Pediatric conditions 11-20 Flashcards
(106 cards)
1
Q
Which Spinal nerve roots are involved in the brachail plexus?
A) C3-C6
B) C5-T1
C) T2-T5
D) L1-L5
A
B
2
Q
What is the most common cause of brachial plexus injury in new borns?
A) Falls
B) Motor vehicle accidents
C) Traumatic births
D) Avulsion
A
C
3
Q
Which type of brachial plexus injury involves stretching of the nerve without tearing?
A) Neuropraxia
B) Neuroma
C) Rupture
D) Avulsion
A
A
4
Q
What is the charactistic feature of a neuroma?
A) Nerve is torn
B) Nerve is stretched
C) Scar tissue forms during healing
D) Roots torn from spinal cord
A
C
5
Q
Which injury involves the tearing of the roots from the spinal cord?
A) Neuropraxia
B) Neuroma
C) Rupture
D) Avulsion
A
D
6
Q
Which of the following is a risk factor for neonatal brachial plexus palsy?
A) Small infant size
B) Shoulder dystocia
C) Cesearean delivary
D) Tumor formation
A
B
6
Q
What percentage of brachial plexus injuries are typically avulsions?
A) 5-10%
B) 10-20%
C) 30-40%
D) 50-60 %
A
B
7
Q
Erb’s palsy primarily effects which part of the brachial plexus?
A) C8-T1
B) C3-C4
C) C5-C6
D) T1-T2
A
C
7
Q
What is the characteristic and position in erb’s palsy?
A) Clenched fist
B) Extended fingers
C) Claw hand
D) Waiter’s tip hand
A
D
8
Q
What percentage of newborns with brachial plexus injuries recover fully?
A) 80-90%
B) 10-20%
C) 100%
D) 30-50%
A
A
9
Q
What is a common long-term complication of brachial plexus injury?
A) Muscular atrophy
B) Increased bone growth
C) Muscular atrophy
D) increased strength
A
A
9
Q
Which syndrome is associated with Klumpke’s palsy due to avulsion of the lower roots ( C8-T1)?
A) Erb’s Palsy
B) Horner’s Syndrome
C) Carpal Tunnel syndrome
D) Guillian
A
B
10
Q
Which muscles are affected by erb’s palsy?
A) Triceps and deltoid
B) Flexor carip and pronator teres
C) Biceps, deltoid, and infraspinatus
D) Gluteus maximus and quadriceps
A
C
11
Q
Which condition is characterized by a “claw hand” due to injury of the flexor muscles of the wrist and digits?
A) Erb’s Palsy
B) Klumpke’s Palsy
C) Carpal tunnel syndrome
D) Thoracic outlet syndrome
A
B
12
Q
What is the most common intervention for ruptures in brachial plexus injuries?
A) Physical therapy
B) Chemotherapy
C) Pain management
D) Nerve transplant
A
D
13
Q
Which type of delivery reduces the risk of anal brachial plexus palsy?
A) Vaginal delivery
B) Cesarean section
C) Forceps delivery
D) Breech delivery
A
B
14
Q
Which nerve are primarily affected in erb-Duchenne palsy?
A) C8-T1
B) C5-C6
C) T1-T2
D) C3-C4
A
B
15
Q
Cerebral palsy occurs in, approximately how many live in high income countries?
A) 1 in 100
B) 1 in 700
C) 1 in 500
D) 1 in 900
A
B
16
Q
The following is the most common motor type of CP?
A) Dyskinetic
B) Ataxic
C) Mixed
D) Spastic
A
D
16
Q
Cerebral Palsy is caused by damage to the developing brain, most often occurring:
A) Before birth
B) After birth
C) During birth
D) During adulthood
A
A
17
Q
Approximately what percentage of children with CP prematurely?
A) 10%
B) 25%
C) 45%
D) 65%
A
C
18
Q
What tool is used to classify the gross motor function of children with CP?
A) Hammersmith Infant Neurological Assessment
B) Gross Motor Function Classification System (GMFCS)
C) Manual Ability Classification system (MACS)
D) General Movement Assessment
A
B
19
Q
Which type of CP is characterized by involuntary movements?
A) Mixed
B) Spastic
C) Dyskinetic
D) Ataxic
A
C
19
Q
Hemiplegia and CP affects which part of the body?
