week 8

Question 1

cerebral palsy

Answer 1

motor function disorder caused by nonprogressive brain defect present at or shortly after birth

• symptoms depend on injury severity
• palsy = lack musc control
• more common males

Question 2

aetiology CP

Answer 2

anything causing damage to immature brain
- some CP is never diagnosed
- “immature” is not defined

Question 3

types of CP

Answer 3

congenital: 90% of case

prenatal: prior to birth i.e. maternal drug use, alc, toxin, illness

perinatal CP: at or around time of birth
- low birth weight
- preterm birth
- o2 deprivation

acquired CP: 10%, happens 28 days post birth

postnatal CP: infection of brain, injury, cerebrovascular accidents i.e. stroke, heart defect

Question 4

topographical classification of CP

Answer 4

diplegic CP: both legs affected…sometimes arms

hemiplegic CP: one side of body i.e. L arm and leg

monoplegia: only one limb affected, very rare

triplegic CP: 3 limbs, rare

quadriplegic or tetraplegic CP: whole body…arms, legs, and trunk
- sometimes face and mouth

problematic classification bcs little distinction

Question 5

hypotonia

Answer 5

laxity of muscles

often diagnosed w CP diagnoses

Question 6

degree of disability CP classification

Answer 6

mild CP: min impact, fine motor mvmnts
- can go undiagnosed

mod CP: gen musc mvmnts, speech, fine motor skills
- can impact daily life, but good function

severe CP: little to no control, reflexes

Question 7

clinical types CP

Answer 7

diagnosed according to predominant type

spastic CP: 65%, damage to motor cortex resp for motor commands
- hypertonic musculature: stiff
- co-contraction: agonist and antagonist contract same time
- pigeon-toed scissor gait and hemiplegic gait/lean one side

athetoid CP: 25%, damaged basal ganglia
- unpreditcable and purposeless mvmnt aka CUP mvmnt
- CUP mvmnt bcs musc tone foes b/w hypertonic and hypotonic
- mainly quadriplegic

ataxic CP: 10%, most undiagnosed
- damaged cerebellum, balance and coordiantion
- irregular and imbalanced steps

mixed CP: 2+ types of CP…mult brain areas damaged

Question 8

GMFCS

Answer 8

gross motor function classification system: kids and youth under 18, classes according to typical abilities and gross motor function

5 pt scale
typical, rather than best function

meaningful activities i.e. wheeling, sitting, walking
- age based desc bcs motor funct changes w age

lvl 1: walks no limits
2: walks w limits
3: walks using handheld device
4: may use powered mobility, self mobile w limits
5: manual wheelchair

ages are “between birthdays” not yrs old

Question 9

behaviour indicators of CP

Answer 9

neurological soft signs:
- attention deficits
- hyperexcitability, stim reflexes
- rigidity around concepts
- unstable emotions
- poor visual input

Question 10

complications w CP

Answer 10

contracture: muscs shorten bcs of hyperactive stretch
- joint becomes fixed and causes pain
- prevent i.e. splints, bracing, exercise

scoliosis

Question 11

spina bifida

Answer 11

2nd most common complex condition after CP

neural tube defect: occurs first 4 wks of conception

affects brain, SC, or coverings

incomplete fev of spinal column
- can be repaired but permanent nerve damage
- limb paralysis

folic acid: can reduce risk by 70%

Question 12

risks of spina bifida

Answer 12

prior preg w NTD
family history NTD
insling dependent diabetes
obesity
anti seizure meds