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23 Cards in this Set
- Front
- Back
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Definition of tone
What is normal tone |
Resistance to passive stretch--amt of tension a mm has at rest
Normal tone is high enough to resist effects of gravity in posture and movt yet low enough to allow freedom of movt |
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Hypertonia defined
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Condition marked by an abnormal inc in muscle tension anda reduced ability of a muscle to stretch
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What may high tone be caused by? What is this condition called in children under 2?
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May be caused by injury to mo pathways in CNS, which carry info to mm and control posture, tone, and reflexes
Called CP--may get this dx to help with insurance reimbursement May result from injury or disease |
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Spastic hypertonia
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Uncontrollable mm spasms, stiffening of mm, shock-like contractions, and abnormal mm tone
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Dystonic hypertonia
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mm resistance to passive stretching at low speds, and a tendency of a limb to return to a fixed, invol (and sometimes abnormal) posture following movt
As seen in parkinsonism Called athetiosis when seen in CP |
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Rigidity
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Invol stiffening or straightening out of mm, accompanied by abnormally inc mm tone and reduced ability of a mm to stretch
As seen in parkinsonism (most common) |
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TBI - most common cause in:
Infants Preschoolers 5-9 yo 10-14 yo |
infants = 2/3 falls
preschoolers = falls and MVA 50/50 5-9 = equally divided btwn falls/MA/sports 10-14 = sports/recreation |
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Shaken Baby Syndrome:
Anatomic features Injury |
Weak neck with large head
Initial injury is hypoxia, followed with brain swelling Subdural hemorrhages also caused by mvmt within subdural space Retinal hemorrhages (good diagnostic indicator) and skeletal injuries common |
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Consequences of near drwoning accidnets
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Apnea followed b aspiration
Evolving hypoxemia cause neuronal injury and leads to circulatory collapse and myocardial damage Dysfxt of multiple organ systems causing further ischemic brain injury |
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CP AKA...?
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Static Encephalopathy
Caused by non-progressive lesion in the immature brain |
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Is CP progressive or non-progressive?
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Non-progressive, but as they grow up it is more challenging ot maintain mm length, so it may appear progressive
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What is CP a "disorder of"
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Movement and posure secondary to brain damage before, during, or after birth
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5 types of CP and what part of brain is thought to be involved
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Spastic - mo. cortex
Dyskinetic (dystonia or athetosis) - BG Ataxic - cerebellum Hypotonic - unknown, given name of CP for insurance purposes Mixed - spasticity and dyskinesia |
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GMFM classifications for CP into motor function
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Hemiplegia (36%)
Diplegia (41%) Quadriplegia (7%) Dyskinesia (10%) Ataxic (5%) |
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4 types of tx to keep in mind for high tone child
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Developmental considerations
Protective considerations (positioning/support) Education Mobility |
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Is CP progressive or non-progressive?
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Non-progressive, but as they grow up it is more challenging ot maintain mm length, so it may appear progressive
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What is CP a "disorder of"
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Movement and posure secondary to brain damage before, during, or after birth
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5 types of CP and what part of brain is thought to be involved
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Spastic - mo. cortex
Dyskinetic (dystonia or athetosis) - BG Ataxic - cerebellum Hypotonic - unknown, given name of CP for insurance purposes Mixed - spasticity and dyskinesia |
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GMFM classifications for CP into motor function
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Hemiplegia (36%)
Diplegia (41%) Quadriplegia (7%) Dyskinesia (10%) Ataxic (5%) |
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4 types of tx to keep in mind for high tone child
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Developmental considerations
Protective considerations (positioning/support) Education Mobility Try to have the child perform cognitively stimulating activities If CP child isnt walking by 8 y.o. they likely wont walk--W/C has been shown to drive other forms of mobility |
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What are some protective considerations to keep in mind for high tone children?
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Positioning - Custom high chair, sitting--help support developmental milestones, prevent 2 impairments, position for eacting
Support - standers, protect joints (AFO, SMO (Supramalleolar orthotics), etc.)--commonly have to block knee hyperext |
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What things should you educate family on for high tone?
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General CP info
Development Prevention of secondary impairments Protect joints Enrichment--give kids decision-making ability whenever possible |
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What is an indication for ability to walk in high tone children?
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Able to do so by 8 yo
Usually Hemi's and Di's walk, sometimes quads |
