CNS damage before, during, or after birth (80% occur before birth) Prenatal causes: maternal rubella, maternal diabetes, anoxia, toxemia 10% caused during birth by: trauma, asphyxia Postnatal causes: head trauma, meningitis, poisoning
What are the s/s of cerebral palsy?
Inability to suck or keep food in mouth, difficulty in voluntary movements, difficulty separating legs during diaper changes, will use one or both hands but NOT legs
What are some facts regarding SPASTIC cerebral palsy?
It's the most common type of CP, includes hyperactive reflexes, rapid muscle contractions, muscle weakness, underdevelopment of limbs, individuals tend to WALK ON TOES crossing one foot in front of the other.
What are some facts about ATHETOID CP?
It's the second most common, arms are affected more than legs, and body movements increase during stress
What are some facts about ATAXIC CP?
It's a more rare type of CP, nystagmus (eyes jiggle back and forth), tremors, muscle weakness, sudden movements are almost impossible
What are the usual treatments for CP?
CP has NO CURE. Tx involves the entire family & includes: braces, ROM exercirses, orthopedic surgery, medications to control spasticity and seizures. Stem cell transplants have shown remarkable results.
What is the probable cause of sickle cell anemia?
Presence of hemoglobin S in RBCs
What are the s/s of sickle cell anemia?
Anemia, episodes of severe pain called sickle cell crisis, fever, chronic fatigue, tachycardia
What are the usual treatments provided to sickle cell anemia patients?
Pain medications, good hydration, chronic blood transfusions, and bone marrow transplants
What are the probable causes of neural tube defects?
Exposure to radiation and viruses during the FIRST 23 DAYS of gestation, genetic factors, lack of folic acid
What are the s/s symptoms of neural tube defects?
Spina bifida & meningocele may have no neurological deficit Myelomeningocele - permanent neurological damage
What are the usual treatments for neural tube defects?
Spina bifida - none; meningocele and myelomeningocele - surgery
What are the probable causes of Tourette Syndrome?
It's thought to be genetic (autosomal dominant; however no specific gene has been identified), may also be linked to chemicals in the brain, 4 times more likely to occur in boys
What are the s/s of Tourette Syndrome?
Facial tics in early childhood, later other tics may follow including: arm thrusting, throat clearing, jumping, eye blinking, or shoulder shrugging. The use of curse words or inappropriate phrases occurs in only a small # of individuals.
What are the usual treatments of Tourette Syndrome?
With mild symptoms, there may be no treatment. Antipsychotic meds may be used to lessen symptoms; Clonidine (a bp med) has been used to reduce tics, Tetrabenazine is commonly prescribed.
What are the probable causes of hydrocephalus?
May be genetic or a developmental disorder; may be caused by traumatic head injury, diseases such as meningitis or tumors, or intraventricular or subarachnoid hemorrhages.
What are the s/s of hydrocephalus?
Enlarged head, bulging fontanelles
What is the usual treatment of hydrocephalus?
What are the two types of hydrocephalus?
Communicating (faulty absorption) and noncommunicating (obstruction)
What are the probable causes of fetal alcohol syndrome?
Mother drinks EXCESSIVELY during pregnancy. (Majority of children diagnosed with FASD, mother's consumed at least 8-10 drinks per day; women who drank 4-6 drinks per day had children with subtle signs; less than 2 drinks per day seem to not harm the fetus)
What are the s/s of FASD?
Small stature, mild facial abnormalities, poor coordination, hyperactive behavior, poor reasoning and judgment skills, speech and language delays
What are the usual treatments for FASD?
Treatment is symptomatic.
What are the probable causes of pyloric stenosis?
Unknown cause; may be hereditary; one of the MOST COMMON developmental abnormalities of the digestive system
What are the s/s of pyloric stenosis?
Projectile vomiting is classic symptom; sings of dehydration and starvation may be evident
What are the usual treatments for pyloric stenosis?
Surgery - pyloromyotomy (incision and suture of the pyloric sphincter)
What are the probable causes of cystic fibrosis?
Genes - if both parents are carriers of the recessive gene, the child has a 25% chance of having the disease
What are the s/s of cystic fibrosis?
Huge amounts of abnormally thick mucus, especially in lungs
What are the usual treatments for cystic fibrosis?
Supportive; may include generous salting of food, physical therapy, cupping and other techniques to loosen and remove secretions, oxygen therapy
What are the probable causes of Hirschprung's disease (AKA Congenital Aganglionic Megacolon)?
Cause is unknown, appears to be hereditary.
What are the s/s of Hirschprung's disease?
Severe abdominal distention and feeding difficulties; after neonatal period symptoms may include fever, failure to thrive, and explosive watery diarrhea; in adolescense symptoms may include chronic constipation and abdominal distention
What are the usual treatments for Hirschprung's disease?
What are some facts about Hirschprung's disease?
