CP and LD (Week 9)

Question 1

Group of permanent or chronic neurological disorder, affecting movement, balance and posture

Answer 1

Cerebral palsy

Question 2

When does CP occur?

Answer 2

fetal period, during birth, or in early infancy but not diagnosed until later

Question 3

4 topographical classification of CP

Answer 3

1. Monoplegia/ Monoparesis
2. Diplegia/ Diparesis
3. Hemiplegia/ Hemiparesis
4. Quadriplegia/ Quadriparesis

Question 4

2 Motor function classification of CP

Answer 4

1. Pyramidal

2. Extrapyramidal

Question 5

Extrapyramidal is broken into what 2 categories

Answer 5

1. Dyskinetic

2. Ataxia

Question 6

If injury to pyramidal area what type of mvmt is affected?

Answer 6

voluntary

Question 7

If injury to extrapyramidal area what type of mvmt is affected?

Answer 7

involuntary mvmt bc areas like basal ganglia, thalamus, cerebellum are affected

Question 8

Most common type of CP (3)

Answer 8

• spastic CP (pyramidal)
  o 1. Hemiplegia
  o 2. Diplegia
  o 3. Quadriplegia

Question 9

Type of dyskinetic CP with symptoms:

 Writhing mvmts, repetitive, rhythmic, slower

Answer 9

Athetoid

Question 10

Type of dyskinetic CP with symptoms:

 Jerky almost like a spasm

Answer 10

Chorea

Question 11

Type of dyskinetic CP with symptoms:

• Sustained posture esp. in trunk
• move, fix, and then come out of the mvmt

Answer 11

Dystonic

Question 12

Type of dyskinetic CP seen along w/spastic quadriplegia frequently

Answer 12

Dystonic

Question 13

What is chorea commonly seen with?

Answer 13

chorea athetosis

Question 14

CP that affects balance and coordination

Answer 14

Ataxic CP

Question 15

9 risk factors for CP

Answer 15

• Prematurity & SGA
• Multiples
• Prenatal infections: CMV, toxoplasmosis, rubella
• Rh disease
• Challenging labor
• Placental inefficiencies
• Brain infections (post birth)
• Toxin exposure: mercury
• Brain injury

Question 16

3 complications that put baby at higher risk of getting CP

Answer 16

 1. Interventricular Hemorrhage (IVH)
 2. Hypoxic-Ischemic Encephalopathy (HIE)
 3. Periventricular Leukomalacia (PVL)

Question 17

Bleeding into the ventricular space within the brain hemispheres

Answer 17

Interventricular Hemorrhage (IVH)

Question 18

Risk factors for IVH (3)

Answer 18

o prematurity, SGA,
o respiratory distress syndrome
o patent ductus arteriosus (PDA)

Question 19

When can IVH occur?

Answer 19

in-utero or after they are born esp. premies

Question 20

What grade of IVH is when bleeding expands beyond germinal matrix into the ventricular system?

Answer 20

Grade II

Question 21

What occurs during Grade III IVH?

Answer 21

Bleeding dilates the ventricles and they are pushing on other brain tissue

Question 22

What % of Grade III IVH get CP?

Answer 22

30%

Question 23

What grade of IVH has periventricular Hemorrhagic Infarction (PHL-IVH) in addition to IVH?

Answer 23

Grade IV

Question 24

Describe Grade I IVH?

Answer 24

Bleeding into a network of blood vessels in the roof of the lateral ventricles (isolated to germinal matrix)

Question 25

What % of Grade IV IVH get CP?

Answer 25

75%

Question 26

What do the following symptoms indicate? - bulging fontanelle - seizures - decreased reflexes, tone, suck - apnea, bradycardia, anemia

Answer 26

IVH

Question 27

Why is a mom given prenatal corticosteroids?

Answer 27

 if they know the mom may deliver early to try to prevent a premature birth

Question 28

If mom has increased risk of bleeding or bleeding disorder what can she take?

Answer 28

Vitamin K

Question 29

2 medical internventions for IVH

Answer 29

1. Effective resuscitation and ventilation | 2. Maintain hemodynamic stability (BP stable)

Question 30

in a scissoring gait, what muscles are overactive?

