Unit 7 Flashcards
What are children with SCI more likely to get than an adult with an SCI?
-Nueromuscular scoliosis and hip subluxation
Most pediatric SCIs occur after what age?
-15 years
For children with an incomplete SCI, what percent go on to have a normal life span?
-83%
What is the most common cause of pediatric SCI?
-MVA
What non-traumatic incidence can cause SCI?
-tumors, transverse myelitis, AV Malformation, AA instability
Autonomic Dysrefflexia occurs in SCIs at or above what level?
-T6
Children under 10 have difficulty completing which part of the ASIA exam?
-pin prick
What part of the ASIA exam has a decreased reliability in those under 15?
-Motor Exam
What should you use in place of MMT in those under 5?
-Functional Assessment
For SCI above T1 what type of external device is recommended?
-Stander
What region of the spine does spina bifida most likely occur?
-The Thoracolumbar Region
What time frame does the neural tube not close during utero to cause spina bifida?
-Within the first 30 days
What are 3 causes of Spina Bifida?
-genetics, too little maternal folic acid, maternal use of valporic acid
What MSK abnormalities can be caused by muscle imbalances from spina bifida?
-Hip Dislocation, Talipes Equinovarus
Children with spina bifida may have cognitive abnormalities, How will these children present to be to indicate this?
-“Chatty”
What other neurological condition is common in children with spina bifida?
-Hydrocephalus (up to 90%)
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
What are the Signs and Symptoms of Hydrocephalus?
-Sunsetting (low) eyes, Bulging anterior Frontelle
What is an Arnold Chiari (Chiari II) Malformation?
-When the cerebellum and brainstem are displaced distally through the foramen magnum
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)
