Peds - Spina Bifida Flashcards
Name the 5 environmental risk factors for spina bifida
- low socioeconomic class
- Midspring conception
- maternal obesity
- in utero exposure to anticonvulsant drugs (VPA, Carbamazepine)
- maternal febrile illness
Neurulation of the anterior and posterior neuropores occurs during _____ week after conception
post-neurulation phase occurs _____ which produces skin covered lesions
3rd - 4th week
4-7 weeks,
Normal neural tube closure starts in ____ week of gestation from mid-cervical level and proceeds in both cephalad and caudad directions
3rd
Defect of neural tube closure is thought to occur around day _____ and accounts for most lesions through mid-lumbar
26
Caudal regression of embryonic tail with rostral extension, resulting in fusion with the neural tube results in formation of the spinal cord by day ____
53 - lesions of lower lumbar/sacral area occur before this day.
Two markers associated with NTD
alpha-fetoprotein
acetylcholinesterase
AFP is reliable in 80% of open NTDs in 13-15 weeks
amniocentesis is done by week _____ for detecting elevated amnitiotic fluid AFP. Will not detect _____
16-18
closed NTDs without leakage of fetal CSF
Frequent signs of SB occulta
(5)
- pigmented nevus
angioma
hirsute patch
dimple
dermal sinus on overlying skin
three types of SP cystica
meningocele
myelomeningocele
myelocele
What does “spina bifida aperta” mean?
any NTD lesion which the deformity is open to the environment
SB occulta is rarely associated with ___- and ____ and therefore must be followed
sacral lipoma and tethered cord
most common location of lesion for SB occulta?
L5/S1
Name the contents of the cystic sac in the following:
1. meningocele
2. myelomeningocele
3. myelocele
- spinal fluid, meninges
- spinal fluide, meneges, spinal cord
- cystic cavity is in front of the anterior wall of the spinal cord causing protrusion of spinal cord
myelomeningocele is associated with _____ >90% of cases
arnold-chiari malformation complicated by hydrocephalusq
which is the most common type of SB cystica
myelomeningocele