Quiz 2 Flashcards
What are postural reflexes?
Group of reflexes (automatic movements) maintain body position and equilibrium during rest or during movement by changing the distribution of MT in the limbs and trunk.
What is Gower’s sign?
Medical sign indicates weakness of the proximal muscles,usually LE.
Patient uses hands and arms to “walk” up own body from a squatting position due to lack of hip and thigh muscle strength.
Seen in Duchenne muscular dystrophy
In Duchenne’s MD what muscles commonly hypertrophy?
Calf and deltoid
What treatments are available for MD?
Pacemaker may be required for certain types of muscular dystrophy due to cardiac problems.
Myotonia (delayed relaxation of a muscle after strong contraction) caused by Myotonic Muscular Dystrophy can be treated with medications such as quinine, pheytoin, or mexiletine.
There is NO actual long term treatment.
There is NO known cure for muscular dystrophy. Inactivity leads to worsening of the disease. Physical therapy and assistive devices (Wheelchair, standing frames) may be helpful
What are 2 symptoms of congenital hypotonia
- Lack of spontaneous movement
- Hip subluxation or dislocation is a high probability
- UE are either extended or flexed but child may have difficulty transitioning from one to the other
- Legs are excessively abducted and it is difficult for the child to adduct their hips against gravity
- If the child is hypotonic in utero, then he/she may be born with a hip dislocation.
Name a potential cause of seizures in infants?
o Brain malformations
o Lack of O2 during, or before delivery, or @ birth
o Low levels of blood sugar, blood calcium, blood magnesium or other electrolyte disturbances
o Inborn errors or metabolism (chemical disorders)
o Intracranial hemorrhage (bleeding in the brain)
o Maternal drug use
Name a potential cause of seizures in children?
o Congenital conditions (Down syndrome, Angelman’s syndrome; tuberous sclerosis and neurofibromatosis)
o Genetic factors (primary seizure disorders)
o Progressive brain disease (rare)
o Head trauma
What is a challenge in treating pediatric stroke?
- Children brought to the hospital within a median of 1.7 hours after onset
- Median diagnosis 12.7 hours, over half were diagnosed more than 24 hours after arrival
- This is a challenge because of the treatment for stroke. The tPA (tissue plasminogen activator - clot busting drug, needs to be given to patients suspected of stroke sooner rather than later. I believe it is within the first 3 hours (this is not mentioned in the slide). Hence, the reason why it is important to note the time when the patient started reported symptoms of stroke. ER physicians always ask this question. )
Name a common medication for treating seizures in children?
o Tegretol
o Carbatrol
o Dilantin
o Depakote
What is the brachial plexus?
A network of nerves that begins in the back of the base of the neck and extends through the armpit. It is formed by the union of portions of the fifth through eighth cervical spinal nerves and the first thoracic spinal nerve. Damage to the brachial plexus can affect nerves responsible for muscle function and sensation of the arm and chest.
If brachial plexus injured, what muscles might be involved?
o C5 = Rhomboid and levator scapulae (dorsal scapular nerve)
o C5, C6, C7 = serratus anterior (long thoracic nerve)
o C5 = Diaphragm (phrenic nerve)
o C5, C6 = sublclavius muscle (nerve to subclavius)
o C5, C6 = supraspinatus and infraspinatus (suprascapular nerve)
o C5, C6, C7 = pectoralis major and pectoralis minor (lateral pectoral nerve)
o C5, C6, C7 = coracobrachialis, brachialis, biceps brachii (musculocutaneous nerve)
o C5, C6 = subscapularis, teres major (subscapular nerve)
o C6, C7, C8 = latissimus dorsi (thoracodorsal nerve)
o C5, C6 = Deltoid, teres minor(axillary nerve)
o C5, C6, C7, C8, T1 = triceps brachii, supinators, extensor muscles of the forearm, brachioradialis (radial nerve)
o C8, T1 = pectoralis major and pectoralis minor (medial pectoral nerve)
o C8, T1 = flexor carpi ulnaris, flexor digitorum profundus, thenar muscles, lumbricals, intrinsic hand muscles
How does CSF circulate through the brain?
- lateral ventricles
- interventricular formamina
- 3rd ventricle
- cerebral aqueduct
- 4th ventricle
- subarachnoid space
- returns to venous system via arachnoid granulations
- most of the CSF empty into the superior sagittal sinus
What is a common treatment for hydrocephalous?
VP shunt
Define myelomeningocele?
- Protrusion of spinal cord and meninges through back - cystic covering
- Myelomeningocele is a neural tube defect in which the bones of the spine do not completely form, resulting in an incomplete spinal canal. This causes the spinal cord and meninges (the tissues covering the spinal cord) to protrude from (stick out of) the child’s back
Name one characteristic of Down Syndrome
o Widened nasal bridge o Low set of ears o Single palmar crease o Wide-spaced 1st toe o Hypotonia o Pelvic dysplasia o Mental retardation o Cardiac malformations (AV canal defect) o Ligamentous laxity o Atlanto-axial instability
Name the 4 categories of CP
Spastic Diplegia
Spastic Quadriplegia
Unilateral CP
Extrapyramidal
Which CP category is associated with extrapyramidal movements?
Athetoid and Dyskinetic
What medications would be used to ameliorate extrapyramidal movements?
Levodopa
Baclofen pumps
What types of medications would be used to ameliorate movements due to spasticity?
benzodiazepines
dantrolene
baclofen
