Case 19- spina bifida Flashcards
hydrocephalus
abnormal build-up of cerebrospinal fluid (CSF) in and around the brain
hydromyelia
abnormal amount of CSF in the spinal cord that increases pressure on the nerves and causes weakness
latex allergy
allergic reaction of varying severity of proteins presented in natural rubber latex
Meninges
membrane covering the brain and the spinal cord
meningocele
CSF and meninges, but no neutral elements, protrude through abnormal vertebral opening.
presentation ranges from normal to partial paralysis ( or motor impairment) and or bowel and bladder dysfunction
Myelomeningocele
Protrusion of spinal cord nad surrounding meninges through abnormal opening in the vertebrae
most serious type of spinal bifida with most significant health implications
scoliosis
lateral curvature of the spine to the left or right. in children with myelomeningocele, scoliosis often results from lack of neuromuscular control
ventriculoperitoneal (VP) shunt
tube with valves that is inserted in the brain to permit drainage of CSF to the abdominal cavity
vesicoureteral reflux
urine traveling from the bladder back into the kidneys
general PT plan of care/goals
prevent loss of ROM in upper and lower extremities as well as upper extremity overuse injuries; maximize independent functional mobility; optimize health-related quality of life; maximize health and fitness including strength and aerobic capacity
PT interventions
patient and family education regarding long-term implications of spina bifida and the risks for obesity, osteoporosis, and urinary tract infections; exercises to maintain ROM and improve strength; functional mobility training (transfers, wheeled mobility, ambulation)
precautions for PT
decreased cardiorespiratory endurance (higher resting heart rate and increased heart rate during activities); increased risk for fracture secondary to osteoporosis; increased risk for hip dislocation and skin breakdown secondary to decreased sensation; latex allergy; incontinence during exercise; difficulties with thermoregulation; increase risk of falls; increase spasticity with exercise
complications interfering with PT
illness (cold, flu, bladder infection); pronounced spasticity, arnold chiari malformation, fracture, pressure sore, tethered cord syndrome, symptomatic hydromyelia, symptomatic hydrocephalus, VP shunt failure
the weeFIM is a reliable and valid assessment tool that can measure change in function overtime in the functional ability of children with spina bifida
Grade A
upper extremity strength training programs increase strength and independent wheelchair mobility in children with spina bifida
Grade B
treadmill training improves gait speed and aerobic fitness in ambulatory children with spina bifida
Grade B
Children with spina bifida are an increased risk for all the following except
tuberculosis
Children with spina bifida are at increased risk for what?
-latex allergy: overexposure to medical supplies
- urinary tract infection: incomplete emptying of bladder and decreased innervation and control of bladder
which of the following is true about ambulation in children with spina bifida?
Their ability to ambulate is dependent on the level of the spinal cord lesions
Children with spina bifida typically have– below the level of lesions
motor impairment