It is an obstruction and dilation of colon with feces due to inadequate intestinal motility; more common in males; may occur with other congenital diseases (Down's Syndrome)
What are the three forms of congenital hip dysplasia?
Unstable hip dysplasia, incomplete dislocation, and complete dislocation
What are the probable causes of congenital hip dysplasia?
Hormonal therapy during birth or incorrect fetal position during birth
How is congenital hip dysplasia diagnosed?
Positive Ortalani's sign (click felt when abduction of the femure of prone infant)
What are the usual treatments for congenital hip dyslpasia?
Surgery (the earlier the BETTER)
What are the types of depression?
Major depression - often results in suicide; Dysthymia - less severe; Postpartum depression - affects 10% of new parents; Season affective disorder - caused by lack of sunlight
Describe major depression
Major depression causes individuals to have feelings of worthlessness, despair, hopelessness, and guilt. They have difficulty sleeping, working, studying, and enjoying life.
What are the s/s of depression?
Predominantly sad mood, along with loss of interest in pleasurable activities, that last more than several days. May seem unhappy and apathetic; have difficulty concentrating and be unable to finish tasks; fatigue and insomnia can occur as well as loss of appetite or overeating
Other pertinent info about depression
Difficult to treat; patients often take themselves off of medications
Psychosis; the most chronic and disabling of the severe mental illnesses; patient hears internal voices or believe that others are controlling their thoughts or are plotting to kill them; 5 different types of schizophrenia; CT scans identify changes associated with schizophrenia
What are the s/s of schizophrenia?
Symptoms are classified as positive or negative. Positive symptoms include: hallucinations, delusions, and disorganized speech; negative symptoms include: alogia (inability to speak owing to a mental condition or symptoms of dementia), attention deficit, and avolition (decreased motivation)
Pertinent info about schizophrenia
Many schizophrenia patients do not adhere strictly to their treatment regimen, especially taking the medications as prescribed
Describe anxiety disorders
Can be crippling; most common mental health problem; affect a person's relationships with others and/or how they relate to their environment
What are the 5 types of anxiety disorders?
Generalized anxiety disorder - excessive, unrealistic worry lasting > 6 months; Obsessive-complusive disorder - perform ritualistic behaviors (affects women 2x as much as men); panic disorder - most severe form, mimics heart attack (affects women 2x as much as men); PTSD - common in military personnel and victims of violent attacks, victims suffer 1)flashbacks/nightmares, 2)avoidance of place related to trauma, and 3)emotional numbing or attachment to others; phobias - irrational fear of a particular thing
Pertinent info about anxiety disorders
Treatment can be complicated because these disorders are often accompanied b y depression and substance abuse; very common and highly treatable but only 1/3 of affected people seek treatment
Describe eating disorders
Anorexia nervosa - self-imposed starvation, irrational fear of gaining weight, DEATH may occur; Bulemia nervosa - gorging and then purging of food, may include laxative use or use of diuretics
What are the s/s of anorexia nervosa?
Loss of at least 25% of original body weight in absence of a detectable underlying medical disorder
What are the s/s of bulemia nervosa?
High incidence of dental decay
Describe autism spectrum disorders
Asperger's syndrome - mild version Rett syndrome - normal early development followed by loss of purposeful use of hands, gait abnormalities Childhood disintegrative disorder - develop normally until age 3 or 4, hen lose social and communication skills severe - most severe type
What causes autism spectrum disorders?
NO KNOWN CAUSE but there's a great deal of speculation
What are the s/s of autism spectrum disorders?
Delays in socialization and communication
What are the typical treatments for autism spectrum disorders?
Behavioral therapies, medications to treat depression and anxiety
Describe bipolar disorder
AKA manic depressive disorder; characterized by cycling mood changes from severe highs (mania) to severe lows (depression); tends to run in families; treated with mood stabilizing medications; prognosis complicated by: substance abuse, financial problems, difficulties in relationships, suicide
What is lordosis?
Abnormal inward curvature (swayback)
What is kyphosis?
Abnormal outward curvature (humpback)
What is scoliosis?
Abnormal sideways curvature (S shape)
What is kyphoscoliosis?
Combination of kyphosis and scoliosis, most severe type and can cause cardiac and pulmonary dysfunctions due to the "squishing" of the area that houses the lungs and heart
What are the typical causes and usual treatments for deformities of the spine?
Causes - congenital defects, poor posture, idiopathic, different leg lengths; treatments - PT, exercise, back braces, surgery, analgesics for the brain (emotional support is essential)
What is a herniated intervertebral disc?
AKA "slipped disc" or "ruptured disc"; causes pressure on spinal nerves resulting in pain and disability; most common sites: 4th&5th lumbar and 5th lumbar&1st sacral vertebra; more common in men; 1 in 50 people will have this problem
What are the typical causes, s/s and usual treatments for deformities of the spine?
Causes - spinal trauma from a fall, straining or heavy lifting; s/s - sciatic nerve pain worsened by coughing, sneezing, or bending; tx - bedrest, traction of LE, back brace, surgical removal of herniated disc
What causes fractures?
