JODHPUR AIIMS SNO-2018
Child Health Nursing (Pediatrics)
Easy
Hyper tonicity and scissoring leg movements are expected clinical findings in?
Appeared in: JODHPUR AIIMS SNO-2018
Explanation
- Cerebral Palsy (CP) is a motor disorder caused by damage to the developing brain.
- Hypertonicity, or spasticity, is the most common motor abnormality in CP, resulting from damage to upper motor neurons.
- Scissoring leg movements are a classic sign of spastic CP, caused by severe tightness (spasticity) in the hip adductor muscles, which pulls the legs together and causes them to cross.
Why Other Options Were Wrong
- Option A: Autism is a neurodevelopmental disorder. Its core features are deficits in social communication and the presence of restricted, repetitive behaviors. It is not defined by spasticity or scissoring gait.
- Option C: Mental Retardation (now called Intellectual Disability) is characterized by below-average intelligence and a lack of skills needed for daily living. While it can co-occur with CP, it is a separate diagnosis and does not cause the specific motor signs mentioned.
- Option D: Schizophrenia is a psychiatric illness. Its primary symptoms involve psychosis, such as hallucinations and delusions. While motor disturbances like catatonia can occur, they are different from the spastic hypertonicity seen in CP.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Clinical manifestations of neurological and psychiatric disorders, specifically identifying the classic signs of Cerebral Palsy helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- Nurses play a vital role in managing children with Cerebral Palsy by implementing interventions to manage spasticity, prevent joint contractures through range-of-motion exercises, and ensure safety from falls due to gait instability.
- Early identification of signs like hypertonicity and scissoring is crucial for initiating early intervention services (physical, occupational, and speech therapy) to maximize the child's functional abilities.
- What if? If the child presented with 'hypotonia' (low muscle tone) and poor balance instead, the nurse would suspect a different type of CP, such as ataxic or athetoid CP, which would require different management strategies focusing on stability and coordination rather than managing spasticity.
How to Approach the Question
- First, identify the key clinical signs presented in the question: 'hypertonicity' and 'scissoring leg movements'.
- Recognize these as specific motor system abnormalities. 'Hypertonicity' means high muscle tone (spasticity), and 'scissoring' is a specific type of abnormal gait.
- Systematically evaluate each option to see which disorder classically presents with these specific motor signs.
- Recall or deduce that Autism and Schizophrenia are primarily neurodevelopmental/psychiatric disorders with different characteristic signs.
- Differentiate between Mental Retardation (a cognitive disorder) and Cerebral Palsy (a motor disorder).
- Conclude that the combination of spasticity and a scissoring gait is a hallmark presentation of Spastic Cerebral Palsy.
Concept Tested & Keywords
- Concept Tested: Clinical manifestations of neurological and psychiatric disorders, specifically identifying the classic signs of Cerebral Palsy.
- Stem keywords: Hyper tonicity, scissoring leg movements, clinical findings
- Lead-in keywords: expected
Question ID
QayuFkYneKazI0lCsFSqTM
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 1559-1561, 3898-3900
Practise the full JODHPUR AIIMS SNO-2018
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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