Unit 1 Exam Flashcards

Question

Atypical Development 4-6 months

Answer 1

- no head control - no tummy tolerance - cortical thumb - fisting - no grasp - no smiling or cooing - arches in sitting - obligatory reflexes - asymmetrical reflexes - handedness - slipping through axilla

Answer 2

- lack bright affect - enjoys supine position - presence of any reflexes - no mobility - poor sitting quality - no protective reactions - no parachute - no babbling - does not turn to name being called - no interest in social game

Answer 3

- any delays in 0-8 month skills - no words "mama" or "moo" - not pointing - not trying to get attention

Answer 4

- no interest in other children - no imitating - no pointing - not using push toys - no spontaneous meaningful 2 word phrases

Answer 5

Onset= 28 weeks gestation Inhibited= rooting: 3 months/ Sucking = 0-6 months Characteristics= - rooting; head turns toward stroked cheek - sucking; rhythmic sucking

Answer 6

Characteristic= 1st head moves post to trunk--> then abduction, extension of limbs then adduction, flexion of limbs Onset= 28 weeks gestation Inhibited= 5-6 months

Answer 7

Onset= 28 weeks gestation Inhibited= 0-9 months Characteristic= flexion after stimulus to feet

Answer 8

Onset= 10 weeks gestation Inhibited= 0-4 months Characteristic= flexion after stimulus to the hand

Answer 9

Onset= 37 weeks gestation Inhibited= 2 months Characteristic= reciprocal steps when feet contact surface

Answer 10

Onset= birth- 2months Inhibited= 0-5 months Characteristic= flexion on the skull side and extension on the face side (fencing position)

Answer 11

Onset= 4-6 months Inhibited= 8-12 months Characteristic: - Neck Flexion= UE neck flexion and LE extension - Neck Extension= UE extension and LE flexion

Answer 12

Onset= birth Inhibited= 0-6 months Characteristic: - Prone= flexion tone - Supine= extension tone

Answer 13

Onset= 34 weeks gestation Inhibited= 4-6 months Characteristic= body rotates in line with head Function = transitions rolling

Answer 14

Onset= birth-2 months Inhibited= persists through life Characteristic= Upright head with body movement Function= Visual orientation and balance

Answer 15

Onset= 34 weeks gestation Inhibited= 4-5 months Characteristics= Body follows limbs Function= Learning to roll

Answer 16

Onset= 3-4 months Inhibited= 12-24 months Characteristics= Head, trunk, hip extension when prone in air Function= initiate extension tone

Answer 17

Onset= birth-2 months Inhibited= persistent throughout life Characteristic= head vertical when body is lifted Function= balance reaction, visual orientation

Answer 18

Onset= 6 months Inhibited= persistent through life Characteristic= Body tilt, concave side upward abduct up UE and LE, adduction low UE + LE

Answer 19

Onset= 7-8 months Inhibited= Persists through life Characteristic= Body tilt concave side upward/head rotates to ipsilateral side

Answer 20

Onset= 12-21 months Inhibited= persists through life Characteristic= Body tilt to concave side upward/ UE flex, LE extension, UE abductions

Answer 21

Placenta separates or pulls away from uterine wall

Answer 22

Placenta Shifts and drops to opening of the cervix

Answer 23

Brain pathology is more likely etiology

Answer 24

Causes are more likely hypoxic-ischemic events or infections- this is where cord strangulations occur

Answer 25

Placenta previa/abruption or positional--> HIE from labor ( baby not getting O2)

Answer 26

- for 5 months - 16 yr - Evaluates change in gross motor function in kids with CP

Answer 27

- for 12 months - 21 years - Focus on function and need for caregiver assistance 1- self care 2- mobility 3- social function

Answer 28

- for term - 20 week post term - predictive of CP - just observational skills Motor: 1- general/voluntary movement 2- fidgety movement 3- cramped synchronous movement

Answer 29

- for <4 months - Motor outcome measure - function performance in daily life - Identify CP early on

Answer 30

- For 0-6/7 yr - estimates motor competence compared to normative sample - Assist planning education programming

Answer 31

- for 0-18 months - Gross motor delay - Don't have to touch baby (parent can)

Answer 32

- for 2 months - 2 years - assess 34 items - neurological exam

Answer 33

0=no increase in tone 1= slight increase in tone manifested by a catch and release or by minimal resistance at the end of ROM 1+= Light increase in tone manifested by a catch and release or by minimal resistance at less than half ROM 2= More marked increase in muscle tone through most of the ROM 3= Considerable increase in muscle tone passive movement difficult 4= affected parts in rigid flexion or extension

