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Pediatrics > Myelodysplasia > Flashcards

Myelodysplasia Flashcards

1
Q

Myelodysplasia

A
  • defective development of spinal cord (any part, especially lower)
  • spina bifida is one type
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2
Q

Spina Bifida Occulta

A
  • closed SC lesion
  • large/small subcutaneous lipoma
  • dimples above gluteal cleft/may have tuft of hair/discolored
  • with or without paralysis at birth
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3
Q

Spina Bifida Aperta

A
  • open SC defect protruding dorsally
  • usually categorized as myelomeningocele
  • protrude dorsally
  • not covered in skin
  • motor nerve paralysis
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4
Q

Neurulation

A
  • folding of ectoderm on each side of primitive spinal cord to form a tube from hind brain to S2
  • before gestational day 28
  • most of spina bifida is from problems with neurulation
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5
Q

Canalization

A
  • nerve cells form to become distal end of SC
  • caudal to S2
  • impairments cause skin covered meningoceles and lipomas of SC distal to L3
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6
Q

Diagnosis of neural tube defects

A
  • AFP blood test
  • 2nd trimester US
  • amniocentesis analysis
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7
Q

Classifications of Spina Bifida

A
  • Asperta

- Occulta

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8
Q

Impairments

A
  • MS deformity
  • Osteoporosis
  • Motor Paralysis
  • Sensory Deficits
  • Hydrocephalus
  • Cognitive Dysfunction
  • Language Dysfunction
  • Latex Allergy
  • UE dyscoordination
  • Visuoperceptive deficits
  • CN palsies
  • spasticity
  • Progressive neurologic dysfunction
  • Seizures
  • Neurogenic Bowel/Bladder
  • Skin breakdown
  • obesity
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9
Q

Postural Deviations/Contractures:

Thoracic->L2

A
  • hip flexion
  • abduction & ER
  • knee flexion
  • ankle PF
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10
Q

Postural Deviation/Contractures:

L3-L5

A
  • knee flexion
  • lumbar lordosis
  • genu & calcaneal valgus
  • pronated foot
  • crouched gait
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11
Q

Postural Deviations/Contractures:

Sacral

A
  • mild hip/knee contractures
  • lumbar lordosis
  • ankle/foot may be valgus/varus, sup/pron
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12
Q

Goals/Intervention:

Infancy

A
  • manage dislocated hips/foot deformities
  • family edu
  • handling
  • facilitate sensorimotor experiences
  • prepare for mobility
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13
Q

Goals/Intervention:

Preschool

A
  • address impairments
  • promote play & self-care
  • ID effective means of independent mobility
  • orthotics
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14
Q

Goals/Intervention:

School-age/Adolescence

A
  • mntn achieved level of activity
  • prevent deterioration
  • seating/mobility
  • promote participation in age-appropriate sport & activities
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15
Q

Mobility by age_____

A

1-2 years

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16
Q

Mobility:

Thoracic->L3

A

-Wheelchair

17
Q

Mobility:

L4 and lower

A
  • walk with AD
  • reverse walker/crutches
  • may require w/c when older
18
Q

Mobility:

Sacral

A
  • May walk alone

- may need upper limb when older

19
Q

Orthotics:

Sacral

A
  • SMO

- supramalleolar orthosis

20
Q

Orthotics:

L4-S1

A

AFO

21
Q

Orthotics:

L3-L4

A

KAFO

22
Q

Orthotics:

L1-L3

A
  • HKAFO

- RGO

23
Q

Orthotics:

Thoracic-L2

A
  • THKAFO

- Parapodium

24
Q

Outcomes:

Thoracic

A
  • w/c
  • sliding board tfr
  • supervised living
25
Q

Outcomes:

L1-L2

A
  • KAFO/RGO and upper limb support for household ambu
  • w/c community
  • 50% live independently
  • employment rare
26
Q

Outcomes:

L3

A
  • KAFO and forearm crutches for household ambu
  • w/c for community
  • 60% live independently
  • 20% employed
27
Q

Outcomes:

L4

A
  • functional ambu with forearm crutches and AFO
  • w/c for community
  • 20% continue to ambu as adults
  • 60% live independently
  • 20% employed
28
Q

Outcomes:

L5

A
  • ambu w/o orthoses but may need for alignment
  • upper limb support or w/c
  • 80% live independently
  • 30% full time employment
  • 20% part time employment
29
Q

Outcomes:

S1-S3

A
  • ambu w/o orthoses or upper limb support

- foot orthoses may be good for alignment

30
Q

Causes of Neural Tube Disorders

A
  • genetics
  • teratogens
  • nutritional deficiencies
31
Q

Exam

A
  • tone
  • dislocated hips/foot deformities
  • spontaneous activity and elicited movement
  • strength
  • sensation
  • ROM
  • position sense
  • fine/gross motor development
  • ADL
  • Joint alignment
  • mobility/gait
  • accessibility of environment
  • bed mobility/floor/transfers
  • w/c mobility

Pediatrics (13 decks)

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