Unit 7 Flashcards by Alexander Crist

What are children with SCI more likely to get than an adult with an SCI?

-Nueromuscular scoliosis and hip subluxation

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Most pediatric SCIs occur after what age?

-15 years

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For children with an incomplete SCI, what percent go on to have a normal life span?

-83%

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What is the most common cause of pediatric SCI?

-MVA

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What non-traumatic incidence can cause SCI?

-tumors, transverse myelitis, AV Malformation, AA instability

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Autonomic Dysrefflexia occurs in SCIs at or above what level?

-T6

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Children under 10 have difficulty completing which part of the ASIA exam?

-pin prick

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What part of the ASIA exam has a decreased reliability in those under 15?

-Motor Exam

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What should you use in place of MMT in those under 5?

-Functional Assessment

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For SCI above T1 what type of external device is recommended?

-Stander

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What region of the spine does spina bifida most likely occur?

-The Thoracolumbar Region

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What time frame does the neural tube not close during utero to cause spina bifida?

-Within the first 30 days

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What are 3 causes of Spina Bifida?

-genetics, too little maternal folic acid, maternal use of valporic acid

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What MSK abnormalities can be caused by muscle imbalances from spina bifida?

-Hip Dislocation, Talipes Equinovarus

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Children with spina bifida may have cognitive abnormalities, How will these children present to be to indicate this?

-“Chatty”

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What other neurological condition is common in children with spina bifida?

-Hydrocephalus (up to 90%)

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What is thought to be the cause of hydrocephalus in children with spina bifida?

-an increase of CSF pressure once the Neural Tube is closed

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What are the Signs and Symptoms of Hydrocephalus?

-Sunsetting (low) eyes, Bulging anterior Frontelle

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What is an Arnold Chiari (Chiari II) Malformation?

-When the cerebellum and brainstem are displaced distally through the foramen magnum

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What is tethered cord?

-where the spinal cord adheres to the site of the occlusion; can cause stretching of the spinal cord

What can tethered cord syndrome result in?

-Gait Dysfunction, bowel or bladder dysfunction, Increased tone and DTRs, Decreased strength and sensation

Tethered cord lesions are most common in spina bifida lesions below what level?

-T12

Children with thoracic spina bifida lesion commonly present with with LE Posture?

-“frog leg” Hip Abd & ER, Knee Flex, PF

A child with a upper lumbar spina bifida insult will have what impairments?

Weak quads

- But active Hip Flexors and Abductors

What type of orthosis may be useful for a child with a upper lumbar spina bifida lesions?

-Total Contact Orthosis

What type of orthotic can be used for upright activities for those with thoracic or high lumbar spina bifida lesions?

-A frame (toronto frame)

Those with thoracic or high lumbar spina bifida lesions can progress to what type of orthorics to help them ambulate?

-RGO of HKAFO (can do step to or step through)

What are two common orthopedic insults in those with lower lumbar spina bifida lesions?

-hip dislocation and scoliosis

What hip muscles may be intact in those with a lower lumbar spina bifida lesion?

-hip flexors and adductors (may have good to poor abductors)

In those with lower lumbar spina bifida lesions the glute max and lateral hamstrings will present how?

-weak

In those with lower lumbar spina bifida lesions the quads and medial hamstrings will present how?

-strong

What foot malformation may someone with a lower lumbar spina bifida lesion present with?

-Pes Cavus

What muscles will present as weak with a person with a sacral Spina Bifida Lesion? (2)

-glute max, and gastroc

What muscles may present as stong with a person with a sacral spina bifida lesion?

-glute med, knee flexors

What are the key indicators of shaken infant syndrome?

-Retinal hemorrhaging, and subdural hemotoma

Why are children more prone to accel/deccel brain injuries?

-their brains have a higher water content

What test is used to determine with severity of a TBI and possible outcomes in children?

-Pediatric Coma Scale

A come lasting longer than how many weeks is accociated with poor outcomes in a child with a TBI?

-4 weeks

What is a predictor of prognosis in children with TBI, especially if it lasts for longer than 3 months?

-post traumatic amnesia

Children below what age have a poor survival rate for TBI?

-2 years old

What is Anoxia most commonly cuased by?

-Near drowning, but surviving longer than 24 hours

Near drowning results in neurological damage what percent of the time?

-1/3 (33%)

How many levels are there in the Pediatric Ranchos Scale?

-3

What is Level I on the Pediatric Ranchos scale?

-Higher Level Respone

What is a Level II on the Pediatric Ranchos Scale?

-Agitated and Confused

What is level III-V on the pediatric ranchos scale?

-Lower Level or no response

What is the best OM for children with a TBI?

-GMFM 88

What is an important intervention for a child with a TBI that is in Ranchos III-V?

-Tilt table (40-60 min/day; 5 days/week)