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(3) Pediatric Rehabilitation > S3L1: Cerebral Palsy > Flashcards

S3L1: Cerebral Palsy Flashcards

1
Q

T/F. The ff. Are part of development

  • gross & fine motor
  • speech & language
    -personal & social
  • Cognitive
A

T

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2
Q

Identify the wrong statements

Head Circumference

  • 34 cm at birth (average)
  • Glabella & supraorbital ridges to the occipital protruberance
  • Measured up to 5 years and thereafter if CNS pathology is suspected
A

35 cm at birth (average)

Measured up to 3 years and thereafter if CNS pathology is suspected

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3
Q

Identify the wrong statements

Height

  • Full term newborn = 45 cm (average)
  • In children under 5 years, recumbent length is much more precise than standing height
  • Adult height = 3x height during 3y/o
  • Peak growth
A

Full term newborn = 50 cm (average)

Adult height = 2x height during 2 y/o

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4
Q

Identify the wrong statements

Weight

  • Birth = 3500 g (average)
  • Normal range = 2500 – 4500 g
  • LBW: 1500-2499 g
  • VLBW: 1000-1499 g
  • Extremely LBW: 800-999 g
  • Micropemie: < 700 g
A

Birth = 3400 g (average)
Micropemie: < 800 g

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5
Q

Modified T/F

According to Braddom…

  • Spastic Quadriplegia: N birth weight
  • Spastic Diplegia: LBW
A

TT

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6
Q

Identify the wrong statements

  • Head grows fastest during infancy
  • Trunk grows fastest in adolescence
  • Extremity grow fastest from 1 year to puberty
A

Trunk grows fastest in infancy & adolescence

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7
Q

Head circumference in cm

At birth:

4 mos:

1 year:

Maturity:

A

35

41

47

57

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8
Q

Weight in g

At birth:

5 mos:

12 mos:

Until adolescent:

A

3400

Double

Triple

2 kg/yr

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9
Q

Height in cm

At birth:

12 mos:

4 years:

Early school age:

Prepubescence:

A

50

75

100

5 cm/yr

5-8 cm/yr

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10
Q

T/F. PTs can treat cerebral palsy, spinal dysraphism, anterior horn cell diseases, muscular dystrophies, hydrocephalus, juvenile rheumatoid arthritis, meningitis

A

T

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11
Q

Identify the development

Flexor withdrawal
Crossed extension
Traction
Moro
Startle
Palmar & Plantar grasp

A. Primitive/Spinal
B. Tonic/Brainstem
C. Midbrain/Cortical

A

A

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12
Q

Identify the development

Equilibrium
NOB BOB BOH
Optic righting with & without vision
Protective extension

A. Primitive/Spinal
B. Tonic/Brainstem
C. Midbrain/Cortical

A

C

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13
Q

Identify the development

Positive supporting
ATNR STNR TLR
Associated Reactions

A. Primitive/Spinal
B. Tonic/Brainstem
C. Midbrain/Cortical

A

B

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14
Q

____ to the immature brain may be brought about by the combination of immaturity and fragile vascular structures
especially the watershed zone next to the
____ in the capillaries of the
germinal matrix

A

Compromised blood flow

Lateral ventricles

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15
Q

A collection of syndromes of diverse etiology, pathology and clinical manifestations caused
by _______ which lead to
neuromuscular and other symptoms of
Cerebral dysfunction

A

NON-PROGRESSIVE LESIONS TO AN
IMMATURE BRAIN

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16
Q

Arrange the Degree of Bleeding

  • Intraventricular hemorrhage with normal ventricular size
  • Germinal matrix
  • Intraventricular hemorrhage with
    parenchymal hemorrhage (increase risk up to 90% of neurologic sequelae)
  • Intraventricular hemorrhage with dilatation of ventricular size
A
  1. Germinal matirx
  2. Intraventricular hemorrhage with normal ventricular size
  3. Intraventricular hemorrhage with dilatation of ventricular size
  4. Intraventricular hemorrhage with
    parenchymal hemorrhage (increase risk up to 90% of neurologic sequelae)
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17
Q

