Cerebral Palsy and Prenatal Factors Quiz
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Questions and Answers

Before what age do the early signs of cerebral palsy (CP) typically appear?

  • 10 years
  • 1 year
  • 3 years (correct)
  • 5 years
  • Congenital cerebral palsy is caused by a permanent brain insult during which period(s)?

  • Prenatal only
  • Postnatal only
  • Prenatal, perinatal, or postnatal (correct)
  • Perinatal only
  • Which of the following conditions affecting the mother during pregnancy can lead to congenital CP in the child?

  • Morning sickness
  • High blood pressure
  • Gestational diabetes
  • Kidney infections (correct)
  • Neonatal hyperbilirubinemia can result in which type of cerebral palsy if left untreated?

    <p>Athetoid CP (C)</p> Signup and view all the answers

    Which of the following is the LEAST likely cause of acquired cerebral palsy?

    <p>Genetic mutations (A)</p> Signup and view all the answers

    Considering the causes of congenital CP, which scenario presents the HIGHEST risk for a newborn developing cerebral palsy?

    <p>A premature infant born to a mother who occasionally consumes alcohol during pregnancy. (A)</p> Signup and view all the answers

    A researcher is investigating the correlation between prenatal care quality and the incidence of congenital cerebral palsy in a specific population. Which of the following data points would provide the STRONGEST evidence supporting a causal relationship between inadequate prenatal care and increased CP risk?

    <p>A statistically significant association between the number of prenatal visits attended and CP diagnosis rates, adjusted for socioeconomic status and maternal age. (A)</p> Signup and view all the answers

    Which of the following best describes the primary mechanism of injury in Shaken Baby Syndrome (SBS)?

    <p>Acceleration-deceleration forces causing brain trauma. (C)</p> Signup and view all the answers

    A hallmark clinical sign of Shaken Baby Syndrome (SBS) is:

    <p>Subdural and retinal hemorrhages without external signs of abuse. (C)</p> Signup and view all the answers

    Why are babies more susceptible to Shaken Baby Syndrome (SBS)?

    <p>Babies' necks are weak, and cervical facet joints are shallow and horizontally oriented. (A)</p> Signup and view all the answers

    During the initial emergency care for a patient with suspected Shaken Baby Syndrome (SBS), what is the MOST critical intervention?

    <p>Promptly assessing and managing airway, breathing, and circulation (ABCs). (D)</p> Signup and view all the answers

    A physical therapist is treating a child years after the initial trauma from Shaken Baby Syndrome (SBS). Which of the following impairments are they least likely to address, considering the long-term effects of SBS?

    <p>Acute pain flares from the initial injury. (C)</p> Signup and view all the answers

    Which of the following is NOT typically considered a secondary condition associated with cerebral palsy (CP)?

    <p>Visual acuity improvement (B)</p> Signup and view all the answers

    A child with CP sees an array of medical professionals as part of the multidisciplinary approach. Which of the following professionals is LEAST likely to be involved in the medical management of CP?

    <p>Cosmetic Surgeon (A)</p> Signup and view all the answers

    What is the primary purpose of a selective dorsal rhizotomy in the management of cerebral palsy?

    <p>To decrease muscle tone and spasticity (A)</p> Signup and view all the answers

    Which of the following medications is NOT typically used for the reduction of hypertonia/spasticity in individuals with cerebral palsy?

    <p>Phenytoin (A)</p> Signup and view all the answers

    Why is intrathecal baclofen administration often preferred over oral baclofen for managing spasticity in cerebral palsy?

    <p>It delivers the medication directly to the cerebrospinal fluid, minimizing systemic side effects. (A)</p> Signup and view all the answers

    What is a tenotomy procedure, often performed in managing contractures related to cerebral palsy?

    <p>A surgery to lengthen or completely sever a tendon. (A)</p> Signup and view all the answers

    Which of the following is the MOST significant disadvantage of administering baclofen orally for spasticity management?

