neuro-peds Flashcards
disorder of the LMN and motor nuclei of brainstem with progressive weakness and atrophy, symmetrical effects,
spinal muscular atrophy
most common form of SMA
intermediate onset of 7-18 mo of age never stands death <2 years px dependent on respiratory function symmetrical weakness of LE, tongue, hand tremors, decreased DTR, facial mm spared, hypotonia, joint laxity
All facial and IQ function remains intact with SMA
TRUE
spina bifida occulta
midline defect in vertebral bodies w/o protrusion of SC,
meningocele
the meninges protrude through defect in posterior vertebral deficit SC is normal
myelomeningocele
herniation of both meninges and SC through posterior vertebral bodies
Why does SB occur?
combination go hereditary and environment
What can decrease risk of SB?
folic acid intake
Where do majority of spina bifida injuries occur?
lumbar and sacral regions
SB: sacral lesion
B/B dysfunction
can ambulate
SB: lumbosacral lesion
B/B dysfunction and ankle instability
SB: lumbar lesion above L3
will require W/C for mobility outside home
can be low level ambulatory in home
SB: thoracolumbar
w/c bound
80% of children with myelomeningoecele will have hydrocephalus
TRUE
s/s of hydropcephalus
bulging fontanelle, split sutures, sunset eyes, lethargy, poor feeding, vomiting, irritability, apnea, CSF leakage
ventricular periotoneal shunts can cause what?
infection!
HA, vomting, seizures
chiarii malformation
cerebellum is pushed down into spinal canal
which allergy is common in SB?
latex allergy
sensation is needed for what?
learning
sensory integration involves what?
organization, interpretation, and adaptation of sensory info to execute motor function
primary systems of focus for sensory integration
vestibular, proprioceptive, tactile, vision
sensory modulation disorders
overresponsivity
underresponsivity
sensory seeking
sensory modulation des.
receive sensory input, but behavioral response is abnormal
sensory discrimination disorder description
sensation is difficult to interpret, hypotonic patients, dyspraxia, poor feedforward reactions (auditory, vestibular, tactile)
sensory based motor disorder-postural disorder
sensory deficits impact postural control, slumped postures
sensory based motor disorder-dyspraxia
motor coordination issues due to conception, sequencing, and execution problems. Fine motor greatly affected. gross motor skills may or may not be impaired
treatment for sensory integration disorders
VESTBULAR activities first!!!
Duchenne MD
only occurs in boys, usually identified by age 3, death by late teens due to cardiac/pulmonary effects,
cause of Duchenne MD
absencd of protein dystrophin (present in skeletal, cardiac, smooth muscle)
DMS s/s
pelvic girdle weakness GOWER sign toe walking contractures respiratory effects cardiac effect
How often are you eligible for a WC?
3 years as child, 5 years as adult
indications for WC
non-functional, non-ambulatory, undafe amb. weakness
indications for seating system
prevent pressure ulcers, decrease pain accommodate ortho deformity, issues with comfort, poor sitting stability
DO NOT “stretch” the individual into new position for seating system
TRUE, need to maintain current ROM
standard WC flexibility requires what
90 hip flexion
70 knee flexion
neutral DF/PF
fixed deformity vs flexed deformity
fixed: designed to support the deformity
flexed: system applies to correct the deformity
pelvic obliquity is named for what
named for the LOWER SIDE
pelvic rotation is named for what
named for the forward side
rib hump is on the convex side!!! or to the ide of the curvature (R curve, R rib hump)
TRUE
When should you check for a rib hump?
before puberty growth spurt
girls 9-11
boys 12-14
bracing should be done in people with more than how many degrees of curvature?
24 degrees
signs of CP
abnormal tone, primitive reflexes that don’t integrate, postural reactions that don’t develop including head control, equilibrium, postural reactions don’t develop, postural tone that is one sided
CP can be acquired in utero, birth, or post-natal.
