Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Movement science 2 > Cerebral Palsy: effects of Atypical Development on motor control and posture > Flashcards

Cerebral Palsy: effects of Atypical Development on motor control and posture Flashcards

You may prefer our related Brainscape-certified flashcards:
Biology 101 flashcards
1
Q

What is CP defined as

A

a group of permanent disorders
- often accompanied by disturbances of sensation, perception, cognition, communication, and behavior, by epilepsy, and by secondary musculoskeletal problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Cerebral Palsy- involvement

A
  • involves one or more extremities
  • trunk is usually involved
  • clinical presentation varies greatly
  • impairments in sensation, perception, cognition, communication, and behavior
  • Seizure disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Epidemiology in CP

A
  • incidence 2/1000 live births
  • higher incidence with males
  • tends to be higher in African Americans than in whites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of CP occur…

A
  • Prenatal 70%
  • peri-natal 5-10% (neonates)
  • post natal 6%
  • most often it is due to low birth weight or maternal factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

CP is associated with what causes

A
  • mechanical trauma
  • traumatic brain injury
  • Atypical uterine growth
  • genetic factors
  • prematurity
  • low birth weight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How to best diagnosis CP

A
  • MRI > CT
  • MRI cannot always be done in the NICU
  • MRI or CT also revels treatable conditions such as hydrocephalus, arterial venous malformation (AVM), subdural hematomas
  • Diagnosis, classification, and treatment are often based on abnormalities tone (where it happened in the brain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Prenatal causes of CP

A
  • Maternal infections eg rubella, herpes simplex
  • inflammation of placenta (chorion)
  • Rh incompatibility (mother is + and baby is -)
  • Drugs taken by mother during pregnancy
  • diabetes during pregnancy
  • genetic causes
  • exposure to radiations
  • maternal jaundice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Peri-natal causes of CP

A
  • prematurity, immature respiratory and cardiac functions
  • asphyxia: body is deprived of O2
  • meconium aspiration: 1st bowel movement is in placenta and they end up ingesting it
  • birth trauma
  • disproportion
  • breech delivery
  • rapid delivery
  • low birth weight
  • coagulopathy
  • prolonged labor
  • multiple births
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Post natal causes of CP

A
  • brain damage secondary to cerebral hemorrhage, trauma, infection, anoxia, ischemia
  • low blood sugar
  • MVA
  • Shaken baby syndrome
  • drowning
  • lead exposure
  • infections
  • meningitis
  • encephalitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Other causes of CP

A
  • cerebrovascular event in first 28 days post birth
  • HIE (hypoxic ischemia encephalopathy): lack of O2
  • infections
  • maternal/infant congenital brain malformation
  • jaundice/kernicterus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3 types of lesions with neurological damage and CP

A
  1. hemorrhage
  2. encephalopathy
  3. neuropathy due to malformations of the CNS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hemorrhage: neurological damage

A
  • below the lining of the ventricles intraventricular hemorrhage
  • grades 1-4 (not always predictive of how bad the CP is)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Encephalopathy

A
  • anoxia or hypoxia
  • HIE: hypoxic ischemia encephalopathy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the old categories of cerebral palsy

A
  • congenital
  • acquired
  • genetic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Traditional classifications of cerebral palsy

A
  • monoplegia: 1extremity is affected (crouch gait)
  • diplegia/paraplegia: 2 extremities are affected
  • triplegia: 3 extremities are affects
  • hemiplegia: 1/2 body is affected
  • tetraplegia/double hemiplegia: 4 extremities are affects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Diaplegia

A
  • LE affected with little to no upper body spasticity
  • most common form of spastic
  • most people with spastic diplegia are fully ambulatory but are tight and have a scissor gait
  • flexed knees and hips to vary degrees and moderate to sever abduction
  • near sighted and intelligence is unaffected in most cases
  • in 1/3 cases strabismus may be present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