    <p>It requires larger doses due to limited blood-brain barrier permeability, leading to systemic side effects. (C)</p> Signup and view all the answers

    A child with cerebral palsy exhibits neglect of their left upper extremity and has difficulty with tasks requiring awareness of their body's position in space. Which impairment is MOST likely contributing to these challenges?

    <p>Spatial awareness impairment, affecting kinesthesia and proprioception (D)</p> Signup and view all the answers

    A 5-year-old child with cerebral palsy is scheduled for a Baclofen pump implantation. During the pre-operative assessment, the parents express concern about the pump's maintenance. Which statement reflects the MOST accurate and comprehensive information regarding the long-term management of an intrathecal Baclofen pump?

    <p>The pump needs refills every few months, requires periodic programming adjustments, and will eventually need replacement after several years. Regular follow-up appointments are essential. (A)</p> Signup and view all the answers

    Which of the following is NOT typically assessed by therapists (PT, OT, Speech) in the acute care setting?

    <p>Financial planning (C)</p> Signup and view all the answers

    The Rancho Los Amigos Levels of Cognitive Functioning scale is primarily used for what purpose?

    <p>To standardize communication among medical professionals regarding cognitive recovery. (D)</p> Signup and view all the answers

    According to the information provided, what is a key consideration when providing coma stimulation interventions?

    <p>Avoiding overstimulation by controlling the environment. (D)</p> Signup and view all the answers

    In physical therapy, kinesthetic and proprioceptive awareness can be enhanced through which intervention?

    <p>Compression (C)</p> Signup and view all the answers

    Which of the following is MOST important when using splinting, orthotics, and immobilizers?

    <p>Involving family and caregivers in the process. (C)</p> Signup and view all the answers

    What is the primary goal of physical therapy interventions related to functional mobility?

    <p>To maximize independence in daily activities and community reintegration. (D)</p> Signup and view all the answers

    What aspect of posture is the MOST important to address in physical therapy interventions?

    <p>Address postural issues, malalignment, and asymmetries (B)</p> Signup and view all the answers

    What type of motor skills are re-educated by physical therapy?

    <p>Re-education of developmental motor skills (appropriate for infant/child’s age) (C)</p> Signup and view all the answers

    How does challenging a child with cognitive tasks performed simultaneously with motor tasks enhance their development?

    <p>It helps the child learn to process possibly conflicting information, improving motor planning, sequencing, and executive functioning skills. (B)</p> Signup and view all the answers

    Which statement BEST encapsulates the nuanced relationship between sensory input and motor output during advanced rehabilitation?

    <p>Systematically increasing the complexity and potential conflict within sensory inputs, while simultaneously demanding precise motor sequencing, challenges and refines higher-level executive functions. (D)</p> Signup and view all the answers

    According to the Gross Motor Classification System, which level indicates the highest level of function for an infant or child?

    <p>Level I (B)</p> Signup and view all the answers

    Which of the following is a potential cause of Cerebral Palsy (CP)?

    <p>All of the above (D)</p> Signup and view all the answers

    Which type of tone is characteristic of Athetoid Cerebral Palsy?

    <p>Writhing movements and fluctuating tone (B)</p> Signup and view all the answers

    Which of the following is a common secondary condition observed in children with Cerebral Palsy?

    <p>Seizures (D)</p> Signup and view all the answers

    In the context of pediatric traumatic brain injury (TBI), what defines a 'traumatically induced physiologic disruption of brain functioning'?

    <p>Brain dysfunction resulting from external mechanical force (B)</p> Signup and view all the answers

    Which of the following mechanisms is typically associated with a coup injury in traumatic brain injury (TBI)?

    <p>The brain striking the skull at the point of impact (B)</p> Signup and view all the answers

    Epidural hematomas and increased intracranial pressure are classified as what kind of injuries following a Traumatic Brain Injury?

