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ENS 307 > Lecture 11 - Cerebral Palsy > Flashcards

Lecture 11 - Cerebral Palsy Flashcards

1
Q

What is cerebral palsy?

A

An umbrella term which covers many motor impairments caused by lesions in the brain acquired early in development

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2
Q

What is the cutoff age for developing cerebral palsy?

A

2 years old

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3
Q

Who first referred to the disease as cerebral palsy in 1888?

A

William Olser

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4
Q

What did Sigmund Freud suggest in 1897?

A

That cerebral palsy may be related to the development of the brain in the womb

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5
Q

How prevalent is cerebral palsy?

A

1.5-2 per 1000 births

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6
Q

What is the cerebral palsy the leading cause of?

A

Childhood disability affecting function and movement

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7
Q

Which stage of development is most susceptible to cerebral palsy?

A

Prenatal

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8
Q

How is the severity of cerebral palsy classified?

A

By the Gross Motor Functional Classification Scale

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9
Q

How does the GMFCS classify the severity of cerebral palsy?

A

By describing the functional capabilities based on mobility

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10
Q

How many levels of severity are there according to the GMFCS?

A

Five

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11
Q

What is level I of the GMFCS?

A

Walks without restrictions; limitation in more advanced gross motor skills

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12
Q

What is level II of the GMFCS?

A

Walks without assistive devices; limitations are walking outdoors and in the community

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13
Q

What is level III of the GMFCS?

A

Walks with assistive mobility devices; limitations are walking outdoors and in the community

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14
Q

What is level IV of the GMFCS?

A

Self-mobility with limitations; children are transported or use powered mobility outdoors in the community

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15
Q

What is level V of the GMFCS?

A

Self-mobility is severely limited even with the use of assistive technology

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16
Q

What are the two major areas affected by cerebral palsy?

A

Motor centers, pyramidal cells, and corticospinal pathway

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17
Q

What are motor centers responsible for?

A

Direct voluntary movement

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18
Q

What are pyramidal cells responsible for?

A

Motor cortex neurons

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19
Q

What is the corticospinal pathway responsible for?

A

Begins at pyramidal cells and synapses directly to spinal motor neurons

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20
Q

What is the mechanism of injury for cerebral palsy?

A

Injury to the motor cortex neurons with decreases input to the spinal neurons

21
Q

What is the effect of injury to the motor cortex neurons?

A

Affects motor control
Decreases the number of effective units
Produces abnormal muscle control and weakness

22
Q

What are the signs and symptoms of cerebral palsy?

A

Known hypoxic or ischemic event
Muscle tone alterations
Delayed or failure to meet developmental milestones
Persistence of primitive reflexes

23
Q

What type of muscle tone alterations can occur with cerebral palsy?

A

Spasticity

24
Q

What is spasticity?

A

Stiffness of muscles

25
Q

What is the recommended age for diagnosis of cerebral palsy?

A

3-5 years of age

26
Q

Why is there a suggested delay in diagnosis for cerebral palsy?

A

Because signs and symptoms often change through child development. Some children “outgrow” their cerebral palsy

27
Q

How does a physician examine a patient for cerebral palsy?

A 
MRI/CT
Spinal alignment
Active and passive ROM in joints
Motor power
Muscle tone
Movement disorders
Limb deformities
28
Q

What is the only way to definitively diagnose cerebral palsy?

A

Brain scan (MRI/CT)

29
Q

What type of spinal abnormalities can occur as a result of cerebral palsy?

A

Kyphosis, lordosis, and scoliosis

30
Q

What is kyphosis?

A

Excessive upper curvature of the spine

31
Q

What is lordosis?

A

Excessive lower curvature of the spine

32
Q

What is scoliosis?

A

Medial/lateral curve of the spine

33
Q

How are gait abnormalities assessed?

A

Using the observational gait scale

34
Q

What characteristics of gait are looked for using the observational gait scale?

A 
Pez equinus
Crouched gait
Jumping gait
Scissoring
Windblown pelvis
35
Q

What is pez equinus?

A

Excessive curling of the toes causing the individual to walk on top of their toes

36
Q

What are some common arm deformities associated with cerebral palsy?

A 
Shoulder internal rotation
Elbow flexion
Forearm pronation
Wrist flexion
Thumb in palm
37
Q

What are some common leg deformities associated with cerebral palsy?

A 
Hip flexion
Hip adduction
Knee flexion
Ankle equinus
Hindfood valgus
Toe flexion
38
Q

How can cerebral palsy be classified in terms of affected extremities?

A

Monoplegia, hemiplegia, diplegia, and quadriplegia

39
Q

What is monoplegia?

A

Affects only one limb, usually an arm

40
Q

What is hemiplegia?

A

Affects one side of the body including arm, leg, and trunk

41
Q

What is diaplegia?

A

Affects symmetrical parts of the body (legs or arms)

42
Q

What is quadriplegia?

A

Affects all four limbs

43
Q

What are some non motor symptoms associated with cerebral palsy?

A 
Epilepsy
Speech impairment
Vision
Dental problems
Poor nutrition
Psychological and cognitive problems
44
Q

Is there a cure for cerebral palsy?

A

No

45
Q

How can cerebral palsy be treated?

A 
Physical therapy
Occupational therapy
Speech therapy
Botox
CIT
Dorsal Rhizotomy
Tendon transfer/muscle lengthening
46
Q

How can botox be used to treat cerebral palsy?

A

To relax spasticity of muscles

47
Q

What is CIT?

A

Constraint Induced Therapy

48
Q

How can CIT be used to treat cerebral palsy?

A

By placing a cast on the good limb to force use of bad limb in functional activities and train it

49
Q

How can a dorsal rhizotomy be used to treat cerebral palsy?

A

By cutting off some of the sensory feedback coming to the dorsal root of the spine to dampen reflexes

ENS 307 (12 decks)

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