CP

Question 1

Possible Prenatal causes of CP

Answer 1

developmental brain malformation, genetic/chromosomal abnormalities, intrauterine exposure (radiation, drugs, infection), neurological event

Question 2

possible perinatal causes of CP

Answer 2

prematurity, birth asphyxia (stuck in birth canal bc no O2), trauma, meconium aspiration

Question 3

Factors that affect extent of injury

Answer 3

timing
duration
individual variability

Question 4

Levels of CP (GMCS)

Answer 4

1. Walk no limitation
2. Walk with limitation
3. Walk using hand held mobility device
4. Self mobility with limitation may use powered mobility
5. Transported in manual WC

Question 5

Lesion in brain, usually BILAT, caused by ischemia which results in necrosis of white matter around lateral ventricles

Answer 5

Periventricular leukomalacia (PVL)

Question 6

What is the leading known cause of CP / cognitive impiarments in premature infants?

Answer 6

PVL

Question 7

what is PVL caused by

Answer 7

reduction in blood flow

Question 8

lack of O2 to the brain due to reduced blood flow

Answer 8

hypoxic - ischemic encephalopathy

Question 9

Clinical presentation of perinatal stroke (hemi CP)

Answer 9

one sided UE and LE involvement
UE typically more involved
initial symptom may be when fam notices decreased use of UE

Question 10

presents as
delayed response to visual stimuli
visual field preference
attraction to color/light
difficulty with visual novelty

Answer 10

cortical visual impairment (not acuity, visual processing)

Question 11

CV / pulmonary complications of CP

Answer 11

• bronchopulmonary dysplasia, vent dependency
• Secondary to scoliosis
• aerobic capacity (increased weight/decreased strength)
• energy expenditure in relationship to ambulatory status

Question 12

MSK impairments

Answer 12

strength (unable to generate normal vol force, poor neural drive, co activation)
ROM (spasticity/decreased m control, m tightening)
high incidence of scoliosis, hip instability, bone torsion/version

Question 13

common ROM measurements

Answer 13

popliteal angle, DF, hip flexion, hip IR/ER, hip ADD/ABD

Question 14

examination CP red flags

Answer 14

atypical movement patterns, delayed milestones, retained primitive reflexes, hyper-reflexive DTRs, clonus, abnormal m tone

Question 15

Examples of atypical movement patterns

Answer 15

early appearance of skills (standing, head control–increased m tone)

cramped synchronized movements (appear rigid, all limb/trunk m contract and relax almost sync.) highly predictive (98%)

Question 16

atypical performance: rolling

Answer 16

does not progress past segmental roll, extremities get stuck, reflexed interfere (ATNR)

Question 17

atypical performance: sitting up

Answer 17

always fall to one side
no protective ext
do not use one side to prop and/or keeps UE postured
thrusts backwards

Question 18

atypical performance: crawling

Answer 18

only uses one side
no or limited LE use
does not progress past army crawling
“bunny hop”

Question 19

common gait patterns to CP

Answer 19

toe walking
hemiparesis
scissoring
crouched
ataxic

Question 20

type of gait pattern:
retraction of involved side, including pelvis
little to no heel rise
genu recurvatum

Answer 20

hemiparesis

Question 21

type of gait pattern:
common with spastic diplegia
due to increased tone in med hamstrings/adductors

characterized by: hip flexion, IR, ADD, PF
accompanied with trunk compensations

Answer 21

scissoring

Question 22

type of gait pattern:
excessive hip and knee flexion ankle DF due to decreased strength (initially, then decreased ROM as well)

Answer 22

crouched

Question 23

type of gait pattern:
over/undershooting
poor foot placement
wide BOS

Answer 23

ataxic