Developmental Neuro

Question 1

What is the diagnostic criteria for DCD

Answer 1

learning and coordinated movement is difficult
early onset of development
all other neuro issue been ruled out
difficulty with motor that intefere with ADLs

Question 2

What is a specific test and measure for DCD partication?

Answer 2

CAPE (childrens assessment of participation and enjoyment)
goal attainment scale
canadian occupational performance measure

Question 3

What are DCD diagnosis specific tests?

Answer 3

DCD’Q’07 age 5-15
movement assessment battery for children-2 = gold standard
<5th % on MABC2– probable DCD

Question 4

What activity limitation test and measure for DCD?

Answer 4

motor development – BOT 2

Question 5

What age should you do individual PT for children with DCD?

Answer 5

<5-6

Question 6

WHat is the CO-OP

Answer 6

cognitive orientation to daily performance (CO_OP)
7 key features =
guided discovery,
client chosen goals,
dynamic performance analysis (DPA)
parent involvement
structured interventional formal 10-12 sessions.

Question 7

What age do you focus on group therapy sessions

Answer 7

> 6 years old

Question 8

What intervention specific to DCD?

Answer 8

CO-OP
neuromotor task training
motor imagery

Question 9

Is there a medical management for DCD

Answer 9

no medications, but can treat co-morbidities

Question 10

What is the diagnostic criteria for autism?

Answer 10

DSM-V
impairment in social communication/interaction
restricted/repetitive behavior

Question 10

What is the classification of level of support

Answer 10

level 1= support
level 2= mod support
level 3= substantial support

Question 11

What is the pathophysiology of autism?

Answer 11

synapses do not undergo normal pruning during childhood and adolescense
cerebral morphology differences in volume and geometry
brains of indiviudals with autism are large
overgrowth in temporal lobe

Question 12

What are common co morbid conditions of autism

Answer 12

ADHD, OCD, DCD, anxiety/ mood, psychosis

Question 13

What are predictive factors for autism?

Answer 13

geriatric pregnancy, medications during pregnancy, air pollution, genetics

Question 14

What is the medical management for autism?

Answer 14

no specific, but can managed other medical conditions

Question 15

What is autism diagnostic observation schedule (ADOS)?

Answer 15

gold standard– completed by psychologists, along with clinial observation
semi structured assessment of communication, social interaction and play for individuals
4 modules– child to adult

Question 16

What is the screening for autism

Answer 16

M-CHAT-R used for 6- 30 months

Question 17

What are interventions for autsim?

Answer 17

focus on meaningful interventions
short duration
ICF components
accomodate environment
integrate interventions with daily routines

Question 18

What is a common impaitment or deviation for children with autsim?

Answer 18

idiopathic toe walking

Question 19

What is idiopathic toe walking?

Answer 19

condition in which children ambulate with bilateral toe-toe pattern without known etiology

Question 20

What are interventions for idiopathic toe walking?

Answer 20

behavioral strategies (flippers, heels, squeakers)
followed by serial casting followed by orthotic

Question 21

What is spina bifida

Answer 21

type of neural tube defect

Question 22

When does the caudal neural tube close?

Answer 22

day 28

Question 23

When does the rostral neural tube close?

Answer 23

day 24

Question 24

What is the double hit theory

Answer 24

maldevelopment of the neural tube + exposure to amniotic fluid= damage to normal spinal cord tissue

Question 25

What are risk factors for spina bifida?

Answer 25

polycentric inheritance
envirnmental
follic acid deficeincy

Question 26

How do you diagnose spina bifida?

Answer 26

lab alpha- fetoproteint at 13-15
fetal ultrasound 16-24 wks
amniocentesis at 16-18

Question 27

Which diagnostic test is 100% accurate?

Answer 27

amniocentesis

Question 28

What is a banana sign?

Answer 28

cerebellum appears banana like because it is wrapped around the posterior brainstem due to downward traction of the spinal cord
indicative of Chiari II

Question 29

What is a lemon sign?