T/F. The 5 BASIC SUBTYPES OF HYPOXIC-ISCHEMIC NEUROPATHOLOGY includes

  • Parasagittal Cerebral Injury
  • Periventricular leukomalacia
  • Focal and Multifocal Ischemic Brain Necrosis
  • Status Marmoratus
  • Selective Neuronal Necrosis
A

T

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18
Q

Involved zone of Parasagittal Cerebral Injury

A. Bilateral cortical zone
B. Bilateral white matter necrosis
C. MCA: most commonly affected (L>R)
D. Basal ganglia
E. Most common variety of injury

A

A

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19
Q

Involved zone of Periventricular leukomalacia

A. Bilateral cortical zone
B. Bilateral white matter necrosis
C. MCA: most commonly affected (L>R)
D. Basal ganglia
E. Most common variety of injury

A

B

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20
Q

Involved zone of Focal and Multifocal Ischemic Brain Necrosis

A. Bilateral cortical zone
B. Bilateral white matter necrosis
C. MCA: most commonly affected (L>R)
D. Basal ganglia
E. Most common variety of injury

A

C

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21
Q

Involved zone of Status Marmoratus

A. Bilateral cortical zone
B. Bilateral white matter necrosis
C. MCA: most commonly affected (L>R)
D. Basal ganglia
E. Most common variety of injury

A

D

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22
Q

Involved zone of Selective Neuronal Necrosis

A. Bilateral cortical zone
B. Bilateral white matter necrosis
C. MCA: most commonly affected (L>R)
D. Basal ganglia
E. Most common variety of injury

A

E

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23
Q

Involved functions of Parasagittal Cerebral Injury

A. Proximal extremity function with UE>LE
B. LE are more likely affected
C. Motor function
D. Rarely occurs in isolation
E. Specific parts are involve including CN 5&7

A

A

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24
Q

Involved functions of Periventricular leukomalacia

A. Proximal extremity function with UE>LE
B. LE are more likely affected
C. Motor function
D. Rarely occurs in isolation
E. Specific parts are involve including CN 5&7

A

B

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25
Q

Involved functions of Focal and Multifocal Ischemic Brain Necrosis

A. Proximal extremity function with UE>LE
B. LE are more likely affected
C. Motor function
D. Rarely occurs in isolation
E. Specific parts are involve including CN 5&7

A

C

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26
Q

Involved functions of Status Marmoratus

A. Proximal extremity function with UE>LE
B. LE are more likely affected
C. Motor function
D. Rarely occurs in isolation
E. Specific parts are involve including CN 5&7

A

D

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27
Q

Involved functions of Selective Neuronal Necrosis

A. Proximal extremity function with UE>LE
B. LE are more likely affected
C. Motor function
D. Rarely occurs in isolation
E. Specific parts are involve including CN 5&7

A

E

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28
Q

FRQUENT LONG TERM CONSEQUENCE of Parasagittal Cerebral Injury

A. Spastic Quadriplegia
B. Spastic Diplegia, Spastic Quadriplegia
C. Spastic Hemiplegia, Spastic diplegia & seizures
D. Choreoathetosis
E. Mental retardation and seizures

A

A

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29
Q

FRQUENT LONG TERM CONSEQUENCE of Periventricular leukomalacia

A. Spastic Quadriplegia
B. Spastic Diplegia, Spastic Quadriplegia
C. Spastic Hemiplegia, Spastic diplegia & seizures
D. Choreoathetosis
E. Mental retardation and seizures

A

B

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30
Q

FRQUENT LONG TERM CONSEQUENCE of Focal and Multifocal Ischemic Brain Necrosis

A. Spastic Quadriplegia
B. Spastic Diplegia, Spastic Quadriplegia
C. Spastic Hemiplegia, Spastic diplegia & seizures
D. Choreoathetosis
E. Mental retardation and seizures