Answer 34

Motor disorder characterized by a velocity dependent increase in tonic stretch reflexes (muscle tone) with exaggerated DTR resulting from hyperexcitability of the stretch reflex and lack of descending inhibition

Answer 35

Low muscle tone creating - creating too much movement

Answer 36

Alpha gamma coactivation: fusimotor/gamma system is disordered because the descending pathways are damaged - Fusimotor/gamma= descending pathway gamma motor m.n. innervates the muscle spindle that sets the tension of the muscle - Alpha= muscle contracts/shortens activating gamma to set the tension

Answer 37

Increase in muscle tone creating too little movement (stiffness)

Answer 38

- Death or damage and softening of the white matter, the inner part of the brain that transmits information b/w the nerve cells and the Spinal cord as well as from one part of the brain to another - Grade 1= Increased periventricular echogenicity (IPE) is persisting more than 7 days - grade 2= IPE develops into periventricular cysts - Grade 3= IPE developing into extensive periventricular cysts, occipital and fronto-parietal (looks like swiss cheese) - Grade 4= in deep white matter developing into extensive subcortical cysts

Answer 39

- Based off of radiological findings - Grade1 = Hemorrhage limited to the geminal matrix area: may be unilateral or bilateral - Grade 2= blood noted within the ventricular system but not distending it: with blood in 10-50% of the ventricle - Grade 3= Blood in ventricles with distension or dilation of ventricles: blood in more than 50% of the ventricles - Grade 4= Periventricular hemorrhagic infarction, cystic periventricular luekomalacia: Intraventricular hemorrhage with parenchymal extension

Answer 40

- Results of perinatal asphyxia and due to ischemia and hypoxemia/anoxia - Preterm and full term babies - Risk Factors: placenta problems, prolapsed umbilical cord , decreased maternal oxygenation, reduced maternal blood flow to the placenta

Answer 41

- Specific areas of neuronal death caused by infarction of specific cerebral arteries - middle cerebral artery most frequent - typically unilateral--> spastic hemiplegic CP

Answer 42

- spastic type (75-88%) --> corticospinal tracts - lesions to the motor cortex or white matter - often includes symptoms of " central" hypotonia - corticospinal tract = excitatory --> lateral tract= crosses- extremities --> Medial/Ant= ipsilateral- axial/trunk

Answer 43

- Dyskinetic (15%) - lesions to the basal ganglia= athetosis - Lesions to the cerebellum= ataxic (4%) - Often includes symptoms of central hypotonia - vestibulospinal tract= excitatory, posture, balance, antigravity UE/LE flexion - reticulospinal tract= excitatory, Lateral = hypotonicity/ Medial= hypertonicity, spasticity - Rubrospinal tract= excitatory to flexors/inhibitory extensors, postural tone and FM skills - tectospinal tract= visual stimulation

Answer 44

- Most severe - Lack of inhibition of descending corticospinal tract - Can walk 2-3 years, has femoral anteversion, knee valgus, tibial torsion, WBOS - Spastic adductors, posterior pelvic tilt Causes: - Prematurity - Ischemia - Aspiration - Infection - Endocrine/metabolic

Answer 45

- 1/2 body affected - damage to one side of the brain causing motor disability on the opposite side - Decrease strength and increase in tone - Cortical thumb Causes - Thrombophilic disorders - Infection - genetic/developmental - periventricular hemorrhagic infarction Neuropathology: - stroke in utero or neonatal - localized HIE/IVH

Answer 46

- Athetoid: Unwanted movements, withering movements, and difficulty with initiation and cessation of movement - dysarthria - Always quadriplegic - Ataxic= cerebellum- lack of coordination, jittery movement pattern, nystagmus Causes: - Asphyxia - Kernicterus - Mitochondrial - genetic/metabolic Neuropathology: -basal ganglia - putamen - globus pallidus - thalamus

Answer 47

- Typical looking, some issues on sand or ground - Children walk indoors and outdoors and climb stairs without limitation - Children perform gross motor skills but speed, balance, and coordination are impaired

Answer 48

- need to use handrail on stairs, SLS - Children walk indoors, outdoors, and climb stairs holding onto a railing but experience limitations walking on uneven surfaces and inclines and walking n crowds or confined spaces

Answer 49

- Can ambulate short distances, need wheeled mobility for longer distances - Children walk indoors and outdoors on a level surface with an assistive mobility device - Children may climb stairs holding on railing - children may propel a wheelchair manual or are transported when traveling for long distances or outdoors on uneven terrain

