Pediatric conditions and treatment Flashcards
Periventricular leukomalacia can result in what disability?
CP
What grades of periventricular hemorrhage can lead to CP?
grades 2-4
- graded from 1-4
T/F: CP is always d/t issues during birth.
false, can be prenatal, perinatal, or postnatal
T/F: Infant jumpers/walkers would be an appropriate intervention for premature infant children.
false, they encourage extensor tone which we’re trying to limit
What does athetoid CP look like?
decreased tone, floppy, foot stability in proximal joints, ataxia/incoordination in upright
What are the gross motor classifications for kids with CP?
I-V
I = walks without restrictions II = walks without device, limitations walking in community III = walks with AD, still limited in community IV = self mobility with limitations; power mobility in community V = self mobility severely limited, even with assistive technology
Why is a posterior walker used over an anterior walker for kids with CP?
promotes better posture and decreases extensor tone in arms from arm posture used to support oneself
You’re working with a patient who has an intrathecal baclofen pump. What are some symptoms that would indicate overdose?
drowsiness dizziness respiratory depression seizures hypotonia loss of consciousness
What are the different types of spina bifida and their severities?
occulta = no spinal cord involvment
cystica = visable/open lesion
- myelomeningocele = CSF and herniated cord tissue in cyst
- meningocele = only CSF in cyst, no cord
Why do defects in neural tube occur, resulting in spina bifida?
decreased folic acid, infection, exposure to alcohol/valproic acid, hot tub soaks
What other issues are common to occur with spina bifida? (think brain, MS)
hydrocephalus (lots of these kids have shunts to relieve pressure)
talipes equinovarus (club foot)
High level lumbar patients with spina bifida might need what to ambulate?
RGO
You’re educating a patient with spina bifida’s family on how to watch for shunt malfunction. What symptoms should you tell them to look out for?
headache, bulging fontanelles, decreased muscle tone, seizure/vomiting, increased irritability, redness along shunt tract
What’s the difference between Erb’s paralysis and Klumpke’s paralysis?
Both come from traction or compression injury to unilateral brachial plexus during birth or cervical rib abnormality
- Klumpke’s is lower: C8-T1 (finger flexors, wrist flexors/extensors)
- Erb’s involved C5-6 (upper arm paralysis down to long extensors in wrist/thumb)
What’s the prognosis of a traction injury?
they resolve spontaneously
Waiter’s tip posture is commonly seen in what injury?
Erb’s palsy
What does PT intervention look like for babies with brachial plexus injuries?
partial immobilization of limb on abdomen
- gentle ROM after to prevent contracture
- gentle constraint of unaffected arm via positioning
What are the optimal feeding techniques for patients with downs?
short, frequent feeding sessions to improve energy conservation
T/F: Traction is an appropriate modality for kids with downs.
FALSE b/c they’re so lax
Why does heterotopic ossification occur?
prolonged immobility combined with increased tone around joint
T/F: Weakness in DMD begins from proximal to distal.
true
What does a positive Gower’s sign indicate?
weak quads and glutes - using UEs to walk up legs
What are common contractures that form with DJD?
PF contracture
lumbar lordosis
TFL contracture
kyphoscoliosis
What should you tell the family about encouraging/not encouraging physical activity for their child newly diagnosed with DMD?
you WANT to encourage physical activity through recreational exercise and functional activities
- helps maintain strength/CV function
T/F: Night splints are often given immediately to patients with DMD as contractures usually develop early.
true, especially in PFs and TFL
T/F: Patients with DMD are losing muscle so need progressive resisted exercise to gain more muscle.
no they cannot exercise at maximal levels, overwork injury occurs and that torn muscle fiber is now gone forever
T/F: Estim used in kids with DMD has been shown to improve contractility.
true
What meds help to prolong life in DMD d/t improvements in pulmonary dysfunction?
steroids
What positioning equipment can be effective in reducing effects of the tonic labrynthine reflex?
side lyers
- they also put hands in visual field which is good
For what years is an EIP in place? (early intervention program) What about IEP? (individual education plan)
birth to 3 = EIP
3-21 = IEP
