Deck 7: Neuromuscular System: Examination, Evaluation, and Diagnoses

Question 1

Which of the following changes in body structures most likely explain the muscle weakness observed in children with cerebral palsy?

A) Decreased type I fast twitch fibers
B) Decreased type II slow twitch fibers
C) Increased number of cross bridges
D) Shortened sarcomeres

Answer 1

A
Explanation: In addition to neural changes caused by cerebral palsy, muscle tissue changes including decreased type I fast twitch fibers can lead to muscle weakness.

Question 2

Which of the following postural strategies would be typically used to maintain balance during a challenging activity?

A) Bilateral ankle dorsiflexion primarily
B) Recruitment of the abdominal muscles prior to that of the tibialis anterior
C) Recruitment of the tibialis anterior prior to that of the abdominal muscles
D) Use of the ankle strategy

Answer 2

B
Explanation: As seen in Figure 7.3B, a hip strategy will be used during challenging balance activities. This strategy requires activation of musculature in the following sequence: proximal to distal sequential activation of the abdominals, quadriceps, and tibialis anterior muscles.

Question 3

Which of the following health conditions would be the most likely diagnosis for a child demonstrating difficulty with socialization, communication, and behavior?

A) Autism spectrum disorder
B) Cerebral palsy
C) Developmental coordination disorder
D) Down syndrome

Answer 3

A
Explanation: The terms autism spectrum disorders and pervasive developmental disorders are used to indicate behavior conditions that exist on a continuum ranging from mild to severe involvement in the areas of socialization, communication, and behavior.

Question 4

Which is the most likely diagnosis for a child presenting with mild hypotonia, muscle weakness that is most pronounced in the hands, poor postural control, motor coordination difficulties, and delayed motor milestone acquisition without cognitive deficits?

A) Cerebral palsy
B) Developmental coordination disorder
C) Down syndrome
D) Hydrocephalus

Question 5

Which of the following home exercise programs would be most effective for children with Down syndrome and developmental coordination disorder to prevent secondary conditions including type 2 diabetes and cardiovascular disease?

A) Baseball
B) Gymnastics
C) Soccer
D) Swimming

Question 6

Which of the following impairments of body function would you expect in a child with Down syndrome?

A) Hypotonicity
B) Muscle atrophy
C) Seizures
S

Question 7

Which of the following statements most accurately defines spasticity?

A) Constant resistance to passive movement
B) Hyperreflexia associated with increased resistance to passive movement
C) Upper motor neuron syndrome
D) Velocity-dependent increased resistance to passive movement

Question 8

When performing a well-child screening for a 1-year old, which of the following signs could indicate a potential diagnosis of autism spectrum disorder?

A) Inability to independently dress
B) Inability to jump down off step
C) Inability to say "ball"
D) Inability to say "Daddy help"

Question 9

Which component of the International Classification of Functioning, Disability, and Health would include the assessment of bed mobility, communication, and self-care?

A) Activities
B) Body functions and structures
C) Health condition
D) Participation

Question 10

Which theory of motor control underlies the use of proprioceptive neuromuscular facilitation quick stretch of the biceps to facilitate elbow flexion?

A) Dynamic systems theory
B) Hierarchical theory
C) Motor programming theory
D) Reflex theory

Question 11

What postural control problem would best explain a decreased ability to lift heavy objects, lean over to retrieve things from the floor, step up onto surfaces without support, step forward, or maintain stance stability with rotation of head and trunk?

A) Adaptive control
B) Proactive control
C) Reactive control
D) Steady-state balance

Question 12

Which of the following activities would be more difficult for a 6-year-old child with developmental coordination disorder at school?

A) Interacting with peers
B) Jumping jacks in physical education class
C) Putting on a coat
D) Sitting in a chair

Question 13

Which component of the International Classification of Functioning, Disability, and Health would include the assessment of ROM, motor function, and sensation?

A) Activities
B) Body functions and structures
C) Health condition
D) Participation

Question 14

Which of the following is a higher risk for adults with Down syndrome than the normal population?

A) Bladder infections
B) Patellofemoral instability
C) Cataracts
D) Rheumatoid arthritis

Question 15

What aspect of postural control is specifically tested by the Functional Reach Test?

A) Anticipatory postural control
B)

Question 16

Which of the following would best describe a typical posture for a child with Down syndrome?

A) Ankle plantar flexion, hip internal rotation, and hip adduction
B) Flat feet, wide base of support, and hyperextended knees
C) Hip external rotation, knee flexion, and ankle dorsiflexion
D) Narrow base of support, hip internal rotation anterior pelvic tilt

Question 17

Which of the following diagnostic pediatric standardized tests would be most appropriate to administer to a 7-year-old child to assist in confirming a diagnosis of developmental coordination disorder?

A) Bruininks-Oseretsky Test of Motor Proficiency-2
B) Developmental Coordination Disorder Questionnaire
C) Movement Assessment Battery for Children
D) Peabody Developmental Motor Scales-2

Question 18

Based upon the available evidence, which of the following interventions would be most effective for an 8-year-old child with developmental coordination disorder working on kicking a ball and hitting a target?

A) Kicking a ball into a goal inside, outside, and outside with peers
B) Kicking a large ball into a small goal
C) Riding a bike around the park
D) Running around obstacles

Question 19

A 4-year-old child is diagnosed with Down syndrome. Which of the following pediatric standardized tests would be most appropriate to administer if the child and family's goal was to improve ability to transfer into and out of a car, walk up and down stairs safely, brush teeth and dress independently, and play interact with peers?

A) Alberta Infant Motor Scale
B) Gross Motor Function Measure
C) Peabody Developmental Motor Scales-2
D) Pediatric Evaluation of Disability Inventory

Question 20

When working with a child with myelomeningocele, you need to remember that there is an increased prevalence of allergy to which of the following items?

A) Latex
B) Milk
C) Peanut
D) Pollen

Question 21

The Glasgow Coma Scale and the Rancho Los Amigos Scale-Levels of Cognitive Functioning are two tests used to measure the child's ability to follow directions, process sensory stimulation, and determine overall basic cognitive and behavioral function in what patient population?

A) Cerebral palsy
B) Down syndrome
C) Myelomeningocele
D) Traumatic brain injury

Question 22

An 8-year-old child diagnosed with cerebral palsy independently walks with bilateral forearm crutches indoors at all times and independently propels a manual wheelchair for long distances outside. He sits in a chair with minimal trunk support at school but is unable to hop, jump, or run. Which of the following Gross Motor Function Classification System levels best describes this child's cerebral palsy?

A) Level I
B) Level II
C) Level III
D) Level IV

Question 23

A 9-year-old child diagnosed with myelomeningocele and hydrocephalus presents with blurred vision, headache, increased spasticity, and lethargy. What is most likely causing these symptoms?

A) Bladder infection
B) Flu
C) Tethered cord
D) Ventricular peritoneal shunt infection/malfunction