Muscle System Development

Brachial Plexus Injury is caused by

baby is stuck in the birth canal or presents with an arm or shoulder or breech birth

why does breech cause brachial plexus injuries

because it is hard because it causes traction on the nerves.

what is erbs palsy

most commmon brachial plexus injury, C5-6, waiters tip postion

What is a problem with erbs palsy

sensory loss is pressetn and neglect is a problem

What are the main muscle problems with erbs palsy

deltoids, biceps, but grasp is intact

Klumpke’s palsy is

brahcial plexus injruy of lower roots C7-T1

Klumpke’s palsy characterisitc

paralysis of wrist flexors, extensors, and intrinsics of wrist and hand (loss of thumb opposition), CLAW HAND, shoudler and elbow are fine

what is the prognosis for brachial plexus injuries

spontaneous recovery, if they don’t use it they lose it,

if tou tranfer a mm it results in an immediate loss of what muscle grade

1 muscle greade

PT assess brachial plexus injury

ROM, strength, educate, GET THEIR HAND TO THEIR MOUTH

Pt treatment for brachial plexus injury

get everything ready for regeneration

spinal muscular atrophy is

progressice degeneration of the cell of the anterior horn

spinal muscular atrophy is the ________ most common fatal disease after_____________

second; cystic fibrouss

spinal muscular atrophy type of genetic disease

inherited autosomal recessive

spinal muscular atrophy all develop

scoli and contactures

type 1 spinal muscular atrophy

acute (most common at 50% SMA) werdnig hoffmann disease

spinal muscular atrophy type 2

childhood onset

spinal muscular atrophy type 3

kugelberg-welander

spinal muscular atrophy type 4

adult onset SMA

TYPE 1 SMA

early onset, progressice loss of anterior horn cells, see in proximal mm and shoulder girdle weakness

no DTR

hypotonic and flaccid paralysis; scoliosis

respiratory complications and restrictive lung disease redults in death within 1-10 years

TPYE 2 SMA

6-18months; similar to type one but slower progressive, mean age of death is 10 yo some can live to adulthood

TYPE 3 SMA

onset is 18 months; often at 8-10yo; proximal shoulder strength is okay, live into adulthood

SMA medical treatment

spinraza is a drug that is fixing it!!!!!! yay!!!

PT treatment for SMA

hit balance between immobilization and strength, get them walking, powerwheel chairs (between 18mons-2year) DO NOT OVERLOAD

Muscular dystrophy is

an inherited disease characterized but progressive weakness of the skeletal and respiratory muscles; degeneration of muscle fibers without evidence of neural degenerationwh

what are the most common types of muscular dystrophy

duchennes, becker, limb-girdle

What is the MOST COMMON muscular dystrophy

Duchenne MD

Duchenne MD

onset 1-4yo: fatal disease mean death at 25yrs, majority of death to pulmonary complications and other due to cardiac disease

duchenne MD characterisitcs

progressice weakness

cardiac involement

static encephalopathy

proximal m wekaness pelvic then shoulder girdle

Clumsy, gowers sign

what is psuedohypertrophy and who gets it

when calf looks big but it is due to fat and fibrous proliferation of the CT; duchenne MD

what is the 1st muscle group is to weakened with duchenne muscle dystrophy and what is the sign

glute max and gower’s sign

IQ of Duchenne MD

average IQ 80

Treatment o DMD

prolong ambulation

what is the surgery for DMD

multilengthening everything and cast

PT and DMD

overload, immobilization, and eccentric is TERRIBLE; use arms to lower; don’t get them to fatique

you need to do respiratory exercises for a pt with DMD what are the 2 best

singing and playing instruments

idiopathic tow walkers genetics?

30-70% usually one parent is a two walker

what is a normal amount of toe walking

intermittent periods of tow walking are normal up to age 3

for ITW what age do they ahve to be over?

3 years old

77% of ITW have speech delay so it may

be more than a Bengin condition

PT has to RULE OUT for ITW

CP (check spasticity), Leg length, DMD, Austim (check communication

what type of ortho are great for ITW

JUMP start kangaroo