Answer 30

adductors

Question 31

why do kids with CP sometimes walk in a crouched position?

Answer 31

compensate for balance issues

Question 32

In kids with CP, is supination or pronation more challenging?

Answer 32

supination

Question 33

What arm position is common for kids with CP?

Answer 33

fingers flexed into fist, FA pronate, wrist UD

Question 34

3 tone reducing medications for CP

Answer 34

botox baclofen pump oral meds such as valium

Question 35

5 surgical intervention for CP?

Answer 35

``` tendon lengthening muscle transfer de-rotation osteotomy spinal fusion selective dorsal rhizotomy ```

Question 36

What is the most important factor when thinking about adaptive equipment?

Answer 36

ALIGNMENT

Question 37

T/F: learning disabilities are recognized before entering school

Answer 37

false

Question 38

This LD has an issue with reading written language

Answer 38

dyslexia

Question 39

This LD has an issue with math and problem solving

Answer 39

dyscalculia

Question 40

This LD has an issue with writing

Answer 40

dysgraphia

Question 41

This LD has an issue with gross/fine motor and function

Answer 41

dyspraxia

Question 42

This LD has an issue with understanding vision or hearing despite normal vision or hearing

Answer 42

Auditory and Visual Processing Disorders

Question 43

What is a common comorbidity with ADHD?

Answer 43

executive function problems

Question 44

When is the DSM-V used to diagnose LDs?

Answer 44

private practice

Question 45

When is the ICD-11 used to diagnose LDs?

Answer 45

private practice

Question 46

When is the IDEA used to diagnose LDs?

Answer 46

public school system

Question 47

What is the name of a custom intervention strategy for a kid with a LD/Special Education?

Answer 47

IEP

Question 48

Brain damage due to hypoxia or ischemia

Answer 48

Hypoxic-ischemic Encephalopathy (HIE)

Question 49

Most significant risk factor for HIE?

Answer 49

asphyxia

Question 50

primary cause of HIE

Answer 50

placental insufficiency

Question 51

Does HIE happen after birth or in utero typically?

Answer 51

in utero

Question 52

What % of babies w/HIE get CP?

Answer 52

10-25%

Question 53

What would the following symptoms indicate? - decreased activity level - poor suck and feeding - respiratory difficulty - seizure in first 24 hrs - temperature instability

Answer 53

HIE

Question 54

White matter closest to the ventricles sustains injury/damage due to hypoxia or ischemia resulting in brain tissue death

Answer 54

Periventricular Leukomalacia (PVL)

Question 55

4 risk factors for PVL

Answer 55

1. prematurity 2. intrauterine infection 3. bleeding during pregnancy 4. IVH

Question 56

What % of babies w/PVL get CP?

Answer 56

60-90%

Question 57

When is critical window to damage oligodendrocytes?

Answer 57

23-24 weeks GA

Question 58

3 early signs to test for CP

Answer 58

1. lack of integrated reflexes 2. signs of UMN damage (increased tone) 3. developmental delays

Question 59

Result of delayed or absent righting rxns in kids w/CP

Answer 59

- trouble protecting themselves when sitting esp. if fall backwards

Question 60

3 characteristics of GMFCS Level 1

Answer 60

o Walks without limitation (started late 18-24 mo) o Soft neurologic signs, o They can sit, crawl

Question 61

What GMFCS Level? o severe head & trunk control limitations, o transported in a manual wheelchair o cognitively may be ok but very low motor development

Answer 61

GMFCS Level V

Question 62

Describe GMFCS Level IV (4)

Answer 62

o Starts to become more sever o May need adaptive seating and supported sitting o May walk short distances w/assistance o Self-mobility with powered mobility assistance

Question 63

What GMFCS Level? o Walks with limitations (by age 4) o can sit but tough to do UE activity like playing

Answer 63

GMFCS Level II

Question 64

What GMFCS Level? o walks with adaptive equipment assistance like a walker o can sit independently or with limited support; some independence in standing transfers

Answer 64

GMFCS Level III