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NPTE-Pediatrics and Development > Pediatric clinical application- Cerebral Palsy > Flashcards

Pediatric clinical application- Cerebral Palsy Flashcards

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1
Q

how is cerebral palsy defined?

A

an umbrella term used to describe a group of non-progressive movement disorders that result from brain damage

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2
Q

what disorder is the most common cause of permanent disability in children

A

cerebral palsy

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3
Q

autopsy reports have indicated lesions resulting in cerebral palsy that include (3):

A

hemorrhage below the lining of the ventricles
CNS damage causing neuropathy and anoxia
hypoxia causing encephalopathy

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4
Q

hypoxic and ischemic injuries resulting in cerebral palsy disrupts what process in a developing fetus?

A

metabolism that results in global damage to fetus

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5
Q

how is CP classified?

A

by neurological dysfunction and extremity involvement

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6
Q

CP is classified by __ dysfunction and __ involvement

A

neurological dysfunction and extremity involvement

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7
Q

what are the primary movement patterns associated with CP?

A

spastic
athetoid

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8
Q

spastic CP involves damage to what brain structures (2)?

A

motor cortex of the cerebrum, UMN damage

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9
Q

athetoid CP involves damage to what brain structure (1)?

A

basal ganglia

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10
Q

the etiology of CP may be __ and is sometimes unknown

A

multifactorial

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11
Q

risk factors for CP are categorized as prenatal (__%), perinatal and postnatal (__%) cases

A

80%, 20%

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12
Q

risk factors for CP are categorized as __ (80%), __ and __ (20%) cases

A

prenatal, perinatal and postnatal

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13
Q

prenatal risk factors for CP include (6):

A

Rh incompatibility
maternal malnutrition
hypothyroidism
infection
diabetes
chromosome abnormalities

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14
Q

perinatal risk factors for CP include (6):

A

multiple or premature births
breech delivery
low birthweight
prolapsed cord
placental abruption
asphyxia

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15
Q

postnatal risk factors for CP include (4):

A

CVA
head trauma
neonatal infection
brain tumor

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16
Q

what is the most common causative factor for CP?

A

prenatal cerebral hypoxia

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17
Q

CP is the __ most common neurological impairment seen in children, following intellectual disability

A

second

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18
Q

CP is a __ disorder of __ and __ movement

A

neuromuscular disorder of posture and controlled movement

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19
Q

why is clinical presentation of CP highly variable?

A

based on area and extent of CNS damage

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20
Q

a child with CP may present with __ tone, __ tone or __ movement

A

high, low, athetoid

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21
Q

how is CP typically classified?

