Provide quick answers for the following regarding: Polio 1. Define diagnosis and
ID: 3479260 • Letter: P
Question
Provide quick answers for the following regarding: Polio
1. Define diagnosis and review neuroanatomical correlates (e.g., brain regions involved)
2. Determine cognitive, motor, perceptual, sensory deficits
3. Review how the diagnosis would impact perception and action development
4. How would you adapt a Physical Education Class to accommodate a
7 year old child with this diagnosis, considering the structural, task and
environmental constraints?
5. Would a separate perceptual-motor program be helpful? What would
you include? Would you refer this individual to a specialist?
Explanation / Answer
answer to part 1
Paralytic poliomyelitis
Poliovirus spreads along certain nerve fiber pathways, preferentially replicating in and destroying motor neurons within the spinal cord, brain stem, or motor cortex. This leads to the development of paralytic poliomyelitis.
The destruction of neuronal cells produces lesions within the spinal ganglia; these may also occur in the reticular formation, vestibular nuclei, cerebellar vermis, and deep cerebellar nuclei. Inflammation associated with nerve cell destruction often alters the color and appearance of the gray matter in the spinal column, causing it to appear reddish and swollen. Other destructive changes associated with paralytic disease occur in the forebrain region, specifically the hypothalamus and thalamus.
Spinal polio
results from viral invasion of the motor neurons of the anterior horn cells, or the ventral (front) grey matter section in the spinal column, which are responsible for movement of the muscles, including those of the trunk, limbs, and the intercostal muscles.Virus invasion causes inflammation of the nerve cells, leading to damage or destruction of motor neuron ganglia. When spinal neurons die, Wallerian degeneration takes place, leading to weakness of those muscles formerly innervated by the now-dead neurons.
Bulbar polio
bulbar polio occurs when poliovirus invades and destroys nerves within the bulbar region of the brain stem. The bulbar region is a white matter pathway that connects the cerebral cortex to the brain stem. The destruction of these nerves weakens the muscles supplied by the cranial nerves, producing symptoms of encephalitis, and causes difficulty breathing, speaking and swallowing.Critical nerves affected are the glossopharyngeal nerve, the vagus nerve, accessory nerve.
Bulbospinal polio
the virus affects the upper part of the cervical spinal cord (cervical vertebrae C3 through C5), and paralysis of the diaphragm occurs. The critical nerves affected are the phrenic nerve (which drives the diaphragm to inflate the lungs) and those that drive the muscles needed for swallowing.
Diagnosis
Paralytic poliomyelitis may be clinically suspected in individuals experiencing acute onset of flaccid paralysis in one or more limbs with decreased or absent tendon reflexes in the affected limbs that cannot be attributed to another apparent cause, and without sensory or cognitive loss.
A laboratory diagnosis is usually made based on recovery of poliovirus from a stool sample or a swab of the pharynx. Antibodies to poliovirus can be diagnostic, and are generally detected in the blood of infected patients early in the course of infection. Analysis of the patient's cerebrospinal fluid (CSF), which is collected by a lumbar puncture ("spinal tap"), reveals an increased number of white blood cells (primarily lymphocytes) and a mildly elevated protein level. Detection of virus in the CSF is diagnostic of paralytic polio, but rarely occurs.
If poliovirus is isolated from a patient experiencing acute flaccid paralysis, it is further tested through oligonucleotide mapping (genetic fingerprinting), or more recently by PCR amplification, to determine whether it is "wild type" (that is, the virus encountered in nature) or "vaccine type" (derived from a strain of poliovirus used to produce polio vaccine).
Answer to part 2
In most people with a normal immune system, a poliovirus infection is asymptomatic. Rarely, the infection produces minor symptoms; these may include upper respiratory tract infection (sore throat and fever), gastrointestinal disturbances (nausea, vomiting, abdominal pain, constipation or, rarely, diarrhea), and influenza-like illness.
Most patients with CNS involvement develop nonparalytic aseptic meningitis, with symptoms of headache, neck, back, abdominal and extremity pain, fever, vomiting, lethargy, and irritability. About one to five in 1000 cases progress to paralytic disease, in which the muscles become weak, floppy and poorly controlled, and, finally, completely paralyzed; this condition is known as acute flaccid paralysis.
Individuals who have recovered from paralytic polio in childhood can develop additional symptoms decades after recovering from the acute infection, notably new muscle weakness and extreme fatigue. This condition is known as post-polio syndrome (PPS) or post-polio sequelae. The symptoms of PPS are thought to involve a failure of the oversized motor units created during the recovery phase of the paralytic disease.
Answer to part 3
Once the polio diagnoses, a proper treatment plan is started.
Most patients recover completely, but many suffer from post polio syndrome and permanent paralysis.
The action development involves active participation of the patient and raising his quality of life.
physical therapy as well as recreational activities play a key role in rapid recovery of patient as well as mental upliftment. Providing proper employment is also necessary.
Answer to part 4
A physical education class of a 7 year old child should involve proper education about the disease along proper exercise plan for the child.
the child should be well educated about the disease and his mediacal condition. he should be taught self care. The physical educator should work on making the child as independent as possible.
exercise plan should include playfull activities such as peg board activities for hand movements, parallel bar for gait correction, trampoline for sensory stimulus as well as balance, BEPS board for balance training.
any architectural barriers should be avoided. the entrance should have ramps instead for staircase. hand rails should be installed for support where ever needed.
wheelchair facilities should be provided.
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