    <p>Secondary injuries (B)</p> Signup and view all the answers

    A patient presents with a Glasgow Coma Scale (GCS) score of 14, loss of consciousness for approximately 25 minutes, and posttraumatic amnesia lasting approximately 30 mins. According to TBI classifications, how would this be classified?

    <p>Mild TBI (C)</p> Signup and view all the answers

    Which of the following signs and symptoms is MOST likely to appear several days after a mild traumatic brain injury (mTBI)?

    <p>Slowed or impaired information processing, disorganization, reduced frustration tolerance, rapid mood changes and increased irritability, difficulties retrieving previous information, increased sensitivity to noise, and reports of being overloaded or overwhelmed (C)</p> Signup and view all the answers

    A child experiences a traumatic brain injury during a sports-related incident. Neurological examination reveals a Glasgow Coma Scale (GCS) score consistently below 8, extensive physical impairments requiring ventilator support, and prolonged post-traumatic amnesia exceeding 24 hours. Assuming optimal medical management, which of the following interventions holds the HIGHEST likelihood of substantially altering the long-term functional trajectory, mitigating severe disability, and facilitating meaningful participation in age-appropriate activities, based on current evidence-based guidelines?

    <p>Initiation of high-intensity, task-specific rehabilitation within a specialized pediatric TBI unit, emphasizing neuroplasticity-driven motor recovery and cognitive retraining, coupled with early integration of adaptive equipment and community-based support services. (B)</p> Signup and view all the answers

    Flashcards

    Congenital Cerebral Palsy

    A brain condition caused by permanent insult during pregnancy, delivery, or shortly after.

    Risk Factors for CP

    Premature birth and low birth weight increase chances of developing cerebral palsy.

    Prenatal Causes

    Conditions during pregnancy that can lead to cerebral palsy include infections like CMV and rubella.

    Postnatal Factors

    Brain damage shortly after delivery can cause CP due to infections, trauma, or lack of oxygen.

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    Acquired Cerebral Palsy

    Type of CP resulting from brain injury in the first few years of life.

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    Hypoxic Ischemic Encephalopathy

    Brain damage caused by lack of oxygen, often a risk in premature infants.

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    Neonatal Hyperbilirubinemia

    Severe jaundice in newborns that can cause brain damage and athetoid CP.

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    Cerebral Palsy (CP)

    A neurological disorder affecting movement and muscle coordination.

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    Vision Impairments

    Conditions like strabismus and visual perceptual problems affecting eye coordination.

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    Oral Motor Dysfunction

    Difficulty with tongue control, eating, and swallowing, impacting communication.

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    Medical Management of CP

    A multidisciplinary approach involving various health professionals to manage CP symptoms.

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    Baclofen

    A medication used to reduce spasticity by affecting muscle tone.

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    Intrathecal Baclofen Pump

    A delivery system for Baclofen directly into the cerebrospinal canal.

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    Seizure Disorders Medications

    Drugs like Phenobarbital and Phenytoin used to manage seizures.

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    Common Side Effects of Baclofen

    Dizziness, weakness, and confusion can occur with Baclofen use.

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    Secondary Conditions of CP

    Conditions like hearing loss and spatial awareness problems arise as complications of CP.

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    Shaken Baby Syndrome (SBS)

    A form of child abuse caused by violently shaking a baby, leading to brain injury.

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    Symptoms of SBS

    Hallmark signs include subdural and retinal hemorrhages, and irritability without external signs of abuse.

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    Initial care for SBS

    First steps include assessing airway, breathing, and circulation; stabilizing blood pressure and stopping hemorrhaging.

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    Neck Structure in Babies

    Babies have weak necks with shallow cervical facet joints, making them vulnerable to injury.

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    Diagnosis methods for SBS

    SBS is often diagnosed using MRI or CT scans to identify brain injuries and bleeding.

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    Rancho Los Amigos Levels

    A scale to assess cognitive recovery following brain injury.

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    Cognitive Functioning Assessment

    Utilizes a multi-level scale for evaluating cognitive abilities post-injury.

