Spine Bifida

Question 1

Hydrocephalus

ACM type2

Answer 1

-irritablity
-personality
-memory loss
-letahrgy
-vomiting
-motor and sensory impairments
-setting sun sign, downward gaze
-3, 4, 5 cranial nerve : pappiloedema
-weakness at level of lesion, spasticity below the level of lesion
B/B dysfnxn

Question 2

Hydrocephalus Mx.

Answer 2

1.positionong- prone /side lying in lap
-holding from armpits
position shd be avoided:
-frog leg sitting
-W sitting
-heel sitting
-cross leg sitting
-ring sitting , for short periods
2. develop head control
-palm under chest-> towel under chest-> hook lying with toys-> on therapeutic ball-> u/e reaching
3. develop trunk control: prop sitting, fwd/bkwd, tranfers in sitting to rotate trunk, deveop righting and eqlbm
4. ambulation: for 12-24 mnths of child needed
beyond 24 mnths: reciprocating gait orthosis, para walker, wheelchair

Question 3

Spina Bifida , functional levels (T11-S2)?
occulta
cystica
meningocele (meninges+ CSF)
myelomeningocele (meninges+CSF+spinal cord)

Answer 3

Causes: folic acid, alcohol, genetic
- increased alpha feto protein even after 14 weeks
-C/M: 
commonest lumbosacral
-cord involved- UMNL , other wise LMNL
-osteoporosis
-Neurogenic bladder in meningomyelocele
Deformities: HIP- dysplasis and dislocation......SPINE-kyphosis and scoliosis.....Ankle-pes cavus and equinovarus