A

C

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31
Q

FRQUENT LONG TERM CONSEQUENCE of Status Marmoratus

A. Spastic Quadriplegia
B. Spastic Diplegia, Spastic Quadriplegia
C. Spastic Hemiplegia, Spastic diplegia & seizures
D. Choreoathetosis
E. Mental retardation and seizures

A

D

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32
Q

FRQUENT LONG TERM CONSEQUENCE of Selective Neuronal Necrosis

A. Spastic Quadriplegia
B. Spastic Diplegia, Spastic Quadriplegia
C. Spastic Hemiplegia, Spastic diplegia & seizures
D. Choreoathetosis
E. Mental retardation and seizures

A

E

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33
Q

Most common prenatal factor

A

Prematurity

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34
Q

Most common perinatal factors

A

Asphyxia

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35
Q

Most common post natal factors

A

Head trauma

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36
Q
  • Prematurity
  • Rh incompatibility
  • Fetal anoxia
  • Maternal infections
  • Inherited causes
  • Drugs, alcohol & teratogens
  • Ecclampsia

A. PRENATAL FACTORS
B. PERINATAL FACTORS
C. POSTNATAL FACTORS

A

A

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37
Q
  • Birth injury
  • Asphyxia
  • Abnormalities in the birth process
  • Neonatal CR distress
  • Prematurity
  • Prolonged labor decrease BW < 800 grams

A. PRENATAL FACTORS
B. PERINATAL FACTORS
C. POSTNATAL FACTORS

A

B

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38
Q
  • Head trauma
  • Vascular accident
  • Encephalopathies
  • Infectious conditions
  • Tumors
  • Battering

A. PRENATAL FACTORS
B. PERINATAL FACTORS
C. POSTNATAL FACTORS

39
Q
  • Monoplegia
  • Triplegia
  • Hemiplegia
  • Quadriplegia/tetraplegia
  • Diplegia
  • Double hemiplegia

A. TOPOGRAPHIC
B. NEUROLOGIC

40
Q
  • Spastic (pyramidal)
  • Dyskinetic (extrapyramidal)
  • Mixed

A. TOPOGRAPHIC
B. NEUROLOGIC

41
Q
  • Aka Little’s Disease
  • UMN findings in the legs more than the arms
  • Scissoring gait pattern
  • Learning disabilities

A. Spastic Diplegia
B. Spastic Athetoid

42
Q
  • Hyperbilirubin encephalopathy results in dyskinetic type
  • Hypoxia affecting the basal ganglia
  • Athetosis
  • Triad of Kernicterus

A. Spastic Diplegia
B. Spastic Athetoid

43
Q
  • Seizures
  • (+) history of prematurity & periventricular leukomalacia
  • Hypotonia (floppy infant) followed by spasticity
  • Most common in premature

A. Spastic Diplegia
B. Spastic Athetoid

44
Q

Components of triad of kernicterus

A
  • Sensorineural hearing loss
  • increased BP
  • loss of upward gaze
45
Q

T/F. the ff are dyskinetic types

  • Athetosis
    -chorea
    -choreoathetoid
  • dystonia
    -ataxic
46
Q

Identify the GMFCS

  • Walks without restriction; limitation in more advanced gross
    motor
47
Q

Identify the GMFCS

Walks without AD; limitations walking outdoors and in the
community

48
Q

Identify the GMFCS

Walks with assistive mobility devices; limitations walking
outdoors and in the community

49
Q

Identify the GMFCS

Self-mobility with limitations; children are transported or use
power mobility outdoors or in the community

50
Q

Identify the GMFCS

Self-mobility is severely limited even with the use of assistive
technology

51
Q

Don’t sit by 4 years old

A. G prognosis for ambulation
B. P prognosis for ambulation

52
Q

Can sit by 2 y/o

Obligatory reflexes suppressed by 18 mos

A. G prognosis for ambulation
B. P prognosis for ambulation

53
Q

a group of permanent disorders of the development of movement and posture, causing activity limitations that are attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain

A

Cerebral palsy

54
Q

T/F. The motor disorders of CP are often accompanied by:

disturbances of sensation, perception, cognition, communication and behavior as well as seizures and secondary musculoskeletal problems.”

