Ped Neuro Rehab Exam 2- Lecture One (Cp) And Neuromuscular Lab

Front 1

Basal ganglia

Back 1

motor output based on cortical info rather than visual. Self initiated vs. visually triggered

Front 2

Problems associated with basal ganglia dysfunction

Back 2

Hypokinesia, bradykinesia, dystonia, hyperkinesia

Front 3

Hypokinesia

Back 3

slow movement

Front 4

Bradykinesia

Back 4

slow in execution of a movement

Front 5

Dystonia

Back 5

sustained posture of twisting of the neck

Front 6

Hyperkinesia/chorea

Back 6

excessive movement. worm-like hand movement.

Front 7

Basal ganglia are damaged, will have problems with:

Back 7

Self- initiated movement
Movement coordination and sequencing of movements.

Front 8

Cerebral motor cortex damage may cause:

Back 8

Paralysis, plegia, or paresis.
Spasticity (hypertonicity)
Abnormal/exaggerated reflexes
Poor postural control
Insufficient force generation
Abnormal extensibility

Front 9

Cerebral cortex damage, problems include:

Back 9

Controlling voluntary movement; control of co-contraction (joint stiffness).
Perceiving and interpreting sensory information.
Making conscious decisions and generation of movements.

Front 10

Weakness

Back 10

inability to generate normal force levels; major impairment with UMN lesion.

Front 11

Paralysis, plegia, or paresis dependent on extent of lesion: Total/severe loss of mm activity:

Back 11

paralysis/plegia

Front 12

Partial/mild loss of mm activity:

Back 12

paresis

Front 13

Paralysis or paresis-

Back 13

decreased voluntary motor unit recruitment and reflexs an inability or difficulty in recruiting skeletal motor units to generate torque or movement.

Front 14

Spasticity/hypertonicity

Back 14

velocity dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. A component of UMN lesion.

Front 15

Cerebral palsy (CP) etiology

Back 15

Damage to CNS areas controlling motor behaviors.
UMN lesion.
Can occur pre, peri, or post natal
Differentiated by etiology, location, and extent of insult.
Non-progressive lesion with progressive musculoskeletal impairments.

Front 16

Motor related impairments (sequela of CP)

Back 16

Abnormal muscle tone- spasticity and abnormal muscle extensibility.
Hyperreflexive
Poor force generation- plegia/paresis
Poor selective control
Poor anticipatory control
Decreased ability to learn movements.
Orthopedic problems- poor posture, overuse injury, biomechanical alignment problem, etc.

Front 17

Other areas of concer in CP that our intervention plans may incorporate:

Back 17

Vision
Auditory
Cognition
Communication
General Health
Feeding
Growth
Behavior
Social

Front 18

Classification of CP by:

Back 18

Distribution
Type of muscle tone
Severity
Gross Motor Function Classification System Expanded and Revised (GMFCS E & R)

Front 19

Classification of CP by distribution:

Back 19

Quadriplegia
Hemiplegia
Diplegia

Front 20

Quadriplegia

Back 20

All four extremities involved. Usually, one is a little bit better than the others.

Front 21

Hemiplegia

Back 21

One side more involved.

Front 22

Diplegia

Back 22

Primarily lower extremity involvement.

Front 23

Classification of CP by type of muscle tone

Back 23

Hypertonia
Hypotonia
Athetosis
Ataxia
Mixed- can have hypertonic extremities and hypotonic trunk, or any other mixture.

Front 24

Classification of CP by severity:

Back 24

mild, moderate, severe

Front 25

GMFCS-E&R

Back 25

Children with CP aged birth to 18 years.
Based on self-initiated movement with emphasis on sitting, transfers, and mobility.
Five levels based on functional limitations and the need for hand-held mobility devices or wheeled mobility.

Front 26

Level 1 GMFCS ER

Back 26

Walks without limitations

Front 27

Level 2 GMFCS ER

Back 27

Walks with limitations

Front 28

Level 3 GMFCS ER

Back 28

Walks using a hand-held mobility device

Front 29

Level 4 GMFCS ER

Back 29

Self-mobility with limitations; may use powered mobility

Front 30

Level 5 CMFCS ER

Back 30

Transported in a manual wheelchair (must be pushed)

Front 31

Neuromuscular lifespan concerns CP

Back 31

Seizures
Declining mobility
Increased joint and muscle pain- check for things like d/l hip and skin breakdown.
Scoliosis and stress related lumbar disorders.
Arthritis
Lack of exercise and decreased endurance.

Front 32

Cardiopulmonary lifespan concerns CP

Back 32

Hypertension
Diabetes
Heart disease

Front 33

Nutritional lifespan concerns of CP

Back 33

Under or overweight. Underweight is more likely b/c they use a lot of energy trying to move. May need to work on energy conservation.

Choking and aspiration are a common cause of death.

Poor dental health- tone of tongue, jaw and mouth make it difficult to do things like brush teeth.

