Midterm

Question 1

Transactional Model of Development

Answer 1

reciprocal relationship between the child and the caregiving environment

Question 2

proximal vs distal environment

Answer 2

distal - curbs, wheelchair ramps, playgrounds, etc

proximal - within the home

Question 3

What is the ACE study?

Answer 3

looks at effect of childhood trauma on health

Question 4

Barnard-Four features of successful parent-child interactions

Answer 4

• Sufficient repertoire of behaviors, such as body movements and facial expressions
• Contingent responses
• Rich interactive content in terms of play materials, positive affect, and verbal stimulation
• Adaptive response patterns that accommodate the child’s emerging developmental skills

Question 5

Multidisciplinary service

Answer 5

Professionals work independently but recognize and value the contributions of other professions

Question 6

Interdisciplinary service

Answer 6

Individuals from different disciplines work together cooperatively to evaluate and develop programs.
Emphasis is on teamwork. Role definitions are relaxed.

Question 7

Transdisciplinary service

Answer 7

There is teaching and ongoing work among professionals across traditional disciplinary boundaries. Role release occurs when a team member assumes the responsibilities of other disciplines for service delivery

Question 8

what are positive signs? examples?

Answer 8

• behaviors that are present and not expected in the typical population
• lead to increased frequency or magnitude of muscle activity, movement, or movement patterns
• hypertonia, chorea, tics, tremor

Question 9

What are negative signs? examples?

Answer 9

• behaviors that are absent because of the pathophysiology
• insufficient muscle activity or insufficient control of muscle activity
• weakness, impaired selective motor control, apraxia, ataxia

Question 10

T/F: Negative signs are easier to detect in the clinic

Answer 10

false - positive signs are easier to detect

Question 11

______ motor signs may be even more significant contributors to disability that _______ signs

Answer 11

Negative, positive

Question 12

Reduced Selective Motor Control

Answer 12

impaired ability to isolate the activation of muscles in a selected pattern in response to demands of a voluntary posture or movement

• muscles are able to generate full force in other contexts, just not voluntary
  ex: activation of knee and hip flexors during DF

Question 13

ataxia

Answer 13

inability to generate a normal or expected voluntary movement trajectory that cannot be attributed to weakness or involuntary muscle activity about the affected joints
- can lead to decreased accuracy

Question 14

Dysmetria

Answer 14

inaccurate motion to a target

Question 15

Dyssnergia

Answer 15

decomposition of multijoint movements

Question 16

Dysdiadochokinesia

Answer 16

lack of rhythmicity

Question 17

Apraxia

Answer 17

impaired ability to accomplish previously learned and performed complex motor actions that is not explained by ataxia, reduced selective motor control, weakness, or involuntary motor activity

Question 18

Developmental dyspraxia

Answer 18

failure to have ever acquired the ability to perform age-appropriate complex motor actions
ex: monkey bars, jump 3 times, tying shoes

Question 19

head/neck extension response

Answer 19

facilitates extension and inhibits flexion

Question 20

head/neck flexion response

Answer 20

facilitates flexion and inhibits extension

Question 21

head/neck lateral flexion response

Answer 21

facilitates hip abduction

Question 22

arms ER, supination, extended elbows response

Answer 22

facilitates trunk extension and inhibits trunk flexion

Question 23

arms IR response

Answer 23

facilitates trunk flexion and inhibits trunk extension

Question 24

Arms horizontal abduction w/ ER response

Answer 24

facilitates ER of hips and inhibits spasticity of pecs

Question 25

Arms elevated overhead w/ ER response

Answer 25

very facilitatory to extension may | - may be too much

Question 26

arms diagonally backward w/ ER response

Answer 26

facilitates trunk extension and hand opening | - may use w/ ambulatory child to build extensor tone

Question 27

Abduction thumbs response

Answer 27

facilitates finger opening

Question 28

legs and pelvis flexion of hips and knees response

Answer 28

favors abduction and ER of hips, ankle DF

Question 29

legs and pelvis ER of lower extremities in standing response

Answer 29

facilitates hip abduction and ankle DF

Question 30

DF of toes 2-5 response

Answer 30

inhibits LE spasticity and facilitates DF

Question 31

anterior pelvic tilt response

Answer 31

promotes extension

Question 32

posterior pelvic tilt response

Answer 32

promotes flexion

Question 33

What is the GMFCS?

