Lecture 5: Management Of Neurologic Conditions Flashcards by sophia carrasco

CP, BP, DCD, Autism (ASD), Myelodysplasia

These are examples of what kind of diagnosis

Neurologic

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What describes a group of disorders of the
development of movement and causing activity
limitation, that are non-progressive disturbances
that occur in the developing fetal or infant brain

Cerebral palsy

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What are motor disorders of CP often accomplished by

Disturbances in sensation , cognition , communication . Perception and/or behavior and/or seizures

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What is the most common motor disability in cildhoood

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T/f: greater then half of the children with CP have a co occurring condition

True

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When can distrubances in the brains function/development occur for CP

prenatal
Birth
Postnatal

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CP can also bc caused by a CNS lesion and what may it result in

Spastic , athetoid , ataxic or mixed movement impairment

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What system is damaged if the patient has pure spasticity only for CP

Pyramidal

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If a patient has athetoid cerebral palsy what system is invovled

Extrapyramidal

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What are the prenatal risk factors during pregnancy for CP (7)

STORCH infections
CHEAP torches
maternal seizure disorder
maternal high BP
maternal toxin exposure
bleeding in 3rd trimester
thyroid hormone disorder

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What are the prenatal risk factors for CP (12)

Multiple Gestation
Hypoxia
Metabolic disorders
Malformation of brain structures
Vascular Insults
Abdominal Trauma
Premature birth (< 32 weeks or < 2500 grams)
blood incompatibility
asphyxia
infection/chorioamniotis
placental abruption
instrumented delivery

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What are the post natal risk factors for CP

 Seizures w/in 48 hrs. after birth
 Cerebral Infarction
 Hyperbilirubinemia
 Sepsis
 Respiratory Distress/Chronic lung disease
 Meningitis

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What are the postnatal risk factors/events later in infant/early childhood for CP

 Infections/meningitis
 Non-accidental trauma (shaken-baby)
 Accidental trauma – TBI – shortly after
birth
 Asphyxia – choking, near drowning

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What is preiventricular leukomalacia

Bilateral white matter necrosis

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Who is periventricular leukomalacia most commonly observed in

Premature infants

< 32 weeks

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What does PVL have a high correlation with

Development of CP

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What is the most common variety of neonatal interventricular hemorrhage

Subependymal germinal matrix IVH

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What grades of Interventricular Hemorrhage (IVH) are correlated with CP

Grades 3 and 4

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Grades 3 and 4 of Interventricular Hemorrhage (IVH) are highly correlated with what

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CP classifications

 Diplegia
 Hemiplegia
 Triplegia
 Quadriplegia

 Diplegia- both legs

 Hemiplegia- one side of body

 Triplegia- 3 limb s

 Quadriplegia- all 4 limbs

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T/F: invovlement for CP is always symmetrical from 1 side to another

False it is rarely symmetrical from side to side

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What is the most common type of CP

Diplegic Spastic CP

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What are the GMFCS levels 1-5

Level 1 – walks w/out limitations
◦ Level 2 – walks w/ limitations but with no walker or anything
◦ Level 3 – walks using a hand-held device
◦ Level 4 – self-mobility w/ limitations; may
use powered mobility
◦ Level 5 – transported in a manual wheelchair

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What GMFCS levle is the most mild and most severe

Level 1= mild
Level 5= severe

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Is CP progressive ?

The lesion in the brain that causes CP is not progressive But in terms of MSK issures it is bc the kids grow

**Poor motor control** affects the **timing** and **coordination** of mm activity but what does it also affect

Mm growth bc mms grow in response to stretch

This is how mm grow  For example, a child gets up in the morning and her bone has grown slightly from day before  As she runs and plays during the day the muscles that span that bone are being stretched.  It is this stretch in conjunction with the presence of growth hormones which signals the muscles to grow in length by adding sarcomeres at the musculotendonus conjunction For kids with CP it is different .. how

Kids with CP are unable to move thru the entire joint ROM repeatedly so then the mms can’t stretch correctly so then the mm cant grow since they grow in response to stretch

What does **tight PF** lead to in the foot

Pronates

What is the **bony lever arm**

Moment arms upon which the mm act on

What does moment =

Center x distance

What **alter bone growth** both in **shape in orientation**

Abnormal mm forces combined with the lack of normal growth stimulation

Abnormal mm forces combined with the lack of normal growth stimulation alters what

Bone growth both in shape and orientation

What are the factors that the depend on the rate of child’s bone growth

* physiological stresses * nutrition * presence of growth hormones

The bones have a preprogrammed blue print for shape but the blueprint is also dependent on the magnitude and direction of what kind of forces

Internal mm and external mm forces that act on the bone

What can alter the bony lever arms in **CP** that is often referred to as **lever arm dysfucntion**

Abnormal mm forces , lack of Normal movement and/or weight bearing , disuse and compensatory mechanisms

What does **autism** significantly affect

Verbal and non verbal communication Social interaction

When is **ASD** generally **evident before**

3 y/o

What is often **impaired** with **ASD**

* motor performance * apraxia * coordination * toe walking

What is **Asperger** characterized by

Significant difficulties in social interactions

**Sensory integration disorder** defects lie in what

Perception , organization and coordination response to sensory information

What is **sensory integration dysfucntion** caused by

Neurological immaturity or malfunction in brain processing

What is is the **behavioral manifestation of sensory processing which leads to modulation and praxis**

Sensory integration

What is a neurophysiologic term that reflects the reception, modulation, integration, and organization of sensory stimuli, but not necessarily the adaptive environmental interaction that we observe.

