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Pediatrics (SE) > Cerebral Palsy > Flashcards

Cerebral Palsy Flashcards

1
Q

What is cerebral palsy? What does it cause?

A
  1. Non-progressive lesion to immature brain during the perinatal period
  2. Results in motor deficits and possible sensory deficits
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2
Q

List 3 possible pathophysiology underlying cerebral palsy.

A
  1. Subependymal hemorrhage
  2. Encephalopathy secondary to anoxia or hypoxia
  3. Neuropathy secondary to CNS malformation
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3
Q

What are the 4 subtypes of CP?

A
  1. Spastic
  2. Ataxia
  3. Athetoid
  4. Hypotonic
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4
Q

____ is the most common type of CP.

A

Spastic

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5
Q

The ____ extremity is typically more affected with quadriparesis/hemiparesis and the _____ extremity is more affected with diparesis.

A

UE more affected with quad and hemiparesis

LE more affected with diaparesis

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6
Q

Describe muscle tone in spastic, ataxic, athetoid, and hypotonic CP.

A 
Spastic = increased tone
Ataxic = slightly decreased tone
Athetoid= fluctuates 
Hypotonic = decreased tone
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7
Q

Describe reaching in spastic, ataxic, athetoid, and hypotonic CP.

A 
Spastic = difficulty getting to object/may move in opposite direction
Ataxic = overshoot in small ranges
Athetoid= overshoot in large ranges 
Hypotonic = hard to generate initial muscle power
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8
Q

Describe the movements seen in spastic and hypotonic children with CP.

A

Spastic: limited movement, movement available in small ranges

Hypotonic: difficulty moving against gravity

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9
Q

Describe the movement seen in ataxic CP.

A

Locks in midrange especially in the trunk

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10
Q

Describe the movement seen in athetoid CP. (3)

A
  1. Excessive, wide range movement
  2. No mid range control or gradation of movement
  3. Rarely in midline
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11
Q

Describe the righting and equilibrium reactions seen in all 4 types of CP.

A

Spastic: limited dependent on degree of spasticity

Ataxic: unreliable, slow initiation then overreacts

Athetoid: Present but exaggerated and disorganized

Hypotonic: minimal response seen

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12
Q

Describe the mobility seen in spastic CP. (2)

A
  1. Bunny hops using arms
  2. Walks with flexed hips and knees, legs internally rotated and adducted, lumbar lordosis, thoracic kyphosis with retracted arms
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13
Q

Describe the mobility seen in ataxic CP. (2)

A
  1. Slightly crouched gait with decreased arm swing and no trunk rotation
  2. Visually fixates on an object
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14
Q

Describe the mobility seen in athetoid CP. (2)

A
  1. Bunny hops using legs

2. Walks with high stepping gait (excessive flexion) or shuffling gait

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15
Q

Describe the mobility seen in hypotonic CP.

A

Walking with legs flexed but with external rotation, flat feet, arms rolled in

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16
Q

List 2 treatment principles to consider when treating children with spastic CP.

A
  1. Slow movement to reduce tone

2. Experience a wide variety of movement and positions

17
Q

List 2 treatment principles to consider when treating children with ataxic CP.

A
  1. Speedy weight shifting

2. Transitional movements especially those with trunk rotation

18
Q

List 2 treatment principles to consider when treating children with athetoid CP.

A
  1. Graded movement
  2. Midrange control
  3. Weight shifting in small range
19
Q

List 2 treatment principles to consider when treating children with hypotonic CP.

A
  1. Bouncing and joint compression to increase tone

2. Increase movement against gravity

20
Q

List 7 primary impairments associated with CP.

A
  1. Insufficient force generation
  2. Altered muscle tone (spasticity)
  3. Abnormal muscle extensibility
  4. Exaggerated/hyperactive reflexes
  5. Poor selective muscle activity
  6. Poor anticipatory regulation
  7. Impaired motor memory (emphasize repetition in treatment)
21
Q

List 4 secondary impairments associated with CP.

A
  1. Skeletal malalignment (femoral anteversion, femoral/tibial torsion)
  2. Abnormal mechanical characteristics to muscle (hypoextensibility-stiffness)
  3. Hyperextensibility (overlengthening)
  4. Atrophy of fast fibers
22
Q

List 3 functional limitations associated with CP.

A
  1. Delayed developmental skills
  2. Limited inefficient mobility
  3. Limited functional skills
23
Q

List 2 gait predictors for children with CP.

A
  1. Sit independently by 24 months

2. Walk before age 8

24
Q

List 4 gait deviations that may be present in children with CP (gage 1991).

A
  1. Abnormal PF/knee extension couple
  2. Crouched gait
  3. Limited swing phase knee motion
  4. Weak abductors & gastroc/soleus
25
Q

List 4 characteristics of the GMF Classification System.

A
  1. 5 levels
  2. Ordinal system
  3. Self initiated movement (emphasis on sitting and mobility)
  4. Present level of function (usual NOT best performance)
26
Q

List the 5 levels of the GMF classification system.

A

Level 1: Walks without restrictions; limitations in more advanced GM skills
Level 2: Walks without assistive devices, limited outdoor and community ambulation
Level 3: Walks with assist. Devices; limitations walking outdoors/in community
Level 4: Limited self mobility; transported/power mobility outdoors/in community
Level 5: Self mobility severely limited even with assistive technology

27
Q

List 8 things to assess when evaluating a patient with CP.

A
  1. ROM
  2. Muscle tone
  3. Muscle strength
  4. Skeletal alignment
  5. Reflexes/reactions
  6. Developmental/functional skills
  7. Gait
  8. Cognitive
28
Q

List 4 assessment tools used to asses patients with CP.

A
  1. Movement Assessment of Infants (MAI)
  2. Gross Motor Function Measure
  3. PEDI
  4. WeeFIM
29
Q

What is a Quality based tool for 4 months of age (picks up early signs of CP)?

A

Movement Assessment of Infants (MAI)

30
Q

List 4 abnormal/immature patterns apparent at the neck in CP patients.

A
  1. Hyperextension
  2. Shoulder elevation
  3. Inactive scapula
  4. Head and neck asymmetry (persistent ATNR)
31
Q

List 3 abnormal/immature patterns apparent at the shoulder in CP patients.

A
  1. Prolonged extension of upper extremities
  2. Lack of scapular activity/ dissociation (hooked to GH joint movement)
  3. Poor weight bearing
32
Q

What 2 things can occur as a result of an anterior pelvic tilt and poor abdominal strength?

A
  1. Overuse of hip external rotation and flexion for balance and weight shifting
  2. Substitutes lateral flexion to weight bearing side
33
Q

What 3 things can occur as a result of an posterior pelvic tilt and over active extensors?

A
  1. Adduction and internal rotation
  2. Sacral sitting with knee flexion
  3. W sitting for function, bunny hopping

Pediatrics (SE) (18 decks)

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