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DPT 772 - Pediatrics II > Quiz #1 > Flashcards

Quiz #1 Flashcards

1
Q

What are the three classifications of adaptive equipment and provide examples of each?

A

→ Assistive Technology: any item used to increase, improve or maintain function

  • Examples include pencil grips, benches to support feet in sitting positions, and simple devices that enhance basic functioning.

→ Alternative Technology: a substitute toward the same end function

  • Includes powered toys, recording devices, and devices that substitute functions (e.g., an alternative communication board).

→ Augmentative Technology: supplements for an inadequate function but the function remains

  • Examples include computers with voice recognition or voice output and powered wheelchairs, providing supplementary support to existing functions.
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2
Q

What roles does adaptive equipment play in patient care?

A
  • reinforces therapy movements
  • prevents undesirable movements
  • decreases caregiver demands, aiding home management
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3
Q

What are the benefits of sitting and standing with adaptive equipment?

A

→ Sitting aids

  • Optimal for UE function
  • Enhances overall functioning by providing an adequate and secure base of support
  • Inhibits abnormal tone, providing a stable base from which the upper extremities can function
  • Improves perception of the environment
  • Significant social benefits

→ Standing aids

  • increase LE WB
  • promote circulation
  • bone mineral density
  • respiratory endurance
  • GI function
  • integumentary health
  • improve/maintain LE ROM
  • modulate spasticity
  • increase UE function
  • vertical reach
  • social interaction
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4
Q

What principles are essential for proper seating and positioning?

A
  • feet support
  • 90-degree hip flexion
  • 95-110-degree backrest angle
  • armrest height (positioned to bear approximately 50% of the weight of the patient)
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5
Q

What are some examples of equipment for different sitting and standing needs?

A

→ Sitting Equipment

  • Hands-free sitter: stable base for functional activities
  • Hands-dependent sitter: Seating to stabilize trunk and pelvis to be able to use UE for function.
  • Propped sitter: total body support

→ Standing Equipment

  • Static: position in prone or supine, only one position, dependent lift into device
  • Multi-positional: option for supine, prone or upright, larger in size, many options for position change with one piece of equipment
  • Prone standers: Accommodate hands-free standing, Closer to horizontal: requires stabilization of shoulder girdle and WB through UE, less benefit of LE WB.
  • Supine standers: Allows weight bearing through the trunk and lower extremities, Supine stander is angled toward a 90-degree upright position, No upper extremity weight bearing, Could see abnormal reflexes in a semi-reclined position.
  • Sit to stand devices: Adjust between sitting and standing, transfer into from sitting, can transition to stand easier or indep.
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6
Q

When is a power wheelchair recommended over a manual wheelchair?

A
  • for severe trunk/UE weakness
  • respiratory compromise
  • endurance issues, or transporting medical devices
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7
Q

How do gait trainers, posterior walkers, and standard walkers differ in mobility support?

A
  • Gait trainers offer wheeled assistance
  • Posterior walkers provide pelvic/hip stability
  • Standard walkers offer minimal support.
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8
Q

How is adaptive equipment selected based on patient needs?

A

Based on patient strength, mobility goals, environment, and functional requirements, following therapist assessments.

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9
Q

What is spina bifida, and what are its classifications?

A
  • Spina bifida is a neural tube defect.
  • Types: Myelomeningocele, Meningocele, Spina Bifida Occulta, among others.
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10
Q

What factors contribute to the risk of spina bifida?

A

Genetics, environmental factors, low maternal folic acid, maternal hyperthermia, and certain medications increase risk.

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11
Q

What is hydrocephalus, and how is it treated?

A

An abnormal CSF accumulation treated by VP/VA shunts or surgery (Chiari malformation management).

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12
Q

What are key elements of physical therapy for neonates with spina bifida?

A
  • MMT
  • ROM
  • side-lying/prone positioning
  • focusing on lesion-level motor assessment
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13
Q

What is the role of sensory assessment and parent education for infants with spina bifida?

A

Assessing touch, pressure, temperature, and educating parents on sensitivity precautions is vital.

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14
Q

What are common PT goals and contracture management strategies for spina bifida?

A

Goals: prevent deformities, improve ROM; manage contractures with PROM exercises and daily stretching.

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15
Q

What orthotics are used for different paralysis levels?

A
  • Thoracic: HKAFOs
  • Lumbar: KAFOs
  • Sacral: AFOs or SMOs, based on mobility level
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16
Q

What gait characteristics and mobility recommendations apply to lumbar and sacral paralysis?

A
  • Lumbar: hyperlordotic spine, crutches
  • Sacral: crouch gait, SMOs; focus on maintaining function.
17
Q

What are tethered cord and hydromelia, and their impact on patients?

A

Tethered cord anchors the spinal cord, hydromelia causes nerve necrosis; both limit mobility.

18
Q

What orthotics and mobility aids are needed based on specific paralysis levels?

A

HKAFOs, RGOs, rolling walkers, and forearm crutches are common aids for varying paralysis levels.

19
Q

What health concerns are specific to young adults with spina bifida?

