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Cuccorullo > Ch 10 - Peds: TBI and CP > Flashcards

Ch 10 - Peds: TBI and CP Flashcards

1
Q

What does not indicate severity of TBI?

A

Presence or absence of skull fractures

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2
Q

What can result in greater shearing injury in children?

A

Incomplete myelination

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3
Q

What are causes of neonatal brachial plexus injuries?

A

– Trauma

– Obstetrical complications

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4
Q

What is Erb–Duchenne Palsy?

A

Due to sudden traction to the neck, causing injury to the upper trunk of the brachial plexus (C5–C6 roots)

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5
Q

What is Klumpke’s Palsy?

A

Due to violent upward pull of the shoulder, causing damage to the lower trunk (C8–T1 roots)

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6
Q

What can be associated with Klumpke’s Palsy?

A

Horner’s syndrome can be associated with injury of the C8 and T1 roots, which affects the superior cervical sympathetic ganglion

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7
Q

What are verbal scores for GCS in <2 yo?

A

1: no response
2: Inconsolable crying, irritable
3: Cries but is inconsistently consolable, moaning
4: Cries but consolable, interacts inappropriately
5: Smiles, oriented to sound, follows objects, interacts

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8
Q

Which children are more likely to sustain TBI?

A

Hyperactive children

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9
Q

How does hypopituitarism present after TBI in children?

A

Growth failure and delayed or arrested puberty

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10
Q

When is HO MC in TBI in children?

A

> 11 yo
More severe injury
2 extremity fractures

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11
Q

When are children considered to have posttraumatic epilepsy?

A

2 or more late seizures

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12
Q

Which has a better prognosis, TBI or anoxic brain injury?

A

TBI

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13
Q

What is cerebral palsy?

A

Primarily of movement control and posture but associated with cognitive and sensory problems resulting from a nonprogressive lesion to an immature brain

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14
Q

What is the leading cause of childhood disability?

A

Cerebral palsy

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15
Q

When do the majority of cerebral palsy cases occur?

A

70-80% in prenatal period

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16
Q

What are risk factors of CP during the prenatal period?

A
  • Prenatal intracranial hemorrhage
  • Placental complications • Gestational toxins
  • Gestational teratogenic agents
  • Congenital malformations of the brain and cerebral vascular occlusions during fetal life
  • TORCH infections
  • Socioeconomic factors
  • Reproductive inefficiency
  • Prenatal hypoxicischemic injury
  • Maternal causes (seizures, MR, hyperthyroidism)
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17
Q

What is the MC antecedent of CP?

A

Prematurity

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18
Q

What are the types of CP?

A

– Spastic (pyramidal) (75%)
– Dyskinetic (extrapyramidal)
– Mixed type

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19
Q

What is the MC type of CP?

A

Spastic diplegia

LE»UE

20
Q

What is a typical cause of spastic diplegia CP?

A

IVH at 28-32 weeks gestation

21
Q

What is seen on MRI with IVH in spastic diplegia CP?

A

Periventricular leukomalacia or post-hemorrhagic porencephaly

22
Q

What is Athetosis?

A

Slow writhing involuntary movements, particularly in the distal extremities

23
Q

What is chorea?

A

Abrupt, irregular jerky movements, usually occurring in the head, neck, and extremities

24
Q

What is Choreoathetoid CP?

A

Combo of athetosis and choreiform movements
Gen large amp involuntary movements
Dominating pattern is the athetoid movement

25
Q

What is Dystonia

A

A slow rhythmic movement with tone changes generally found in the trunk and extremities; associated with abnormal posturing

26
Q

What is Ataxia?

A

Uncoordinated movements often associated with nystagmus, dysmetria, and a widebased gait

27
Q

What is associated with Ataxia CP?

A

Sensorineural hearing loss which has been associated with hyperbilirubinemia and neonatal jaundice

28
Q

What is the MC mixed type of CP?

A

Spastic athetoid (predominant dyskinetic movement pattern with an underlying component of spasticity)

29
Q

Where does ischemia occur in spastic diplegic CP?

A

Hypoperfusion of the germinal matrix of the periventricular region of the premature fetus

30
Q

Which CP group has the highest disability?

A

Quadriplegic

31
Q

What is a GMFCS Level 1?

A

Walks without restrictions
Limitations in more advanced gross motor skills
Does not need handrails

32
Q

What is a GMFCS Level 2?

A

Walks without assistive devices
Limitations walking outdoors and in the community
Uses handrails

33
Q

What is a GMFCS Level 3?

A

Walks with assistive mobility devices

Limitations walking outdoors and in the community

34
Q

What is a GMFCS Level 4?

A

Self-mobility with limitations

Transported or use power mobility outdoors and in the community

35
Q

What is a GMFCS Level 5?

A

Self-mobility severely limited even with use of assistive devices

36
Q

What are good prognosis for ambulation in CP?

A

Independent sitting by 2 years

Ability to crawl on hands and knees by 1.5 to 2.5 years

37
Q

What is a poor prognostic sign for ambulation in CP?

A

Persistence of 3 or more primitive reflexes at 18 to 24 months

38
Q

What is the MC visual deficit in CP?

A

Stabismus

39
Q

What is a good indication of intellectual

potential in CP?

A

Speaking in two to three word sentences by age 3

40
Q

Which CP type MC has MR?

A

Spastic quadriplegia

41
Q

Which CP type MC has seizures?

A

Spastic quadriplegia

Hemiplegia

42
Q

Which CP type MC has oromotor issues?

A

Spastic quadriplegia

Dyskinetic

43
Q

What is the most widely used therapuetic exercise method in CP?

A

Bobath

Also known as neurodevelopmental treatment (NDT)

44
Q

Describe the Asymmetric tonic neck reflex.

A

Head turning to side causes Extremities extend on face side, flex on occiput side (“fencer position”)

45
Q

Describe the palmar grasp reflex.

A

Touch or pressure on palm or stretching finger flexors causes flexion of all fingers

Cuccorullo (16 decks)

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