lecture 5: POC/TX Neuro conditions Flashcards by Rebecca Nam

CP, BP, DCD, autism, myelodysplasia are examples of

neurologic/neuroMSK diagnoses

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CMT, ITW, OI, arthrogryposis are examples of

MSK diagnoses

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congenital heart conditions, cystic fibrosis, asthma, long term mechanical ventilation are examples of

cardiopulmonary diagnoses

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motor disorders of ___ are often accompanied by disturbances in sensation, cognition, communication, perception, and/or behavior, and/or a seizure disorder

cerebral palsy

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T or F: CP is a specific term giving information about the functional level of the individual

F
CP = nonspecific term
does not give info about functional level

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the most common motor disability in childhood

CP
more than half kids have a co-occurring condition

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prenatal risk factors of CP during pregnancy

STORCH
CHEAP
maternal seizure disorder
maternal high BP
maternal toxin exposure
bleeding in 3rd trimester
thyroid/hormone disorders
multi gestation
hypoxia
metabolic disorders
malformation of brain structures
vascular insults
abdominal trauma
preemie (less than 32 weeks, less than 2500 grams)
Blood incompatibiltiy
asphyxia
infection
placental abruption
instrumented delivery
Seizures w/in 48 hrs. after birth
 Cerebral Infarction
 Hyperbilirubinemia
 Sepsis
 Respiratory Distress/Chronic lung disease
 Meningitis

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What does CHEAP stand for

Chicken Pox
Hepatitis (B,C,E)
Enterovirus
AIDS
Parvovirus

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What does STORCH stand for

Syphilis
Toxoplasmosis
Other: varicella zoster virus,
parvovirus B19, or lymphocytic choriomeningitis virus),
Rubella/measles
CMV
Herpes

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describes a group of disorders of the
development of movement and causing activity limitation, that are non-progressive disturbances that occur in the developing fetal or infant brain

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patient with CP: pure spasticity
what is damaged?

pyramidal system

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patient with CP: athetoid cerebral
what is damaged?

extrapyramidal system is involved

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mixed pattern CP: what is damaged

both pyramidal and extrapyramidal systems

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postnatal risk factors for CP later in infancy/early childhood

infections/meningitis
shaken baby (trauma)
accidental trauma TBI right after birth
asphyxia: choking, near drowning
PVL

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bilateral white matter necrosis that is most commonly observed in preemies but can be seen in full term infants
*high correlation with CP

PVL (periventricular leukomalacia)

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What is the most common intraventricular hemorrhage in neonatal IVH?

*subependymal germinal matrix IVH
thin walled vessels bleed easily in this area

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Grade _ and _ IVH correlate with neurodevelopmental sequelae

3 and 4

goes from grade 1-4

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4 CP classifications based on location, 4 based on mvmt patterns

location:
1. diplegia
2. hemiplegia
3. triplegia
4. quadriplegia

mvmt patterns:
1. spastic
2. athetoid
3. ataxic
4. mixed

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Is cognition impaired in CP?

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Most spastic CP is what kind? hemi, diplegic, or quadraparesis?

diplegic 35-45%
quadraparesis 23-30%
hemiparesis 10-15%

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What is the most common kind of dyskinetic CP?

Athetosis 5 to 8%
Dystonic 2 to 3%
Chorea/Ballismus: Rare

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What percent is mixed CP? What about hypotonic CP

mixed: 10-15%
hypotonic: rare

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GMFCS level 1

walk without limits
(can run, jump, but speed balance and coordination are limited)

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GMFCS level 2

walk with limitations
(climb stairs with railing, **may **walk with WC or HHD over long distances. hard time on uneven terrain, inclines, crowded spaces. Min ability to run/jump)

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GMFCS level 3

**walk using hand held device** in most indoor settings (climb stairs with railing and supervision/assistance, WC for long distances)

GMFCS level 4

**self mobility with limitations may use powered W**C may walk for short distances at home with physical assistance, or body support walker when positioned.

GMFCS level 5

transported in manual WC (not self propelled) *limited ability to maintain head and trunk posture or control extremities

Is CP progressive?

no and yes-bc children grow mm grow due to stretch stretch = growth hormones growth hormones = signal adding sarcomeres at musculotendinous junction kids with CP cannot move through ROM, inadequate stretch, inadequate growth

What is lever arm dysfunction?

abnormal muscle forces, lack of normal movement and/or weight bearing, disuse and compensatory mechanisms can alter the bony lever arms

Although bones are genetically preprogrammed for shape, it also depends on magnitude and direction of ___ -__ and _______ acting on bone

internal mm forces external ground reaction forces

Abnormal muscle forces combined with the lack of normal growth stimulation** alter bone _______ The rate of child’s bone growth depends on variety of factors including:

Abnormal muscle forces combined with the lack of normal growth stimulation** alter bone growth both in shape and orientation** The rate of child’s bone growth depends on variety of factors including **physiological stresses,** **nutrition** and **p****resence of growth hormone**

What is autism spectrum disorder?