A) One side of the body
B) Both arms and legs
C) Only the legs
D) Only the arms
A
A
20
What percentage of children with CP unable to walk?
A) 1 in 2
B) 1in 10
C) 1 in 4
D) 3 in 4
C
21
Which of the following is a known risk factor for CP?
A) High birth weight
B) Viral infection of the mother during pregnancy
C) Older maternal age
D) Lack of prenatal care
B
21
What is the most common associated impairment in children with CP?
A) Hearing impairment
B) Vision impairment
C) Intellectual disability
D) Epilepsy
C
22
What is the most common form of spastic CP?
A) Diplegia
B) Hemiplegia
C) Quadriplegia
D) Monoplegia
C
22
Which of the following tools is most predictive of CP in babies younger than 20 weeks?
A) General Movements Assessments
B) Neuroimaging
C) Hammersmith infant Neurological assessment
D) Blood tests
A
23
At what age can babies now be diagnosed as high risk of CP?
A) 1 mon
B) 3-5 mon
C) 6-12 mon
D) 12-18 mon
B
24
Which motor type of CP affects balance, and spatial awareness?
A) Spastic
B) Ataxic
C) Dyskinetic
D) Mixed
B
25
what percentage of CP experience pain?
A) 1 in 5
B) 1 in 3
C) 3 in 4
D) 1 in 10
C
25
Which of the following is not a risk factor for cerebral palsy?
A) Premature birth
B) Low birth weight
C) Maternal bacterial infection
D) Cesarean delivery
D
26
Which type of cerebral palsy arises from damage to the cerebellum?
A) Spastic
B) Dyskinetic
C) Ataxic
D) Mixed
C
27
Which of the following impairments is most likely to resolve in children with cerebral palsy?
A) Vision impairment
B) Epilepsy
C) Intellectual disability
D) Speech difficulties
B
27
What is the primary cause of dyskinetic movements in children with cerebral palsy?
A) Damage to the motor cortex
B) Damage to the basil ganglia
C) Damage to the cerebellum
D) Lack of oxygen at birth
B
28
Which classification system is used to assess the ability of children with CP during daily activities?
A) GMFCS
B) HINE
C) MACS
D) Neuroimaging
C
29
Based on the description given which condition is being exhibited:
Damage to the brain tissue caused by an external mechanical force with resultant loss of consciousness, post traumatic amnesia, skull fracture or objective neurologic findings that can be attributed to traumatic event based on radiologic findings or physical or mental status evaluation.
TBI
30
Who is affected (Males/Females/Both)?
Young and middle-aged men are 1.5x more likely to be injured
31
Causes of TBI closely associated with age and gender:
* **Less than 5 years of age**: falls, MVA, adults inflicting violence
* **Between 5 and 15**: bicycles, skateboard and horses as riders, pedestrians in MVA and sport activities
* **Between 15 and 40**: high speed MVA and motorcycles
31
Prevalence
Most common cause of death and disability in young people
32
When is TBI typically diagnosed?
At time of injury
33
Identify what level of TBI is being exhibited using the Rachos Los Amigos Scale:
**Automatic-Appropriate**. Person goes through daily routine automatically but is robot-like with appropriate behavior and minimal confusion. Has shallow recall of activities, and superficial awareness of, but lack of insight into, his/her condition. Person requires at least minimal supervision because judgment, problem solving, and planning skills are impaired.
A) Level I
B) Level II
C) Level III
D) Level IV
E) Level V
F) Level VI
G) Level VII
H) Level VIII
G) Level VII
33
What scale is used to assess the levels of TBI?
Rachos Los Amigos
34
Identify what level of TBI is being exhibited using the Rachos Los Amigos Scale:
**Confused-Inappropriate, Non-Agitated**. Person appears alert and responds to simple commands. More complex commands, however, produce responses that are non-purposeful and random. The person may show some agitated behavior, but it is in response to external stimuli rather than internal confusion. Is highly distractible and generally has difficulty in learning new information. Can manage self-care activities with assistance. The person’s memory is impaired, and verbalization is often inappropriate.
A) Level I
B) Level II
C) Level III
D) Level IV
E) Level V
F) Level VI
G) Level VII
H) Level VIII
E) Level V
35
Identify what level of TBI is being exhibited using the Rachos Los Amigos Scale:
**Generalized Response**. Person reacts inconsistently and non-purposefully to stimuli in a nonspecific manner. Reflexes are limited and often the same, regardless of stimuli presented.
