Neurology I (PPW)

Question 1

What is Psychomotor development

Answer 1

Child development is the next step in order to become independent in the world.

Psychomotor development is the consequence of both CNS maturation as well as environmental impact and stimulation.

Question 2

Factors affecting the development of the child

Answer 2

• Intrauterine environment (eg alcohol, maternal disease, drugs)
• Diseases genetically conditioned
• Acquired diseases (eg, hypoxia, traumatic states, meningitis)
• Environmental factors:
• socio-economic
• health - nutrition, sleep
• mental - chronic stress, disorder of the bonds

•Own activity of the child

Question 3

Motor development

Answer 3

3-4 months old

• twists to the sides
• propels on the elbows

4-5 months old

• trying to put a leg up
• lying on his stomach lifts his chest, propping himself on his hands
• At 5 months of age, she relies on legs for a while

6-7 months old

• twists around the axis of the body from the back to the stomach and vice versa
• He plays with his own legs
• seated sits surely

9 months old

• He/she sits alone
• stands supported by hands – 30 s.
• stands in a quadrant position

10 months

• stands at the supports
• Crawling

11-13 months

• He walks alone by the hand or at the supports

1,5 years

• Go up and down the stairs holding the railing

2 years

• runs, jumps,

Question 4

Neurological examination

How does one assess the child’s psychomotor development?

Answer 4

The first part of the neurological examination is observation.

By observation, an attempt is made to assess the child’s psychomotor development in four areas: locomotion and posture control, visual-motor coordination, speech and social interaction.

Question 5

Muscular tension and posture disorders

Muscle tension
Muscle tension is regulated centrally by means of…

Answer 5

• Every muscle, even the most relaxed, retains some kind of tension
• Muscle tension is regulated centrally by means of pyramidal and extrapyramidal pathways as well as the cerebellum

Question 6

Types of muscular tension

Answer 6

• Resting tension - the form of tension present during standby time

• Static (passive) - induced by passive motion of immobile muscle

• Postural tension - is associated with resistance to gravity and is important for maintaining a stable body position in space - is caused by gravity

•Dynamic tension - triggered during automatic movements, eg walking

Question 7

Muscular tension disturbances

Answer 7

Muscle tension in pathological conditions can be increased (hypertension) or decreased (hypotension).

I. Peripheral hypotension

• abnormal structure or function of the muscle itself (Muscular dystrophy)
• abnormal function of the neuromuscular junction (myasthenia gravis)
• damage to the peripheral nerves (neuropathies)
• damage of motoneurons of the frontal horns of the core

II. Central hypotension

• Occurs primarily in neonates and infants after severe CNS lesion (hypoxic ischemic encephalopathy). Initially, muscle tension is reduced axially and peripherally, and then muscle tension increases peripherally
• In central hypotension, tendon reflexes are preserved!

III. Muscular Hypertension (???)

Increased muscle tension is a result of damage to extrapyramidal and pyramidal roads.

It occurs in patients after stroke, traumatic brain injury, cerebral palsy, multiple sclerosis, spinal cord disease.