neuromuscular dysfunction additional information Flashcards by Brina Quintanilla Reyes

Describe the pathophysiology, clinical manifestation, and diagnostic evaluation of cerebral palsy.

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what is cerebral palsy?

disorder of posture and movement from static Brian injury perinatally or postnatally that limits activity

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what is the etiology behind cerebral palsy?

injury usually is the case

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what is the clinical manifestations of cerebral palsy?

neuromotor impairment
neuroanatomic disturbance
gait pattern is hindered

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notes
spastic - persitant primitive reflexes, hypertonia

dyskinetic
- chorea, involuntary jerky movements

Dystonic
- slow twisting movements

mixed - everything

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what are the 7 things to note about the development stages in patients with cerebral palsy ?

persistant primitive reflexes
poor head tone after 3 months
rigid or stiff limbs
arching of the back
floppy tone
unable to sit without support after 8 months
clenching of the hands after 3 months

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what is the diagnostic evaluation of cerebral palsy ?

CT scan, ultrasound, MRI

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what is the therapeutic management of cerebral palsy ?

establish locomotion, communication and self help skills

gain optimum appearance and integration of motor functions

correct associated defects as early as possible

provide educational opportunities adapted to the individual Childs needs

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additional interventions for cerebral palsy

physical therapy
occupational therapy
speech therapy
casting or bracing
botox
oral medications
( analgesics, anti-inflammatory, antispasmodic ,anti convulsants )

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Describe the pathophysiology, clinical manifestation, and diagnostic evaluation of spina bifida.

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Before we talk about spinal bifida, what is a neural tube defect?

abnormalities that derive from the embryonic neural tube

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what is anencephaly?

congenital malformation in which both cerebral hemispheres are absent

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what is spinal occult?

refers to a defect that is not visible externally, usually a fatty tissue that grows around the area and gets the spinal cord involved

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what section of the spine does spinal bifida occur in ?

L5 to S1

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what are the 4 skin indications of the spinal bifida?

sacral dimple
port-win angiomatous
dark tufts of hair
subcutaneous lipoma

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what is spinal bifida cystica?

refers to the visible defect with an external saclike protrusion

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what are the 2 types of spinal bifida cystica?

meningocele
myelonmeningocele

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what is the difference between these two ?

meningocele
myelonmeningocele

mein - the spinal cord is not in the sac

Myles - the spinal cord is in the sac, usually wrapping around the area

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how do we prevent spinal bifida from occurring ?

folate acid 0.4mg

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what position do we want patients with spinal bifida in and why?

prone because remember thats their spine right there!

remember these children with spinal bifida are going to have a lot of bowel and urination issues

so what are the two big interventions we are going to do ?

straight cath
bowel regiment !

with a lot of straight Cath, most kids get a latex allergy when having spinal bifida, so what are we going to do ?

latex prevention and try to avoid using it as well

what is spinal muscular atrophy?

progressive weakness and wasting of skeletal muscles caused by degeneration primary of the anterior horn cells

what are the clinical manifestation of spinal muscular atrophy?

hypotonia
absent deep tendon reflexes
weak cry and coughs

fatigue
difficulty swallowing
respiratory issues
gi issues
muscle weakness

what are the 2 diagnosis of spinal muscular atrophy?

genetic testing muscle biopsy

what is the treatment of spinal muscular atrophy?

really there is no cure, but just make them move, emotional support

Describe the pathophysiology, phases of illness, clinical manifestations, and therapeutic management of Guillain-Barré syndrome in the pediatric population.

what is GBS? otherwise known as infectious polyneuritis

acute demyelinating polyneuropathy with a rapid progressive, usually ascending flaccid paralysis

what is the cause of gbs?

bacterial, viral or some vaccinations can cause it

what is the clinical manfiestations of GBS?

tenderness, numbness, weakness paralysis being the worst sign usually starts from the body and going up

what is the main reason why people die from GBS?

respiratory failure because of respiratory paralysis

what is the diagnostic studies behind GBS?

lumbar puncture - elevated protein absent deep tendon reflexes paralytic manifestations electromyography - weak nerves

what is the treatment behind GBS?

IV IG plasmapheresis herpain steroids pain medications respiratory ventilaitons

Discuss tetanus and its prevention through primary vaccination and boosters.

what is tetanus?

an acute preventable fetal disease by an exotoxin called clostridium tetani

what is the number 1 prevention of tetanus ?

DtAP - young kids Tdap - 12 and older

Describe food-borne and infant botulism and risk factors for the development of each.

what is botulism ?

food poisoning that results form the ingestion of the preformed toxin produced by clostridium botulinum otherwise known as feeding your kids under 2 honey! and canned foods ( not properly made )

when do symptoms start to appear in botulism ?

12-36 hours

what is the main clinical manifestations of botusliam in children?

paralysis vomiting unable to with hold their head

what's the treatment for botusilim with infants vs older kids ?

infants - respiratory supportive care really : ( older kids - botulism immune globium or antitoxin

Describe myasthenia gravis (MG) in children: Clinical manifestations, diagnosis, prognosis, and treatment of MG in children

what is myasthenia gravis MG?

autoimmune disorder associated with the attack of circulating antibodies on the acetylcholine receptors, which blocks its function

what is the Clincal manifestations of MG? remember the anagram (7)

people make faces but limited to seven! ptosis - eye dropping muscle weakness fatigue blurred vision / double vision limited facial expressions trouble walking swallowing, speech, chew difficulties

what is the treatment of MG?

in severe cases, cholinestrearse inhibiting drugs are used

Identify the factors that influence the extent of trauma to the spinal cord at the time of injury and the classifications of SCI.

C4 - NECK DOWN C6 - SHOULDER DOWN T4- Below chest L1- waist below these are some factors that can influence the effect of trauma, so like certain locations of the spine can indicate what type of paralysis you can get

what is autonomic dysreflexia? upper part of the body (3) lower part of the body(2) !!!

the paralytic nature of autonomic function is replaced by autonomic dysreflexia, its caused by visceral distention or irritation of the bowel or bladder. which then nerves are blocked flushing bradycardia throbbing headache hypertension cool,clammy pale skin

what is the biggest nursing intervention with autonomic dysreflexia?!!

sit them up at a 90% degree angle