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29 Cards in this Set
- Front
- Back
Define Cerebral Palsy
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Motor symptoms resulting from Dysfunction in early brain development
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Is cerebral palsy static or changing?
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static = doesn't change, BUT as the CNS matures, the original lesion does not change
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T/F: Perinatal difficulties are associated with but NOT THE CAUSE of cerebral palsy (80%)
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TRUE
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T/F: maternal infection or low birth weight significantly increases risk of Cerebral palsy
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TRUE
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T/F: inc. cerebral palsy risk: maternal infection, very low birth weight infants
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TRUE
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Why are very low birth weight infants at inc. risk for cerebral palsy?
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They are more at risk of Intracranial hemmorhage and very high risk of periventricular Leukomalacia
AND immature oligodendroglia are vulnerable to oxidative damage (from stress, ischemia, infection, inflamm) |
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T/F: Many pts with Cerebral palsy function at normal educational and vocational levels
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TRUE
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List the 4 types of Cerebral palsy
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Spastic Diplegia, Hemiplegia, Spastic Quadriplegia, Extrapyramidal
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define Spasticity
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Muscles are high in tone with resistance to stretch but weak in strength
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Define Athetosis
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Slow, writhing, continuous, involuntary movements, most noticable when pt moves purposefully
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Define Ataxia
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unsteady, shaky movements or tremor
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Bilaterally spasticity of LEGS GREATER THAN arms such as brisk LE reflexes, ankle clonus (involuntary contractions), Bilateral Babinski sign. DX?
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Spastic Diplegia
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Baby scissors legs when held upright, commando crawls, and has massive hip Adduction. Dx?
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Spastic Diplegia
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Pt has Bilaterally spasticity of LEGS GREATER THAN arms such as brisk LE reflexes, ankle clonus (involuntary contractions), Bilateral Babinski sign. What do we do to Dx?
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Think Spastic Diplegia
Get MRI to see if there is periventricular leukomalacia (PVL) in area where fibers innervating legs course through internal capsule |
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Whats the MOST SEVERE form of Cerebral palsy?
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Spastic Quadriplegia
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Pt has Marked motor impairment in all 4 extremities. What can you tell the parents they can expect as associated symptoms?
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Think Spastic Quadriplegia
Seizures, MR, swallowing dysfunction Maybe: speech and visual abnormalities |
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What lesions will we see in MRI with Spastic Quadriplegia?
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Severe periventricular leukomalacia
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Pt has dec spontaneous movement in all 4 limbs, babinski, and brisk reflexes in all 4 limbs. Dx?
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Spastic quadriplegia
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Pt has RIGHT Arm reflex brisk and RIGHT LEG reflex brisk. Circumductive gait (AKA hemiplegia gait), Inulateral ankle clonus on RIGHT, and babinski on right. Dx?
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Spastic Hemiplegia
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T/F: pts are less likely to have cognitive abnormalities than to have cognitive abnormalities with Cerebral palsy
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TRUE
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Pt has Pt has RIGHT Arm reflex brisk and RIGHT LEG reflex brisk. Circumductive gait (AKA hemiplegia gait), Inulateral ankle clonus on RIGHT, and babinski on right. Where will we see the LESION on MRI? whats the usual cause
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think spastic hemiplegia
Lesion will be on opposite side from problems, so LEFT Usual cause = infarction in utero or neonatally (OR thrombophilic disorder, or infection) |
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Infant combs out of womb with head hanging down, normal intellect, and can't suckle (oropharyngeal muscles affected). Dx?
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Extrapyramidal Cerebral Palsy
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Infant combs out of womb with head hanging down, normal intellect, and can't suckle/is drooling/tongue thrusting (oropharyngeal muscles affected). What can we tell the parents to expect as the child grows older?
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Think Extrapyramidal Cerebral palsy
As they grow older they'll develop variable tone with rigidity and dystonia |
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baby was void of oxygen for a while during birth. What type of cerebral palsy is most likely?
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Extrapyramidal
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Infant combs out of womb with head hanging down, normal intellect, and can't suckle (oropharyngeal muscles affected). Where do we expect to see the lesion?
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Think Extrapyramidal
Lesion most comonly associated with asphyxiation is bilaterally in the posterior putamen and ventrolateral thalamus |
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An infants Extrapyramidal cerebral palsy is determined to be caused by Kernicterus (bilirubin-induced brain dysfunction). Where is the lesion?
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Globus Pallidus bilaterally
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How do we dx cerebral palsy?
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History of a STABLE (NON-PROGRESSING) disorder with MRI of brain showing location of lesion
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BEST treatment for cerebral palsy?
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PREVENTION
Prenatal care a MUST |
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If you are unable to prevent cerebral palsy, what other steps can you take to treat them?
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Supportive family = parents taught how to care for baby ie how to dec. muscle contractures, how to feed, dress, bath, etc
Physical therapy Walkers, Poles/crutches/standers/computers/bliss symbols OMT!!!!!!!!!!!!!!! (trials ongoing) |