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CMT Exam/Eval Questions with
100% Correct Answers | Verified
for Latest Update
What 9 specific health history factors should be obtained prior to an initial screening of a child w/CMT? - ✔✔
- age at initial onset
- age at onset of symptoms
- pregnancy hx including mom's sense of baby being "stuck" last 6 weeks
- delivery hx including birth presentation or multiple births
- use of assistance during delivery
- head posture/preference and changes in head/face
- family hx of torticullis or other congenital/developmental conditions
- other known/suspected med conditions
- developmental milestones appropriate for age What are MSK conditions that mimic CMT? - ✔✔Klippel-Feil syndrome clavicle fx congenital scoliosis C1-2 rotary subluxation
What are neurological causes of asymmetrical posturing related to CMT? - ✔✔brachial plexus injury, CNS lesions, astrocytoma, brain stem or cerebellar gliomas, agenesis of CNS structures, hearing impairments
- acute pain responses on cervical movement
- tissue masses outside of the SCM or in other areas of the body
- children with Down syndrome
- C1-C2 cervical spine instability
- late onset of a head tilt with known symmetry for the first few months of life
- stridor, wheezing, SOB, cyanotic lips What needs to be done as part of the MSK systems review with CMT? - ✔✔symmetrical shape of face/skull/spine symmetrical alignment of shoulder and hip girdles c-spine vertebrae anomalies rib cage symmetry DDH (developmental hip displasia) symmetrical PROM of neck palpation for SCM masses or restricted movement What needs to be done as part of the neuro systems review with CMT? - ✔✔- abnormal or asymmetrical tone
- retention of primitive reflexes
- resistance to movement
- cranial nerve integrity
- brachial plexus injury
- temperament (irritability, alertness)
- achievement of age-appropriate developmental milestones inclusive of cognitive and social integration w/in family setting
- visual screen comprising symmetrical eye tracking in all directions, noting visual field defects and nystagmus as potential ocular causes of asymmetrical postures What needs to be done as part of the integ systems review with CMT? - ✔✔- skinfold symmetry of the hips and cervical regions
- color and condition of skin w/special attention to signs of pressure and trauma that might cause asymmetrical posturing What needs to be done as part of the cardiorespiratory systems review with CMT? - ✔✔-symmetrical coloration
- rib cage expansion
- clavicle movement to r/o conditions that might cause asymmetrical posturing
- acute upper respiratory tract distress What are causes of acquired torticullis? - ✔✔ocular lesions benign paroxysmal torticollis dystonic syndromes infections Arnold-Chiari malformation syringomyelia posterior fossa tumors
AIMS
PDMS- 2
Argenta's classical classification Motor Function Scale goes from ___ to ___. - ✔✔ 0 - 5 What score is this on the Motor Function Scale? <0 degrees below horizontal line - ✔✔ 0 What score is this on the Motor Function Scale? 0 degrees on horizontal line - ✔✔ 1 What score is this on the Motor Function Scale? 0 - 15 degrees head above horizontal line - ✔✔ 2 What score is this on the Motor Function Scale? 15 - 45 degrees head above horizontal line - ✔✔ 3 What score is this on the Motor Function Scale? 45 - 75 degrees head above horizontal line - ✔✔ 4 What score is this on the Motor Function Scale?
75 degrees above horizontal line - ✔✔ 5 Use ______ for infants <4 months old and _____ for infants >4 months old. (tests and measure) - ✔✔TIMP; AIMS With left SCM CMT, cervical lateral flexion is restricted to the: - ✔✔left With right SCM CMT, cervical lateral flexion is restricted to the: - ✔✔right With left SCM CMT, cervical rotation is restricted to the: - ✔✔right With right SCM CMT, cervical rotation is restricted to the: - ✔✔left With left SCM CMT, frontal flattening occurs on the _____ side. - ✔✔left With right SCM CMT, frontal flattening occurs on the _____ side. - ✔✔right With left SCM CMT, occipital flattening occurs on the _____ side. - ✔✔right With right SCM CMT, occipital flattening occurs on the _____ side. - ✔✔left With left SCM CMT, jaw retraction occurs on the _____ side. - ✔✔left
muscular tightness; loses 15-30 degrees c-spine rotation - ✔✔grade 2 (early moderate) What grade of CMT severity is this? muscular tightness; loses >30 degrees cervical rotation or has SCM nodule - ✔✔grade 3 (early severe) What grade of CMT severity is this? muscular tightness and >15 degrees cervical rotation lost at 7-9 months OR 15-30 degrees cervical rotation lost at 10-12 months - ✔✔grade 6 (late severe) What grade of CMT severity is this? SCM nodule at 7-9 months OR 10-12 months, muscular tightness and >30 degrees cervical rotation lost - ✔✔grade 7 (late extreme) What grade of CMT severity is this? any asymmetry, including postural preference, any difference b/t sides in passive cervical rotation or SCM mass - ✔✔grade 8 (very late) Summarize prognostic indicators. - ✔✔- age of initiation of treatment
- classification of severity
- SCM nodule location and size
- intensity of intervention
- presence of comorbidities
- rate of change
- adherence to HEP What 5 factors indicate full or complete resolution of CMT symptoms? - ✔✔1) participation in PT intervention
- younger age at initiation of treatment
- decreased difference in cervical rotation PROM between sides
- decreased difference in SCM muscle thickness between sides
- the caregiver's ability to frequently implement an HEP of active positioning and passive stretching What amount of resolution will the following child have from CMT? <3 months old, early referral, caregivers adherent w/HEP - ✔✔100% What amount of resolution will the following child have from CMT? 3 - 6 months of age - ✔✔75% What amount of resolution will the following child have from CMT? 6 - 18 months of age - ✔✔30% What is the length of care if patient is <3 months old? - ✔✔1.5-3 months What is the length of care if patient is >3 months old? - ✔✔ 3 - 6 months
List the signs that an infant/child with CMT is not progressing with PT intervention. - ✔✔- asymmetries of head/neck/trunk not resolving after 4-6 weeks of initial intense treatment
- after 6 months of treatment w/only moderate resolution
- older than 12 months on initial exam, facial asymmetry, 10-15 degrees difference persists b/t sides
- older than 7 months on initial exam and tight band or SCM mass present
- side of torticullis changes If the side of torticullis changes, this indicates what other condition? - ✔✔Klippel-Feil syndrome What are d/c criteria from PT intervention? - ✔✔- full PROM w/in 5 degrees of uninvolved side
- symmetrical AROM patterns throughout PROM
- age-appropriate motor development including symmetrical movement patterns b/t sides during static, dynamic, and reflexive movements
- no visible head tilt
- parents/caregivers know what to monitor as child grows (growth spurts = ROM decrease or head tilt returns) What are follow-up recommendations? - ✔✔ 3 - 12 months post-d/c
- positional preference
- structural and movement symmetry of neck, face, head, trunk, hips, UEs & LEs
- developmental milestones check for those