CP classification based on muscle tone

A
  • hypertonic/spastic (further classified by distribution of tone)
  • athetoid: from basal ganglion, with diatonic, smooth motions
  • ataxic: cerebellum not smooth movement patterns
  • flaccid/hypotonic
  • mixed types
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Current classification and definition: of cerebral Palsy

A
  • origin of problem
  • level of involvement
  • predictive information
  • tracts progress over time
  • functional abilities
  • GMFCS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

GMFCS

A
  • Gross motor function classification system
  • you can look and determine where they are and classify severity of mobility with CP
  • based on child’s current gross motor abilities and need of assistive devices
  • used from 2-18 years
20
Q

GMFCS Level 1

A
  • walk at home, school, outdoors and in community
  • they can climb stairs without use of railing
  • children perform gross motor skills such as running and jumping
  • but speed, balance, and coordination are limited
21
Q

GMFCS Level 2

A
  • walk in most settings
  • climb stairs holding onto railing
  • may experience difficulty walking long distances and balancing on uneven terrain, inclines, in crowed areas of confined spaces
  • may walk with physical assistance, handheld mobility device or wheeled mobility over long distances
  • minimal ability to preform gross motor skills such as running/jumping
22
Q

GMFCS Level 3

A
  • walk using hand-held mobility device in most indoor settings
  • may climb stairs holding onto a railing with supervision or assistance
  • children use wheeled mobility when traveling long distances and may self propel for shorter distances
23
Q

GMFCS Level 4

A
  • use methods of mobility that require physical assistance or powered mobility in most settings
  • may walk for short distances at home with physical assistance or use powered mobility or a body support walker when positioned
  • at school, outdoors and in community that are transported in manual wheelchair or in powered mobility
24
Q

GMFCS Level 5

A
  • children are transported in manual wheelchair in all settings
  • limited in their ability to maintain antigravity head and trunk postures and control leg and arm movements
25
Q

Gross motor function measure

A
  • GMFM
  • validated for 5 months to 16 years
  • GMFG-66 and GMFM-88
26
Q

GMFM-66

A
  • provides much more information to assist with realistic goal setting for children with CP
  • some predictive value
  • original
  • ONLY CP
  • tested barefoot and no assistive device
27
Q

GMFM-88

A
  • version valid for use with children with Down syndrome, SMA (spinal muscle atrophy) TBI, OI, hereditary spastic paresis, acute lymphoblastic leukemia
  • tested with shoes on and assistive device
28
Q

Spasticity

A
  • velocity dependent hypertonicity
  • characterized by resistance to passive stretch
  • varies with directions of movement, eg flexion/extension
  • related to loss of inhibition from brainstem to opposite muscle
  • results in increase muscle tone
29
Q

causes of spasticity

A
  • abnormal reaction to sensation
  • adaptive response to allow generation of movement when no alternatives exist
  • adaptive response to instability caused by slow movements
30
Q

non-surgical treatments for spasticity

A
  • PT/OT
  • speech therapy
  • casting/bracing
  • BOTOX
  • oral medications
31
Q

examples of oral medications for spasticity

A
  • baclofen
  • tizanidine
  • dantrolene sodium
  • diazepam
  • clonazepam
  • gabapentin
32
Q

Surgical intervention for spasticity: selective dorsal rhizotomy

A
  • test which nerve fibers in dorsal root cause the spasticity and cut it
  • need PT for 5-6 days per week for months
  • results in reduced afferent neuromotor signals from the LE with the aim of improving gait
  • the dorsal spinal roots transmit sensation from muscle to the spinal cord
33
Q

Surgical intervention for spasticity: SEMLS

A
  • single event multilevel surgery
  • helps correct bone and joint deformities
  • allows for more balanced muscle and joint function
34
Q

Spastic Diplegia/prognosis
- with treatment
- without treatment

A
  • without treatment: progressively poor quality of life because these children cannot walk
  • with intervention: 86% become at least household ambulatory
  • often one side is more affected than other
  • crouched gait
35
Q

Spastic tetraplegia/quadriplegia
- 1st symptoms
- Motor control
- Typical Posture

