07 Neuromuscular Dysfunction Flashcards
CP is a term that describes what?
A group of permanent disorders of the development of movement nad posture, causing activity limitation, that are attributed to non progressive disturbances that occurred in the developing fetal or infant brain.
Most common permanent physical disability in childhood
What are some associated factors with CP?
Maternal Infections
Drug/alcohol use
Anemia
Rubella
ABO
Post natal causes like bacterial meningitis and traumatic brain injury
KNOW: What is a primary goal of neuromuscular dysfunction?
A primary goal is to promote normal neuromuscular postures.
Promote nutrition, socialization, educational opportunities and integration of motor function
What is Spina Bifida Occulta?
A type of NT defect. It’s a non visible vertebra defect with spinal cord and meninges intact.
Skin indicators: Sacral dimple, absence of that spine
What is Spina Bifida Cystica?
Visible defect with external sac like protrusion
What are two types of spina bifida cystica?
- Meningocele
- Meningomyelocele/Myelomeningocele
What is a meningocele?
- The sac has meninges and spinal fluid but no neural elements
- Most kids have no neurologic deficiits because there are no nerves and no cord involvement
What is a myelomeningocele?
- Sac contains meninges, spinal fluid and nerves. Sac may be a fine membrane and prone to leakage of CSF, easily ruptured.
What neurologic deficit occurs in myelomeningocele?
- Deficit and weakness is present below the defect, with bowel and bladder dysfunction.
- Clubfeet and disloacted hip and hydrocephalus may accompany. early treatment increases the chances for normal cognitive ability
- Bladder sphincter and muscle tone affected as result of defective nerve supply
- Fetal surgery may be an option
What are some pre operative nursing care for myelomeningocele?
- Protect sac from infection, sterile, moist and nonadherent dressings.
- Proper position: prone, flat with hips slightly flexed, to reduce spinal fluid pressure
- Monitor HC and fontanels for developing hydrocephalus
What are some post operative treatment of myelomeningocele?
- Observe for leakage of CSF
What is the most common and severe muscular dystrophy?
Duchenne Muscular Dystrophy (DMD)
how do you diagnose DMD?
Confirmed by EMG, muscle biopsy, and serum enzyme measurement
What are some characteristics of DMD?
- Early onset (3 to 5 years of age)
- Progressive muscular weakness, wasting & contractures
- Calf muscle hypertrophy (pseudohypertrophy)
- Characterized by presence of Gower sign, waddling gait, and lordosis
- Loss independent ambulation 9 to 12 years
- Progression until death from respiratory & cardiac failure (adolescent/young adult)
What is the primary goal when treating DMD?
Primary goal is to maintain function in unaffected muscles for as long as possible and promote ROM.