Sensory processing

What is considered an **over responsiveness or under responsiveness to stimulation and may be reflected in sensory seeking or sensory avoiding**

Sensory modulation dysfucntion

What disorders may have neuroanatomic origins in neural activity before motor execution causes dyspraxia and postural disorder

Sensory based motor disorders

What is a standardized testing that has a **family of assessments** provides standardized tools to help evaluate a child's sensory processing patterns in the context of home, school, and community-based activities

Sensory profile 2

What was developed to evaluate sensory processing patterns in the very young. The results provide understanding of how sensory processing affects the child’s daily functioning performance.

The infant/toddler sensory profile

What Does the **adolescent/adult sensory profile** help measure

Sensory provessing patterns and effects on functional performance

How is **sensory processing disorder** diagnosed through

A comprehensive evaluation that includes standardized testing , obersevation and a review of a Childers development

What is **Sensory Integration and Praxis Tests (SIPT)**

A series of tests that assess how a child processes sensory input

What are the 6 sensory systems

 Proprioception  Vestibular  Tactile  Vision  Auditory  Taste and Smell

What are the common sings and SYMTOMS for **DCD**

 Frequently occurs with learning disabilities and attention deficit disorders  Decreased muscle tone  Muscle weakness  Motor incoordination

What is a Genetic disorder in which majority of individuals have **extra 21st chromosome**

What aer the signs and symptoms of DS

 Generalized low tone  Muscle weakness  Joint laxity  Slow postural reactions  Intellectual impairment  Possible heart defects**  Possible cervical instability**

What does deficits of a TBI depend on

The degree of injury

What are common things seen with TBI

 Altered tone  Motor control issues  Weakness  Balance Dysfunction  Impaired gross and/or fine motor ability  Intellectual, behavioral, emotional and/or speech deficits

What is a Group of congenital disorders characterized by varying degrees of **incomplete closure of the embryonic neural tube**

Spina bifida

What a kind of **allergy** does spina bifida have

Latex

What are the 3 classifications of spina bifida based on the degree of neutral tube deficit

* occulta * meningocele * myelomningocele

What is **occulta** as a degree of neutral Tude deficit

Mildest form , sometimes called hidden.. may only see a turf of hair

What is **meningocele**

**Protrusion** of posterior elements of spine with **extrusion** of meninges and CSF but **without** involvement of neutral elements

What is myelomingocele

Extrusion of neutral elements such as nerves and spina cord as well as the meninges and CSF Most severe

There is Relationship between inadequate ____ and ___ __ intake and **neural tube deficits**

Vitamins Folic acid

What is **diminished** and **impaired** for **myelonmeningocele**

* diminished trunk or LE strength and sensation * impaired bowel and bladder

What should u **monitor** for **myelomeningocele**

Scoliosis

What is importance to observe and assess for **myelomeningocele**

Hydrocephalaus

Knowledge of what **2 things** should be known about with patients with **Myelomeningocele**

Shunt malfunctions Tethered cord

What should u look for when thinking **tethered cord** involement for SB/ mylingenolcele

Cutaneous tufts of hair or dimples or skin disocolroation in the low back region

What are **signs** of **tethered cord**

* LBP that worsens with activity and improves with est * leg pain or numbness * gait disturbance * foot or spinal deformities * difficulties with bowel and bladder * repeat UTI’s

What are **shunt malfunctions** warning signs

* Headaches * Vomiting * Lethargy (sleepiness) * Irritability * Swelling or redness along the shunt tract * Decreased school performance * Periods of confusion * Seizures

What can fetal alcohol syndrome result in

 Intellectual impairments  Learning disabilities  Communication deficits  Fine motor deficits

What is **Neurofibromatoses**

Generic disorders that cause tumors to grow in the nervous system

What can **Neurofibromatoses** result in

 Impairs function of the joints and bones  Potential impaired mobility  Potential self-care issues

What are the **interventions** for **Neurofibromatoses**

to prevent secondary impairment and optimize activity and participation

What is STORCH infections

* Syphilis * toxoplasmosis * other infections (varicella zoster( * rubella * CMV (cytomegalovirus) * herpes

What is CHEAP torches

* chicken pox * hepatitis (B,C,E) * Entervirus * AIDs * parovirus