(9.2) Spina Bifida Flashcards
What are neural tube defects (NTDs)?
a group of developmental abnormalities in which the neural tube fails to fuse somewhere along its length from the spinal cord to the brain
How do abnormalities occur in the mechanism of formation of NTDs?
failure of the lower end of the cord to close at 26 days of embryonic life
What abnormalities can be seen in spina bifida?
- skin
- bone
- meninges
- neural tissue
What has folic acid been seen to do?
beneficial effect in preventing the occurrence of NTDs
What are the three types of spinal bifida?
- spina bifida occulta
- meningocele
- myelomeningocele
What is spina bifida occulta?
- split in spine is small
- spinal cord & main nerves cant bulge out
- little damage
What is meningocele?
- split in bone not big enough for spinal cord come through
- ‘balloon’ of skin filled with fluid and blood vessels
What is myelomeningocele?
- split contains spinal cord and nerves are held in a sack also filled with fluid
- degree of damage determine disability
- most common in lumbar spine
What are the symptoms of spinal bifida (6)?
- loss bladder/bowel control
- partial or complete lack sensation
- partial or complete paralysis legs
- weakness hips, legs, feet
- hydrocephalus
- hair and dimpling of sacral area
What does surgical treatment of spinal bifida involve?
- closure lesion on 1st /2nd day life
- sac opened
- covered by skin
- early closure reduces risk infection
What is hydrocephalus?
condition where there is too much CSF in the cranium/head
What is CSF and where is it found?
substance that flows through a channel into the space around the brain and spinal cord, where it also functions as a cushion
What is the role of CSF?
contains nutrients and proteins necessary for nourishment and function of brain & carries waste products away from tissues around brain
When does hydrocephalus occur?
when there is an imbalance between the amount of CSF that is produced and the rate at which it is absorbed
What can cause hydrocephalus to occur?
- blockage in pathways through which fluid travels
- overproduction of fluid
- difficulty absorbing fluid produced
How does hydrocephalus occur in spina bifida patients?
- 65% children with spina bifida
- often develops after closure back lesion
- ventricular system dilates in 3 directions
- lateral ventricles increase obstruction
What are complications for a shunt?
- blockage
- infection
- epilepsy
What are signs of hydrocephalus in infants?
- enlargement of head
- swelling or redness shunt tract
- fever
- irritability
- sunset eyes
What are the signs of hydrocephalus in toddlers?
- enlargement head
- fever
- swelling or redness shunt tract
- vomiting
- headache
What are the signs of hydrocephalus in children/adults?
- headaches and vomiting
- swelling or redness shunt tract
- visual disturbances
- decline in athletic performance and motivation
What are associated neural problems with disruption of immature brain?
- learning & attention difficulty
- vision difficulty
- muscle power & sensation
What does urodynamics test?
bladder control by assessing re urine flow and assist management
What are risk factors for a urinary tract infection?
- urine smells different
- wet in between catherization
- temp, headaches, vomiting
What is the aim of bowel training?
achieve regular bowel motion to avoid accidents and to be clean, healthy & comfortable
What are spinal deformities?
- congenital (kyphosis)
- scoliosis
- paralytic (muscle imbalance)