Answer 29

is the shape of the skull

Question 30

What are the different types of spina bidfia

Answer 30

myelomeniongecele
meninogecele
myocele
spina occulta

Question 31

Describe myelomeningocele

Answer 31

most common
nerves outside spinal tract– open defect
motor, sensory, bowel and bladder impairments
majority 75% lumbar-lumbosacral

Question 32

Decribe meningocele

Answer 32

incomplete skin coverage= CSF leak
neuro signs may normal
pocket but no nerve elements

Question 33

Describe myelocele spina bifida

Answer 33

cystic cavity anterior to the spinal cord
majority 75% lumbar-lumbosacral

Question 34

Describe occulta spina bifida

Answer 34

L5-S1 is most common
no neurological deficits
rarely associated with tehtered cord or lipoma

Question 35

what is hydrocephalus?

Answer 35

CSF build up in the ventricles

Question 36

what is tethered cord?

Answer 36

spinal cord gets stuck to the base of spine
w/ growth SC can’t move

Question 37

What is syringomyelia

Answer 37

pockets of fluid throughout the spinal cord

Question 38

What is Arnold Chiarir Type II Malformation ?

Answer 38

downward displacement of medulla, brainstem and cerebellar tonsil through fooramen mangnum

Question 39

What are the symtpoms of arnold chiari type II?

Answer 39

sleep apnea
palpitations/arrhythmis
diploplia
dysphagia
impaired fine motor coodination and ataxia

Question 40

What are the symptoms of hydrocephalus?

Answer 40

HA
nausea
altered mental status
lethargy
personality change
swallow issues
hoarse cry
vision changes

Question 41

What are the symptoms syringomyelia?

Answer 41

motor changes (fine motor)
sensory changes (temperature)
reflex changes
neck pain

Question 42

What are symptoms of a tethered cord?

Answer 42

motor, sensory, reflex change
back pain
progressive scoliois
bowel or bladder/ sexual changes
change in function

Question 43

What is the sign or gaze palsy associated with severe hydrocephalus?

Answer 43

sunset gaze
upward gaze palsy

Question 44

what is the most frequent shunt complication

Answer 44

infection

Question 45

When do children with thoracic level SB roll?

Answer 45

18 months

Question 46

What are the predictors of ambulation?

Answer 46

lower motor level
no histroy of shunt
no hx of hiip or knee contracture surgery

Question 47

what are the cuntional abilities for thoracic level?

Answer 47

standing at 12-18 months
gait with HKAFO
wheelchair training as early 12 months

Question 48

Functional abilities of lower thoracic and lumbar

Answer 48

RGO after age 3
if L3 spared – child may use AFO

Question 49

Functional abilities of low lumbar aand sacral

Answer 49

bracing may not be required but might benefit from AFO or GRAFO if PF are non-functional

Question 50

What is common impairment in the feet for T6-T12

Answer 50

club foot

Question 51

What is a common gait pattern you might see with a patient with an L4 myelomeningocele?

Answer 51

trendelenburg

Question 52

What are common orthopedic conditions for spina bifida

Answer 52

scoliosis
clubfoot
hip subluxation and dislocation

Question 53

What is neurogenic bowel?

Answer 53

surgery required for patient with difficulty with independence and maintaining continenence
80% of kids have it

Question 54

what is a neurogenic bladder?

Answer 54

present in >90% patients with MMC
hypertonic bladder= thoracic lesions
hypotonic= sacral lesions
need annual renal ultrasouns and renal function testings

Question 55

What is the management for neurogenic bladder?

Answer 55

management= normal renal function and maximize continende
independent catheteization as early as 5/6 years old
UTI ver common
urologic cause 40% deaths between 5-30 years old

Question 56

What are common considerations for skin care for spina bifida?

Answer 56

allergy to latex
high risk for pressure injuries