A

1st symptoms may be difficulty with feeding and generalized hypotonia, escalates to muscle imbalance and spasticity within 1st year of life

motor control:
- extension tone usually dominant (lying in supine causes more extension)
- poor control of flexion
- poor ability to dissociated movement

Typical posture:
- hip adduction, IR
- knee extension
- ankle PF
- shoulder IR
- elbow flexed or extended
- forearm pronation

36
Q

Hemiplegia

A
  • most unsuspected
  • most born full term with very low birth weight
  • often related to maternal infant Rh incompatibility
  • hemolytic disease of newborn
  • prevented by mother taking rhogam
  • UE is more significantly involved than LE
37
Q

Athetosis characteristics

A
  • not common
  • fluctuating muscle tone/writhing movements
  • very noticeable in speech, feeding, UE movement
  • involuntary extraneous movement
  • lack of graded muscle response - difficult to stop and start
  • extremities function best at end ranges
  • some sustain muscle activity too much while others have hard time sustaining it enough to complete a task
  • often asymmetric involvement present
  • incomplete of inadequate balance reactions
  • reflexes may be abnormally retained
  • often hearing loss is present usually intelligence is within typical ranges
38
Q

Athetosis fluctuating tone movement

A
  • involves abnormal involuntary movements
  • movements disappear during sleep and increase with stress
  • interferes with speaking, feeding, reaching, grabbing and any other skills
  • about 20% of CP cases
39
Q

Typical posture for CP with athetosis

A
  • extension of cervical spine with scapular elevation and shoulder IR
  • thoracic kyphosis with lumbar hyperextension
  • lumbar extension often occurs exclusively at thoracolumbar junction
  • Ribcage remains elevated, abdominal overlenghtened and cannot help with postural support - hard to breath
40
Q

Gait with athetosis

A
  • hips and knees are slightly flexed and ankle in DF
  • may initiate weight shift from head or jaw, shuffle feet forward to walk
41
Q

Hypermobility with athetosis

A
  • repetitive exaggerated postures cause excessive mobility and or overlengthened muscles
  • commonly affected joints:
    1. TMJ
    2. Cervical spine
    3. shoulder
    4. elbow
    5. IP joints and thumb
    6. anterior hip capsule
    7. ankle
42
Q

Ataxic CP

A
  • deficits in cerebellum or thalamus
  • generalized hypotonia, initial diagnosis may be floppy baby syndrome
  • low postural tone, difficulty with sustained contraction against gravity
  • Proximal intention tremor with purposeful movement – Jerky movements
43
Q

Hypotonic CP

A
  • associated with global impairments
  • can be initially flaccid at birth
  • can develop into athetosis or spastic type CP
  • hypotonic, little to no movement
  • excessive joint flexibility
  • typical positions: supine “frog leg”, ring sit on floor with posterior pelvic tilt and upper body supported on hands
  • usually not cognitively motivated poor development of skills
44
Q

Primary impairments with CP

A
  • balance both static and dynamic
45
Q

Secondary impairments with CP

A
  • strenght
  • ROM
  • endurance
46
Q

motor learning considerations with CP

A
  • opportunities for movement
  • environment: may need to reposition to move
  • cognition and communication
  • neuromuscular considerations: tone, ability, balance
  • musculoskeletal considerations: kyphosis
  • cardiovascular and pulmonary: most developmentally delayed
  • integumentary: skin breakdown, infections
47
Q

Cerebral palsy prognosis

A
  • 90% of children survive into adulthood from developed countries
  • functional outcomes: 90% of potential reached by age 3 for level 5; 90% of potential reached by age 5 for level 1
  • often develop secondary disorders such as exacerbation of spasticity, metabolic disease, abnormalities of musculoskeletal, fatigue, chronic pain, and deformities
  • decreased ambulation potential in those with rigid or hypotonic types, or persistent tonic neck reflexes
  • if child is not independently sitting by 24 months they will most likely not walk
  • employment: consider level of involvement, cognition, home support, education, vocational training

Movement science 2 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions