Podcast
Questions and Answers
Which of the following is NOT considered a causative factor for postnatal complications?
Which of the following is NOT considered a causative factor for postnatal complications?
Which of the following conditions is associated with postnatal complications?
Which of the following conditions is associated with postnatal complications?
What is one of the cerebrovascular incidents related to postnatal complications?
What is one of the cerebrovascular incidents related to postnatal complications?
What factor can lead to malnutrition, potentially impacting postnatal health?
What factor can lead to malnutrition, potentially impacting postnatal health?
Signup and view all the answers
Which infectious disease is listed as a concern for postnatal complications?
Which infectious disease is listed as a concern for postnatal complications?
Signup and view all the answers
What marks the transition from simple spinal reflexes to more complex movements?
What marks the transition from simple spinal reflexes to more complex movements?
Signup and view all the answers
Which of the following describes primitive brain stem reflexes?
Which of the following describes primitive brain stem reflexes?
Signup and view all the answers
What happens when there is a failure to suppress primitive brain stem reflexes?
What happens when there is a failure to suppress primitive brain stem reflexes?
Signup and view all the answers
How are movements typically developed in the human body?
How are movements typically developed in the human body?
Signup and view all the answers
Which statement is true regarding spinal reflexes?
Which statement is true regarding spinal reflexes?
Signup and view all the answers
What areas of the body are primarily affected by generalized weakness in severe CP?
What areas of the body are primarily affected by generalized weakness in severe CP?
Signup and view all the answers
What characteristic is NOT typically associated with paresis?
What characteristic is NOT typically associated with paresis?
Signup and view all the answers
Which of the following best describes the movement patterns in individuals with paresis?
Which of the following best describes the movement patterns in individuals with paresis?
Signup and view all the answers
What does 'lack of fraction of movement' in paresis imply?
What does 'lack of fraction of movement' in paresis imply?
Signup and view all the answers
Which of the following is a feature associated with slowness in paresis?
Which of the following is a feature associated with slowness in paresis?
Signup and view all the answers
What type of cerebral palsy is described as having less marked symptoms due to the diffuse nature of the lesion?
What type of cerebral palsy is described as having less marked symptoms due to the diffuse nature of the lesion?
Signup and view all the answers
Which type of movements are confined specifically to athetosis in cerebral palsy?
Which type of movements are confined specifically to athetosis in cerebral palsy?
Signup and view all the answers
Which of the following does NOT typically occur in cerebral palsy?
Which of the following does NOT typically occur in cerebral palsy?
Signup and view all the answers
Which statement accurately reflects the movement characteristics in cerebral palsy?
Which statement accurately reflects the movement characteristics in cerebral palsy?
Signup and view all the answers
What kinds of movement may occur in cerebral palsy?
What kinds of movement may occur in cerebral palsy?
Signup and view all the answers
What describes a characteristic symptom of athetosis in children regarding muscle tone?
What describes a characteristic symptom of athetosis in children regarding muscle tone?
Signup and view all the answers
Which of the following is NOT a common physical problem observed in children with athetosis?
Which of the following is NOT a common physical problem observed in children with athetosis?
Signup and view all the answers
How do involuntary movements present in children with athetosis?
How do involuntary movements present in children with athetosis?
Signup and view all the answers
Which of the following areas is least affected by athetosis-related muscle tone fluctuations?
Which of the following areas is least affected by athetosis-related muscle tone fluctuations?
Signup and view all the answers
What is a typical muscle problem noted in children diagnosed with athetosis?
What is a typical muscle problem noted in children diagnosed with athetosis?
Signup and view all the answers
What is suggested to occur alongside the activation of antagonistic muscles according to Rood's approach?
What is suggested to occur alongside the activation of antagonistic muscles according to Rood's approach?
Signup and view all the answers
What process is suggested to occur after repeated contractions of spastic muscles in Rood's approach?
What process is suggested to occur after repeated contractions of spastic muscles in Rood's approach?
Signup and view all the answers
In Rood's approach, what is the relationship between agonists and antagonists during muscle activation?
In Rood's approach, what is the relationship between agonists and antagonists during muscle activation?
Signup and view all the answers
What is the main focus of Rood's approach regarding muscle function?