55
Q

T/F. Six main aspects to the clinical picture of CP includes:

    1. Delay in the development of new skills expected at a child’s chronological age.
    1. Persistence of immature behaviors such as feeding difficulties and retained primitive reflexes that sometimes interfere with function.
    1. Slow rate of progress from one developmental stage to the next.
    1. A smaller variety of skills in comparison with a child who is developing typically.
    1. Marked variations in the sequence of skills greater than that which we might see in typical development.
    1. Atypical and unusual performance of skills
56
Q

Delayed motor development due to

A

brain lesion

57
Q

Hallmark of cerebral palsy

A
  • Weakness
  • Postural problems
  • Balance problems
58
Q

Abnormal movement patterns of CP, except:

  • Hypertonicity
  • Hyperactive reflexes
  • Involuntary movements
  • Abnormal muscle extensibility
  • Skeletal malalignments
  • Hyperactive muscles
A

Hyperactive muscles

59
Q

IDENTIFY THE WRONG STATEMENT. Clinical picture of CP

  • Persistent primitive reflexes
  • Underdeveloped engrams for motor unction
  • Presence of mature reflexes
  • Slow rate of progression from one developmental stage to another
A

Absence of mature reflexes

60
Q

2 treatment approaches to CP

A
  • Neurotherapeutic
  • Movement Science
61
Q

T/F in Roles and strategies of Activity-based approach

  • Practice tasks repetitively for motor development necessary for engram formation.
  • Prevent secondary musculoskeletal impairments and maximize physical functioning (Alleviate pain, Prevention, Restoration overall health)
62
Q

T/F in Roles and strategies of Activity-based approach

  • Foster cognitive social and emotional development of the child
  • Independence
  • Develop, maintain and restore neural structures and pathways
63
Q

Roles and strategies.

Task-specific, function-based

A. Strengthening
B. Bobath
C. Rood

64
Q

Roles and strategies.

  • Key points of control: head, neck, shoulder girdle
  • NDT sequence
  • Head and trunk control
  • Symmetry
  • Extensor activity
  • Rotation
  • Arm support
  • Equilibrium
  • Train basic motor patterns of head and trunk control, symmetry, extensor activity, rotation, arm support and equilibrium reactions

A. Strengthening
B. Bobath
C. Rood

65
Q

Roles and strategies.

  • Techniques of stimulation, are used to activate, facilitate or ‘inhibit’ motor response.
  • Muscle work in stages on an ontogenetic developmental sequence

A. Strengthening
B. Bobath
C. Rood

66
Q

T/F in Developmental Motor Training

  • Next developmental level and not according to chronological age
  • Abnormal posture are modified or corrected by use of specific functions
  • Developmental sequences are flexible and are not a dogmatic scheme.
67
Q

Supine Development

  • Does bridging : __ months
  • Rolls over : ____months
  • Pulls self to sitting : ____months
  • Show head stabilization in midline : ____ months
  • Lies straight, symmetrical: ____ months
A
  • Does bridging : 3-6 months
  • Rolls over : 6 months
  • Pulls self to sitting : 9-12 months
  • Show head stabilization in midline : 4-5 months
  • Lies straight, symmetrical: 8 months
68
Q
  • Shows diminution of head lag
  • Presents asymmetrical supine posture
  • Displays kicking movement

