case 19: spina bifida Flashcards
what is hydrocephalus
abd normal build up of CSF in and around the brain
what is hydromyelia
abdnormal amount of CSF in the spinal cord that increased pressure on the nerves and causes weakness
what is meninges
membranes covering the brain and SC
what is it called when CSF and meninges but no neural elements , protruded through abonormal vertebral opening. presentation ranged from normal to partial paralysis and/or bowel and bladder dysfunction
meningocele
what is myelomeningocele
protrusion of SC and surrounding meninges through abnormal opening in the vertebra’ most serious type of spina biding with most significant health implications
what is. ventriculoperitoneal shunt
tube with valves that is inserted in the brain to permit drainage of CSF to abdominal cavity
what is vesicoureteral reflex
urine traveling from the bladder back into the kidneys
what is the general PT goal and POC for a kid with spina bifida and post tethered cord sx
prevent loss of ROM in UE and LE
maximize independent functional mobility
what is the Pt interventions for a kid with spina bifida and post tethered cord sx
patient adn fam education regarding long term implications like UTI , obsesity and osteoporosis
exercises to maintain ROM and improve strength
what are the precautions for a kid with spina bifida and post tethered cord sx
decreased cardiorespiratory endurance
increased risk from fx secondary to osteoporosis
increased risk for hip dislocation and skin breakdown secondary to decreased sensation
latex allergy
incontinence during exercise
Problems w thermoregulation
Increased risk for falls
Increased spasticity w exercise
what are the complications interfering with PT for a kid with spina bifida and post tethered cord sx
illness
spasticity
arnold chiari malformation
fx
pressure sore
tethered cord syndrome
hyddromyelia
hydrocephalus
VP shunt failure
what is the most common disabling birth defect
spina bifida ; F>M
spina bifida is a incomplete closeure of what
embryonic neural tube
what is the arnold chiari type 2 malformation
when the cerebellar vermis and a portion of the BS descend into the spinal canal
what is the WeeFIM useful for in SB patients
track the impact of functional impairment for children of preschool and young elementary age
what does UE strength training programs increased for children with spina bifida
strength and independent WC mobility (grade B)
what is a grad B that improved gait speed and aerobic fitness in ambulatory children with spina bifida
treadmill training
children with spina bifida have an increased risk for what 3 things
hydrocephalus
UTI
latex allergy
T/F: Ambulation in children with spina bifida depende on the level of their SC lesion
true
What are the precautions during PT (9)
• Decreased cardiorespiratory endurance (higher resting HR and
increased HR during activities)
• Increased risk for fracture secondary osteoporosis
• Increased risk for hip dislocation
• Increased risk for skin breakdown
• Latex allergies
• Incontinence during exercise
• Difficulties with thermoregulation
• Increased Risk for Falls
• Increased Spasticity during exercise
What are the complications interfering with PT (9)
• Illness (UTI)
• Pronounced spasticity
• Arnold-Chiari malformation
• Fracture
• Pressure Sore
• Tethered Cord Syndrome
• VP shunt failure
• Symptomatic hydromyelia
• Symptomatic hydrocephalus
what can symptomatic hydromyelia cause
weakness and pain
In the arms and legs , headaches, and numbness in the neck
What are SYMTOMS of hydrocephalus for infants
- big head
- bulding or tense soft spot on top of head
- downward looking eye s
- high pitched cry
- problems with sucking or feeding
- recurrent vomiting
- seizures
What are SYMTOMS of hydrocephalus in children and adults
- HA
- blurred or double vision
- loss of bladder control
- nausea and comitting
- problem woth balance
- vision problems
- decline in school
- poor coordination