Answer 50

- Have head control, exercise ambulation in classroom - Children may continue to walk for short distances on a walker or rely more on wheeled mobility at home/school/community

Answer 51

- No head control can't use self propel device - Physical impairment restricts voluntary control of movement and the ability to maintain antigravity head and trunk postures - All areas of motor function are limited - Children have no means of independent mobility and are transported

Answer 52

Hip Flexor Length

Answer 53

- Rectus Femoris length (+) if hip rises

Answer 54

- hamstring - >40 = surgery - measures hamstring spasticity

Answer 55

- Gastro vs. soleus - (+) ankle PF (+) ankle dorsiflexion

Answer 56

Femoral Anteversion

Answer 57

● Tibial torsion →Age 1: -27- +20 (means 0) →Age 3: -15- +25 (means 7) →Age 5: -5 to +30 (means 12) →Age 7: 0-+30 (means 18) →Age 9: 3 to +33 (means 20)

Answer 58

- BAD - can only do prolonged functional stretching

Answer 59

- Improves balance in children with CP - 2-3x per week for 6-10 weeks at 65% of max vol. isometric contraction - Plyometrics - active develop: strengthening ( yoga/pushing heavy objects) especially hamstrings will help with gait - Age appropriate play shows functional improvements 10-15 minutes of intense activity for 30-45 minutes of recreational games 2x per week

Answer 60

- adaptive equipment - functional positions to avoid contractures - Increase muscle length over time - Prevents asymmetries

Answer 61

- Prevents contractures - Use alone or with conjunction of Botox/surgery - Restore ROM/muscle length - Helps gait become more functional - Worn at least 2-4 weeks

Answer 62

- Solid or hinged AFO - PF stop: stops PF and makes hamstrings work harder - Supramallelolar orthotics (SMO): prevents pronation - Floor reaction Orthosis: excessive PF and DF - Anterior Shell: pushes on patellar tendon for extensor mechanism good to use with hamstring, gastroc/soleus spasticity

Answer 63

- GMFCS 2-3 - 4 hour operation - sensory nerve fibers in spinal cord usually between bottom of the rib cage and the top of the hips are divided and then the fibers are stimulated and response of of the leg muscles are observed - the muscle with abnormal or excessive response are severed

Answer 64

- >37 weeks gestation - Axillary temp 98.6-99.8 - HR 80-140 bpm - RR 40-60 bpm - 6-9 pounds - Physiological flexion/dorsiflexion - Moro, tonic neck, galant, gag, suck, swallow, plantar/palmar grasp - Sensory system intact (vision 8 inches)

Answer 65

<37 weeks gestation Axillary temp 98.6-99.8 HR 120-160 bpm RR 60+ bpm 2-5 pounds Poor physiological flexion Infant reflexes disorganized Sensory systems underdeveloped Transient tachypnea of the newborn Apnea (shallow breathing) and bradycardia (slowed HR) (A’s and B’s)= this happens because of an immature brainstem/ breathing notification system isn't working/ largely unregulated

Answer 66

by 12 weeks

Answer 67

Protect and feed the baby

Answer 68

To increase the surface area of the brain for growth and development of neuronal connections

Answer 69

-Maintain steady vitals with positioning, calming, self-soothing, non-nutritive sucking -Developmental positioning to minimize alterations in tone, prevent contracture, minimize reflexes -Provide optimal positioning for visual, social, fine, gross and cognitive development

Answer 70

-Prematurity causes pulmonary immaturity and deficiency of surfactant -Low surfactant and production results in increased surface tension, alveolar collapse, diffuse atelectasis and decreased lung compliance -Treatments includes administering surfactant , oxygen supplementation , assist ventilation and ECMO ( extracorporeal membrane oxygenation) - Fetuses begin to produce surfactant between weeks 24 and 28. By 34 weeks most babies have enough naturally produced surfactant to keep the alveoli from collapsing

Answer 71

-Chronic lung disease→ persistent areas of increased densities on chest radiographs -VLBW and ELBW infants require ventilation - Increased airway resistance→ Lots of work to breathe - Pathophysiology→ interstitial fibrosis resulting from alveolar collapse - If the baby still has to be on supplemental O2 by 36 weeks they have BPD

