Mod 3-1 Spina Bifida

Question 1

How many newborns per year in the US are born with Spina Bifida?

Answer 1

About 2,500

Question 2

What is Spina Bifida also known as?

Answer 2

Neural tube defect

Question 3

Out of 1,000 live births, how many are born with the more severe type of spina bifida?

Answer 3

1-2 per 1,000

Question 4

What is the name of the most severe type of spina bifida?

Answer 4

Myelomeningocele

Question 5

What is the definition of spina bifida?

Answer 5

Defect of the spinal canal resulting from failure of the posterior arches of the spine to fuse properly.

Question 6

What typically does not close in spina bifida patients?

Answer 6

The lamina of the vertebra

Question 7

What will be seen in more severe cases of spina bifida?

Answer 7

The meninges and/or the spinal cord are allowed to bulge out of the normal confines of the spine usually with loss of neurologic function below the level of the lesion.

Question 8

When does spina bifida develop?

Answer 8

In the first trimester of pregnancy

Question 9

How is spina bifida discovered?

Answer 9

On x-rays of the newborn infant or by sonography of the fetus in utero.

Question 10

What are environmental risk factors of spina bifida?

Answer 10

Nutrition (low folic acid), infections, drugs, fetal circulatory problems, ionizing radiation

Question 11

What is the etiology of spina bifida?

Answer 11

The cause is unclear but has either environmental or hereditary factors

Question 12

What are the two categories of spina bifida?

Answer 12

Spina bifida occulta and spina bifida cystica

Question 13

Which spina bifida is there no indication of the process unless it is incidentally identified at a future date?

Answer 13

Spina bifida occulta

Question 14

What are the two types of spina bifida cystica? And what differentiates them from spina bifida occulta?

Answer 14

Meningocele and myelomeningocele which are both clearly identifiable at birth.

Question 15

What signs exist with spina bifida occulta?

Answer 15

Slight dimpling of the skin or a tuft of hair over the area of involvement.

Question 16

What neurologic problems are associated with spina bifida occulta?

Answer 16

There are none

Question 17

In this type of spina bifida, the meninges ad the spinal cord herniate through the spinal defect and with spinal fluid and spinal nerve roots are contained in the external sac.

Answer 17

Myelomeningocele, the most severe

Question 18

What type of neurologic deficiencies is associated with myelomeningocele?

Answer 18

Control of the lower limbs, bladder, and rectum.

Question 19

What is the severity of the damage based on in myelomeningocele?

Answer 19

The location of the lesion. The higher up the spine, the more damage is present because spinal nerves are disrupted from the site of the lesion downward.

Question 20

What do almost all of those with myelomeningocele have? Explain it.

Answer 20

Chiari II malformation which is a cause of congenital hydrocephalus causing a downward displacement of the posterior cranial fossa structures - the medulla oblongata and the posterior portion of the cerebellum. As the fetus grows these structures will be forced down through the foramen magnum to lie in the upper cervical region of the spinal canal which causes na obstruction fo the flow of CSF and accumulates in the ventricles of the brain and thus hydrocephalus develops.

Question 21

What may be the only sign of spina bifida occulta presence?

Answer 21

The radiographic evidence of abnormal posterior arches

Question 22

No effect on radiographic technique from spina bifida

Answer 22

none