Peds Neuro

Question 1

characteristics of cerebral palsy

Answer 1

abnormalities of motor activity and posure
non-progressive
changing
involves motor system

Question 2

what can cause CP

Answer 2

perinatal asphyxia
complications of prematurity
perinatal infection
kernicterus

Question 3

6 forms of CP

Answer 3

spastic/pyramidal
non spastic/extrapyramidal
atonic
cerebellar
ataxic
combined

Question 4

most common CP

Answer 4

spastic pyramidal

Question 5

DDx CP

Answer 5

neurodegeneration: leukodystrophies
inborn errors: inherited metabolic disorders, metabolic myopathies, metabolic neuropathy, Neimann Pick, Mitochondrial disorders, lesch nyhan
developmental or traumatic lesions
neoplasms

Question 6

Dx of CP

Answer 6

observation of slow motor development, abnormal muscle tone, unusual posture
assessment of persistent infantile reflexes is important: moro reflex

Question 7

earliest signs of spasticity

Answer 7

resistance to passive motion, especially flexion

Question 8

CP should not be Dx before what age

Answer 8

2 y.o

Question 9

cerebral imaging for CP

Answer 9

CT MRI US

Question 10

goals of OMT in CP patient

Answer 10

muscle tone

proprioceptive input to affect motor output

Question 11

influences on proprioceptive input to affect motor input

Answer 11

primary somatosensory mapping
muscle coupling
movement strategies

Question 12

complaint of chronic muscle spasms

Answer 12

pain

Question 13

how can OMT limit contractures

Answer 13

changing proprioceptive input from joints, CT and muscle which affect posture, balance and movement

Question 14

common complication with CP patients in wheelchairs

Answer 14

hip dislocation as a result of hip contractures

Question 15

Signs pyramidal CP

Answer 15

UMN damage
hypertonic and spasticity
70-80% CP patients
stiff rigid limbs
exaggerated reflexes
jerky movements

Question 16

assoc pathology with spastic CP

Answer 16

hip pathology, scoliosis and limb deformities

Question 17

area of brain implicated in extrapyramidal CP

Answer 17

basal ganglia, thalamus and cerebellum

Question 18

types of extrapyramidal CP

Answer 18

ataxic and dyskinetic

Question 19

main characteristics extrapyramidal CP

Answer 19

impairments in involuntary movement
dyskinesias
dystonias
athetosis

Question 20

types of dyskinetic CP

Answer 20

athetoid– involuntary movement

dystonia/dystonic–trunk mm more than limbs and results in twisted posture

Question 21

most common area of LE affected by postural compensation

Answer 21

hamstring hypertonicity
post innominate and dec lumbar lordosis
extension TLJ
flattened thoracic kyphosis
extended OA

Question 22

myotactic reflex

Answer 22

monosynaptic reflex with sensory input via DRG and motor output from ventral horn

Question 23

Muscle energy types

Answer 23

isometric
isotonic concentric
isotonic eccentric
isolytic
resciprocol inhibition

Question 24

isotonic concentric

Answer 24

same tone, shorten the muscle (let patient win)

Question 25

isotonic eccentric

Answer 25

same tone, lengthen muscle (let physician win)

Question 26

isolytic

Answer 26

quickly overcoming patient contraction

Question 27

reciprocol inhibition

Answer 27

withdrawal and crossed extensor reflexes | applyin gMET to one group of mm to affect antagonist

Question 28

MET is not best choice for kids under what age

Answer 28

8 y.o

Question 29

isolytic MET is good for what

Answer 29

adhesions, fibrosis from long term contraction | can use directly on hypertonic mm

Question 30

Reciprocol inhibition MET used for

Answer 30

decrease tone to hypertonic mm using mm that are better under voluntary hemiplegia unilateral contractures

Question 31

baseline tone in spastic and non spastic CP

Answer 31

dec in nonspastic | inc in spastic

Question 32

50% of what type CP have sensorineural hearing loss

Answer 32

non spastic

Question 33

non spastic CP will have what eye complications

Answer 33

strabismus | nystagmus

Question 34

postural compensations

Answer 34

create balance and stability shortening antigravity mm decrease cervical lordosis, head forward posture common orthopedic problems

Question 35

common complaints postural compensation

Answer 35

back pain, knee, hip pain and HA

Question 36

decreased cervical lordosis can lead to what

Answer 36

extension dysfunction of OA shortening of suboccipital mm chronic HA and bruxism

Question 37

isotonic eccentric ME in nonspastic CP

Answer 37

address shortened mm (antigravity)

Question 38

isotonic concentric ME in nonspastic CP

Answer 38

help strenghten and improve firing patterns of hypotonic mm

Question 39

good technique for all types CP

Answer 39

myofascial release BLT to balance tone and interosseous membrane FPR for short restrictors counterstrain to lengthen and relax tone in long restrictor mm

Question 40

What OMT can parents do for CP patients

Answer 40

rib raising diaphragms lymph pumps to prevent hospitalization

Question 41

OMT for pneumonia and reflux

Answer 41

maximize O2 and ability to clear secretions: ribs thoracic vertebral motion, myofascial motion reduce reflux: diaphragm motion middle cervicals and thoracics, also cranial base

Question 42

importance when working with PC patient

Answer 42

recognize pattern changes that signal something may be happening