True, most common in utero
types of CP and which one is most common
spastic form is most common, involving the motor cortex
dyskinetic involving the basal ganglia (choreic/athetoid)
ataxic involving the cerebellum
hypotonic as well (flaccid)
gross motor functional classification scale
level 1
independent with ambulation, walks without restrictions
GMFCS
level 2
walks without assistive device but has limitations outdoors in the community
GMFCS
level 3
walks with assistive device, WC for longer distances
GMFCS
level 4
self mobility with limitations, uses manual or power WC, may walk short distances
GMFCS
level 5
mobility severely limited, dependent mobility, use of manual power WC
FAS
most common cause of mental dysfunction in the western world
diagnosis of FAS
ALL 3 facial abnormalities: smooth philtrum, thin vermillion, small palpebral fissures AND growth deficits and CNS/neurobehaviorsl d/o
primary goal of PT in public education
to enable children with disabilities to benefit from educational instruction in the least restrictive environment
when should PT be discontinued in the school setting?
when goals have been met, no longer requires expertise of PT, no more potential for improvement, when other goals have been met
APGAR
neonate screen right after birth to check for any problems
0-3 low
Denver 2
screen for developmental delays
0-6 y/o
alberta infant motor function scale
12-18 mo. tests gross motor in supine, prone, sitting, and standing
Peabody
motor function assessment for 0-5 y/o in well and disabled children
BOT 2
motor function (challenging game like tests) 4-21 y/o
bayley 2
comprehensive test for typical and special needs children 1-42 months
failure to thrive
not a diagnosis but a problem
“insufficient usable nutrition”
Dx: decrease in weight, increase in height, weight is less than 2% for their age
nasal flaring, tachypnea, grunting at birth indicative of
respiratory distress syndrome
common in preterm babies
lack surfactant
newborn presenting with bradycardia, hypotonia, shock s/s, seizure
Intraventricular hemorrhage
erb’s palsy vs klumpke’s palsy
erb’s lost C5-C6 placing patient into adducted and IR shoulder
klumpke’s lost C6-T1 putting patient into claw hand
piaget’s cognitive developmental theory
stage 1
sensorimotor
organizaing, building, adapting schemes (0-2 y/o)
piaget’s cognitive developmental theory
stage 2
preoperational
word and images explain the world (2-7)
piaget’s cognitive developmental theory
stage 3
concrete operational
logical thinking, but needs to be concrete (7-11)
piaget’s cognitive develoepmental theory
formal operational abstract thinking (11+)
classical conditioning
Pavlov’s dogs (pairing unconditioned to neutral stimulus)
operant conditioning
consequences alter behavior -/+ renforcement
sensorimotor play
movements seen in infants
practice play
repetitive play
symobilic play
make believe play (5 y/o)
social play
peer interaction (preschool)
constructive play
goal of creating a product
cooperative play
group play
associative play
playing together
parallel play
side by side
onlooker play
watches others play
solitary play
play by self 2-3 years old
unoccupied play
random
motor development, symmetry begins after?
after 4 months
high guard as what?
you transition into new upright skill
early gait characteristics
scap retraction, wide BOS, hip flexion, knee extension, trunk extension, high guard
children and temp
poor temperature regulators and thirst sensitivity
purple crying period is whn
2 months
3 months
POE
4 months
ab/glute activation in prone, minimla to no head lag in pull to sit,
5 months
pivot prone, arm crawling, plantigrade, prop sitting
6 months
sitting alone, prone on hands, independent rolling, supported stance
7months
pull to stand, long sitting
8 months -9 months
climbing, stranger anxiety, quadruped, creeping (normal crawling
8-10
side sitting named for side of trunk elongation
11-12 months
stand to squat , 3-4 words
walking
10-15 months
moro
baby extends neck and arms flail out
crossed extension
paired with flexor withdrawal
NOB
turn head, body follows
BOB
tuen lower body, upper body follows
primitive positive support
hold baby up and they will support themselves, goes away at 2-4 months
protective reactions
anterior
lateral
posterior
6 months, 7 months, 9 months
menstrual age
age counted from mother’s last period
gestational age
age counted form fertilization (38 weeks)
chronological age - amount of preterm (months/weeks)=baby’s adjusted age
6 months old, but 2 months early so adjusted age would be 4 months
TRUE
Developmental dysplasia of the hip
Ortolani vs. barlow maneuver
barlow: hip in place at rest but dislocatable with rest
ortolani: hip dislocated at rest but reducible with manipulation
