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Fall 2014: Clinical Conditions 1 > CP and LD (Week 9) > Flashcards

CP and LD (Week 9) Flashcards

1
Q

Group of permanent or chronic neurological disorder, affecting movement, balance and posture

A

Cerebral palsy

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2
Q

When does CP occur?

A

fetal period, during birth, or in early infancy but not diagnosed until later

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3
Q

4 topographical classification of CP

A
  1. Monoplegia/ Monoparesis
  2. Diplegia/ Diparesis
  3. Hemiplegia/ Hemiparesis
  4. Quadriplegia/ Quadriparesis
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4
Q

2 Motor function classification of CP

A
  1. Pyramidal

2. Extrapyramidal

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5
Q

Extrapyramidal is broken into what 2 categories

A
  1. Dyskinetic

2. Ataxia

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6
Q

If injury to pyramidal area what type of mvmt is affected?

A

voluntary

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7
Q

If injury to extrapyramidal area what type of mvmt is affected?

A

involuntary mvmt bc areas like basal ganglia, thalamus, cerebellum are affected

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8
Q

Most common type of CP (3)

A
  • spastic CP (pyramidal)
    o 1. Hemiplegia
    o 2. Diplegia
    o 3. Quadriplegia
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9
Q

Type of dyskinetic CP with symptoms:

 Writhing mvmts, repetitive, rhythmic, slower

A

Athetoid

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10
Q

Type of dyskinetic CP with symptoms:

 Jerky almost like a spasm

A

Chorea

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11
Q

Type of dyskinetic CP with symptoms:

  • Sustained posture esp. in trunk
  • move, fix, and then come out of the mvmt
A

Dystonic

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12
Q

Type of dyskinetic CP seen along w/spastic quadriplegia frequently

A

Dystonic

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13
Q

What is chorea commonly seen with?

A

chorea athetosis

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14
Q

CP that affects balance and coordination

A

Ataxic CP

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15
Q

9 risk factors for CP

A
  • Prematurity & SGA
  • Multiples
  • Prenatal infections: CMV, toxoplasmosis, rubella
  • Rh disease
  • Challenging labor
  • Placental inefficiencies
  • Brain infections (post birth)
  • Toxin exposure: mercury
  • Brain injury
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16
Q

3 complications that put baby at higher risk of getting CP

A

 1. Interventricular Hemorrhage (IVH)
 2. Hypoxic-Ischemic Encephalopathy (HIE)
 3. Periventricular Leukomalacia (PVL)

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17
Q

Bleeding into the ventricular space within the brain hemispheres

A

Interventricular Hemorrhage (IVH)

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18
Q

Risk factors for IVH (3)

A

o prematurity, SGA,
o respiratory distress syndrome
o patent ductus arteriosus (PDA)

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19
Q

When can IVH occur?

A

in-utero or after they are born esp. premies

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20
Q

What grade of IVH is when bleeding expands beyond germinal matrix into the ventricular system?

A

Grade II

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21
Q

What occurs during Grade III IVH?

A

Bleeding dilates the ventricles and they are pushing on other brain tissue

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22
Q

What % of Grade III IVH get CP?

A

30%

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23
Q

What grade of IVH has periventricular Hemorrhagic Infarction (PHL-IVH) in addition to IVH?

A

Grade IV

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24
Q

Describe Grade I IVH?

A

Bleeding into a network of blood vessels in the roof of the lateral ventricles (isolated to germinal matrix)

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25
Q

What % of Grade IV IVH get CP?

A

75%

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26
Q

What do the following symptoms indicate?

  • bulging fontanelle
  • seizures
  • decreased reflexes, tone, suck
  • apnea, bradycardia, anemia
A

IVH

27
Q

Why is a mom given prenatal corticosteroids?

A

 if they know the mom may deliver early to try to prevent a premature birth

28
Q

If mom has increased risk of bleeding or bleeding disorder what can she take?