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    Coma Stimulation Interventions

    Techniques to increase arousal in patients with low consciousness levels.

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    Proprioceptive Awareness

    Awareness of body position and movement through sensations.

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    Sensory Integration (SI)

    Therapies that help process and respond to sensory information.

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    Functional Mobility Training

    Training focused on improving movements needed for daily activities.

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    Dynamic Balance Activities

    Exercises that improve stability while in motion.

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    Developmental Motor Skills

    Skills related to movement that develop at specific age stages.

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    Postural Issues

    Problems related to alignment and body posture affecting mobility.

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    Motor Planning

    The ability to conceive, plan, and execute coordinated movements.

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    Gross Motor Classification System Level I

    The highest functioning level for infants/children in motor skills.

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    Causes of Cerebral Palsy (CP)

    CP can be caused by oxygen shortage, toxicity, or Rh incompatibility.

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    Athetoid CP

    Characterized by writhing movements and fluctuating muscle tone.

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    Common secondary condition of CP

    Seizures are a frequent secondary condition associated with CP.

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    Pediatric Traumatic Brain Injury (TBI) causes

    Leading causes include motor vehicle accidents and other trauma.

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    Primary injuries in TBI

    Related to forces at the initial impact; can be translational or rotational.

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    Coup and Contrecoup injuries

    Coup is the direct impact, while contrecoup is the opposite side hit.

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    Classification: Mild TBI

    Loss of consciousness <30 mins, GCS 13-15, common injuries include headaches.

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    Classification: Moderate TBI

    Loss of consciousness >30 mins, GCS 8-12; possible skull fracture.

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    CDC update on Mild TBI

    Nearly 3.8 million sports-related concussions occur annually in children.

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    Study Notes

    Pediatric Neurological and Muscular Disorders

    • This is a PowerPoint presentation for Stanbridge University students.
    • The presentation covers a variety of neurological and muscular disorders in children.

    Cerebral Palsy

    • A broad term describing chronic conditions that impair posture and movement.
    • A permanent, non-progressive neurological disorder.
    • Caused by faulty development, injury, or damage to motor areas in the brain.
    • Early signs typically appear before the age of 3.
    • Pathology is connected to prenatal, perinatal, and postnatal brain insults.
    • Premature births and low birth weights are high-risk factors.
    • Infections during pregnancy (CMV, rubella) can damage the developing CNS.
    • Neonatal hyperbilirubinemia, severe untreated jaundice, and Rh incompatibility can contribute.
    • Conditions like lack of oxygen to the brain (hypoxic ischemic encephalopathy), stroke or bleeding (hemorrhage) of the fetus, and premature infant status, alongside toxicity such as drugs or alcohol use during pregnancy, can all contribute.
    • Kidney infections (UTI's) in the mother can harm an infant.
    • Multiple pregnancies are at higher risk.
    • Acquired CP results from brain damage in the early months or years of life. Causes may include brain infections (encephalitis or meningitis), head trauma (falls, car accidents, child abuse).

    Learning Objectives (Cerebral Palsy)

    • Understand the etiology and causes of cerebral palsy (CP).
    • Identify various types and characteristics of CP.
    • Understand sensory, medical, and cognitive problems associated with CP.
    • Understand the role of evaluation and ongoing assessment in the treatment of CP.
    • Identify appropriate treatment strategies for different age spans in children with CP.
    • Understand the roles of other healthcare professionals in managing CP.
    • Be familiar with assistive technologies used for intervention.

    Classification of Cerebral Palsy

    • Quality/severity of muscle tone and movement
    • Pattern of motor impairment or involvement
    • Gross Motor Functional Classification System (includes a table)

    Types of Muscle Tone

    • Spastic CP- hypertonia, increased resistance to passive stretch, abnormal reflexes (clonus), hyperactive DTR, contractures, abnormal posturing
    • Hypotonic CP- poorly defined muscles, decreased responses to DTR, hypermobile joints, floppy, head lag, fatigues easily
    • Athetoid CP- fluctuating tone, writhing movements, stiffening, abnormal postures, dystonia
    • Ataxic CP - poor balance and coordination, jerky movements, wide base of support

    Modified Ashworth Scale

    • A scale used to quantitatively describe muscle tone.
    • Various grades (0-4) with descriptions associated with each stage.