a spectrum of developmental disability characterized by: -verbal, nonverbal communication and social interaction impacts -**impaired motor performance,** coordination/apraxia, t**oe walking** -possible intellectual impairments -poor eye contact -sensitivity to touch/sensory stimuli

autism spectrum disorder ASD is generally evident before __ years of age

3 years

An autism spectrum disorder characterized by significant difficulties in **social interactions**

aspergers ## Footnote Surgeons

sensory integration disorder = sensory processing disorder deficits in _ _ and _ response to sensory information

perception organization coordinated response

what is SPD caused by?

neurological immaturity or malfunction in brain processing

behavioral manifestation of sensory processing which leads to modulation and praxis

sensory integration

neurophysiologic term that reflects the reception, modulation, integration, and organization of sensory stimuli, but not necessarily the adaptive environmental interaction that we observe

sensory processing

considered an over responsiveness or under responsiveness to stimulation and may be reflected in sensory seeking or sensory avoiding

sensory modulation dysfunction

may have neuroanatomic origins in neural activity before motor execution causes dyspraxia and postural disorder

Sensory Based Motor Disorders

family of assessments providing standardized tools to help evaluate a child's sensory processing patterns in the context of home, school, and community-based activities

sensory profile 2

developed to evaluate sensory processing patterns in the very young. The results provide understanding of how sensory processing affects the child’s daily functioning performance.

Infant/Toddler Sensory Profile

Measures sensory processing patterns and effects on functional performance

Adolescent/adult sensory profile

Provides school-based clinicians the ability to evaluate a child's sensory processing skills and how these skills affect classroom behavor and performance

SPSC Sensory Profile School Companion

How is SPD diagnosed?

through comprehensive eval includes standardized testing observations review of child's development

series of tests assessing how a child processes sensory input

Sensory Integration and Praxis Tests (SIPT)

What are the 6 sensory systems

1. proprioception 2. vestibular 3. tactile 4. vision 5. auditory 6. taste/smell

Motor skills disorder with marked impairment in motor coordination interfering with academic achievement or ADLs

developmental coordination disorder (DCD)

DCD frequently occurs with _ and _ disorders

learning disabilities and attention deficit (ADD/ADHD)

true or false: DCD = decreased mm tone, mm weakness, motor incoordination

true

Genetic disorder in which majority of individuals have extra 21st chromosome

Down Syndrome

Down Syndrome is characterized by:

1. generalized low tone 2. mm weakness 3. joint laxity 4. slow postural reactions 5. intellectual impairment 6. possible HEART DEFECTS 7. possible CERVICAL INSTABILITY

TBIs are caused by external force to head. Deficits vary, including:

1. altered tone 2. motor control issues 3. weakness 4. balance issues 5. impaired gross and fine motor 6. intellectual, behavioral, emotional, speech deficits

Acute traumatic lesion of the spinal cord or cauda equina resulting in temporary or permanent sensory and/or motor deficits

SCI

Group of congenital disorders characterized by varying degrees of incomplete closure of the embryonic neural tube

Spina Bifida ## Footnote REMEMBER LATEX ALLERGY

3 classifications of spina bifida

1. occulta 2. meningocele 3. myelomeningocele

protrusion of posterior elements of spine with **extrusion of meninges and CSF **but **without involvement of neural elements**

SB meningocele

extrusion of neural elements such as nerves and spinal cord as well as the meninges and CSF exact cause unknown, combo of genes and environment

SB Myelomeningocele

relationship between inadequate __ and __ intake and neural tube deficits cause MYELOMENINGOCELE

vitamin and folic acid intake

myelomeningocele deficits depend on level of injury: T or F

true

myelomeningocele deficits include:

1. diminished/absent trunk or LE strength and sensation 2. impaired B&B 3. Possible poor motor control 4. Changes in posture and alignment 5. Decreased mobility and activity tolerance *depend of LOI *monitor for SCOLIOSIS

What are 4 considerations with SB myelomeningocele?

1. monitor for scoliosis 2. observe/assess hydrocephalus (VP shunt may be intact) 3. know about shunt malfunctions 4. know about tethered cord

SS of tethered cord

1. tufts of hair, dimples, skin discoloration in LB 2. LBP worse with activity, better with rest 3. leg pain/numbness 4. gait disturbances 5. foot or spinal deformities (sudden change in foot posture) 6. B&B 7. repeat UTIs

SS of shunt malfunctions *may only see 1 of these

* Headaches * Vomiting * Lethargy (sleepiness) * Irritability * Swelling or redness along the shunt tract * Decreased school performance * Periods of confusion * Seizures

Pattern of neurological and physical defects that can develop in a fetus when a woman drinks during pregnancy

FAS: fetal alcohol syndrome

Fetal alcohol syndrome leads to what deficits?

1. intellectual 2. learning disabilities 3. communication deficits 4. fine motor deficits

genetic disorders that cause tumors to grow in nervous system

neurofibromatoses

neurofibromatoses cause what impairments?

1. impaired function of joint and bones 2. impaired mobility 3. self care issues 4. interventions to prevent 2ndary impairment, optimize activity and participation

lecture 5: POC/TX Neuro conditions Flashcards

(68 cards)