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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
What is Dyskinetic CP?
People with dyskinetic forms of cerebral palsy have variable movement that is involuntary, characterised by dystonia, athetosis and chorea
26
What damage results in Dyskinetic CP?
Damage to the basal ganglia
27
What is dystonia?
Twisting and repetitive movements or abnormal sustained postures
28
What is Athetosis?
Slow, continuous, involuntary writhing movements present at rest
29
What is Chorea?
Dance like irregular, unpredictable movements
30
What is Ataxic CP?
Ataxia is the least common form of cerebral palsy. Ataxia means 'without order' or 'incoordination'.
31
What damage results in Ataxic CP?
Damage to the cerebellum
32
How are UL affected in Ataxic CP?
tremor shakiness overshooting (reach too far) difficulties with precise movement and repetition
33
How is LL affected by Ataxic CP?
Instability - high risk of falls Poor balance Wide base gait falls
34
How does Ataxic CP affect speech and swallowing?
Monotone voice breathy sound unusual accelerations or pauses between syllables
35
How does Ataxic CP affect the eyes?
Slow eye movements | eyes may overshoot or underestimate target
36
What percentage of CP brain injury occurs in the prenatal and perinatal period of development?
94%
37
What percentage of CP brain injury occurs during an event more than 28 days after birth?
6%
38
What are risk factors of CP?
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
What are prenatal risk factors of CP?
``` 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
What are perinatal risk factors of CP?
Problems during birth Medical problems associated with immaturity Multiple births Low birth weight
41
What are post-natal factors of CP?
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
What is the average age for CP diagnosis?
18 months
43
What are diagnosis indicators for CP?
``` Floppy when picked up Cannot hold up head stiff muscles unusual postures delays in reaching developmental milestones ```
44
What assessment can be used to assess motor development?
The general movement assessment The developmental assessment of young children (DAYC) The Hammersmith infant neurological assessment (HINE)
45
When can the general movement assessment be performed?
before 20 weeks with specific training
46
When can the DAYC be used for assessment?
6-12 months
47
Which test can predict severity in motor development deficit?
The HINE
48
What age group can use the HINE?
It can be used across all age groups
49
True or false, as lesions occur in an immature brain, some changes/development can be seen over time?
True, this can cause secondary impairments
50
What do the atypical movement patterns seen in CP cause?
diminished strength, contractures in muscle, tendon and ligaments
51
What do soft tissue changes in CP lead to?
Deformities, spinal and joint misalignment
52
True or false, people with CP are at risk of skin breakdown and reduced bone density?
True
53
Why would a person with CP have compromised breathing?
Due to weak postural muscles
54
What are some symptoms of CP?
``` 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
What conditions are associated with CP?
``` 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
What life expectancy do children with CP have?
A normal life expectancy
57
What percentage of children will walk?
70%, 60% independent and 10% with aids
58
What percentage of CP children require a wheelchair?
30%
59
When are severity predictors most accurate in CP?
2 years old
60
What are the 3 evidence based interventions of CP?
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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