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Neuro and MSK Management Flashcards

1
Q

what age group is MACS for?

A

4-18 yo

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2
Q

how is MACS performed?

A

ask someone who knows the child and how the child typically performs

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3
Q

MACS I

A

handles objects easily and successfully

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4
Q

MACS II

A

handles most objects but with somewhat reduced quality and/or speed of achievement

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5
Q

MACS III

A

handles objects with difficulty
needs help to prepare and/or modify activities

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6
Q

MACS IV

A

handles a limited selection of easily managed objects in adapted situations

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7
Q

MACS V

A

does not handle objects and has severely limited ability to perform even simple actions

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8
Q

what is the purpose of the FMS?

A

describe functional mobility in children 4-18 yo with CP

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9
Q

how is mobility described in the FMS?

A

over 3 distinct distances: home (5m), school (50m), in wider community (500m)

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10
Q

FMS 6

A

independent on all surfaces

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11
Q

FMS 5

A

independent on level surfaces
requires rail for stairs

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12
Q

FMS 4

A

uses 1 or 2 sticks

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13
Q

FMS 3

A

uses crutches

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14
Q

FMS 2

A

uses walker or frame

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15
Q

FMS 1

A

uses WC

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16
Q

when is a C or N used for FMS?

A

C - crawling
N - does not apply (can’t complete full distance)

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17
Q

what is the gold standard for classifying CP?

A

GMFM

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18
Q

what type of assessment is GMFM?

A

criterion referenced
observational assessment

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19
Q

what diagnoses is GMFM validated for?

A

CP
down syndrome

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20
Q

GMFM 88 vs 66

A

88: 5mo - 16 yo
66: 5-16 yo

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21
Q

what 5 dimensions does the GMFM include?

A

lying and rolling
sitting
crawling and kneeling
standing
walking, running, jumping

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22
Q

GMFM Score:
0
1
2
3

A

0: does not initiate task
1: initiates task
2: partially completes task
3: completes task

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23
Q

which GMFM should be used for down syndrome?

A

88

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24
Q

what other diagnoses could GMFM be used for?

A

TBI
spinal muscular atrophy
osteogenesis imperfecta
hereditary spastic paresis
acute lymphoblastic leukemia

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25
you need at least ___ steps for GMFM
5
26
you need a space for a ____ meter run for GMFM
4.5 meter
27
GMFM 88 vs 66
88: more items for level V, eval of ambulatory aids and/or orthoses or shoes of interest 66: barefoot
28
which GMFM provides a more meaningful assessment of change?
66
29
precautions for spina bifida
latex allergy observe and assess hydrocephalus VP shunt tethered cord sudden significant changes in foot posture and/or B&B function
30
incidence of shunt malfunction
15%
31
1 year failure rate for VP shunts is ___% for pediatrics and ___ for adult
40-50% peds 29% adult getting lower tho
32
tethered cord signs
weakness, numbness in legs tremors or spasms in leg muscles changes in foot appearance (higher arches, curled toes) loss or worsening of B&B function
33
initial radiographs should be taken between what ages for children with down syndrome?
3-5 years
34
assessment tools for down syndrome
GMFM PDMS-2
35
individuals with disability education improvement act Part B: age group: components:
3-21 yo school aged services components: - IEP - PTE - NOREP
36
how often is an IEP developed?
annually
37
what is a NOREP?
classifies type of classroom and programming
38
individuals with disability education improvement act Part C: age group: components:
birth to 3 yo early intervention services IFSP financial assistance to states for early intervention programs
39
how often is IFSP reviewed?
at least every 6 mo
40
purpose of section 504 of rehabilitation act of 1973
discrimination against individuals with disabilities illegal; protects students
41
Americans with disabilities act of 1990
prohibits discrimination against individuals with disabilities in employment, transportation, public accommodation communities, and government activities
42
_____ system is unreliable in young children (<4 yo)
thermoregulatory
43
dense ordinary CT
heals tendons and ligaments
44
a common complication of tendon regeneration is _____
development of fibrous adhesions b/w tendon and surrounding tissue
45
what layer of embryonic development is bone, cartilage, and muscle derived from?
mesoderm
46
Hueter-Volkman Principle
growth plates produce increase growth in response to tension and decreased growth in response to excessive compression
47
how is bone age usually determined?
X-ray of L wrist, hand, and fingers
48
what is a Risser sign used to assess?
scoliosis
49
a ____ Risser sign indicates that a lot of growth is left and scoliosis will get worse
low
50
when does the anterior fontanelle close?
7-18 months
51
when does the posterior fontanelle close?
1-2 months
52
T/F: therapeutic US is NOT safe over growth plates by diagnostic US is
T
53
what occurs in dominant (classical) OI that leads to brittle bones?
too little or poor quality of type 1 collagen due to genetic mutation of 1 of the type 1 collagen genes
54
what occurs in recessive OI that leads to brittle bones?
mutation in non-collagen genes
55
how long does biochemical (collagen) and molecular (DNA) testing take to diagnose OI?
requires several weeks
56
biochemical (collagen) and molecular (DNA) tests detect almost ___% of type 1 collagen mutations
90%
57
what meds will someone with OI usually be on?
bisphosphonate vit D
58
clinical characteristics of OI
hyperlaxity of ligaments fragile skin poor thermoregulation blue sclerae dentinogenesis imperfecta (teeth)
59
how do you educate a parent on infant handling with OI?
- carry w/ widespread hands over head/shoulders and bottom - diaper changes done by lifting butt not ankles - do not twist or pull body parts
60
rules with MMT and OI
may NOT be possible if tolerate - do a midshaft of bone
61
what MMT should never be performed for OI pt?
no isolated trunk extension or flexion to assess core strength (d/t spine fx possible)

Peds (20 decks)

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