A) Level I
B) Level II
C) Level III
D) Level IV
E) Level V
F) Level VI
G) Level VII
H) Level VIII
B) Level II
36
Identify what level of TBI is being exhibited using the Rachos Los Amigos Scale:
**Confused-Agitated**. Person is in a heightened state of activity and severely confused, disoriented, and unaware of present events. Behavior is frequently bizarre and inappropriate to the immediate environment. She/he is unable to perform self-care. If not physically disabled, the person may perform automatic motor activities such as sitting, reaching and walking as part of this agitated state, but not necessarily as a purposeful act.
A) Level I
B) Level II
C) Level III
D) Level IV
E) Level V
F) Level VI
G) Level VII
H) Level VIII
D) Level IV
37
Identify what level of TBI is being exhibited using the Rachos Los Amigos Scale:
**No Response**. Person appears to be in a deep sleep and is unresponsive to stimuli.
A) Level I
B) Level II
C) Level III
D) Level IV
E) Level V
F) Level VI
G) Level VII
H) Level VIII
A) Level I
37
Identify what level of TBI is being exhibited using the Rachos Los Amigos Scale:
**Localized Response**. Person’s responses are specific but inconsistent, and are directly related to the type of stimulus presented, such as turning head toward a sound or focusing on a presented object. The individual may follow simple commands in an inconsistent and delayed manner.
A) Level I
B) Level II
C) Level III
D) Level IV
E) Level V
F) Level VI
G) Level VII
H) Level VIII
C) Level III
38
Identify what level of TBI is being exhibited using the Rachos Los Amigos Scale:
**Confused-Appropriate**. Person shows goal-directed behavior but relies on cueing for direction. Can relearn old skills such as activities of daily living, but memory problems interfere with new learning. She/he has a beginning awareness of self and others.
A) Level I
B) Level II
C) Level III
D) Level IV
E) Level V
F) Level VI
G) Level VII
H) Level VIII
F) Level VI
39
Identify what level of TBI is being exhibited using the Rachos Los Amigos Scale:
**Confused-Appropriat**e. Person shows goal-directed behavior but relies on cueing for direction. Can relearn old skills such as activities of daily living, but memory problems interfere with new learning. She/he has a beginning awareness of self and others.
A) Level I
B) Level II
C) Level III
D) Level IV
E) Level V
F) Level VI
G) Level VII
H) Level VIII
H) Level VIII
40
What is the primary cause of traumatic brain injury (TBI)?
a) Genetics
b) External mechanical force
c) Lack of oxygen
d) Bacterial infection
B
41
TBI is the most common cause of death and disability in which population?
a) Elderly individuals
b) Infants
c) Young people
d) Middle-aged women
C
42
What age group is at the highest risk for TBI?
a) 0-4 years and 15-19 years
b) 5-10 years and 30-40 years
c) 20-25 years and 50-60 years
d) 70+ years
B
43
Which of the following is an example of a non-traumatic brain injury?
a) Motor vehicle accident
b) Carbon monoxide exposure
c) Falls
d) Sports injuries
B
44
What is the term used for brain damage that occurs directly under the point of impact?
a) Contrecoup injury
b) Coup injury
c) Secondary injury
d) Focal injury
B
45
Which type of rigidity is characterized by spastic extension of both the upper and lower extremities?
a) Decorticate rigidity
b) Decerebrate rigidity
c) Ataxia
d) Flaccid paralysis
B
46
Which scale is used to measure levels of awareness and cognitive functioning after a TBI?
a) Glasgow Coma Scale
b) Rancho Los Amigos Scale
c) Gross Motor Function Classification System
d) Manual Ability Classification System
B
47
What is the most common postural deficit in individuals with TBI following prolonged bedrest?
a) Posterior pelvic tilt
b) Anterior pelvic tilt
c) Scoliosis
d) Kyphosis
A
48
Which of the following is NOT commonly associated with TBI?
a) Ataxia
b) Decreased functional endurance
c) Increased muscle strength
d) Limitations of range of motion
C
49
Which of the following cognitive functions is commonly impaired in TBI patients?
a) Reflexes
b) Memory
c) Language fluency
d) Hearing
B
50
What is a common perceptual skill deficit in TBI patients?
