Management of Neurologic Conditions Flashcards
CP Types and Pyramidal System Involvement
Pure spasticity - Pyramidal system is damaged
Athetoid Cerebral - extrapyramidal system is involved
Mixed Pattern - both systems are injured
Postnatal Risk Factors (CP)
Seizures within 48 hours after birth
Cerebral Infarction
Hyperbilirubinemia
Sepsis
Respiratory Distress / Chronic Lung Disease
Meningitis
Events later in Infancy / Early Childhood (that increase risk for CP)
Infections / Meningitis
Non-Accidental Trauma (shaken baby)
Accidental Trauma (TBI shortly after birth)
Asphyxia (choking, near drowning)
Periventricular Leukomalacia (PVL)
Bilateral white matter necrosis
Most common in premature infants / can be seen in full-term infants
High correlation with development of CP
Interventricular Hemorrhage (IVH)
Most common (neonatal) variety is Subependymal Germinal Matrix IVH
Thin walled vessels in this area bleed easily
Grades 1-4 (3 and 4 correlate with neurodevelopmental sequelae)
What is the most common type of Spastic CP?
Diplegic
What is the most common type of Dyskinetic CP?
Athetosis
GMFCS Level 1
Walk at home / school / outdoors in the community
Can climb stairs without the use of a railing
Can run / jump
Speed / balance / coordination limited
GMFCS Level 2
Children walk in most settings
Climb stairs holding onto a railing
May experience difficulty with long distances / balancing on uneven terrain / inclines / crowded areas or confined spaces
Minimal ability to run / jump
GMFCS Level 3
Walk using a hand-held mobility device in most indoor settings
May climb stairs holding railing OR with supervision / assistance
What is the commonality between GMFCS Levels 2 and 3?
Children may used wheeled mobility when traveling long distances (self-propel short distances in Level 3)
GMFCS Level 4
Children use methods of mobility that require physical assistance or powered mobility in most settings
MAY walk for short distances at home with physical assistance
GMFCS Level 5
Children transported in a manual WC in ALL settings
Children limited in ability to maintain antigravity head and trunk postures + control arm / leg movements
Muscles grow in response to ___.
stretch
What has to come together in order for the muscle to catch up with a growing bone?
stretch / growth hormones
Signals muscles to grow in length by adding sarcomeres at the musculotendinous conjunction
Why are muscles inadequately stretched in children with CP?
They are unable to move through the entire joint ROM repeatedly
Lever Arm Dysfunction (in the context of CP)
Lever Arm Dysfunction: Abnormal Bony Lever Arms (moment arms upon which the muscles act)
Moment: Force acting at a distance from an axis / rotational center causing an object to rotate
Abnormal muscle forces / lack of normal movement and WB / disuse and compensatory mechanisms in CP can alter Bony Lever Arms
CHEAP Torches Infections
Chicken Pox
Hepatitis (B, C, E)
Enterovirus
AIDS
Parvovirus (dogs, GI symptoms)
Sensory Integration Disorder
Deficits lie in perception / organization / coordinated response to sensory information
Caused by neurological immaturity or malfunction in brain processing
6 Sensory Systems
Proprioception
Vestibular
Tactile
Vision
Auditory
Taste and Smell
All areas work in a continuous feedback framework
Sensory Integration vs. Sensory Processing
Processing - reception / modulation / integration / organization of sensory info
Integration - behavioral manifestation of Sensory Processing
Sensory Modulation Dysfunction
Over responsiveness or under responsiveness to stimulation
May be reflected in sensory seeking or sensory avoiding
Sensory Based Motor Disorders
May have neuroanatomic origins in neural activity before motor execution causes dyspraxia and postural disorder
Sensory Integration and Praxis Tests (SIPT)
Series of tests that assess how a child processes sensory input
TBI is defined as a ___ force to the head.
external
TBI Deficits
Altered tone
Motor control issues
Weakness
Balance dysfunction
Impaired gross and / or fine motor ability
Intellectual / behavioral / emotional / speech deficits
Implications of Fetal Alcohol Syndrome
Intellectual impairments
Learning disabilities
Communication / fine motor deficits
Neurofibromatoses
Genetic disorders that cause tumors to grow in the NS
Impairs function of joints and bones
Potential impaired mobility / self-care issues