What is the main focus of Rood's approach regarding muscle function?
Signup and view all the answers
What happens to shortened muscles when their antagonists are activated, based on Rood’s findings?
What happens to shortened muscles when their antagonists are activated, based on Rood’s findings?
Signup and view all the answers
Study Notes
Cerebral Palsy (CP)
- CP is a group of conditions characterized by permanent motor dysfunction
- Caused by non-progressive brain damage in early life
- Often accompanied by emotional, social, and family difficulties
- Severity ranges from total dependence to independent self-care, walking, running, etc.
- It's a neurodevelopmental impairment
- Caused by a non-progressive lesion in single or multiple locations in the immature brain
- The lesion leads to persistent movement and posture disorders in infants
- Not a single disease but a group of neurological disorders with varied causes
Etiology (Causes)
- CP can occur as a developmental defect or as a result of insult or trauma to the fetal or infant's brain
- Prenatal causes can include:
- Viral infections (e.g., rubella)
- Exposure to radiation
- Drug use
- Genetic abnormalities leading to brain malformations
- Vascular insufficiency during fetal development
- Perinatal causes (during birth):
- Injuries during birth (e.g., breech or forceps delivery)
- Asphyxia
- Premature or low birth weight babies
- Postnatal causes (after birth):
- Accidents
- Infections of the central nervous system (CNS)
- Other infections (e.g., encephalitis, measles, anoxia, and post-epilepsy)
- Cerebrovascular accidents
- Malnutrition
Possible Causes (in detail)
- Problems During Pregnancy (60%):
- Prematurity
- Lack of oxygen (O2)
- Trauma
- Rh incompatibility, blood incompatibility
- Mothers age or infections and metabolic problems or exposing to X-ray's
- Problems During Delivery (30%):
- Lack of oxygen (O2) during labor
- Cord around the neck
- Rh incompatibility, or incompatible blood, not treated.
- Sudden pressure changes during delivery
- Pelvic obstructions
- Mothers age or infections
- Problems During Infancy (10%):
- Fractures
- penetrating wounds
- CNS infections
- Anoxia (lack of O2)
Motor Dysfunction
- Brain damage leads to disorganized and delayed development of neurological mechanisms
- Problems in postural control, balance, and movement.
- Resulting in inefficient and uncoordinated muscle activation
- Can involve hypertonic or hypotonic muscles, with weakness.
- This can involve:
- Seizers
- Difficulty sucking/feeding
- Peg teeth
- Mental retardation
- Delay in motor skill development
- Dysarthria
- Visual/hearing abnormalities
Classification of CP
- Based on clinical signs:
- Spastic type (hemiparasis, diplegia, quadriparesis): About 70%
- Dyskinetic form (athetosis, dystonia, chorea, ballismus, tremor): About 20-25%
- Rare types (ataxia, rigidity, atonia)
- Mixed type
- Topographical classification:
- Quadriplegia (involvement of all four limbs)
- Diplegia (more involvement in legs than arms)
- Paraplegia (involvement of both legs)
- Triplegia (involvement of three limbs)
- Hemiplegia (involvement of one side of the body)
- Monoplegia (involvement of one limb)
Types of Muscle Tone Disturbance
- Hypotonia
- Hypertonia
- Fluctuating Tone
Physical Problems (Spasticity)
- Low tone in trunk muscles
- Spasticity in extremities
- Incomplete righting reflexes
- Maintaining extremities in mid-range
- Stereotypical (patterned) movement
- Slow movement
- Associated reactions
- Deformities from muscle/joint tightness
- Fear of movement
Physical Problems (Athetosis)
- Fluctuating muscle tone, more pronounced in limbs compared to head/trunk
- Muscle spasms
- Involuntary movements
- Inability to contain movement segments
- Lack of muscle co-contraction/gradation
- Asymmetry in both posture and movement
- Limited lower limb involvement
- Movement/control of head affects rest of the body
- Incomplete righting/equilibrium reactions
Physical Problems (Ataxia)
- Usually hypotonic, some can exhibit increased tone
- Poor co-contraction/sustained posture holding
- Dysmetria (difficulty with fine motor control)
- Present righting/equilibrium/protective reflexes, but poorly coordinated
Physical Problems (Hypotonia)
- Severe hypotonia or flaccidity present in some cases
- Can be transient or become spasticity or athetosis
- May be present with abducted, externally rotated, flexed arms and legs
- Lack of head control
- Protective side turning and kicking may be absent
- Respiratory issues (shallow respiration) dysphagia and drooling are typical
Complications of CP
- Seizures
- Injuries from mobility
- Reduced mobility
- Reduced communication skills
- Reduced intellect
- Social stigmatization
Motor Disorders in CP
- Postural fixation disorders
- Primitive brain stem reflex failure
- Tone disorders
- Paralysis of voluntary movements
- Involuntary movements
- Failure of cortical reactions development
Disorder of Postural Fixation
- Defective postural fixation – Inability to maintain an upright head & trunk position
- Most important & apparent defect (except mildest forms of hemiplegia)
- In early life, the disorder will be most apparent due to the child's inability to perform voluntary movements due to posture defects
Failure of Suppression of Primitive Brain Stem Reflexes
- Normal movement development flows from simple, spinal reflexes to higher/complex patterns
- Brain damage affects more intricate movements, simpler reflexes may persist
- These crude reactions are centered in the brain stem.
