Spina Bifida, Syringomyelia, Cerebral Palsy (Exam 2) Flashcards
T/F: neural tube defects can occur anywhere along the neural tube
true
What is the most common region for a neural tube defect?
distal aspect of the spinal cord
What accounts for most CNS malformations?
neural tube defects
What are the 4 types of neural tube defects?
1) anencephaly
2) myelomeningocele
3) meningocele
4) spina bifida occulta
What is anencephaly?
-malformation of anterior end of neural tube
-failure of the rostral neuropore
-partial absence of brain and calvarium
-forebrain does not develop
-stillborn baby
Generally speaking, what is spina bifida?
-neural tube does not close properly
-can occur anywhere in the spine
-vertebral structures do not form
-often results in damage to spinal cord and/or nerves
-may cause physical and intellectual disabilities
What is a myelomeningocele?
-a fluid filled sac containing part of the spinal cord and nerves
-involves both the spinal cord and meninges
-causes moderate to severe disabilities
What is the most serious type of spina bifida?
myelomingocele
What is a meningocele?
-a fluid filled sac protrudes through an opening in the baby’s spine
-does not contain the cord in the sac
-can cause minor disabilities
What is the mildest form of spina bifida?
spina bifida occulta
What is spina bifida occulta?
-small gap at the posterior aspect of the vertebral arch
-often asymptomatic
-does not cause any disabilities
-often presents with a tuft of hair over the defect area
What is syringomyelia?
Boards q
-development of a fluid filled cyst called a syrinx within the spinal cord
-the cyst is filled with CSF and can block CSF flow
-most commonly occurs in the cervical region, which affects the brachial plexus nerve roots
-the cyst may enlarge and damage the cord
-impeded CSF flow would increase intracranial pressure
-can be due to congenital defect (Arnold-Chiari Malformation), trauma, tumors, infections
-may be asymptomatic until patient hyperflexes or hyperextends
-destruction of the gray and white matter around the syrinx, specifically sensory fibers crossing the anterior spinal commissure to join the spinothalamic tract
-isolated loss of pain and temp sensation across the shoulders and upper extremities
-patient experiences a cape like or shawl like distribution where they do not feel pain and or temp in areas usually covered by a cape or shawl
What is an Arnold-Chiari Malformation?
-brain tissue extends into the spinal canal
-can be asymptomatic, or symptoms can be triggered by a traumatic event like a car accident
-there are 3 types
What are the 4 complications of Arnold-Chiari Malformation?
1) hydrocephalus
2) spina bifida
3) tethered cord syndrome
4) syringomyelia
What is the most common type of Arnold-Chiari Malformation?
type 1
What is the mildest form of Arnold-Chiari Malformation?
type 1
What is type 1 Arnold-Chiari Malformation?
-develops as the skull and brain are growing
-cerebellar tonsils extend into the foramen magnum
-herniation of the cerebellar tonsils, medulla, and 4th ventricle into the spinal canal
What is type 2 Arnold-Chiari Malformation?
-observed via ultrasound in utero
-small shallow posterior fossa
-greater amount of brain tissue extends through the foramen magnum
-often associated with myelomeningocele spina bifida
What is type 3 Arnold-Chiari Malformation?
-observed via ultrasound in utero
-cerebellum and brainstem protrude into the foramen magnum
What is the most severe type of Arnold-Chiari Malformation?
type III
What is cerebral palsy?
-non-progressive neurological motor deficit associated with injury during the prenatal and perinatal periods
-brain injury occurring in the perinatal period
-probable causes of brain injury include: cerebral anoxia (baby loses oxygen, most common cause, can be cord wrapped around neck), hemorrhage (this happens when mom is Rh- and baby is Rh+ the mom develops Abs against baby’s blood), stroke with mom or baby, CNS infection of mom or baby, or encephalopathy
-4 types of cerebral palsy
What is the most common motor disability in childhood?
cerebral palsy
What are the 4 types of cerebral palsy?
1) spastic
2) ataxic
3) athetoid or dyskinetic
4) mixed
What is spastic cerebral palsy?
-muscles appear stiff and tight
-increased muscle tone
-arises from motor cortex damage
-damages UMNs
-dystonia
-hyper-reflexive DTR
-has 3 types of gait: spastic diplegic gait (scissor walk), spastic hemiplegic gait, spastic quadriplegia (cannot walk)
What is the most common type of cerebral palsy?
spastic
What is ataxic cerebral palsy?
-characterized by shaky movements
-affects balance and sense of position in space
-arises from cerebellum damage or its pathways
-hypotonia (abnormally low muscle tone)
-hyporeflexia (decreased DTR)
-ataxic wide based gait
What is athetoid or dyskinetic cerebral palsy?
-characterized by obvious abnormal involuntary movements like chorea, athetosis, choreoathetosis, involuntary facial expressions
-arises from basal ganglia damage
-non-ambulatory
-can become more severe with stress, decrease with relaxation and disappear entirely with sleep
What is mixed cerebral palsy?
-combination damage of both spastic and athetoid/dyskinetic
-significantly impaired function
delayed growth and development
-wheelchair bound
-dysphagia (difficulty eating)
-dysarthria (impaired speech)
-intellectual impairment
-seizures
What is the most severe cerebral palsy?
mixed