    Types of Muscle Tone (cont.)

    • Spastic Cerebral Palsy: the most common form under this classification, including stiff and tight muscles making normal movement difficult, and increased resistance to stretch (can be velocity-dependent)
    • Hypotonic CP: decreased muscle strength and difficulty with anti-gravity muscle control, commonly presenting as a "floppy" infant.
    • The other types - Diplegia, Hemoparesis/Hemiplegia, Tetraparesis, Triplegia, Monoplegia

    Classification of Cerebral Palsy (cont.) *

    • The third type is a Gross Motor Functional Classification system.
    • The scale categorizes by the severity or functional capability.
    • It provides a qualitative, objective measure of prognosis for gross motor skills.
    • Classified based on the child's skills, not age. (there are 5 levels).

    Secondary Conditions of CP

    • Seizures
    • Cognitive/intellectual impairment
    • Vision impairments
    • Orthopedic issues (contractures, scoliosis, equiinovarus, hip subluxation)
    • Dental problems
    • Hearing loss
    • Oral motor dysfunction
    • Spatial awareness impairment

    Management of CP

    • Medical Management: Multidisciplinary approach with specialists like an optometrist, physical therapist, etc.
    • Pharmaceuticals: Medications to decrease tone, control seizures, and manage reflux.
    • Surgical Interventions: Gastric tube placement, baclofen pump insertion, correction of orthopedic deformities (such as contractures, tenotomy, tendon lengthening, hip dislocation/subluxation, scoliosis.
    • Common medications: Baclofen, diazepam, dantrolene, botulinum toxin injections, phenol injections.

    Learning Assessment Questions

    • Several questions are presented in the slides, relating to the classification of CP, causes, types, the characteristics of the different kinds of CP, clinical signs, and secondary conditions.

    Pediatric Traumatic Brain Injury

    • Learning objectives covering causes, severity characterization, importance of the Glasgow Coma Scale and Rancho Los Amigos Levels of Cognitive Functioning , treatment plans, and the CDC's updates on pediatric concussions.
    • Types of injury, clinical signs, and classifications of TBI (from mild to severe).
    • Information on the CDC update on mild TBI (concussions), including recognizing symptoms, assessing the child, taking the child to a health care professional, presentations or red flags if a child is sent to an ER/hospital, and education for parents/caregivers.
    • Glasgow Coama Scale.
    • The Rancho Los Amigos Levels of Cognitive Functioning..

    Shaken Baby Syndrome (SBS)

    • Learning objectives for learning about recognition, diagnosis, health-related problems, parent education strategies, conditions involving the event, a child's injury predisposition, short- and long-term health-related issues, reporting suspected child abuse, and the institutional responsibility to report.
    • Pathology of SBS, clinical signs, including pale or blue skin, lethargic eyes, trouble breathing, seizures, sleepiness or lethargy, irritability, vomiting and poor feeding.
    • Medical treatment, physical therapy assessment and intervention techniques.

    Rheumatic Disorders

    • Learning objectives to identify types of juvenile arthritis and intervention techniques.
    • Includes information about juvenile rheumatoid arthritis.
    • Pathology and types of JRA, covering the clinical signs for each type (Pauciarticular, Polyarticular, Systemic). JRA's secondary factors (skeletal abnormalities, ophthalmic considerations).
    • Intervention techniques, including pharmaceutical and physical therapy treatment plans discussed for each type of rheumatic disorder.

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    Description

    Test your knowledge on cerebral palsy (CP) and its connections to prenatal factors. This quiz covers early signs of CP, congenital causes, and risk factors associated with maternal conditions. Challenge yourself to understand the complexities surrounding this neurological condition.

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