MIDTERMS: Pedia Flashcards
Q: A physical therapist is examining a 5-year-old infant with cerebral palsy. The infant has an abnormal amount of extensor tone. Which of the following is incorrect positioning device for the family and caregiver?
A. Carry the child with hips flexed and externally rotated.
B. Keep the patient in a supine position.
C. Position the child in side-lying.
D. Use a seated position with the trunk supported.
B. Keep the patient in a supine position.
: A child with spastic CP is having difficulty releasing food into her mouth. Once the child has brought the food to the mouth, it would be helpful for the caregiver to:
A. Apply vibration to the child’s shoulder.
B. Slowly stroke the finger extensors in a distal to proximal direction.
C. Quickly rub the child’s back.
D. Apply firm pressure to the palm.
B. Slowly stroke the finger extensors in a distal to proximal direction.
Which of the following is inappropriate for a physical therapist to include in the treatment plan of an infant with a gestational age of 27 weeks and Down syndrome?
A. Tactile stimulation with the fingertips of the examiner.
B. Use of auditory stimuli to engage the child.
C. Tactile stimulation with the entire hand rather than the fingertips of the examiner.
D. Positioning the child with the head supported in midline.
C. Tactile stimulation with the entire hand rather than the fingertips of the examiner.
A physical therapy plan of care for a child with spastic CP who is 3 y/o chronologically and cognitively but at a 6-month-old gross developmental level would include:
A. Walking with support around the therapy room.
B. Reaching for a multicolored object while in an unsupported, guarded sitting position.
C. Playing catch with a lightweight ball.
D. Crawling on hands and knees.
B. Reaching for a multicolored object while in an unsupported, guarded sitting position.
Surgical neurectomy is useful in CP for controlling localized spasticity. This procedure can be particularly useful in the management of:
A. Hip flexor spasticity.
B. Hip adductor muscle spasticity.
C. Knee flexor spasticity.
D. Elbow extensor spasticity.
B. Hip adductor muscle spasticity.
A PT working in early intervention is helping a parent to get the baby to hold and drink from a bottle. Based on typical development, the therapist should begin to introduce this skill between:
A. 3–4 months.
B. 6–8 months.
C. 9–12 months.
D. 12–15 months.
B. 6–8 months.
The most appropriate school physical therapy intervention for a child with decreased sitting balance but normal tone would be:
A. Provide aquatic therapy.
B. Practice standing balance exercises.
C. Adapt a desk and a wheelchair to provide adequate sitting balance during class time.
D. Encourage walking with assistance in the classroom.
C. Adapt a desk and a wheelchair to provide adequate sitting balance during class time.
An 18-month-old patient has difficulty in sitting, complicated by poor sitting balance. When he tries to eat, he drags his hand with difficulty and brings the food to his mouth unsuccessfully, which frustrates him. The physical therapist should:
A. Practice the activity for short periods of time.
B. Place the child in a supported standing position to encourage postural alignment.
C. Use an assistive device to stabilize the arms.
D. Encourage independent feeding without intervention.
A. Practice the activity for short periods of time.
A six-year-old born with myelomeningocele at the L2 level is referred for physical therapy treatment at home. In determining the plan of care, it would NOT be appropriate to emphasize:
A. Vigorous range of motion of the lower extremities.
B. Strengthening of the upper extremities.
C. Development of sitting balance.
D. Prevention of pressure sores.
A. Vigorous range of motion of the lower extremities.
An infant demonstrates that ATNR is NOT obligatory when he/she can:
A. Turn the head and bring hand to mouth on the same side.
B. Flex both arms and legs when placed in supine.
C. Crawl on hands and knees without head movement.
D. Keep the head in midline while reaching.
A. Turn the head and bring hand to mouth on the same side.
The most important concern before treating a 2-year-old patient with cerebral palsy is:
A. Gestational age.
B. Tone abnormalities.
C. Cognitive level.
D. Family involvement.
A. Gestational age.
In preparing a home physical therapy program for a 2-year-old child with Down syndrome, the best activity to facilitate walking would be:
A. Tummy time with arm support.
B. Weight shifting in standing, while dancing to music.
C. Walking in water.
D. Crawling on the floor.
B. Weight shifting in standing, while dancing to music.
When a patient is lying supine and tilts to the left, the balance reaction that occurs is:
A. The neck flexes laterally to the right, trunk side flexion to the right, and arm and leg on the right abduct and extend.
