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Spina Bifida

Spina Bifida Presentation

What is SB? Congenital abnormality of spine; Failure of fusion of posteiror vertebral arch
What is myelodysplasia? Defective development of any portion of SC; can be Aperta or Occulta
Aperta Visible or Open; Myelomenigocele or Meningocele
Myelomeningocele Open SC; No skin; Spinal paralysis; Meninges & nerve can protrude in any direction
Meningocele Skin-covered; Initially no paralysis; Contains membrane/non-fxnal nerves
Lack of what important nutrient causes SB? Folic Acid
Occulta Hidden/Not Visible; Lipoma
Lipoma Distinct mass of fat; Abnormal skin pigmentation; Hirsutism; Skin appendages; Gluteal dimples; Contains fibrous tract in subdural space
Hair on the lower back caused by SB is known as what? Faun's Beard
Myelodysplastic Lesions- Abnormal Neuralation During embyologic building of neural tube, a defect occurs somewhere b/t the hindbrain & S2
Myelodysplastic Lesions- Canalization Distal to S2; Groups of cells clump together causing cystic structures that gather into canals; Causes: unknown
What are 3 teratogens? Alcohol; Valproic Acid (anti-convulsant); Street Drugs
Incidence & Prevalence of SB 1-5/1000 live births in the US; Low incidence in blacks; Higher in Mexican/Canadian populations
Diagnosis of SB US; Amniotic Fluid; Serum alpha-fetoprotein screen
SB Impairment List Scoliosis; Club feet; Torsion of long bones; Genu varus/valgus; Joint contractures/arthrogryposis; Limb deformities; Paralysis; Osteoporosis; Diminished/absent ssn
What kind of muscle tone? Low to Flaccid
Hydrocephalus 25%+ children born with myelomeningocele; 60% after surgical closure of lesion; Can cause Arnold Chiari malformation
More Impairments... Cognitive delay; B&B (neurogenic); Seizures; Skin breakdown; Obesity
Exam, Eval, Intervention Define current status; ID potential impairments; implement preventative measures; Monitor changes in status
Exam & Intervention at Infancy Understand normal, then compare to what is present in SB pt; Orthopedic concerns: Hip dislocations/mgmt & foot deformities; Mm tone; Voluntary vs. reflexive mm mvmts; ROM & strength; Parent ed & handling
Ongoing Monitoring Joint alignment; Mm imbalance; Contracture development; Positioning; Changes in mm tone, nn involvement & fxnal improvement/decline
How often should neurodevelopmental team assessments be performed? Yearly or Bi-yearly
PT Treatments Parent ed; Bracing; Serial casting/positioning splints; Mobility aids/equipment; Educate people who interact with pt; Compensatory strategies; Facilitate independence
PT Treatment Participations with peers, academics, community activities; Pain mgmt; Transition & manage equipment if fxnal level changes; Post-surg intervention for regaining lost fxn
Created by: 1190550002