How are fractures diagnosed?
What are typical treatments for fractures?
Immobilization, open reduction (surgery), closed reduction (non-surgical)
What are complications of fractures?
What are the different types of fractures?
Closed simple fracture - no external wound Open or compound fracture - portion of bone protrudes through skin Greenstick - bone is partially bent and split (occurs most frequently in children) Comminuted - bone is splintered into pieces and embedded in surrounding tissue Impacted - one of the broken ends is forced into the interior of the other Incomplete partial fracture - stress (doesn't include whole bone)
"wear and tear" disease, increases with age; most common type of arthritis; affects both sexes equally; degeneration of joint cartilage (hip and knee joints are most commonly affected); NO known prevention; NO known cure
What are the accepted treatments for osteoarthritis?
Pain relief, injection of artificial joint fluid, PT, hip or knee replacement surgery
Describe rheumatoid arthritis
Chronic inflammatory disease affecting synovial membranes of multiple joints, destroys cartilage, erodes bone, and deforms joints; characterized by spontaneous remissions and exacerbations; NOT an "old person's disease"; cause is unknown but thought to be autoimmune
What are the acceptable treatments for rheumatoid arthritis?
Reduce inflammation and pain, preserve joint function, prevent deformity; lifelong treatment is necessary and RA requires major lifestyle changes
What is osteomyelitis?
An infection of the bone forming tissue; more common in children
What are the probable causes of osteomyelitis?
Trauma resulting in formation of hematoma & development of staph infection; prosthetic hardware in the bone, diabetics, dialysis patients, IV drug abusers are high risk
What are the accepted treatments of osteomyelitis?
Get rid of infection; bedrest and parentally administered antibiotics; often suffice; surgical drainage to remove pus and dead bone may be necessary
What is a migraine?
A recurrent, incapacitating headache often accompanied by nausea and vomiting; caused by constriction and dilation of cerebral arterioles; may be hereditary; certain foods can trigger an attack
What are the s/s of a migraine?
Premonitory symptoms include flashing lights, buzzing in the ear, unusual craving for sweet foods. Once the pain of an attack begins it is usually accompanied by photophobia, N & V
What are the acceptable treatments for migraines?
Pain medication, bedrest in a darkened room; NO CURE; NO PREVENTION
What are the s/s of a spinal cord injury?
Total or partial loss of motor and sensory functions, including bowel, bladder & sexual function
Spinal cord injuries above C3 result in ________.
What are accepted treatments for spinal cord injuries?
Restore spinal alignment, stabilize injured spine, decompress structures, early rehab
What is peripheral neuropathy?
AKA peripheral neuritis; degeneration of the nerves supplying the distal muscles of the extremities causing loss of sensation, pain, inability to control muscle; diabetic neuropathy is the most common cause
What are the s/s of peripheral neuropathy?
(slow) muscle weakness, tenderness & pain, loss of reflexes, clumsiness
How is peripheral neuropathy treated?
Depends on identifying the underlying cause and treating or curing it; analgesics and bedrest are essential, PT, OT, and orthopedic interventions may be recommended
What is Bell's Palsy?
A disorder of the facial nerve (7th cranial nerve) causing paralysis of the muscles of one side of the face; cause is unknown; s/s - facial weakness, drooping mouth, drooling saliva, eye doesn't close completely
What are accepted treatments of Bell's Palsy?
Usually goes away on its own in 1-8 weeks; antiviral meds and anti-inflammatory drugs may be prescribed if the cause is found to be viral; electrical stimulation, massage, warm moist heat, and analgesia may be prescribed
What is a cerebrovascular accident?
Stroke; 2 types - occlusion (ischmic) - 70%-80% and bleeding (hemorrhagic) - death is more common with this type
What are the s/s of CVA (stroke)?
Unilateral weakness, paralysis, speech impairment, gait disturbance... (depends on the portion of the brain affected)
What are the accepted treatments for CVA (stroke)?
Depends on the severity and type; ischemic - meds can be given within a specific time period to break up the blood clot
What is epilepsy?
Chronic brain disorder with recurring attacks of abnormal sensory, motor, and psychological activity; can begin at any age; generally the cause is unknown
What are the s/s & Rx for epilepsy?
S/S - "aura" followed by seizure; Rx - anticonvulsant meds
Describe alzheimer's disease
A chronic, ultimately fatal, organic syndrome
What are the s/s of alzheimer's disease?
Progressive memory impariment followed by deterioration of judgment, reasoning ability, & other cognitive skills (occur in stages: early stage, progressive stage, terminal stage)
What are accepted treatments for alzheimer's?
No cure but 2 different types of meds are used to treat cognitive problems, 1)cholinersterase inhibitors and 2)memantine
Describe Parkinson's disease
Chronic disease characterized by progressive muscle rigidity and involuntary tremors; cause is unknown but related to deficiency of dopamine