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Clinical Medicine - OT > Week 4 - Paeds Cerebral Palsy > Flashcards

Week 4 - Paeds Cerebral Palsy Flashcards

1
Q

What is cerebral palsy?

A

A physical disability that affects movement and posture.

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2
Q

When does CP appear?

A

Early infancy or childhood

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3
Q

What is the definition of CP?

A

CP is an umbrella term for a group of disorders. It is permanent but not unchanging and involves a disorder of movement and/or posture and of motor function.

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4
Q

What causes CP?

A

CP is due to a non-progressive interference, lesion or abnormality, where the interference, lesion or abnormality originates in the immature brain.

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5
Q

True or false, CP is the most common physical disability in childhood?

A

True

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6
Q

How many people live with CP in Australia?

A

34000

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7
Q

How is CP classified?

A
  1. The way it affects people’s movement
  2. The part of the body affected
  3. How severe the affects are
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8
Q

What is Quadriplegic CP?

A

All 4 limbs are affected as well as the muscles of the trunk, face and mouth

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9
Q

True or false, Quadriplegic CP is not bilateral

A

False, as it affects both sides of the body, it is bilateral

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10
Q

What is Diplegic CP?

A

Both legs are affected and the arms may be affected to a lesser extent.

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11
Q

What is Hemiplegic CP?

A

2 limbs are affects but only on one side of the body.

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12
Q

True or false, Diplegic CP is a bilateral CP?

A

True, it affects both sides of the body

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13
Q

True or false, Hemiplegic CP is bilateral?

A

False, Hemiplegic CP only affects one side of the body

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14
Q

What classification system is used for classifying the severity of Gross Motor Skills in CP?

A

Gross motor functional classification system

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15
Q

What classification system is used for classifying the severity of fine motor skills?

A

The manual ability classification system

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16
Q

What classification system is used for classifying the severity of communication?

A

Communication function classification system

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17
Q

What is the most common form of CP?

A

Spastic CP

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18
Q

What percentage of individuals with CP are affected by spastic CP?

A

70-80%

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19
Q

When does the motor cortex damage occur in spastic CP?

A

Occurs before, during or after birth

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20
Q

How does spastic CP affect the UL?

A

Flexion at the elbow, wrist and fingers

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21
Q

How does spastic CP affect the LL?

A

Flexion at the hip, adduction or scissoring of the thighs, flexion at the knees, equinovarus foot posture.

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22
Q

What is scissoring?

A

A form of gait abnormality primarily associated with spastic cerebral palsy where the thighs are adducted.

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23
Q

What is equinovarus foot posture?

A

Clubfoot, a common foot abnormality, in which the foot points downward and inward.

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24
Q

What causes spastic CP?

A

damage to the motor cortex before, during or after birth.

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25
Q

What is Dyskinetic CP?

A

People with dyskinetic forms of cerebral palsy have variable movement that is involuntary, characterised by dystonia, athetosis and chorea

26
Q

What damage results in Dyskinetic CP?

A

Damage to the basal ganglia

27
Q

What is dystonia?

A

Twisting and repetitive movements or abnormal sustained postures

28
Q

What is Athetosis?

A

Slow, continuous, involuntary writhing movements present at rest

29
Q

What is Chorea?

A

Dance like irregular, unpredictable movements

30
Q

What is Ataxic CP?

A

Ataxia is the least common form of cerebral palsy. Ataxia means ‘without order’ or ‘incoordination’.

31
Q

What damage results in Ataxic CP?

A

Damage to the cerebellum

32
Q

How are UL affected in Ataxic CP?

A

tremor
shakiness
overshooting (reach too far)
difficulties with precise movement and repetition

33
Q

How is LL affected by Ataxic CP?

A

Instability - high risk of falls
Poor balance
Wide base gait
falls

34
Q

How does Ataxic CP affect speech and swallowing?

A

Monotone voice
breathy sound
unusual accelerations or pauses between syllables

35
Q

How does Ataxic CP affect the eyes?

A

Slow eye movements

eyes may overshoot or underestimate target

36
Q

What percentage of CP brain injury occurs in the prenatal and perinatal period of development?

A

94%

37
Q

What percentage of CP brain injury occurs during an event more than 28 days after birth?

A

6%

38
Q

What are risk factors of CP?

A

Maternal risk factors (thyroid, pre-eclampsia, bleeds, infection, placental abnormalities, multiple births, rubella)
Born premature - 10% babies born before 28 weeks, 5% born 28-31 weeks have CP
Term born - Babies born with Encephalopathy, 12% had CP

39
Q

What are prenatal risk factors of CP?

A 
Genetic disorders
Maternal health factors
Teratogenic agents
Placental disruption
Lack of growth or factors affecting foetal growth
RH blood type incompatibility
Viral diseases in early pregnancy
40
Q

What are perinatal risk factors of CP?

A

Problems during birth
Medical problems associated with immaturity
Multiple births
Low birth weight

41
Q

What are post-natal factors of CP?

A

Severe and untreated jaundice
Infections eg. Meningitis or encephalitis
Alcohol/drug intoxication during breast feeding
Hypoxic ischemic encephalopathy
Trauma during birth or shortly after

42
Q

What is the average age for CP diagnosis?

A

18 months

43
Q

What are diagnosis indicators for CP?

A 
Floppy when picked up
Cannot hold up head
stiff muscles
unusual postures
delays in reaching developmental milestones
44
Q

What assessment can be used to assess motor development?

A

The general movement assessment
The developmental assessment of young children (DAYC)
The Hammersmith infant neurological assessment (HINE)

45
Q

When can the general movement assessment be performed?

A

before 20 weeks with specific training

46
Q

When can the DAYC be used for assessment?

A

6-12 months

47
Q

Which test can predict severity in motor development deficit?

A

The HINE

48
Q

What age group can use the HINE?

A

It can be used across all age groups

49
Q

True or false, as lesions occur in an immature brain, some changes/development can be seen over time?

A

True, this can cause secondary impairments

50
Q

What do the atypical movement patterns seen in CP cause?

A

diminished strength, contractures in muscle, tendon and ligaments

51
Q

What do soft tissue changes in CP lead to?

A

Deformities, spinal and joint misalignment

52
Q

True or false, people with CP are at risk of skin breakdown and reduced bone density?

A

True

53
Q

Why would a person with CP have compromised breathing?

A

Due to weak postural muscles

54
Q

What are some symptoms of CP?

A 
Low endurance
Fatigue
Dysarthria
Speech problems
Decreased voice quality
Decreased expressive and receptive language
Visual impairments
Auditory processing and reception
Tactile hypersensitivity
Sensory processing issues
55
Q

What conditions are associated with CP?

A 
Pain
Behavioural concerns 1:4
Intellectual disability 1:2
Non Ambulant 1:3
Hip displacement 1:3
Non verbal 1:4
Epilepsy 1:4
Bladder incontinence 1:4
Sleep disorders 1:5
Blindness 1:10
56
Q

What life expectancy do children with CP have?

A

A normal life expectancy

57
Q

What percentage of children will walk?

A

70%, 60% independent and 10% with aids

58
Q

What percentage of CP children require a wheelchair?

A

30%

59
Q

When are severity predictors most accurate in CP?

A

2 years old

60
Q

What are the 3 evidence based interventions of CP?

A
  1. Child active rehabilitation approaches
  2. Compensatory and environmental adaptation approaches
  3. Health and secondary prevention approaches

Clinical Medicine - OT (35 decks)

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