Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

special pops > Myelomeningocele / Spina Bifida > Flashcards

Myelomeningocele / Spina Bifida Flashcards

1
Q

Development of Nervous System

A
  1. neural plate
  2. neural tube
  3. brain and SC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Neural tube closure is completed by

A

day 26

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

defect in neural tube closure and overlying posterior vertebral arches

A

spina bifida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

potential cause of spina bifida

A

genetic predisposition that may enhanced factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Genetic RF for spina bifida

A
  1. celtic origin

2. family hx spina bifida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Spina bifida:

environmental factors

A
  1. lower socioeconomic status

2. folic acid and Vit A deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Spina Bifida Prenatal testing

A
  1. AFP abnormaly high in amniotic fluid past 14 weeks gestational age
  2. compare w/ ultrasound results
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Spinda Bifida:

Occulta

A
  1. failure of vertebral arches to meet and fuse in 3rd month
  2. overlying skin dimple, pigmentation, or patch of hair
  3. lumbosacral area common site
  4. usually non neuro or msk dysfunction
  5. higher incidence of urinary tract disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Spinda Bifida:

Cystica

A

Failure of neural tube and vertebral arches to close w/cystic protrusion of meninges with or w/out spinal cord

A. Meningocele

B. Myelomeningocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Meningocele

A
  • spinal cord remains in vertebral canal but may be abnormal

- lipomeninggocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lipomeninggocele

A

superficial fatty mass in lower lumbar/sacral area. high incidence of B&B dysfunction, tethered cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Myelomeningocele

A
  • extensive SC abnormalities
  • most common in thoracic and lumbosacral regions
  • anencephaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Anencephaly

A

cranial end of neural tube doesn’t fuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q 
Myelomeningocele:
Clinical manifestation (9)
A
  1. loss of sensory/motor function
  2. orthopedic abnormalities
  3. hydrocephalus
  4. brain/SC abnormalities
  5. B&B dysfunction
  6. Cognitive impairment/Learning issues
  7. Integumentary impairment
  8. disturbed growth and development
  9. psychosocial issues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Myelomeningocele:

Orthopedic abnormalities due to…

A

lack of sensorimotor function in utero or lack of movement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Myelomeningocele:

Loss of sensory and motor function dependent on:

A
  1. degree of SC abnormality
  2. Traction or stretch on SC
  3. Trauma to exposed neural tissue during delivery
  4. Postnatal damage resulting from dying/infection of neural plate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Myelomeningocele:

Sensory Impairment

A
  1. Sensation below level of lesion impaired may not exactly match level (incomplete lesion)
  2. includes kinesthetic, proprioceptive, somatosensory
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Myelomeningocele:

2 main types of motor dysfunction

A
  1. complete loss of function below level of lesion

2. Mixture of flaccidity and spasticity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Myelomeningocele:

Orthopedic problems

A
  • deformity
  • contractures
  • osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Myelomeningocele:

deformity and contractures due to:

A
  1. muscle imbalance
  2. stress
  3. posture
  4. gravity
  5. congenital
  6. decreased sensation
  7. neuro complications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Myelomeningocele:

typical congenital malformations

A
  1. hemivertebrae
  2. deformed vertebral bodies/ribs
  3. missing ribs
  4. lumbar kyphosis
  5. club feet
  6. rocker bottom feet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Myelomeningocele:

Osteoporosis

A

secondary to lack of WB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Myelomeningocele:

Hydrocephalus

A
  • present in 80-90% of cases

- blockage of normal CSF flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hydrocephalus signs

A
  1. increased head size
  2. bulging fontanelles
  3. irritability
  4. lethargic
  5. sunset eyes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Hydrocephalus interventions

A
  1. Ventroatrial shunt

2. Ventroperitoneal shunt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Signs of shunt malfunction:

Infants

A
  1. bulging fontanelle
  2. vomiting
  3. change in appetite
  4. “sunset” sign (eyes)
  5. edema/rednes
  6. thinning of skin
  7. high pitched cry
  8. irritability
  9. lethargy
  10. seizures
  11. excessive growth
27
Q

Signs of shunt malfunction:

Toddlers

A
  1. vomiting
  2. irritability
  3. seizures
  4. headaches
  5. redness/edema
  6. lethargy
  7. new nystagmus/squint
28
Q

Signs of shunt malfunction:

school aged children

A
  1. vomiting
  2. irritability
  3. seizures
  4. headaches
  5. redness/edema
  6. lethargy
  7. new nystagmus/squint
  8. memory changes
  9. handwriting changes
29
Q

arnold chiari malformation

A

brainstem and cerebellum herniate through foramen magnum, usually into upper cervical canal

30
Q

Arnold Chiari Malformation:

Symptoms

A
  • respiration issues
  • paralysis of vocal cords
  • bulbar dysfunction
  • apnea
  • swallowing issues
  • abnormal gag
  • UE weakness
31
Q

Hydromyelia

A

dilation of center of canal of SC. May be focal, multiple, or diffuse

32
Q

Hydromyelia:

cause

A

consequence of untreated/inadequately treated hydrocephalus

33
Q

Hydromyelia:

symptoms

A
  1. UE muscle weakness
  2. rapidly progressive scoliosis
  3. spasticity
  4. ascending motor loss in LE
34
Q

