neuromuscular dysfunction additional information

Question 1

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

Question 2

what is cerebral palsy?

Answer 2

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

Question 3

what is the etiology behind cerebral palsy?

Answer 3

injury usually is the case

Question 4

what is the clinical manifestations of cerebral palsy?

Answer 4

neuromotor impairment
neuroanatomic disturbance
gait pattern is hindered

Question 5

notes
spastic - persitant primitive reflexes, hypertonia

dyskinetic
- chorea, involuntary jerky movements

Dystonic
- slow twisting movements

mixed - everything

Question 6

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

Answer 6

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

Question 7

what is the diagnostic evaluation of cerebral palsy ?

Answer 7

CT scan, ultrasound, MRI

Question 8

what is the therapeutic management of cerebral palsy ?

Answer 8

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

Question 9

additional interventions for cerebral palsy

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

Question 10

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

Question 10

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

Answer 10

abnormalities that derive from the embryonic neural tube

Question 11

what is anencephaly?

Answer 11

congenital malformation in which both cerebral hemispheres are absent

Question 12

what is spinal occult?

Answer 12

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

Question 13

what section of the spine does spinal bifida occur in ?

Answer 13

L5 to S1

Question 14

what are the 4 skin indications of the spinal bifida?

Answer 14

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

Question 15

what is spinal bifida cystica?

Answer 15

refers to the visible defect with an external saclike protrusion

Question 16

what are the 2 types of spinal bifida cystica?

Answer 16

meningocele
myelonmeningocele

Question 17

what is the difference between these two ?

meningocele
myelonmeningocele

Answer 17

mein - the spinal cord is not in the sac

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

Question 18

how do we prevent spinal bifida from occurring ?

Answer 18

folate acid 0.4mg

Question 19

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

Answer 19

prone because remember thats their spine right there!

Question 20

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 ?

Answer 20

straight cath
bowel regiment !

Question 21

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

Answer 21

latex prevention and try to avoid using it as well

Question 22

what is spinal muscular atrophy?

Answer 22

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

Question 23

what are the clinical manifestation of spinal muscular atrophy?

Answer 23

hypotonia
absent deep tendon reflexes
weak cry and coughs

fatigue
difficulty swallowing
respiratory issues
gi issues
muscle weakness

Question 24

what are the 2 diagnosis of spinal muscular atrophy?

Answer 24

genetic testing
muscle biopsy

Question 25

what is the treatment of spinal muscular atrophy?

Answer 25

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

Question 26

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

Question 27

what is GBS?
otherwise known as infectious polyneuritis

Answer 27

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

Question 28

what is the cause of gbs?

Answer 28

bacterial, viral or some vaccinations can cause it

Question 29

what is the clinical manfiestations of GBS?

Answer 29

tenderness, numbness, weakness
paralysis being the worst sign

usually starts from the body and going up

Question 30

what is the main reason why people die from GBS?

Answer 30

respiratory failure because of respiratory paralysis

Question 31

what is the diagnostic studies behind GBS?

Answer 31

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

Question 32

what is the treatment behind GBS?

Answer 32

IV IG
plasmapheresis
herpain
steroids
pain medications
respiratory ventilaitons

Question 33

Discuss tetanus and its prevention through primary vaccination and boosters.

Question 34

what is tetanus?

Answer 34

an acute preventable fetal disease by an exotoxin called clostridium tetani

Question 35

what is the number 1 prevention of tetanus ?

Answer 35

DtAP - young kids
Tdap - 12 and older

Question 36

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

Question 37

what is botulism ?

Answer 37

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 )

Question 38

when do symptoms start to appear in botulism ?

Answer 38

12-36 hours

Question 39

what is the main clinical manifestations of botusliam in children?

Answer 39

paralysis
vomiting
unable to with hold their head

Question 40

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

Answer 40

infants
- respiratory supportive care really : (

older kids
- botulism immune globium or antitoxin

Question 41

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

Question 42

what is myasthenia gravis MG?

Answer 42

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

Question 43

what is the Clincal manifestations of MG?

remember the anagram (7)

Answer 43

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

Question 44

what is the treatment of MG?

Answer 44

in severe cases, cholinestrearse inhibiting drugs are used

Question 45

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

Question 46

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

Question 47

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

Answer 47

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

Question 48

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

Answer 48

sit them up at a 90% degree angle