MS part 1

Question 1

down syndrome

Answer 1

overexpression of genes found on chromosome 21

Question 2

what do pt’s eventually develop with down syndrome

Answer 2

alzheimers

Question 3

what is treatment directed towards with down syndrome

Answer 3

medical problems presented

Question 4

common problems with older down syndrome pt’s

Answer 4

obesity
DM
CV
osteoarthrititic degenration of the spine - nerve pain
osteoporosis of vertebral or long bone fx

Question 5

clinical manifestations with down syndrome

Answer 5

• muscle hypotonia
• atlantoaxial instability secondary to ligamentous laxity
• feeding disorders
• cardiac defects
• flat occiput
• recurrent patellar dislocations
• excessive foot pronation
• late hip dislocations
• scoliosis

Question 6

scoliosis

Answer 6

• abnormal lateral curvature of spine

Question 7

what can scoliosis cause

Answer 7

• limb length inequality
• muscular dystrophy
• rotation of vertebral column around its axis occurs and causes associated rib cage deformity –> restrictive lung disease

Question 8

functional scoliosis

Answer 8

• postural defect secondary to pain, poor posture, leg length discrepancy & muscles spasms
• can be corrected

Question 9

structural scoliosis

Answer 9

• fixed curvature of the spine associated with vertebral rotation and asymmetry of the ligamentous supporting structures
• congenital

Question 10

if the curvature of scoliosis is <20 deg, what can occur?

Answer 10

rarely causes problems

Question 11

if curvature for scoliosis is >60 degrees, what can happen

Answer 11

• severe issues
• pulmonary insufficiency
• reduced lung capacity
• back pain
• degenerative spinal arthritis
• disk disease
• sciatica

Question 12

management of scoliosis for PT

Answer 12

• prevention of postural scoliosis

- exercises and ESTIM for pt with muscular imbalances

Question 13

PT management for scoliosis

Answer 13

• exercise for paraspinals

- strengthen trunk extensors, abs, gluteal muscles, iliopsoas & hip extensors

Question 14

prognosis for scoliosis

Answer 14

depends on likelihood of progression

Question 15

curvature <40 at skeletal maturity

Answer 15

progression small

Question 16

curvature >50 at skeletal maturity

Answer 16

• spina biomechanically unstable

- curve likely to progess throughout life

Question 17

spinda bifida

Answer 17

• occur when the neural tube doesn’t properly close during embryo phase
• incomplete fusion of the posterior vertebral arch (meninges do not protrude)

Question 18

meningocele

Answer 18

• external protrusion of meninges
• forced into gaps within vertebrae
• minor disabilities, no nerve damage

Question 19

myelomeningocele

Answer 19

• most severe

- protrusion of the meninges and SC

Question 20

hydrocephalus

Answer 20

• build up of too much CSF in the brain

- treatment: shunting

Question 21

are mental functions compromised in pt’s with hydrocephalus

Answer 21

no

Question 22

developmental dysplasia of the hip (DDH)

Answer 22

• ball of the femur is loose in the socket and be easy to dislocate - can lead to ligamentous laxity
• socket too shallow or not there

Question 23

treatment for DDH

Answer 23

encourage ROM but avoid displacement of the hip

Question 24

muscular dystrophy

Answer 24

ongoing, symmetric, muscle loss/weakness with increasing deformity and disability

Question 25

duchenne's MD

Answer 25

most common alterations of protein dystrophin repeated bouts of muscle damage lead to atrophy & fibrosis, eventually muscle degeneration

Question 26

when is MD identified in children

Answer 26

when the child has difficulty getting up off the floor, falls frequently, difficulty climbing stairs, waddling gait, increased lumbar lordosis

Question 27

what gait pattern is often seen with MD

Answer 27

tredelenburg | ambulation continues to deteriorate

Question 28

shoulder involvement seen with MD

Answer 28

scapular winging | instability

Question 29

other things seen with MD

Answer 29

``` scoliosis cognitive loss respiratory restrictive disease cardiac, dilated cardia myopathy GI ```

Question 30

prognosis for MD

Answer 30

pulmonary and cardiac complications bring down prognosis

Question 31

interventions for MD

Answer 31

active as possible dont over exercise aquatic therapy diaphragmatic breathing

Question 32

osteogenesis imperfecta (OI)

Answer 32

brittle bone disease | disease of collagen synthesis affecting bones and CT

Question 33

OI management

Answer 33

fx prevention and control | splints

Question 34

torticollis

Answer 34

- dystonia - syndrome of involuntary sustained or spasmodic muscle contractions involving co-contractions of the agonist and antagonist - contracted SCM - not a diagnosis

Question 35

which way does the head tilt with torticoliis

Answer 35

contracted SCM produces head tilt to the affected side with rotation of chin to opposite side

Question 36

PT implications for torticollis

Answer 36

stretch and strengthen neck muscles