A. Supine Development 0-3 months
B. Supine Development 4-6 months
C. Supine Development 6-9 months

69
Q

Problems:
* Delayed diminution of head lag

  • Abnormal performance
  • Opisthotonus
  • Legs in FAbER
  • Strap Hanger
  • Hip dislocation
  • Pull to sit = LE ext and add

A. Supine Development 0-3 months
B. Supine Development 4-6 months
C. Supine Development 6-9 months

70
Q
  • Exhibits head stabilization in midline and off the surface
  • Shows head rising/righting; overcomes head lag
  • Does pelvic bridging
  • Brings feet to mouth or chin

A. Supine Development 0-3 months
B. Supine Development 4-6 months
C. Supine Development 6-9 months

71
Q

Problem

  • Patient cannot bring hands to midline – lack in symmetry
  • Persistence of head lag
  • Inability to do bridging
  • Abnormal performance (LE in EAdIR)
  • Inability to roll

A. Supine Development 0-3 months
B. Supine Development 4-6 months
C. Supine Development 6-9 months

72
Q
  • Rolls, assumes to sitting
  • Lies straight and symmetrical

Problems
* Inability to roll over or pull himself towards sitting

  • Persistent abnormal posturing

A. Supine Development 0-3 months
B. Supine Development 4-6 months
C. Supine Development 6-9 months

73
Q
  • Lifts head to 45 n 2 months and 90 in 34 months
  • Starts weight nearing on the forearm when doing prone on elbows
  • Turns head from side to side

A. Prone Development 0-3 months
B. Prone Development 4-6 months
C. Prone Development 6-9 months

74
Q

Problems

  • Baby does not like prone position
  • Dob
  • Difficulty in moving/extending the head
  • Difficulty in using the hands
  • Increase in flexor tone
  • Delayed development of head control
  • Abnormal performance

A. Prone Development 0-3 months
B. Prone Development 4-6 months
C. Prone Development 6-9 months

75
Q
  • Weight bears on forearm or elbows or on forearm and knees
  • Weight bears on forearms with overhead reach
  • Rolls from prone to supine in 4 months

A. Prone Development 0-3 months
B. Prone Development 4-6 months
C. Prone Development 6-9 months

76
Q

Problem

  • Inability to rise on to knees, on forearms and knees
  • Emergence of mermaid crawl or commando crawl
  • Inability to roll over from prone to supine

A. Prone Development 0-3 months
B. Prone Development 4-6 months
C. Prone Development 6-9 months

77
Q
  • Weight bears on hands/ prone on hands and on hands and knees (quadruped)
  • Does overhead reach while weight bearing unilaterally
  • Does pivot prone
  • Crawls
  • Pulls to stand with support

A. Prone Development 0-3 months
B. Prone Development 4-6 months
C. Prone Development 6-9 months

78
Q

Problems

  • Difficulty in weight bearing and staticdynamic activities
  • Persistence of mermaid crawl or commando crawl

A. Prone Development 0-3 months
B. Prone Development 4-6 months
C. Prone Development 6-9 months
D. Prone Development 9-12months

79
Q
  • Half kneels and leans on hands
  • Kneels with arm support
  • Bear walks / elephant walks (hip and knee extended)
  • Pulls to stand through half kneeling
  • Stands up through quadruped

A. Prone Development 0-3 months
B. Prone Development 4-6 months
C. Prone Development 6-9 months
D. Prone Development 9-12months

80
Q

Problems

  • Delayed reciprocal crawling
  • Difficulty in maintaining half kneeling position
  • Inability to rise on hands and knees to stand
  • Inability to change positions from prone – sitting or prone –squatting
  • Absence of equilibrium and protective reactions

A. Prone Development 0-3 months
B. Prone Development 4-6 months
C. Prone Development 6-9 months
D. Prone Development 9-12months

