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Neuro Rehab Final > Neural Tube Defects > Flashcards

Neural Tube Defects Flashcards

1
Q

What are the three types of cells in a fetus?

A
  1. ectoderm- NS, skin, teeth
  2. mesoderm- blood vessels, muscles, bones
  3. endoderm- GI, GU, pulm system
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2
Q

What happens during weeks 4-5 of the fetal development?

A

heart begins, neural tube, eyes and ears, limb buds, rapid brain/head growth, bronchi

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3
Q

When is the neural plate formed?

A

formed by day 18

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4
Q

What are the two different parts of the neural plate?

A
  1. neural tube- CNS, Brain, SC

2. neural crest- PNS, CN, spinal nerves, ANS, ganglia

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5
Q

When does the neural ectoderm close and what are two different types of processes?

A

26-28 days

  1. neurilation- cranial
  2. canalization- caudal
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6
Q

What is spinal dysraphism?

A

term to describe congenital abnormalities that include defects of the vertebrae, spinal cord or root

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7
Q

What is spina bifida occulta?

A

non fusion but there are no neural problems

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8
Q

What is SB cystica?

A

neural, vertebrae arches fail to close properly

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9
Q

What are two kinds of SB cystica?

A
  1. meningocele

2. myelomeningocele

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10
Q

What is SB cystica meningocele?

A

Cystic sacs with meninges and CSF

SC stays within canal but may have abnormalities

no clinical signs or may have varied

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11
Q

What is SB cystica myelomeningocele?

A

still have sacs but SC and menineges are in the sac causing sensory and motor impairments at level of lesion and below

also area of damage is exposed

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12
Q

What is the cause of SB?

A

genetics, teratogens, nutritional deficits

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13
Q

What are risk factors for SB?

A

previos NTD pregnancy, maternal insulin dept DM, Sz meds, lower SES, obesity

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14
Q

What are common clinical presentations of SB?

A

absesnse of sensory or motor function at and below lesion Bilaterally

loss of neural control of bowel and bladder

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15
Q

What are common complications with SB?

A

CNS- hydrocephalus, arnold chiari malformation

MS

multisystem- latex allergy, obesity, osteoporosis, skin breakdown

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16
Q

What are symptoms of hydrocephalus?

A

increased ICP, sunsetting of eye, bulging fontanelle, VS instability

17
Q

What is a Arnold Chiari II malformation?

A

cerebellar hypoplasia, caudal displacement of cerebellum and medulla through foramen magnum

18
Q

What are sx of ACM II?

A

stridor, apnea, GE reflux, paralysis of vocal cords, swallowing problems

19
Q

What are signs of progressive neurological dysfunction?

A

changes in spasticity, strength, sensation and pain, scoliosis, changes in bowel/bladder sphincter control

20
Q

What is the cause of PND?

A

tethered cord syndrome- scarring of neural cord to overlying dura or skin- produces traction on neural structures

21
Q

What are other related CNS complications with SB?

A

vision, perceptual motor, communication, dev. delays

22
Q

What factors attribute to MS complications?

A

muscle imbalance, PND, intrauterine position, deformities after fracture

23
Q

When should patients with SB have follow up exams with PT?

A

every 6 months until 24 months old then annually through adulthood

24
Q

Why is strength testing so important for SB pts?

A

loss of strength could be indicative of PND

25
Q

What are LE strength predictors for ambulation?

A

0-3 iliospsoas strength - partial or complete w/c use

4-5 iliopsoas and quad- community ambulation

4-5 gluteal and anterior Tib, community ambulation with no AD or orthosis

26
Q

What are factors that will affect outcomes in SB pts?

A

motor level, age, cognition, body proportions, sensation, orthopedic complications, UE function, spasticity

27
Q

What is the major focus of PT?

A

minimize impact or and development of bony deformities,postural changes and abnormal tone/strength

28
Q

What are most important interventions during infancy?

A

family education, positioning, mobility, postural control

29
Q

What are most important interventions during childhood?

A

mobility, transfers, ambulation and fitness

30
Q

What are most important interventions during adolescence?

A

functional changes, equipment for mobility, self management, fitness

31
Q

What are common complaints in adult SB pts?

A

obesity, incontinence, recurrent UTI, joint pain, HTN, depression, social integration

32
Q

What is most common cause of morbidity of SB?

33
Q

What is a reciprocating gait orthosis indicated?

A

L1-L3 motor level need some HF

34
Q

When is a HKAFO indicated?

A

need support for weak hip

35
Q

When is a KAFO indicated?

A

L3-4, if weak at knee, absent ankle ms, if unstable knee

36
Q

What is a AFO indicated?

A

L4-S1, weak or absent ankle ms but atlas 4/5 knee extension

37
Q

When is supramaleolar orthotics indicated?

A

shoe insert with support at ankle, S1

Neuro Rehab Final (10 decks)

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