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National Physical Therapy Examination: Pediatrics > Pediatrics: Interventions: Cerebral Palsy > Flashcards

Pediatrics: Interventions: Cerebral Palsy Flashcards

1
Q

Cerebral Palsy: Pathology

A
  • Non-progressive encephalopathy caused by
  • Hemorrhage below the lining of the ventricles
  • Hypoxia
  • Malformations and Trauma to the CNS
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2
Q

Cerebral Palsy: Classifications: One limb

A
  • Monoplegia
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3
Q

Cerebral Palsy: Classifications: Two lower limbs

A
  • Diplegia
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4
Q

Cerebral Palsy: Classifications: Upper and Lower limbs on one side of the body

A
  • Hemiplegia
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5
Q

Cerebral Palsy: Classifications: All four limbs

A
  • Quadriplegia
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6
Q

Cerebral Palsy: Classifications: Trunk

A
  • Can be involved in all types
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7
Q

Cerebral Palsy: Movement Disorders: Spastic

A
  • Increased tone
  • Lesion of motor cortex
  • Lesion of projections of motor cortex
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8
Q

Cerebral Palsy: Movement Disorders: Athetosis

A
  • Fluctuating muscle tone
  • Involuntary slow writhing movements
  • Lesion of Basal Ganglia
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9
Q

Cerebral Palsy: Movement Disorders: Ataxia

A
  • Instability of movement especially ambulation

- Lesion of cerebellum

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10
Q

Cerebral Palsy: Movement Disorders: Dystonia

A
  • Involuntary movements with sustained contractions
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11
Q

Cerebral Palsy: Movement Disorders: Hypotonia

A
  • Decreased Muscle Tone
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12
Q

Cerebral Palsy: Movement Disorders: Mixed

A
  • Mixture of movement disorders
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13
Q

Cerebral Palsy: Impairments

A
  • insufficient force generation
  • Tone abnormality
  • Poor selective control of muscle activity
  • Poor anticipatory postural control
  • Decreased ability to learn unique movemnts
  • Abnormal patterns of movement in total flexion or extension
  • Persistence of primitive reflexes
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14
Q

Cerebral Palsy: Spastic Cerebral Palsy

A
  • Increased muscle tone in antigravity muscles

- Abnormal postures and movement with mass patterns of flexion and extension

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15
Q

Cerebral Palsy: Spastic Cerebral Palsy: Patterns of Contracture: Upper Extremity

A
  • Scapular Retractors
  • Glenohumeral extensors
  • Glenohumeral adductors
  • Elbow flexors
  • Forearm pronators
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16
Q

Cerebral Palsy: Spastic Cerebral Palsy: Patterns of Contracture: Lower Extremity

A
  • Hip flexors
  • Adductors
  • Internal Rotators
  • Knee flexors
  • Ankle plantar flexors
17
Q

Cerebral Palsy: Spastic Cerebral Palsy: Other

A
  • Visual
  • Auditory
  • Cognitive
  • Oral
    Motor deficits may be seen with spastic CP
18
Q

Cerebral Palsy: Spastic Cerebral Palsy: Crouching Gait

A 
Walks with 
- Hip flexion
- Adduction
- Internal rotation
- Knee flexion
May also toe walk
19
Q

Cerebral Palsy: Athetoid Cerebral Palsy:

A
  • Involuntary, slow, writhing movements
  • Generalized decreased muscle tone (floppy baby syndrome)
  • This is a result of basal ganglion involvement
20
Q

Cerebral Palsy: Athetoid Cerebral Palsy: Stability

A
  • Functional stability is impaired especially in proximal joints
21
Q

Cerebral Palsy: Athetoid Cerebral Palsy: Ataxia and incoordination

A

When child assumes upright with

  • Decreased base of support
  • Muscle tone fluctuations
22
Q

Cerebral Palsy: Athetoid Cerebral Palsy: Other

A

Deficits to

  • Visual tracking
  • Speech delay
  • Oral motor
23
Q

Cerebral Palsy: Athetoid Cerebral Palsy: Reflexes

A 
Tonic reflexes like
- ATNR
- STNR
- Tonic labyrinthine reflex
May be persistent blocking functional postures and movement
24
Q

Cerebral Palsy: Ataxic Cerebral Palsy

A
  • Low postural tone and poor balance
  • Stance and gait are wide based
  • Intention tremor of hands
  • Movement uncoordinated
  • Ataxia follows initial hyoptonia
  • Poor visual tracking and nystagmus
  • Speech articulation problems
  • May occur in conjunction with spastic or athetoid CP
25
Q

Cerebral Palsy: Interventions and Goals: Minimize effects of impairment

A
  • Static positioning and dynamic patterns of movement to habitual abnormal spastic patterns
  • Symmetry in postures
  • Elongate spastic Hamstrings and heel cords via stretching or in some cases serial casting
26
Q

Cerebral Palsy: Interventions and Goals: Maximize Gross Motor Functional Level

A
  • Functional motor skills
  • Postural control
  • Developmental activities
  • Weight bearing
27
Q

Cerebral Palsy: Interventions and Goals: Equipment: Seating

A
  • Head neutral
  • Trunk upright
  • Hips, knees and ankles at 90 degrees flexion
  • Wheel chair may be tipped posteriorly to decrease extensor tone and maintain hip flexion
28
Q

Cerebral Palsy: Interventions and Goals: Equipment: Prone or Supine Standers and Parapodium

A
  • Promotes weight bearing through LE
  • Need at least 5 hours/week for bone mineralization
  • Tonic Labrynthine Reflex will elicit extensor tone in supine and flexor tone in prone
29
Q

Cerebral Palsy: Interventions and Goals: Equipment: Side Lying

A
  • Will help decrease effect of tonic labyrinthine reflex
30
Q

Cerebral Palsy: Interventions and Goals: Equipment: Rollator Walkers

A
  • Posterior collator helps child maintain upright position and arm position helps decrease extensor tone
31
Q

Cerebral Palsy: Prognosis

A
  • Good prognosis for ambulation if child can sit independently by 2 years of age
  • If ambulation takes place most often it will take place by 8 years of age

National Physical Therapy Examination: Pediatrics (18 decks)

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