81
Q

Prone Development

  • Rolls from prone to supine: ___ months
  • Weight bears on hands and knees: ___ months
  • Assumes supported kneeling: ___months
  • Head raises and hold: ___months
  • Assumes crawl position: ___months
A
  • Rolls from prone to supine: 3-6 months
  • Weight bears on hands and knees: 6-9 months
  • Assumes supported kneeling: 11months
  • Head raises and hold: 0-3 months
  • Assumes crawl position: 9-11 months
82
Q
  • Sits and leans on hands
  • Sits with support gradually removed
  • Sits on chair with back and arms support

Problems
* Delayed motor development
* Persistence of abnormal postures and malalignment

A. Sitting Development 3-6 months
B. Sitting Development 6-9 months
C. Sitting Development 9-12months

83
Q
  • Sits independently
  • Sits and reaches out or objects, first unilaterally the bilaterally
  • Develops protective reactions

Problems
* Delay in developmental milestones

A. Sitting Development 3-6 months
B. Sitting Development 6-9 months
C. Sitting Development 9-12months

84
Q
  • Sits and plays without hand support
  • Sits in various positions
  • Rises from and goes back to sitting position

Problems
* Inability to sit steadily for >10 mins
* Impaired balance in transitional positions
* Absence of equilibrium and protective reaction

A. Sitting Development 3-6 months
B. Sitting Development 6-9 months
C. Sitting Development 9-12months

85
Q
  • Pulls to stand
  • Exhibits trunk supported standing and bouncing in standing
  • Shows supported standing and weight bearing of legs
  • Stands and holds on to furniture or with pelvic support
  • Stands and starts to weight shift

A. standing Development 3-9 months
B. standing Development 9-12months

86
Q

Problems

  • Delayed weight bearing
  • Poor stability and abnormal postures
  • Persistent primitive reflex
  • Absence of equilibrium and protective reaction

A. standing Development 3-9 months
B. standing Development 9-12months

87
Q
  • Stands alone – weight shifts
  • Cruises
  • walks

Problems
* Delayed motor development
* Abnormal postures and gait deviations

A. standing Development 3-9 months
B. standing Development 9-12months

88
Q

Things that Needs to be developed in prone development except:

  • Head control
  • Neck control
  • Shoulder control
  • Counterpoising of neck
  • Counterpoising of arm and leg
  • Pelvic control
  • Tilt, equilbrium and protective reaction
A

Neck control

89
Q

Sitting Development

  • Sits alone: ___months
  • Develops cervical and lumbar lordosis: ___months
  • Sits in various positions: ____months
  • Develops tilting reactions: ___months
  • Sits lean on hands: ___months
A
  • Sits alone: 6-9 months
  • Develops cervical and lumbar lordosis: 7-9 months
  • Sits in various positions: 9-12 months
  • Develops tilting reactions: 6-9 months
  • Sits lean on hands: 4-6 months
90
Q

Standing Development

  • Cruises: ____months
  • Stands, holding on to furniture: ____months
  • Anterior tilts pelvis for stability: ___months
  • Shows sinking or astasia with head control:___months
  • Flings out arms in protective extension: ____ months
A
  • Cruises: 9- 12 months
  • Stands, holding on to furniture: 7-9 months
  • Anterior tilts pelvis for stability: 9-12 months
  • Shows sinking or astasia with head control: 3-6 months
  • Flings out arms in protective extension: 12-24 months
91
Q

T/F. In Primitive Reflexes, the Goal is to integrate primitive reflexes in order to promote mature reflexes

92
Q

Identify the Infantile Reflexes

  • Interfere with protective extension response and balance reaction
  • Weight bearing on UE- POE, POH
  • Facilitate equilibrium and protective reactions

A. Moro and Startle
B. Palmar Grasp

93
Q
  • Interferes with manipulative skills (transfers of objects, voluntary release)
  • Facilitate finger extension and inhibit finger flexion
  • Weight bearing – POE – POH quadruped

A. Moro and Startle
B. Palmar Grasp

(3) Pediatric Rehabilitation (13 decks)

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