Spina Bifida Flashcards
In utero exposure to what 2 anticonvulsants can result in spina bifida
Valproic acid and carbamazepine
Most common type of spina bifida
Myelomeningocele
What nerve roots somatically innervate the bladder through the pudendal plexus?
S2-S5
At what level of spina bifida can children sit normally?
If L4-5 is spared
Most common level of spina bifida occulta
L5-S1
Which level of spina bifida leads to complete leg paralysis
T6-T12
What nerve roots parasympathetically innervate the bladder?
S2-S4
How is level of spina bifida lesion related to IQ?
The higher the lesion, the lower the IQ
Which level of spina bifida leads to pes cavus foot
S1-S2 or S3-S4
What procedure do children with hydrocephalus need?
Ventriculoperitoneal shunting
What weeks do you test for AFP?
13-15 weeks
What physical exam finding is used to prognosticate bowel continence in spina bifida?
Bulbocavernous or anocavernous reflex
Which level of spina bifida leads to hip and knee flexion contractures
T6-T12
Treatment of bilateral hip dislocation without restriction of joint mobility in spina bifida
Leave alone
Downward displacement of medulla and brainstem through the foramen magnum
Arnold-chiari malformation
Which level of spina bifida leads to equinus foot
T6-T12 or L1-L3
What nerve roots sympathetically innervate the bladder?
T10-L2
What weeks do you do an amniocentesis?
16-18 weeks
Which level of spina bifida leads to calcaneovarus foot with ankles dorsiflexed
L4-L5
Which level of spina bifida leads to knee extension contractures
L4-L5
Below what spinal level of spina bifida can children ambulate without device
At or below S1
When do children with spina bifida begin rolling? And what is normal?
Normal = rolling by 7 months
Spina bifida = 18 months
2 main types of spina bifida
Occulta and cystica
Which type of spina bifida may be associated with Arnold-chiari malformation
Myelomeningocele
What 4 countries has the highest incidence of spina bifida
England, Scotland, Wales, Ireland
Which level of spina bifida leads to knee flexion contractures
L1-L3
What weeks do you do a fetal US
16-24 weeks
Which type of spina bifida has a cystic sac that contains the spinal cord?
Myelomeningocele
Which country has the lowest rate of spina bifida
Japan
Most common cause of death in spina bifida
Central respiratory dysfunction
What calcinosis is common with UTI of what bacteria in spina bifida patients?
Proteus
What fails to fuse in spina bifida occulta
Posterior elements of vertebrae
What 2 things can you measure in maternal serum and amniotic fluid to test for NTD?
Alpha-fetoprotein and acetylocholinesterase
What is spina bifida aperta
Any NTD where deformity is open to environment
At what age can you start intermittent catheterization for spina bifida?
5-6 yo
Why do spina bifida patients have precocious puberty
Premature activation of hypothalamus pituitary gonadal axis from increased pressure on hypothalamus