Front 34

Generalized problems in CP

Back 34

Osteoporosis
UTI
Hearing loss
GI

Front 35

Women's health

Back 35

Privacy (reproductive health, breast exam, PAP smears, routine exam)

Menstruation late

Front 36

Selected PT interventions

Back 36

Postural control
Mobility/gait
Developmental milestones promoted at the appropriate chronological age with typical movement patterns to minimize abnormal development.
Positioning
AT equipment
Functional joint range
Strength, endurance, balance, coordination
Joint and skin integrity
Orthopedic, orthotics, splints
Independence
Self-determination (take responsibility for disability and express needs)
Play/leisure
Team member including family and child

Front 37

Dysmetria, damage is located...

Back 37

cerebellum

Front 38

Dysmetria, movements look like

Back 38

tremor b/c of constant adjustments and overshoot.

Front 39

Intention tremor, damage is located:

Back 39

cerebellum

Front 40

Intention tremor, movements look like:

Back 40

Circular tremor as approach the target during voluntary movement. Primarily problem executing.

Front 41

Dystonia, damage is located:

Back 41

basal ganglia

Front 42

Dystonia, looks like:

Back 42

twisting of muscles. Pain management is important.

Front 43

Ataxic gait, damage located:

Back 43

cerebellum

Front 44

Ataxic gait, looks like:

Back 44

wide BOS, trunk instability, difficulty placing foot on the ground and progressing forward. Can't walk tandem.

Front 45

Chorea, damage located:

Back 45

basal ganglia

Front 46

Chorea, looks like:

Back 46

worm- like movements of arms (and legs)

Front 47

Clonus, damage located:

Back 47

UMN- tracts in cortex

Front 48

Clonus, looks like:

Back 48

involuntary contractions typically in foot, knee, wrist, etc.

Front 49

Spastic quadriplegia: what's injured, describe muscle tone and extensibility:

Back 49

Cerebral motor cortex

High tone, low extensibility

Front 50

Hemiplegia: what's injured, describe muscle tone and extensibility:

Back 50

Unilateral cerebral cortex, motor area

limbs, trunk, face on opposite side severely weak. Low tone, high extensibility.

Front 51

Spastic diplegia: what's injured, describe muscle tone and extensibility:

Back 51

Cerebral motor cortex

symmetrical involvement of arms, legs, or face.
high tone, low extensibility

Front 52

Neuromuscular disorder manifestations vary greatly based on:

Back 52

Age (gestation or term) at the time of neurological disruption/malformation/injury.
Location and severity of the neurological disruption/malformation/injury

Front 53

Ectoderm (mesoderm-notochord)

Back 53

gives rise to the neural plate

Front 54

Neuro development: 3-4 weeks

Back 54

Formation (neural plate folds) and closing of neural tube.

Front 55

What disorder may occur during the first 3-4 weeks?

Back 55

Myelodysplasia/spina bifida

Front 56

Neuro development: 5-6 weeks

Back 56

Formation of basic structures and brain subdivisions. Neural tube flexes at level of midbrain.
Prosencephalon, mesencephalon, rhombencephalon.

Front 57

Damage that may occur at 3-12 weeks

Back 57

Agenesis of the corpus callosum

Front 58

Agenesis of corpus callosum

Back 58

May have partial or complete absence of corpus callosum.

Lose bilateral coordination, visual perception, mild developmental delay, severe MR, and CP

Front 59

Neurodevelopment 8-16 weeks

Back 59

Formation and proliferation of neural and glial cells

Front 60

Probs at 8-16 weeks

Back 60

Microencephaly

Front 61

Neuro development 9-20 weeks

Back 61

Neurons move from ventricular and subventricular zones to final destination.

Front 62

Problems that may develop during 9-20 week period:

Back 62

Lissencephaly (9-13 weeks)- genetic
Generalized or focal seizures

Front 63

Neuro development:24 weeks- 2-3 years

Back 63

Alignment, orientation, and layering of neurons
Synaptogenesis
Growth of axons and dendrites
Myelenation of axons
Elimination of neurons, neuronal processes and synapses.

Front 64

Problems that may develop from 24 weeks - 2-3 years

Back 64

Range from mild coordination and learning disorder to CP.

Front 65

When would you use a standing frame for a child?

Back 65

Allow them to complete activities in standing and interact with their peers and allow them to have weight bearing to model bones.

Front 66

Post-birth brain damage due to immature cardiopulmonary system may include:

Back 66

hypoxia
Increased BP> IVH> periventricular leukomalacia
Ischemia
Asphixia

Front 67

Function of the cerebellum

Back 67

Receives visual and cortical input to help send a motor response

Front 68

Motor problems due to cerebellar damage

Back 68

Dysmetria
Hypotonia
Tremors
Ataxic gait

Front 69

Dysmetria

Back 69

Overshoot or undershoot a target

Front 70

Tremors due to cerebellar damage occur when?

Back 70

During voluntary movement
On approach to a target
When maintaining position

Front 71

When there's cerebellar damage, will have problems with:

Back 71

Postural control
Planning and executing movement
Smooth volitional multijoint movements

If block vision, they may do better.