MS part 1 Flashcards
down syndrome
overexpression of genes found on chromosome 21
what do pt’s eventually develop with down syndrome
alzheimers
what is treatment directed towards with down syndrome
medical problems presented
common problems with older down syndrome pt’s
obesity
DM
CV
osteoarthrititic degenration of the spine - nerve pain
osteoporosis of vertebral or long bone fx
clinical manifestations with down syndrome
- muscle hypotonia
- atlantoaxial instability secondary to ligamentous laxity
- feeding disorders
- cardiac defects
- flat occiput
- recurrent patellar dislocations
- excessive foot pronation
- late hip dislocations
- scoliosis
scoliosis
- abnormal lateral curvature of spine
what can scoliosis cause
- limb length inequality
- muscular dystrophy
- rotation of vertebral column around its axis occurs and causes associated rib cage deformity –> restrictive lung disease
functional scoliosis
- postural defect secondary to pain, poor posture, leg length discrepancy & muscles spasms
- can be corrected
structural scoliosis
- fixed curvature of the spine associated with vertebral rotation and asymmetry of the ligamentous supporting structures
- congenital
if the curvature of scoliosis is <20 deg, what can occur?
rarely causes problems
if curvature for scoliosis is >60 degrees, what can happen
- severe issues
- pulmonary insufficiency
- reduced lung capacity
- back pain
- degenerative spinal arthritis
- disk disease
- sciatica
management of scoliosis for PT
- prevention of postural scoliosis
- exercises and ESTIM for pt with muscular imbalances
PT management for scoliosis
- exercise for paraspinals
- strengthen trunk extensors, abs, gluteal muscles, iliopsoas & hip extensors
prognosis for scoliosis
depends on likelihood of progression
curvature <40 at skeletal maturity
progression small
curvature >50 at skeletal maturity
- spina biomechanically unstable
- curve likely to progess throughout life
spinda bifida
- occur when the neural tube doesn’t properly close during embryo phase
- incomplete fusion of the posterior vertebral arch (meninges do not protrude)
meningocele
- external protrusion of meninges
- forced into gaps within vertebrae
- minor disabilities, no nerve damage
myelomeningocele
- most severe
- protrusion of the meninges and SC
hydrocephalus
- build up of too much CSF in the brain
- treatment: shunting
are mental functions compromised in pt’s with hydrocephalus
no
developmental dysplasia of the hip (DDH)
- ball of the femur is loose in the socket and be easy to dislocate - can lead to ligamentous laxity
- socket too shallow or not there
treatment for DDH
encourage ROM but avoid displacement of the hip
muscular dystrophy
ongoing, symmetric, muscle loss/weakness with increasing deformity and disability
duchenne’s MD
most common
alterations of protein dystrophin
repeated bouts of muscle damage lead to atrophy & fibrosis, eventually muscle degeneration
when is MD identified in children
when the child has difficulty getting up off the floor, falls frequently, difficulty climbing stairs, waddling gait, increased lumbar lordosis
what gait pattern is often seen with MD
tredelenburg
ambulation continues to deteriorate
shoulder involvement seen with MD
scapular winging
instability
other things seen with MD
scoliosis cognitive loss respiratory restrictive disease cardiac, dilated cardia myopathy GI
prognosis for MD
pulmonary and cardiac complications bring down prognosis
interventions for MD
active as possible
dont over exercise
aquatic therapy
diaphragmatic breathing
osteogenesis imperfecta (OI)
brittle bone disease
disease of collagen synthesis affecting bones and CT
OI management
fx prevention and control
splints
torticollis
- dystonia
- syndrome of involuntary sustained or spasmodic muscle contractions involving co-contractions of the agonist and antagonist
- contracted SCM
- not a diagnosis
which way does the head tilt with torticoliis
contracted SCM produces head tilt to the affected side with rotation of chin to opposite side
PT implications for torticollis
stretch and strengthen neck muscles