A

Obesity, urinary infections, chronic decubitus, joint pain, hypertension, neurologic and social issues are common.

20
Q

What physical deformities are common in spina bifida patients?

A

Clubfoot, flatfoot, and pes cavus (high arch) are frequent deformities requiring attention.

21
Q

What are the common causes of pediatric burns?

A
  • thermal (fire, hot liquids)
  • chemical
  • electrical
  • mechanical (road rash)
  • cold (frostbite) are causes
22
Q

What are the classifications of burns and their characteristics?

A
  • 1st degree: epidermis
  • 2nd degree: partial dermis
  • 3rd degree: full dermis and subcutaneous layers
23
Q

What is included in PT management for burn patients?

A

ROM exercises, splinting, and positioning to prevent contractures are essential components.

24
Q

How do burn locations affect deformity risks and positioning needs?

A
  • anterior burns risk flexion contractures
  • posterior burns risk hyperextension
  • positioning helps prevent deformities
25
Q

What are characteristics and treatments for hypertrophic scars?

A

Red, raised, non-pliable; treatments include pressure garments, scar massage, and silicone applications.

26
Q

What scar treatment and sun protection measures are important?

A

Pressure garments, massage, and UV protection help prevent scar worsening and encourage healing.

27
Q

What surgical options are available for severe scarring?

A

Options include Z-plasty and laser treatments to improve mobility and appearance of scars.

28
Q

What are essential education points for families on scar care?

A

Teach about pressure garment use, skin inspection, and gentle care to avoid complications.

29
Q

Why are pressure garments essential, and how should they be maintained?

A

Pressure garments prevent contractures, require 24-hour wear, and should be kept clean and properly fitted.

30
Q

For optimal seating posture, how should the hips be positioned?

  • A) At a 45-degree flexion
  • B) At a 90-degree or more flexion
  • C) Extended at 180 degrees
  • D) Slightly hyperextended
A
  • A) At a 45-degree flexion – This position would not provide adequate stability or posture for sitting.
  • B) At a 90-degree or more flexion – Correct! Hips should be flexed to at least 90 degrees, as this promotes a stable seated position and can help reduce extensor posturing.
  • C) Extended at 180 degrees – Full extension is unsuitable for sitting posture and would not support functional sitting.
  • D) Slightly hyperextended – Hyperextension does not provide a stable base and could lead to poor posture.
31
Q

What type of walker is most suitable for children with minimal support needs?

  • A) Gait trainer
  • B) Posterior walker
  • C) Standard walker
  • D) Rolling walker
A
  • A) Gait trainer – Gait trainers provide significant support and options for partial weight-bearing and are often used in early ambulatory training.
  • B) Posterior walker – While these offer support, they are typically used when the child needs postural control and stability beyond minimal assistance.
  • C) Standard walker – Correct! Standard walkers are most suitable for children with minimal support needs, providing basic assistance while allowing greater independence.
  • D) Rolling walker – Although similar to a standard walker, rolling walkers generally offer more support for users who may need assistance with balance but not full body weight-bearing.
32
Q

What condition is associated with the downward herniation of the cerebellum through the foramen magnum, commonly seen in spina bifida patients?

  • A) Hydrocephalus
  • B) Tethered cord syndrome
  • C) Arnold Chiari Malformation
  • D) Lipomeningocele
A
  • A) Hydrocephalus – This involves the accumulation of cerebrospinal fluid within the ventricles, which can be associated with spina bifida but does not describe cerebellar herniation.
  • B) Tethered cord syndrome – This is a condition where the spinal cord is abnormally attached, often at the site of a previous lesion, restricting its movement.
  • C) Arnold Chiari Malformation – Correct! This malformation involves the downward herniation of the cerebellum through the foramen magnum, frequently leading to complications like hydrocephalus in patients with spina bifida.
  • D) Lipomeningocele – This refers to a fatty mass in the lumbar or sacral region that may cause neurological issues but is not related to cerebellar herniation.
33
Q

Which orthotic is most commonly used for children with low lumbar paralysis (L4-L5) to support ambulation?

  • A) Reciprocating gait orthosis (RGO)
  • B) Hip-knee-ankle-foot orthosis (HKAFO)
  • C) Knee-ankle-foot orthosis (KAFO)
  • D) Supramalleolar orthosis (SMO)
A
  • A) Reciprocating gait orthosis (RGO) – RGOs are often used for children with higher levels of paralysis (thoracic and high lumbar) requiring significant support for ambulation.
  • B) Hip-knee-ankle-foot orthosis (HKAFO) – HKAFOs are typically used for children with thoracic or high lumbar paralysis where additional support is necessary for hip stability.
  • C) Knee-ankle-foot orthosis (KAFO) – Correct! KAFOs provide support for the knee and ankle and are suitable for children with low lumbar (L4-L5) paralysis who have stronger hip muscles but need knee and ankle support.
  • D) Supramalleolar orthosis (SMO) – SMOs offer minimal support at the ankle and are more appropriate for children with less severe motor impairments.

DPT 772 - Pediatrics II (17 decks)

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