A

monoplegia
diplegia
hemiplegia
quadriplegia

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22
Q

monoplegia

A

involvement of one extremity

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23
Q

diplegia

A

involvement of BLE, may also affect BUE

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24
Q

hemiplegia

A

unilateral involvement of upper and lower extremities

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25
quadriplegia
involvement of all extremities
26
how else is CP classified?
mild, moderate, severe
27
what are the general characteristics of CP (6)?
motor delays abnormal muscle tone and motor control reflex abnormalities poor postural control high risk for hip dislocations balance impairments
28
children with CP are at high risk for __ __
hip dislocation
29
what other cognitive (1) and sensory (3) processes are disrupted in conjunction with CP?
intellect vision hearing perceptual skills
30
all other characteristics of CP aside from: motor delays abnormal muscle tone and motor control reflex abnormalities poor postural control high risk for hip dislocations balance impairments disruption of intellect disruption of vision disruption of hearing disruption of perceptual skills are __ dependent
classification
31
what imaging techniques and lab studies can be useful in confirmation of a CP diagnosis?
electroencephalography (EEG) x-ray of the hip blood and urine tests
32
if CP is suspected through clinical findings, including seizures, what imaging technique may be performed to support the diagnosis of CP?
electroencephalography (EEG)
33
if CP is suspected through clinical findings, including __, electroencephalography (EEG) may be performed to support the diagnosis of CP
seizures
34
x-ray of the hip is useful is ruling out __ __ in patients with suspected CP and may be useful in confirming diagnosis of CP
hip dislocation
35
what imaging technique performed on the hip is useful in ruling out hip dislocation in patients with suspected CP and may be useful in confirming diagnosis of CP
x-ray
36
blood an urine tests can be used to investigate __ causes of CP and may be useful in confirming the diagnosis of CP in a patient with suspected CP
metabolic
37
what lab tests can be used to investigate metabolic causes of CP and may be useful in confirming the diagnosis of CP in a patient with suspected CP
blood and urine
38
__ usually will diagnosis CP secondary to the observed outward characteristics
observation
39
aside from use of imaging and lab studies, CP is regularly confirmed through what aspects of PT examination (5)?
-extensive neurological evaluation -patient observation -patient history including developmental progress -presence of pathological reflexes -differential dx to r/o other potential disorders
40
what subjective information (8) is important to document during evaluation of a patient with suspected/confirmed CP?
PMH risk factors maternal course of pregnancy medications family history current characteristics social history social support system
41
what objective information (17) is important to perform/test during evaluation of a patient with suspected/confirmed CP?
-A&O -adapted pain scale -resting/dynamic posture -aerobic capacity/endurance: vital signs at rest/activity, lung auscultation -ventilation, respiration, circulation: breathing patterns, respiratory strength, accessory mm utilization -posture (rest/dynamic) -A/PROM -joint integ/mobility: hyper/hypomobility of a joint -muscle tone/strength -sensory integ: proprioception, kinesthesia -DTRs and pathological reflexes (Babinski, ANTR, Moro) -integumentary: skin, sensation -neuromotor development/sensory integration: reflex mvmt patterns, involuntary movement, sensory integration tests, gross/fine motor skills, developmental milestones -motor function: equilibrium/righting reactions, coordination, posture/balance, sensorimotor integration, Barthel index, Bayley Scale of Infant Development, Alberta Infant Motor Scale, Bruininks-Oseretsky Test of Motor Proficiency, PEDI -orthotic, protective, supportive devices -static/dynamic balance -assistive/adaptive devices -environmental/home/work barriers/hazards (current and potential)
42
what pathological reflexes (3) should be assessed when evaluation a patient with CP?
Babinski ATNR Moro
43
what assessments (5) should be performed when assessing motor function during an evaluation of a patient with CP?
Barthel Index Bayley Scale of Infant Development Bruininks-Oseretsky Test of Motor Proficiency Alberta Infant Motor Scale PEDI
44
potential complications of CP (7)?
aspiration pneumonia contractures scoliosis constipation intellectual disability epilepsy
45
common comorbidities of CP (6)?
learning disabilities seizure disorders vision and hearing impairments b&b dysfunction microcephalus hydrocephalus
46
secondary impairments of CP (1)?
psychosocial issues for patient and family members
47
effective medical management of CP requires a __-__ team approach
life-long
48
what might a patient with CP require in terms of pharmacological intervention (3)?
anti-anxiety medications anti-spasticity medications anti-convulsant medications
49
physical therapy for CP often uses __ treatment and __ __ techniques
neurodevelopmental; sensory integration
50
what should physical therapy treatment for a patient with CP generally include?
patient/caregiver edu normalization of tone stretching strengthening balance mobility skills motor learning developmental milestones positioning
51
what types of equipment (3) might be prescribed to a patient with CP?
adaptive equipment specialized wheelchair seating orthotics
52
what types of surgical intervention (5) may be required for a patient with CP?
hip correction contracture release motor point block dorsal rhizotomy scoliosis correction
53
a home care/exercise program is also a __-__ process that will require ongoing __ to meet progression of goals for a patient with CP
life-long; modification
54
family/caregiver involvement is vital for patients with __-__ CP
moderate-severe
55
__/__ involvement is vital for patients with moderate-severe CP
family/caregiver
56
what should a home exercise program for a patient with CP generally include (6)?
caregiver education exercise stretching positioning mobility training strengthening
57
what is the likely outcome of a course of physical therapy for a patient with CP?
PT will attempt to maximize a patient's level of current function and prevent secondary loss
58
the likely outcome of a course of physical therapy for a patient with CP will attempt to maximize patient's level of __ __ and prevent __ loss
current function; secondary
59
if a patient with CP is going to ambulate, it typically occurs by the age of __
8
60
the ability or inability to __ will have a large impact on direction and goals of therapeutic intervention
ambulate
61
CP is a non-progressive, but __ condition
permanent
62
the long-term effects and overall functional outcome of a patient with CP depend on the __ of injury, associated __ and __ support
extent, impairments, caregiver
63
what is the prognosis for children with mild to moderate CP?
near normal lifespan
64
what is the prognosis for children with severe CP?
roughly half of children die by age 10
65
roughly half of children with severe CP die by age __
10
66
what is a common differential diagnosis of CP?
arthrogryposis multiplex congenita
67
what kind of condition is arthrogryposis multiplex congenita? where does it typically occur?
neuromuscular, non-progressive, in utero
68
arthrogryposis multiplex congenita (AMC) is a __, __-__ condition that occurs in __
neuromuscular, non-progressive in utero
69
AMC is classified into how many forms?
3
70
an infant with AMC is born with what impairments?
multiple contractures and may have fibrosis bands that developed in place of muscle
71
what is the prognosis for a patient with AMC?
near normal lifespan
72
is intelligence typically effected by AMC?
no, normal intelligence
73
why is it usually difficulty for a patient with AMC to live independently?
due to their level of physical disability

NPTE-Pediatrics and Development (9 decks)

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