Answer 33

gross motor functional classification system

Question 34

T/F: GMFCS is an outcome measure

Answer 34

false - it is a classification system

Question 35

T/F: In CP, stiffness is usually greater distally than proximally.

Answer 35

true

Question 36

athetosis

Answer 36

slow, involuntary, and writhing movements of the limbs, face, neck, tongue, and other muscle groups

Question 37

GMFCS Level V – 90% of motor potential reached by age ___

Answer 37

3

Question 38

GMFCS Level I- 90% of motor potential reached by age ___

Answer 38

5

Question 39

What are poor prognosis for ambulation?

Answer 39

- rigidity | - persistent tonic neck reflexes

Question 40

What are predictors of ambulation potential?

Answer 40

- hemiplegic | - sit by 24 months

Question 41

Nearly all who eventually walk do so by age ___ – only exception are kids w/ pure athetosis

Answer 41

8

Question 42

Indications needed for posterior spinal fusion

Answer 42

curve approaching 90 degrees when the child is sitting w/ difficulty side bending back towards the middle

Question 43

benefits of standers

Answer 43

- standing w/ abducted hip to promote compression of hip | - weight bearing helps acetabulum form, blood flow, bone density, improved digestion, breathing, alertness

Question 44

What type of deformity is more common at the foot and ankle in hemiplegia? What muscles are weak?

Answer 44

varus deformity | - weak fibularis/peroneals, spastic anterior and posterior tibialis

Question 45

Kids start to realize their differences around age __

Answer 45

6

Question 46

How to test for femoral antetorsion?

Answer 46

lay kid on stomach and IR and ER LE

Question 47

uncompensated femoral antetorsion gait

Answer 47

pigeon toe

Question 48

compensated femoral antetorsion gait

Answer 48

gait w/ external tibial torsion

Question 49

How to assess for tibial torsion? What is more common?

Answer 49

lay kid in prone and look down calcaneus and look at angle to the thigh external is more common than internal

Question 50

What muscle is weak w/ foot flat?

Answer 50

tib posterior

Question 51

What muscle is weak w/ flat foot step?

Answer 51

poor DF

Question 52

What muscle is weak w/ toe walking?

Answer 52

PF contracture

Question 53

CP knee flexion gait cause

Answer 53

hip or knee contracture

Question 54

CP lacking hip extension gait can lead to what?

Answer 54

can lead to crouched gait and/or shorter stride length

Question 55

______ pulls tibia backwards to help extend the knee in midstance

Answer 55

Soleus

Question 56

Why is there limited swing phase knee motion in CP?

Answer 56

hip flexors supply momentum and rectus gets recruited and ends up also extending knee - 2 joint muscles are a problem in CP

Question 57

crouched gait requirements. What does it require?

Answer 57

knee flexion > 20 during initial contact or stance phase - requires more quad strength, chronic stress to knee, and often results in patella alta

Question 58

The crouched position itself reduces ________ control. What muscle becomes a knee flexor that is not usually a knee flexor?

Answer 58

extensor - rectus femoris

Question 59

Kids exposed early on to alcohol have different ________ as that is developed early

Answer 59

facial features

Question 60

Kids exposed later in term to alcohol have _________

Answer 60

behavioral issues

Question 61

What are the causes of crouched gait? (6)

Answer 61

- lower limb extensor weakness - loss of PF/knee extension couple - weakness of soleus - lever arm dysfunction due to femoral and tibial torsion - popliteal angle/spastic hamstrings - tight hip flexors