a) Difficulty with body scheme
b) Color blindness
c) Loss of peripheral vision
d) Increased auditory sensitivity
A
51
Which of the following is an example of a primary brain injury?
a) Hypoxia during recovery
b) Seizures occurring after the injury
c) Direct blow to the head
d) Swelling that develops after the injury
C
52
What is the primary cause of decorticate rigidity in TBI?
a) Damage to the cerebellum
b) Damage to the brainstem
c) Damage to the spinal cord
d) Damage to the cerebral hemispheres
D
53
TBI patients often have abnormal muscle tone and spasticity, which may include:
a) High tone only
b) Low tone only
c) A combination of high and low tone
d) No changes in tone
C
54
What is a common psychosocial issue experienced by individuals with TBI?
a) Improved self-esteem
b) Loss of social roles
c) Increased independence
d) Enhanced cognitive abilities
B
55
What type of brain injury involves damage on the side opposite the impact?
a) Coup injury
b) Focal injury
c) Diffuse injury
d) Contrecoup injury
D
56
Which of the following is a typical consequence of secondary brain injury?
a) Immediate loss of consciousness
b) Brain swelling and increased intracranial pressure
c) Direct trauma to the skull
d) Skull fracture
B
57
Which primitive reflex may be impaired if the midbrain is injured in a TBI?
a) Stretch reflex
b) Protective equilibrium reactions
c) Gag reflex
d) Deep tendon reflexes
B
58
Decerebrate posturing indicates damage to which part of the brain?
a) Brainstem
b) Cerebellum
c) Cerebral cortex
d) Hippocampus
A
59
How many spinal nerves do we have in the body?
31 Spinal nerves
60
Refers to the most caudal segment of the spinal cord with **normal sensory and motor function** on both sides of the body
Neurological
60
Match the the number of spinal nerves to the correct pairs:
8 Cervical spinal nerve pairs
12 Thoracic pairs
5 Lumbar pairs
5 Sacral pairs
1 Coccygeal
A) (T1-T12)
B) (S1-S5)
C) (C1-C8)
D) (L1-L5)
E) 1 pair
C) 8 cervical spinal nerve pairs (C1-C8)
A) 12 thoracic pairs (T1-T12)
D) 5 lumbar pairs (L1-L5)
B) 5 sacral pairs (S1-S5)
E) 1 coccygeal pair
61
Refers to the most caudal segment of the spinal cord with **normal sensory function on both sides of the body**
Sensory Level
62
Similarly defined (to sensory) with respect to motor function
Motor Level
63
Which type of scale is used when idenifying the level of a SCI?
ASIA Impairment Scale
64
No sensory or motor function is preserved in the sacral segments S4 – 5.
A=Complete
B=Incomplete
C=Incomplete (grade 0-2)
D=Incomplete (at least 50%)
E=Normal ("neuro intact")
A=Complete
65
Sensory but no motor function is preserved below the neurological level and includes one of the following: any pinprick or light touch sensation in S45 or any deep anal sensation. **Must have “sacral sparing”**
A=Complete
B=Incomplete
C=Incomplete (grade 0-2)
D=Incomplete (at least 50%)
E=Normal ("neuro intact")
B=Incomplete
66
Motor function is preserved below the neurological level, and most muscles below the neural level of injury are less than grade 3 (grade 0-2).
A=Complete
B=Incomplete
C=Incomplete (grade 0-2)
D=Incomplete (at least 50%)
E=Normal ("neuro intact")
C=Incomplete
67
Motor function is preserved below the neurological level, and at least 50% of the muscles below the neurological level have a muscle grade greater than or equal to 3 (Grade 3,4,or 5)
A=Complete
B=Incomplete
C=Incomplete (grade 0-2)
D=Incomplete (at least 50%)
E=Normal ("neuro intact")
D=Incomplete
68
Sensory and motor function are normal, but elements or spasticity or SCI type pain may remain. Not truly “neuro intact”
A=Complete
B=Incomplete
C=Incomplete (grade 0-2)
D=Incomplete (at least 50%)
E=Normal ("neuro intact")
E=Normal
69
What percentage of new spinal cord injury (SCI) cases in the U.S. occur in males?
a) 50%
b) 78%
c) 25%
d) 90%
B
70
What is the approximate annual incidence of spinal cord injuries in the United States?