A

Vitamin K

29
Q

2 medical internventions for IVH

A
  1. Effective resuscitation and ventilation

2. Maintain hemodynamic stability (BP stable)

30
Q

in a scissoring gait, what muscles are overactive?

A

adductors

31
Q

why do kids with CP sometimes walk in a crouched position?

A

compensate for balance issues

32
Q

In kids with CP, is supination or pronation more challenging?

A

supination

33
Q

What arm position is common for kids with CP?

A

fingers flexed into fist, FA pronate, wrist UD

34
Q

3 tone reducing medications for CP

A

botox
baclofen pump
oral meds such as valium

35
Q

5 surgical intervention for CP?

A 
tendon lengthening
muscle transfer
de-rotation osteotomy
spinal fusion
selective dorsal rhizotomy
36
Q

What is the most important factor when thinking about adaptive equipment?

A

ALIGNMENT

37
Q

T/F: learning disabilities are recognized before entering school

A

false

38
Q

This LD has an issue with reading written language

A

dyslexia

39
Q

This LD has an issue with math and problem solving

A

dyscalculia

40
Q

This LD has an issue with writing

A

dysgraphia

41
Q

This LD has an issue with gross/fine motor and function

A

dyspraxia

42
Q

This LD has an issue with understanding vision or hearing despite normal vision or hearing

A

Auditory and Visual Processing Disorders

43
Q

What is a common comorbidity with ADHD?

A

executive function problems

44
Q

When is the DSM-V used to diagnose LDs?

A

private practice

45
Q

When is the ICD-11 used to diagnose LDs?

A

private practice

46
Q

When is the IDEA used to diagnose LDs?

A

public school system

47
Q

What is the name of a custom intervention strategy for a kid with a LD/Special Education?

A

IEP

48
Q

Brain damage due to hypoxia or ischemia

A

Hypoxic-ischemic Encephalopathy (HIE)

49
Q

Most significant risk factor for HIE?

A

asphyxia

50
Q

primary cause of HIE

A

placental insufficiency

51
Q

Does HIE happen after birth or in utero typically?

A

in utero

52
Q

What % of babies w/HIE get CP?

A

10-25%

53
Q

What would the following symptoms indicate?

  • decreased activity level
  • poor suck and feeding
  • respiratory difficulty
  • seizure in first 24 hrs
  • temperature instability
A

HIE

54
Q

White matter closest to the ventricles sustains injury/damage due to hypoxia or ischemia resulting in brain tissue death

A

Periventricular Leukomalacia (PVL)

55
Q

4 risk factors for PVL

A
  1. prematurity
  2. intrauterine infection
  3. bleeding during pregnancy
  4. IVH
56
Q

What % of babies w/PVL get CP?

A

60-90%

57
Q

When is critical window to damage oligodendrocytes?

A

23-24 weeks GA

58
Q

3 early signs to test for CP

A
  1. lack of integrated reflexes
  2. signs of UMN damage (increased tone)
  3. developmental delays
59
Q

Result of delayed or absent righting rxns in kids w/CP

A
  • trouble protecting themselves when sitting esp. if fall backwards
60
Q

3 characteristics of GMFCS Level 1

A

o Walks without limitation (started late 18-24 mo)
o Soft neurologic signs,
o They can sit, crawl

61
Q

What GMFCS Level?
o severe head & trunk control limitations,
o transported in a manual wheelchair
o cognitively may be ok but very low motor development

A

GMFCS Level V

62
Q

Describe GMFCS Level IV (4)

A

o Starts to become more sever
o May need adaptive seating and supported sitting
o May walk short distances w/assistance
o Self-mobility with powered mobility assistance

63
Q

What GMFCS Level?
o Walks with limitations (by age 4)
o can sit but tough to do UE activity like playing

A

GMFCS Level II

64
Q

What GMFCS Level?
o walks with adaptive equipment assistance like a walker
o can sit independently or with limited support; some independence in standing transfers

A

GMFCS Level III

Fall 2014: Clinical Conditions 1 (17 decks)

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