Neuromuscular/Muscular Dysfunction Flashcards
What is Cerebral Palsy (CP)?
group of permanent movement, balance, and posture disorders that appear in infancy or early childhood
Cerebral palsy (CP) risk factors?
- Preterm birth
- Low birth weight
- CNS malformation
- Asphyxia during birth
- Intracranial hemorrhage after birth
Cerebral palsy (CP) clinical manifestations?
- Delay in achieving developmental milestones
- Difficulty swallowing or uncontrolled drooling
- Poor sucking
- Clenched fists beyond 3 months of age
- Stiff or rigid limbs
- Arching of back
Types of Cerebral palsy (CP)?
- Spastic
- Dyskinetic
- Ataxic
- Mixed
What is Spastic CP?
stiffness and tightness in muscles (most common type)
What is Dyskinetic CP?
involuntary, uncontrolled, repetitive movements
What is Ataxic CP?
incoordination with decreased muscle tone
What is Mixed CP?
symptoms from spastic, dyskinetic, and ataxic
Cerebral palsy (CP) management?
-
Medications
- Botulinum toxin type A (Botox) - reduce spasticity to improve mobility and pain control
- Baclofen (Reduce Spasms-Implanted pump for intrathecal administration –(into spinal canal)
- Management of Seizures
- Mobilization and Assistive Devices
- Physical Therapy
- Surgical interventions for contractures
- Nutrition interventions
What are neural tube defects?
- congenital anomalies due to incomplete closure of the neural tube (forms the brain and spinal cord)
Describe Spina Bifida Occulta.
- Dimple or hair noted at the base of the spine. No protrusion of meninges.
- Ultrasound to determine if there is any underlying problem.
- Treatment is usually not needed.
Describe Meningocele.
protrusion of meninges, CSF, no nerves within a sac of skin
Describe Myelomeningocele.
protrusion of meninges, CSF, and nerves within sac of skin
Neural tube defects nursing management?
- Side lying or prone position to protect defect
- Prevent infection (cover w/ moist sterile dressing)
- LATEX precautions- all spina bifida patients
- Antibiotics
Neural tube defects therapeutic management?
- Management of genitourinary function
- Bowel control
- Prevention of pressure ulcers
- Promote mobility, PT/OT
What is Guillain Barre Syndrome (GBS)?
- Rare autoimmune disorder where the body’s immune system attacks peripheral nervous system
- Usually preceded by viral illness that induces an abnormal autoimmune response targeting peripheral nerves
Guillain Barre Syndrome (GBS) etiology?
unknown
Guillain Barre Syndrome (GBS) s/s?
- Acute symmetric ascending paralysis that occurs 2-4 weeks after viral or bacterial illness
- Gait abnormalities
- Diminished or lost reflexes
- Respiratory failure due to paralysis
Guillain Barre Syndrome (GBS) management?
- Treatment is supportive
- Respiratory support
- Steroids, IV immunoglobulin, and plasmapheresis (plasma exchange).
- Low–molecular-weight heparin, gabapentin (neuropathic pain), analgesics
- Risk of recurrence low
- 10-20% of patients will require mechanical ventilation
What is Duchenne Muscular Dystrophy (DMD)?
genetic disorder characterized by progressive muscle degeneration and weakness
Who does Duchenne Muscular Dystrophy (DMD) affect more?
primarily affects boys (x-linked), typically becoming evident around ages 3 to 5
Duchenne Muscular Dystrophy (DMD) signs and symptoms?
- Progressive muscle weakness*, wasting, and contractures
- Affects proximal before distal limb muscles, & lower extremities before upper extremities
- Waddling gait, frequent falls, Gower’s sign
- Pts. usually wheelchair bound by ~12 years of age
- Average expectancy 28 years
How is DMD diagnosed?
- child’s blood sample and test it for creatine kinase
- an enzyme that muscles release when they are damaged
high CK level is a sign that child could have DMD
How to treat DMD?
- steroid medications to maintain muscle strength
- “exon skipping” medicine which increases the amount of dystrophin protein
- gene therapy, replaces mutated dystrophin gene with a dystrophin gene that works