Hydromyelia:

interventions

A
  1. shunt revision
  2. posterior cervical decompression
  3. flushing device (into pleural cavity)
35
Q

Tethered Cord

A

Pathological fixation of SC in abnormal caudal location

causes mechanical stretch, distortion, and ischemia

36
Q

Tethered cord symptoms

A
  1. decreased strength
  2. LE spasticity
  3. back p! at site of sac closure
  4. change in urological function
37
Q

Tethered cord intervention

A

release

38
Q

Myelomeningocele:

Cog / learning issues

A
  • visual motor perceptual deficits
  • difficulties w/spatial relations
  • difficult development of hand dominance
  • poor hand function
  • “cocktail party speech”
39
Q

Myelomeningocele:

Integumentary

A
  1. latex allergy

2. pressure sores

40
Q

Myelomeningocele:

Bowel and Bladder maintenance

A

self cath taught early if possible

41
Q

Myelomeningocele:

PT intervention

A

age appropriate assessment / interventions for:

  1. ROM / MMT
  2. sensory testing
  3. developmental testing
  4. positioning
  5. equipment needs
  6. education for family
  7. balance
  8. coordination
  9. reflexes
  10. address tone and skin condition
42
Q

Myelomeningocele:

Age specific issues- Prenatal

A
  1. referral to EI
  2. possible sac closure in utero
  3. C section to prevent trauma to neural sac
43
Q

Myelomeningocele:

Age specific issues- Newborn

A
  1. sac closure w/in 24-48 hrs
  2. shunt procedure
  3. assess function to determine baseline pre/post sx
  4. ID muscle imbalances/deforming forces
  5. ID need for positioning, bracing, taping
44
Q

Myelomeningocele:

Age specific issues- Newborn MMT

A

observation

  1. state
  2. positions
  3. spontaneous movement in response to sensory input
  4. differentiate between reflex and voluntary movement
45
Q

Myelomeningocele:

Age specific issues- infant/toddler

A
  1. facilitate developmental sequence
  2. prevent deformity
  3. home program
  4. early WB (watch alignment)
  5. skin care
  6. emphasize balance and equilibrium in standing/sitting/core str
  7. importance of fine motor skills
46
Q

Myelomeningocele:

Age specific issues- Toddler/preschool

A
  1. emphasize progressive LE WB / gait training
  2. EI and school based programs
  3. adaptive equipment
  4. bladder training
47
Q

Myelomeningocele:

MMT for toddler-preschool

A

antigravity control in developmental positions, during play, and weighted toys

48
Q

Myelomeningocele:

Sensory for toddler-preschool

A

start assessing light touch and position changes as cognitive and language skills permit

49
Q

Myelomeningocele:

Age specific issues- 6-adolescent

A
  1. by 6, aware of their differences
  2. constantly reevaluate due to rate of growth
  3. independent community mobility: WC
  4. prepare family for changes in adolescence.
50
Q

Myelomeningocele:

thoracic level

A
  1. flaccid LE: frog leg position
  2. prone positioning, ROM, gentle wrapping
  3. surgical intervention
  4. total contact orthosis for standing
  5. resting AFO to maintain foot position
51
Q

Myelomeningocele:

surgical intervention

A

IT band, hip ER, knee flexors

52
Q

Myelomeningocele:

walking w/parapodium

A

learn to use head and upper trunk to shift weight

53
Q

Myelomeningocele:

T12-L3

A
  1. strong hip flexors/ADD
  2. require bracing to stand
  3. hip subluxation and dislocation common
  4. parapodium/ swivel walker/ A frame
  5. RGO, HKAFO
54
Q

Myelomeningocele:

L4-L5

A
  1. strong hip FLX/ADD
  2. some hip ABD
  3. strong quads, medial hamstrings
  4. anterior tib active, some foot intrinsics
  5. Use of floor reactive AFO
55
Q

Myelomeningocele:

L4-L5 AD for rotation

A

Twister Cables

56
Q

Myelomeningocele:

L4-5 AD for weak quads

A

KAFO

57
Q

Myelomeningocele:

sacral level

A
  1. full or partial innervation of hip ext, lat hams, glut med, med hams, quads
  2. variation of innervation in foot/ankle
  3. gastroc may be weak
  4. watch for crouched gait w/weight gain
  5. aggressive trx for hip instability
58
Q

Myelomeningocele:

Sacral. What to watch for w/weak gastroc

A

toe flexors may provide some plantar flexion, but not strong enough for gait.

AFO needed

59
Q

Pschosocial Adjustment:

0-6 months

A

parents may be in shock/denial.

may misinterpret or reject info

60
Q

Pschosocial Adjustment:

6-18 months

A
  • stressful

- many appointments/hospitalizations

61
Q

Pschosocial Adjustment:

2 years-school age

A

concerns about toilet training and social acceptability

62
Q

Pschosocial Adjustment:

6 y.o.

A
  1. child more aware of disability
  2. family attitudes/ environment influence child’s adjustment
  3. important to have interaction w/peers and age appropriate responsibilites
63
Q

Pschosocial Adjustment:

adolescence

A
  1. B&B management
  2. sexual issues
  3. females- potential for orgasm/fertility
  4. men usually sterile w/small testicles and penis. potential for erection/ejaculation depending on lesion

special pops (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions