Neurological Flashcards Preview

PAEDS > Neurological > Flashcards

Flashcards in Neurological Deck (24):
1

Primary MOI for ABI

Occurs at time of injury
Direct impact
Deceleration or shearing forces

2

Secondary MOI for ABI

Increased ICP
Ischaemic hypoxia
Intracranial haemorrhage
Electrolyte imbalance
Infection
Seizures

3

Acute Mx principles for ABI

Ventilate with normal PCO2
Maintain BP and CPP
Surgical management
Tx of complications

4

How to measure ABI?

GCS
PTA
Loss of consciousness
Severity

5

What is PTA

Time between time of injury and time person regains continuous day to day memory

6

Describe severity

Mild: GCS 13-15
Moderate: GCS 9-12
Severe: QCS <9

7

Medical complications of ABI

Neuroendocrine dysfunction
Respiratory
Nutrition
Bladder/Bowel
Autonomic Dysfunction
Heterotrophic Ossification
Sensory Deficits
UMNL +/- symptoms

8

Symptoms of dysautonomia

Increased BP
Increased HR
Vasodilation
Spasms
Dilated pupils

9

Management of PTA

Minimise noise
Encourage communication
Educate family
Use cues for memory
Structure and routine

10

Physical sequele (11)

1. GMS and FMS impairments
2. Balance/coordination
3. Speed of response time
4. Tremor
5. Rigidity/spasticity
6. Hearing impairment
7. Visual impairment
8. Sensory changes
9. Higher executive function changes
10. Motor output
11. Swallowing difficulties

11

Cognitive sequele (7)

1. Arousal and attention
2. Agitation
3. Memory and learning
4. Speed of info processing
5. Executive functioning
6. Visuoperceptual abilities
7. Speech and language difficulties

12

Early/Later stage PT management of ABI

Early stage:
1. Arousal/stimulation
2. Orientation to environment
3. Feeding and communication trials
4. Manage tone
Later stage:
1. Support increased function
2. Facilitate child participation
3. Promote integration
4. Promote mobility

13

Define Cerebral Palsy

A group of permanent disorders affecting the development of movement and posture causing activity limitation, attributed to non-progressive disturbances.

14

GMFCS

1 - Walks without limitations
2- Walks with limitations
3 - Walks with hand-held mobility device
4 - Needs assistive technology
5 - No head control

15

Causes of CP

Antenatal: maternal infections, placental problems, maternal ingestion of toxins
Peri-natal: premature, birth asphyxia
Post-natal: infections , accidents, strokes, interventions

16

PT Mx of Dyskinesia

1. Postural control - moving to midline, reduce internal perturbations, functional orientation, postural awareness, task orientation
2. Gross motor - functional mobility, transfers
3. Fine motor - ADL's, Education
4. Muscle strength and endurance - antigravity, NWB closed chain, functional, strengthening, graded contraction
5. Selective motor control - isolated contraction, purposeful movement
6. ROM - increase and preserve ROM
7. Sensory - awareness of triggers, sensory cueing to stabilise posture and movement

17

Which muscles affected in Erb's palsy?

Scapular protractors and elevation - rhomboids, serratus, subscap, levator snap
Shoulder F and ER - ant debts, supraspin/infraspin, teres minor
Elbow fix - biceps
Supination - brachioradialis, supinator
Wrist and finger ext - long ext of wrist and fingers

18

Position of Klumpke's Palsy

Clawing position in hand

19

What are the 3 S's?

Alert parents to be aware of poor sensation (hot water, tight clothing)
Teach parents to carefully support flaccid arm/hand (cradle when carrying)
Safe positioning during sleep and play (not lying on aff arm)

20

What are the 3 P's?

Positioning to avoid contractures
Passive facilitation/mobilisation into limited ROM (shoulder ER/ABD, elbow F/Sup, wrist ext)
Promote active mvmt (active-assisted movement, sensory stimulation for muscle activation)

21

Other PT Tx of BPP

Sensation - warm baths or massage
Gross Motor - gradually increases prone position when awake to promote symmetry if shoulder stable, then 4 point
Posture and balance - supporting, protecting, weight-shift
Fine motor - reaching and hand function during ADL's

22

MSK Mx of BPP

Muscle activation and strength
Muscle length
joint range
Registration
Proprioception

23

Diagnostic criteria for DCD

1. Performance in daily activities that require motor coordination is substantially below expected given age
2. Disturbances significantly interfere with academic achievement or ADL's.
3. Disturbance not due to general medical condition and doesn't meet criteria for major behavioural disorders
4. If mental retardation present motor difficulties are in excess of those normally associated with such a condition

24

Describe Mx of DCD

Start with arousing action song to build tone
Dynamic anti-gravity stability for trunk
Mirror games for postural alignment
Control varying speeds of movement
Muscle activation
Trunk control
Add pertubations/postural demand
Muscle strength