsy
  • criterion-referenced
  • can be used for Down syndrome
  • can give one dimension
46
Q

______________ is a neck condition that arises when the spinal cord becomes compressed—or squeezed—due to the wear-and-tear changes that occur in the spine as we age. The condition commonly occurs in patients over the age of 50.

A

spondylotic myelopathy

  • MSK issue in aging with cerebral palsy

Pediatrics (22 decks)

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