Tonic Labyrinthine Reflex
- This reflex affects tone throughout the body and is triggered by head position relative to gravity.
- Extensor tone is maximal when the individual is supine.
- Flexor tone is maximal in the prone position.
Tonic Neck Reflexes
- This reflex is determined by head position-related extension or flexion of the neck.
- The reflexes determine if the head is positioned in extension/flexion affecting the response & movement of the opposite arm & leg.
Moro Reflex
- It's an important primitive reflex in infants observed by wide spread arm abduction
- Response assists in maintaining bodily security during the first inspiration to ensure survival.
- Its absence or presence beyond 4 months might indicate abnormal development
- This reflex can interfere with posture control & sitting.
Clinical Signs of CP
- Feeding difficulties (suck/swallow/lack of interest)
- Gaze abnormalities (fixation/delayed smiling)
- Tone abnormalities (reduced/increased)
- Behavioral abnormalities (irritability, anxiety, lack of interest in sounds or visual cues, and sleep disturbance)
- Delayed postural development and asymmetry in head/trunk
- Uneven development of movement or tone
- Delayed motor development
Management of CP in Children
- Early diagnosis crucial for early treatment and better outcomes
- Management involves multiple disciplines (pediatrics, neurology, psychology, social work, PT, OT, education, orthopaedics, ophthalmology, nursing)
- Assessment establishes developmental and functional levels.
- A profiling of strengths/weaknesses for the child helps with individualized management planning
Assessments for CP
- Medical assessment (MRI/CT, hearing/visual testing, blood tests, EEG)
- Physical assessment, history-taking , reflexes, tone, fine/gross motor, feeding, sensory, musculoskeletal
- Neuropsychiatric assessment (Stanford-Binet Intelligence Scale, McCarthy Scales of Children's Abilities, Bayley Scales of Infant Development, Vineland Social Maturity Scale)
- Speech/language assessment: includes oral motor skills, speech production, cognitive-linguistic function
General Principles of Treatment
- Teamwork amongst all disciplines involved
- Repetition of motor activities
- Understanding of individual needs and abilities
- Early treatment and child motivation
- Parental involvement
Treatment Techniques
- Bobath technique (neurodevelopmental approach)
- aims to inhibit abnormal reflexes and facilitate normal movement
- focus on normal motor development sequences
- Rood's approach
- emphasizes controlled sensory stimulation
- uses autogenetic sequences of activity
- focuses on activity, input, and functional outcomes
- Temple Fay approach (progressive pattern movements)
- Phelps technique (orthopaedic)
- Deaver technique (muscle education/braces)
- Phol technique (muscle education)
- Schwartz technique (environmental simplification for motivation)
- Gillette technique (stretching and exercises for alignment)
- Irene Collis (mental capacity and early treatment approach)
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Test your knowledge on postnatal complications and their associated factors. This quiz covers causative agents, related conditions, and neurological aspects that impact postnatal health. Challenge yourself and assess your understanding of this important topic.
