Mngmt of Neuro

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Mngmt of Neuro
2011-11-16 16:42:37
Specific Diagnoses Treatment

Specific Diagnoses and Treatment
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  1. - Nonprogressive but often changing impairment syndrome caused by a defect, anomaly, or lesion of the developing brain.
    - May occur before, during, or after birth.
    Cerebral Palsy
  2. What poses a high risk for CP?
  3. Whole body involved but LE's more involved than UE's.
  4. Whole body involved - trunk and extremities.
  5. Only one side of the body is involved.
  6. Only one UE or less frequently one LE is involved, very rare.
  7. Three extremities involved, often one UE is spared.
  8. Both LE's involved, true form very rare. Usually a diplegia with involvement of UE's so mild it is not noticed.
  9. What are the different types of CP? (4)
    • Spastic (hypertonic)
    • Athetoid
    • Ataxic
    • Hypotonic
  10. What type of CP has low tone in the neck and trunk, and high tone in extremities?
  11. What type of CP has excessive sustained muscle contractions with certain muscle groups tending to overpower others?
  12. What type of CP has:
    - global low tone, proximal to distal
    - fluctuating muscle tone in extremities
    - movement tends to be asymetrical and forceful
  13. - Movement occurs between one extreme of range to the other extreme with little control in midranges.
    - Difficulty co-activating to get smooth reciprocal motion.
    What typt of CP?
  14. - Muscle tone fluctuates from low to low normal, decreased muscle force generation.
    - Disturbance in balance and kinesthesia.
    - May have tremor and dysmetria.
    What type of CP?
  15. - Movement disorganized due to unreliable proprioceptive and vestibular information.
    - Movement away from midline is difficult because they cannot control center of mass.
    What type of CP?
  16. - Floppy babies
    - Have difficulty generating, grading, and sustaining movement.
    What type of CP?
  17. What is the second most common birth defect after Down's Syndrome?
  18. - Vertebral arch fails to close.
    - The spinal cord herniates through the vertebral column resulting in injury to the spinal cord.
  19. - Herniation of part of the brain downward.
    - CSF is blocked.
    Arnold-Chiari malformation
  20. Results when CSF is obstructed and accumulates, causing pressure on surrounding areas.
  21. What are some signs and symptoms of shunt malfunctions?
    • Bulging fontanelle
    • High-pitched cry
    • Sun-set sign of the eye - indicates raised intracranial pressure
    • Edema and redness along shunt tract
  22. Name some congenital or aquired orthopedic deformities?
    • Club feet and other foot deformities
    • Dislocated hips and congenital contractures
    • Kyphoscoliosis
  23. After many years of catheterization and other medical procedures, a person with spina bifida has an increased chance of developing ____________.
    Latex allergy
  24. Fixation of the spinal cord in an abnormal location usually associated with scar tissue.
    Tethered cord
  25. Tethered cord signs and symptoms?
    • Decreasing strength
    • New spasticity
    • Back pain
    • Changes in urological function
    • Changes in coordination
  26. What are the major PT goals of a myelomeningocele patient?
    • Prevent contractures and skin breakdown
    • Facilitate normal sensorimotor development
    • Increase independent mobility
    • Introduce conpensatory strategies
  27. Hereditary myopathy characterized by progressive muscular weakness, deterioration of muscle fiber, and replacement of muscle fiber with fibrous and fatty tissue.
    Duchenne muscular dystrophy
  28. - Cardiac and GI muscles involved
    - Tendon reflexes regress to weak and then none
    - No sensory loss
    - Muscles innervated by cranial nerves are spared, except SCM
    - Bowel and bladder spared
    Duchenne muscular dystrophy
  29. What are the 3 phases of muscular dystrophy?
    • Phase I: Early phase
    • Phase II: Postural change
    • PhaseIII: Non-ambulatory phase
  30. What phase of MD?
    - Early signs of muscle weakness beginning to be noticed
    - Delayed coordination - primarily in gross motor
    - Slow, labored gross motor activities
    - Walking becomes slower - tires easily
    Phase I: Early phase
  31. What phase of MD?
    - Continue muscle weakness and functional loss
    - Will see anterior pelvic tilt, wide BOS, shoulders and head arched to balance in standing
    - Child moves using momentum and lateral sway rather than weight shifts
    Phase II: Postural change
  32. What phase of MD?
    - May spend 90% of the day using a WC
    - UE wekness more apparent - shoulder subluxation
    - Accelerated development of joint contractures
    - Marked difficulty with ADL's
    Phase III: Non-ambulatory phase
  33. A child that presents with:
    developmental delay
    Down syndrome