a) 5,000
b) 17,700
c) 54,000
d) 100,000
B
71
What is the most common cause of spinal cord injuries in the U.S.?
a) Falls
b) Sports injuries
c) Vehicular accidents
d) Violence
C
72
Which age group has seen an increase in the average age at injury for SCI, from 29 years in the 1970s to what age currently?
a) 30 years
b) 35 years
c) 43 years
d) 50 years
C
73
Which type of SCI is the most common in terms of prevalence?
a) Complete tetraplegia
b) Incomplete paraplegia
c) Incomplete tetraplegia
d) Complete paraplegia
C
74
Which of the following defines a complete spinal cord injury?
a) No sensory or motor function below the level of injury
b) Loss of sensation but partial motor function below the injury
c) Only loss of motor function below the injury
d) Sensory and motor function preserved but impaired
A
75
What does tetraplegia refer to?
a) Paralysis of both legs
b) Paralysis of all four limbs
c) Paralysis of only the arms
d) Paralysis of only the lower body
B
76
Which level of complete tetraplegia is the highest where an individual can live independently without an attendant?
a) C5
b) C6
c) C7
d) T1
B
77
What is autonomic dysreflexia most commonly associated with in SCI patients?
a) Lesions below T5-6
b) Lesions above T5-6
c) Brain injuries
d) Lumbar fractures
B
77
What is a common cardiovascular complication seen in SCI patients when moving to an upright position?
a) Hyperthermia
b) Bradycardia
c) Orthostatic hypotension
d) Tachycardia
C
77
Which symptom is NOT typically associated with autonomic dysreflexia?
a) Headaches
b) Nasal congestion
c) Sweating below the level of lesion
d) Flushing above the level of lesion
C
78
What does “neurological level” refer to in SCI classification?
a) The highest segment with motor function
b) The most caudal segment of the spinal cord with normal sensory and motor function
c) The first segment with reflexive response
d) The highest level of pain perception
B
78
What is spasticity in SCI patients defined as?
a) Decreased resistance to movement
b) Loss of motor control
c) Complete muscle paralysis
d) Increased resistance to sudden movement
D
78
Which level of SCI affects motor function in the arms, legs, trunk, and pelvic organs?
a) Tetraplegia
b) Paraplegia
c) Hemiplegia
d) Monoplegia
A
78
What percentage of SCI cases are due to falls?
a) 15.4%
b) 31.6%
c) 45.2%
d) 10.8%
B
79
Which condition in SCI patients results from an increase in muscle tone, leading to resistance against passive movement?
a) Spasticity
b) Hypertonia
c) Flaccidity
d) Paralysis
B
79
Which spinal cord segment is involved in autonomic regulation, especially in temperature control, above which lesions can cause thermoregulatory problems?
a) C5
b) T1
c) T8
d) L2
C
80
Which percentage of new SCI cases are due to violence?
a) 8.2%
b) 13.8%
c) 20.4%
d) 4.6%
B
81
Which of the following is **NOT** a common cause of spinal cord injury?
a) Sports injuries
b) Vehicular accidents
c) Cardiovascular disease
d) Falls
C
82
Which spinal cord injury level is most commonly associated with independence in daily activities?
a) C5
b) C6
c) C7
d) T1
C
82
Which type of spinal cord injury affects only the lower extremities and possibly the pelvic organs, depending on the injury level?
a) Tetraplegia
b) Hemiplegia
c) Paraplegia
d) Quadriplegia
C
83
What is venous thromboembolism, a potential complication in SCI patients?
a) The development of blood clots in the spinal cord
b) A type of pressure ulcer in SCI patients
c) A drop in heart rate
d) A condition involving blood clots in veins, which can lead to pulmonary embolism
D
84
What is a typical symptom of orthostatic hypotension in SCI patients?
a) Fever
b) Dizziness
c) Hyperactivity
d) Muscle spasticity
B
85
What is the approximate percentage of incomplete paraplegia cases in people with SCI?
a) 11.5%
b) 20.4%
c) 47.2%
d) 3.5%
B
86
Which of the following is a function of the autonomic nervous system that can be affected by SCI?
a) Voluntary motor control
b) Reflex responses
c) Regulation of heart rate and blood pressure
d) Memory processing
C
