Hypertonicity and scissoring leg movements are expected clinical findings in?

JODHPUR AIIMS SNO-2018

Child Health Nursing (Pediatrics)

Easy

Appeared in: JODHPUR AIIMS SNO-2018

Explanation

Hypertonicity, or increased muscle tone, is a cardinal sign of spastic cerebral palsy, the most common type of CP.
Scissoring of the legs occurs when an infant is held by the axillae; the legs adduct and cross due to severe spasticity in the hip adductor muscles.
These signs are due to damage to the developing brain's motor cortex, which controls muscle tone and movement.
Spastic diplegia, a form of CP often associated with prematurity, characteristically involves bilateral spasticity of the legs that is greater than in the arms, leading to a scissoring gait.

Option A: Autism is a neurodevelopmental disorder primarily affecting social interaction, communication, and behavior. While motor coordination issues can be present, hypertonicity and scissoring are not characteristic features.
Option C: Mental retardation, now termed Intellectual Disability, involves significant limitations in intellectual functioning and adaptive behavior. It does not inherently cause hypertonicity or scissoring, although it is a common comorbidity in children with severe cerebral palsy.
Option D: Schizophrenia is a severe mental health disorder characterized by psychosis (hallucinations, delusions) and disorganized thought. It does not present with hypertonicity and scissoring legs. While catatonic schizophrenia can involve motor abnormalities like rigidity, it is distinct from the spasticity seen in CP.

Clinical Relevance

Nursing practice connection: Knowing Clinical manifestations of Cerebral Palsy helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Early recognition of signs like hypertonicity and scissoring is critical for a timely diagnosis of cerebral palsy, enabling early intervention services that can significantly improve long-term outcomes.
Nurses play a key role in developmental screening, identifying these motor abnormalities during routine infant check-ups, and educating families about the condition and management plan.
A key nursing responsibility is managing spasticity to prevent painful muscle contractures, which can lead to fixed deformities and require surgical correction. This involves physiotherapy, proper positioning, and administering muscle relaxant medications.

How to Approach the Question

First, identify the key clinical signs presented in the question: 'hypertonicity' and 'scissoring leg movements'.
Recall the pathophysiology of common pediatric neurological disorders.
Analyze each option: Autism is primarily a behavioral and communication disorder. Mental retardation (Intellectual Disability) is a cognitive disorder. Schizophrenia is a psychiatric disorder.
Recognize that hypertonicity and scissoring are classic motor signs resulting from upper motor neuron damage.
Connect these specific motor signs to Cerebral Palsy, particularly the spastic type, which is characterized by increased muscle tone and abnormal movement patterns.
Select Cerebral Palsy as the condition that most directly aligns with the described physical findings.

Concept Tested & Keywords

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 578-580

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1496-1498