Neuromuscular conditions

Question 1

what is cerebral palsy

Answer 1

a permanent, non-progressive motor disorder that occurs due to damage to the brain before birth or within 2 years of birth

Question 2

what is spina bidifa

Answer 2

this is the failure of the neural tube to close. It varies in severity

Question 3

what is muscular dystrophy

Answer 3

This is a progressive muscle weakness disease that is genetically inherited

Question 4

name some types of complex exceptional needs

Answer 4

• learning and mental functions
• communication problems
• motor skills
• self-care
• hearing and visual difficulties

Question 5

what is the criteria for a young person to be classified as having complex exceptional needs

Answer 5

< 19 yoa, must have at least 4 different impairments and require feeding OR 2 different imprints and require ventilation

Question 6

what are the causes of cerebral palsy

Answer 6

Pre-natal = drugs, smoking, alcohol, rubella, toxaemia, toxoplasmosis
Peri-natal = anoxic injuries, prematurity (most common), infection
Post-natal = infection or head trauma

Question 7

what are the anatomical classifications of cerebral palsy

Answer 7

Monoplegia = one limb affected
Quadraplegia = all limbs affects
Diplegia = lower limbs affected
Hemiplegia = half of the body affected

Question 8

what are the physiological classifications of cerebral palsy

Answer 8

Spastic = characterised by increased muscle tone due to damage within the pyramids or the motor cortex 
Athetoid = non-spastic/fluctuating muscle tone and involuntary movements
Ataxia = caused by damage to the brain stem/cerebellum and result in posture and balance problems

Question 9

what is meant by monoplegia cerebral palsy

Answer 9

one limb affected

Question 10

what is meant by diplegia cerebral palsy

Answer 10

both lower limbs affected

Question 11

what is meant by quadriplegic cerebral palsy

Answer 11

all limbs affected

Question 12

what is meant by hemiplegic cerebral palsy

Answer 12

half of the body affected

Question 13

what is meant by spastic cerebral palsy

Answer 13

characterised by increased and non-fluctuating muscle tone

Question 14

what is meant by athetoid cerebral palsy

Answer 14

fluctuating muscle tone and involuntary movements

Question 15

what is meant by ataxia cerebral palsy

Answer 15

difficulty with posture and balancing

Question 16

name some clinical signs of cerebral palsy

Answer 16

• speech, hearing and visual problems
• learning difficulties
• epilepsy
• feeding difficulties
• behavioural problems

Question 17

what is meant by an antalgic gait

Answer 17

when the stance phase is relatively short in comparison to the swing phase - this suggests that there is weight bearing pain

Question 18

what is meant by a trandelenberg gait

Answer 18

this is when the hip stabiliser muscles have been damaged and the affected hip will dip. the leg of the affected side will swing outwards when walking

Question 19

what are the prerequisites of a normal gait

Answer 19

S - stability in stance 
S - no swing
S - save energy
S - step length 
S - safe prepositioning of the foot

Question 20

what is meant by kinematics

Answer 20

how the body moves through space - measured in metres

Question 21

what is meant by kinetics

Answer 21

the forces that are exerted on the body - measured in newtons

Question 22

what spinal curvature is common in cerebral palsy

Answer 22

scoliosis

Question 23

name some indications of surgery in cerebral palsy

Answer 23

to improve sitting, to prevent hip displacement, to prevent respiratory failure

Question 24

in what proportion of those with cerebral palsy does hip displacement occur

Answer 24

1/3

Question 25

what is gross motor function and why is it important to determine this in patients

Answer 25

this is a tool that assesses how severe someone cerebral palsy it - it is a scale that determines how well they are walking: Level 1 = walking with no limitations 2 = walking with limitations 3 = walking with a hand held mobility device 4 = using an electronically monitored device 5 = being transported in a manual wheelchair

Question 26

name some things involved in the management of cerebral palsy

Answer 26

- physiotherapy - surgery - muscle relaxants in spastic CP - soft tissue release - bone realignment

Question 27

name the benign form of spina bifida

Answer 27

occulta

Question 28

what can be done during pregnancy to prevent spina bifida

Answer 28

folic acid

Question 29

what is meningocele spina bifida

Answer 29

this is when there is a cyst int he meninges but the nerve roots are intact

Question 30

what is myelomeningocele spina bifida

Answer 30

this is when the nerve roots are exposed or present in the meningeal cyst

Question 31

what are the 2 main types of muscular dystrophy

Answer 31

Duchenne's and Beckers

Question 32

what is Duchenne's muscular dystrophy

Answer 32

this is the most severe form, it is recessive sex linked and children are usually in a wheelchair by the age of 12

Question 33

what is Becker's muscular dystrophy

Answer 33

this is more minor and people are usually in a wheelchair by the age of 30

Question 34

name some clinical signs of muscular dystrophy

Answer 34

shoulders and arms back, tummy sticking out, foot drop, tip toe contractors, thin and weak thighs and thick calfs, poor balance and falls over a lot, learning difficulties