Answer 72

Grade 1= isolated germinal matrix hemorrhage Grade 2= IVH with normal sized ventricles Grade 3= IVH with acute ventricular dilation Grade 4= IVH with hemorrhage into the PV-white Main ischemic lesion of an infant caused by necrosis of the white matter surrounding the ventricle Watershed zones/major blood vessels / a lot of vulnerability

Answer 73

- Disorder of reduced umbilical cord blood supply - Lack of glucose to the brain - results in energy failure - oxidative stress

Answer 74

- Group of problems that can arise if the mother does opioid drugs/cannabis during pregnancy - Child can have increased impulsivity, hyperactivity, destructive behaviors, memory dysfunction, decreased IQ - Adolescents have a higher rates of drug use , decreased concentration, decreased memory, depression, schizophrenia, anxiety disorder - A score 8 or higher on the test the kid will need intervention and follow up

Answer 75

- An acute inflammatory disease of the bowels - Occurs most frequently in the first 6 weeks of life (BW <2000g) Symptoms: - vomiting - Abdominal distension - Bloody stool - Lethargy Treatment: - Broad spectrum antibiotics Surgical treatment: - NG tube placement for intestinal decompression - G-tube placement - Resection and diversion of necrotic bowel

Answer 76

-Condition of the very low birth weight and extremely low birth rate -Potentially blinding eye disorder for infants born before 30 weeks gestation - One of the most common causes of sight loss, life long blindness, visual impairment

Answer 77

-The accumulation of excessive amounts of bilirubin in the blood - Part of the red blood cell found in bile and broken down in the liver - In premature babies the liver is still immature and that's why the skin color changes - If not taken care of can move to the brain and cause CP

Answer 78

-Most frequent and distinct neurological sign -90% occurs in the first 5-15 days Caused by: -HIE -IBH -anatomical defects -hypoglycemia -Drug withdrawal

Answer 79

- Alcohol rapidly crosses the blood brain barrier and the placenta of the fetus - Syndrome #1 cause of cognitive deficits in the child - Growth deficiency - Cardiac defects -Microcephaly - Dysmorphology

Answer 80

- PDA should close within 15 hours after birth - Ovale should close within 2-3 months after birth - Ductus arteriosus can be more problematic since it connects the pulmonary artery to the aorta - In premies it can stall out and then surgery is needed to correct the problems

Answer 81

- Difficult labor→ Erbs palsy → Klumpke’s palsy - Usually a stretch injury - Erbs palsy is condition adduction, IR, elbow extension and pronation -->Nerve roots C5-C6 -Klumpke's palsy --> Nerve roots C8-T1 - Causes Adduction, elbow flexion and claw hand posture interossei of the hand very tight fingers, wrist flexion Risk factors -Big babies -Multiple babies -forceps breech - Shoulder first - Prolonged labor

Answer 82

-Genetic disorder - Disorder of mucus → prevents normal functioning of the lungs, pancreas, small intestine, small capillaries in the lungs , bronchi of the lungs -CF affects how salt and water move into the lungs which affects the glands the make mucus - Sweat test done in babies Signs and symptoms : -Coughing -Wheezing -Multiple lung infections -SOB -Slow growth -Big appetite -Loose stool -Painful tummies -Petite kids Receive lung transplants

Answer 83

Triad: 1. Subdural hematoma 2. Encephalopathy 3. Retinal hemorrhage -Child abuse -Brain in the cavity of the skull gets hurt causing bruising, swelling, damage

Answer 84

Encasement/swaddling Graded sensory motor input Non-nutritive sucking Positioning : prone, supine, side-lying, sitting

Answer 85

Supine→ early WB through the LEs→ towel rolls to decrease the effects of reflexes→ facilitate use of UEs for object exploration, visual regard

Answer 86

Side-lying → scapular protraction and trunk elongation, working on subtle WS→ disassociating the upper and lower trunk using a BOB reaction → ideal for HR, RR, BP, O2 saturation (QUIZ QUESTION) → dampens tonic reflexes → better cranial modeling→ proven to help with weight

Answer 87

Prone→ stretches the hip and knee/rectus femoris→ facilitates active extension and head control→ eye hand awareness and proprioception → breathing may be difficult —> not possible with ventilator babies and cardio-pulmonary issues → improved hip positioning→ nice cranial molding

Answer 88

Sitting Up right → Active head control→ trunk control→ Wb through spine, UE, LE→ Frees hands for exploration → Disassociation of trunk with UE and LE → Gentle WS with elongation → visual regard changes (tracking) → cognition usually smarter and can see the world through a different perspective

Unit 1 Exam Flashcards

(113 cards)