Specific Pediatric Disabilities

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ANNichols
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67390
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Specific Pediatric Disabilities
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2011-02-19 14:02:10
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Specific Pediatric Disabilities
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Specific Pediatric Disabilities
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  1. Cerebral Palsy
    "Little's Disease"
    Diagnosis is based on a definite motor deficit and classification according to type of motor abnormality
  2. Cerebral Palsy
    "Little's Disease"
    is caused by
    damage to immature CNS, can cause mental retardation, seizures, hearing deficits, speech involvement and visual-motor perception deficits
  3. Children with Cerebral Palsy are impaired primarily
    in the midbrain area
  4. children who are diagnosed with Cerebral Palsy typically have
    neurological and developmental issues in the areas of vision, hearing, sensation, l anguage, mobility and manual competence
  5. Causes of CP include:
    • anoxia
    • hemorrhage
    • infection
    • trauma
    • prematurity
    • breech delivery
    • compromised umbilical cord
    • forceful delivery
    • drug exposure
    • diseases
    • meconium aspiration
  6. Types of Cerebral Palsy
    • Spastic-increased tone
    • Hypotonic-decreased tone
    • Athetoid-mixed tone
    • Ataxic-decreased tone
    • Opisthotonos-increased tone, fluctuating tone
  7. Sub-types of CP
    • Monoplegic-involvement of 1 extremity
    • Quadriplegic-involvement of all 4 extremities
    • Diplegic-involvement of either UE or LE
    • Hemiplegic-involvement of one side
    • Triplegic-involvement of 3 extremities
  8. Down's Syndrome
    diagnosed due to specific physical features and presence of extra chromosome on #21 and occurs in 1/600 live births on average
  9. Common health problems and facial features related to Down Syndrome
    • Instability of the atlantoaxial joint.
    • Hypotonic/hypertonic
    • Congenital heart defects
    • Mental/Physical retardation
    • Slanted eyes and space wide apart
    • Flat bridge of nose, low set ears, short neck eyes wide
    • Small mouth with large tongue
    • Moderate to severe joint laxity
    • Hand/foot crease is complete across palm w/ space between big toe and next toe
  10. Fetal Alcohol Syndrome
    • Can be caused by little/excessive alcohol use during pregnancy
    • Incidence is 1/250 live births
  11. Characteristics of FAS include
    • Elf-like face, eyes widely spaced w/ narrow eyelids, nose is short and upturned, jaw is underdeveloped, groove in upper lip is shortened or flat and presence of malocclusion of the teeth
    • Small stature, microcephalic, strabismus, short fingers and low set ears
    • Hyperactive, hypertonic, poor attention span and mental retardation
    • Increased incidence of congenital heart disease and hip dislocation
  12. Muscular Dystrophy
    Duchenne's type
    • X-linked and most severe w/ diagnoses at age 3 in males only
    • Incidence is 2/10,000 live births with death occurring in the 2nd and 3rd decade due to respiratory/cardiac failure
  13. Signs of Muscular Dystrophy
    • Deterioration in ambulation skills and presence of large calf muscles
    • Calf and thigh muscles initially enlarage--enlarged muscle tissue is eventually replaced by fat and connective tissue (pseudohypertrophy)
  14. Duchene muscular dystrophy is
    an inherited disorder characterized by rapidly progressive muscle weakness which starts in the legs and pelvis and later affects the whole body
  15. Spina Bifida
    • Congenital defect in the spinal column with incomplet closure of the vertebral canal due to failure of fusion of vertebral arches.
    • Most common congenital anomaly and occurs in 1 or 2/1,000 live births
  16. Types of Spina Bifida
    • Occulta-vertebral arches remain unfused bu there is no herniation of displacement of the meninges.
    • Cystila Meningocele-vertebral arches are unfused, there is no herniation of the meninges and part of the cord or nerve may be in a sac, and function is midly involved or normal
    • Cystila Myelomeningocele-most commont type and usually occurs in the lumbrosacral region.
    • -vertebral arches are unfused and herniation is usually present
    • -displacement of or disruption of the nerve/cord w/ the presence of neurological signs and abnormal development of the spinal cord
    • -Hydrocephalus is present in 80% of these cases and requires placement of a shunt because flow of cerebral-spinal flid is obstructed from the 4th ventricle to the cerebral subarachnoid space
  17. Mental Retardation
    • Causes are due to multiple diseases, syndromes, etc.
    • Measurement follows guidelines:
    • -Borderline-IQ = 68-73
    • -Profound-IQ = 20
  18. Seizures
    *Epileptic*
    discharge of normal cells that is excessive and uncontrollabe
  19. Seizures
    *Grand mal*
    activity lasting over 30 - 60 seconds
  20. Seizures
    *Petit mal*
    short bursts of activity that last seconds and is often characterized by blank look and unresponsiveness of individual w/o losing consciousness
  21. Seizures
    *Lennox*
    • Gastault
    • Degenerative seizure activity
  22. Seizures
    *Infantile spasms*
    seizure activity under 1 year
  23. Juvenile Rheumatoid Arthritis (Still's Disease) (JRA)
    • Onset is before age 16 w/ a median age of 5 years
    • Usually subsides folllowing puperty but can leave joint deformities
    • Treatment includes PT for PROM, paraffin wax baths for hands, medications
  24. Complaints w/ JRA
    • joint pain
    • swelling
    • tenderness
    • limitation of movements
    • heat
    • fatigue
    • rash
    • stiffness
    • possible visual impairment
  25. Acquired Immune Deficiency Syndrome (AIDS)
    Characteristics
    • low birth weight
    • failure to thrive
    • interstitial pneumonitis
    • chronic diarrhea
    • reccurrent viral and bacterial infections
    • muscle weakness
    • reduced opportunity for mobility
  26. Brachial Plexus Injury
    Pathology
    Compression/traction injury to brachial plexus secondary yto prenatal or postnatal events
  27. Bracial Plexus Injury
    Pathology/Symptoms
    range from swelling of the neural sheath to total abulsion of the nerve roots from the spinal cord causing sensory w/ or w/o motor involvement
  28. Erb's Palsy
    • upper plexus injury to C5 and C6 nerves
    • nerve injurty that effects teh movement of a child's shoulder, arm, and hand.
  29. Erb's Palsy usually occurs
    • when too much force is applied to the baby's head, while trying to pull out a baby stuck in the birth canal.
    • When baby's shoulder gets stuck in the birth canal, it is called "shoulder dystonia"
  30. Baby w/ plexus injury Erb's Palsy
    typically holds limp arm down by side w/ forearm turned inward and wrist bent
  31. Klumpke Paralysis/Palsy
    lower plexus injury to C7, C8, and T1
  32. Erb-Klumpke Paralysis/Palsy
    mixed involvement from C5-T1
  33. Plexus injury Intervenetion
    • avoid further damage w/ no active intervention until 2 wks post injury except gentle ROM
    • Elicit muscle function
    • Surgery

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