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40 Cards in this Set
- Front
- Back
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What is developmental disability?
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wide array of disabilities present in early childhood, and limit physical, mental, emotion, and social development
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What is cerebral palsy?
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- umbrella term
- result of a lesion in CNS before age of 2 resulting in abnormal muscle tone and sensorimotor control |
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What is traumatic brain injury (TBI)?
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- external force/injury to brain tissue
- may be called CP if occured before 2 |
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What is epilepsy?
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- disorder involving recurrent seizures (result of discharge of neurons in CNS
- may result in neuronal damage if seizures persist |
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Describe Hemispheric Lateralization
hemiplegia? |
left cerebral hemisphere receives sensory from and sends messages to right side of body
right cerebral hemisphere receives sensation from/sends messages to left side of body hemiplegia involves only 1 cerebral hemisphere |
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Function of frontal lobe?
parietal lobe? occipital lobe? temporal lobe? |
frontal lobe- judgment and primary motor (body movement)
parietal lobe- sensation occipital lobe- vision temporal lobe- hearing |
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what parts of the body is correlated to cells near the medial longitudinal fissure?
think homunculus damage results in? |
lower extremities
damage results in spastic diplegia |
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what parts of the body is correlated to cells near the lateral surface of the brain?
think homunculus damage results in? |
lower extremities, upper extremities, and face
damage to 1 hemisphere results in spastic hemiplegia (frequently due to hemorrhage or TBI) damage to both results in spastic quadriplegia (frequently due to asphyxia or severe PVL) |
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Is the lesion in Cerebral Palsy progressive?
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nope.
HOWEVER. the result of the lesion is progressive, due to a growing and changing body system |
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what are several risk factors associated with cerebral palsy?
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CNS problems (IVH, PVL), LBW, low APGARS
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Terminology of muscle tone!
Define 1) Hypotonia 2) hypertonia a) spasticity b) rigidity 3) dyskinesia 4) ataxia |
1) hypotonia- reduced muscle tone/ floppy
2) hypertonia- excessive stiffness and abnormal postures 2a) spasticity- clasp knife increase in muscle tone on passive movements (often w/ increased tendon reflexes) 2b) rigidity- constant increased in tone of "lead pipe" character 3) dyskinesia- involuntary motor or posturing present at rest (dystonic) random jerky movements (chorea) slow, writhing movements (athetosis) 4) ataxia- postural instability and limb incoordination |
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Know the difference
monoplegia- 1 limb hemiplegia- one side tetraplegia- 3 limbs diplegia- lower extremities quadriplegia- 4 limbs |
=
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Describe hypotonia
(define hypotonicity) (how is it evaluated) (what is the term for extreme hypotonicity) (describe ROM) |
hypotonicity- decrease in muscle tone
evaluated by feeling resistance during PROM extreme hypotonicity = flaccidity increase in ROM - co-contraction of proximal joints absent/weak - deep tendon reflexes are diminished - difficulty moving against gravity |
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Describe the science behind hypertonicity-spasticity
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in CP, a lesion in cortex results in lack of of descending inhibition, so muscles continuously contract due to stimulation from muscles/skin
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why is Hypertonicity-spasticity referred to as the clasp knife?
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the muscle suddenly relaxes after initial resistance
(works somewhat like a Swiss knife) |
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In hypertonicity-spasticity, is there increased resistance in both antagonist and agonist muscle groups?
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cant be both
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What extensor/flexor pattern should we know about hypertonicity-spasticity?
what reflexes are in spastic muscle groups |
UE flexion dominates
LW extension w/ adduction dominates hyperactive deep tendon reflexes present in spastic muscle groups |
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what are some factors that influence spasticity?
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- anxiety, fear, temperature, sensory overload, position of head and body
-relaxation, health, satisfaction decreases muscle tone |
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Hypertonicity-rigidity is associated what lesions of the:
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basal ganglia
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In hypertonicity-rigidity, is there increased muscle tone in both antagonist and agonist muscle groups?
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yes simultaneously
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Constant resistance throughout ROM in hypertonicity-rigidity is called:
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plastic or lead pipe rigidity
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Hypertonicity-Rigidity
imagine a robots arm movement. term used to describe such rhythmic resistance? |
cogwheel rigidity
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does dyskinesia refer more to movement patterns or passive tone?
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refers more to movement patterns
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Describe these movements under dyskinesia
1) dystonic 2) chorea 3) athetosis 4) choreoathetosis appear to be smiling a lot, loud vocals |
1) dystonic: rigid posturing
2) chorea; rapid, random jerky movements 3) athetosis: large uncontrolled movements 4) choreoathetosis: rapid, random, jerky, writhing movements |
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Describe Ataxia
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-involves trunk and limbs in space
-instability/lacks control of movements - UE movements jerkys - overshooting (remember that example w/ touching your nose) - timing is difficult - wide gait, unsteady - looks drunk - voice shaky |
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just know for CP
abnormal postures lead to a reduced range of motion around a joint, which leads to a "fixed" deformity and eventually a "bony" deformity lack of movement leads to skin maceration oral muscles lead to feeding problems GE reflux in silent aspiration |
continued.
lack of movement leads to hypersensitivity |
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what are some medical treatments for CP?
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oral (baclofen): affect muscles, causes drowsiness
injections (botox) to spastic muscle every 3-6 months intrathecal baclofen- pump implanted into body that feeds baclofen to CSF. skips side effects, reduces muscle tone. |
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What are some orthopedic surgical treatments for CP?
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1) muscle lengthening
2) tendon transfers 3) tenotomy- used in hips, muscles cut, muscles grow back lengthened 4) joint fusing- used at thumb to make the digits more functional |
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What are the 2 briefest type of seizures?
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myoclonic and atonic seizures
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Is there any loss of consciousness in myoclonic seizures? describe the movements during such a seizure
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no loss of conciousness
sudden movements that range from arm flinging to bending of upper torso and head |
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Describe atonic seizures (common name for it?)
atonic seizures are just the opposite of ____ seizures in presentation |
sudden loss of muscle tone
common name: drop seizure! opposite of myoclonic seizure in presentation |
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Is status epilepticus seizures severe?
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yes, life threatening
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do status epilepticus seizures occur frequently?
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nope
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describe status epilepticus seizures
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- prolonged seizure
- infrequent - life threatening - single seizure of cluster of seizures that is prolonged (yes its in the notes) - may result in irreversible brain damage - may occur as a result of hypoxic-ischmeic episode, brain tumor, or brain malformations |
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what are 2 methods for diagnosing for epilepsy?
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electroencephahogram EEG
variety of imaging techniques including positive emission tomography PET |
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what are 2 ways to manage epilepsy?
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- antiepileptic drugs (must balance risks w/ benefits!)
- ketogenic diet |
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Describe how ketogenic diet works to manage epilepsy
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ketogenic diet forces brain to use fat rather than carbs,
16% stop seizing, 50% reduce seizing, difficult diet |
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describe how surgery would help epilepsy
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- remove seizure focus on brain (e.g. part of temporal lobe)
- causes impairment in area (a removed portion of temporal lobe = memory loss) - also may stop the spreading of seizures by cutting the corpus collosum (commisurotomy) |
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IMPORTANT! OT SAFETY QUESTION! 2 POINTS!
how long should a seizure last until you should call for emergency? |
5-10 minutes
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IMPORTANT! OT SAFETY QUESTION! 2 POINTS!
if a child is having a seizure, what is the proper handling technique (as an OT) |
place child on floor/bed, turn to side to prevent choking; loosen clothing around neck
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