B. The neck flexes to the left, trunk extends, and both arms extend.
C. The trunk flexes to the right and the arms and legs flex.
D. The neck flexes forward and trunk rotates to the right.
A. The neck flexes laterally to the right, trunk side flexion to the right, and arm and leg on the right abduct and extend.
In order to inhibit extensor tone when handling a young cerebral palsy child, the caretaker should be instructed to:
A. Carry the infant with hips extended and back arched.
B. Carry the infant with hips flexed and externally rotated and upper back supported.
C. Hold the child upright with head extended.
D. Encourage extension activities in prone.
B. Carry the infant with hips flexed and externally rotated and upper back supported.
A 4-year-old child with moderate spastic diplegia is referred to physical therapy for an adaptive equipment check. All of the following equipment would be appropriate except:
A. Walker with posterior support.
B. Prone stander.
C. Ankle-foot orthosis (AFO).
D. Wheelchair with proper seating.
B. Prone stander.
An infant who was 33 weeks gestational age at birth and is now 3 weeks chronological age demonstrates colic. In this case, the best intervention the physical therapist could teach the mother is:
A. Provide gentle rocking.
B. Neutral warmth.
C. Gentle passive stretching.
D. Use of a vibrating mat.
B. Neutral warmth.
A 6-year-old spastic quadriplegic CP patient was referred to you. The following problems are present: (-) RGR, (-) head and trunk control, and full dependence in all aspects of ADL. All of the following inhibition techniques may be used EXCEPT:
A. Slow rhythmic movements.
B. Gentle rocking.
C. Sudden, quick movements.
D. Deep pressure.
C. Sudden, quick movements.
A therapist attempts to improve neck and upper back extension in an infant with developmental delay. When passively placed in prone prop, the infant quickly falls into the prone position. The therapist plans to position the child and then use toys and play objects to get the child to look up. Which position would be the most appropriate to meet the therapist’s treatment objectives?
A. Prone over a gymnastic ball.
B. Seated in a high chair with trunk support.
C. Supine on the floor.
D. Standing with support.
A. Prone over a gymnastic ball.
Follows strictly developmental sequence; child is not permitted to use motor skills that are beyond his level of development (if cannot crawl, should not walk).
Neuromotor Development
A spastic quadriplegic CP patient exhibits scissoring gait secondary to spasticity of hip adductors. What preliminary activity to walking is best to correct this problem?
A. Stretching exercises for the hip abductors.
B. Pressure on the insertion of adductor muscles.
C. Strengthening exercises for the hip extensors.
D. Tummy time with support.
B. Pressure on the insertion of adductor muscles.
What is missing in the developmental milestone of a 2-month-old child?
A. Ability to sit unsupported.
B. Rolling over from supine to prone.
C. Ability to track objects with eyes while in a prone position.
D. Walking with assistance.
C. Ability to track objects with eyes while in a prone position.
Principle is integration of therapy and education, a unified system of rehabilitation for people with neurological disorders such as cerebral palsy, PD, MS, CVA, and other brain injuries.
Conductive Education
Bracing is employed extensively to correct deformity, obtain upright position, and control athetosis.
Muscle Education and Braces (Phelp’s)
Patterning is a series of exercises designed to improve a child’s neurologic impairments; it requires that these exercises be performed over many hours during the day by several persons who manipulate a child’s head and extremities to mimic the evolutionary patterns.
Doman – Delacato Approach
Therapeutic goals are to facilitate the automatic regulation or control of the body’s position; to facilitate the active maintenance of the support function of the extremities.
Reflex Locomotion (Vojta)
A 3-year-old with spina bifida needs mobility augmentation for outdoor movement. Which mobility device should be recommended?
a) Wheelchair
b) Posterior walker
c) Ankle–foot orthosis
b) Posterior walker
