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PEDS 2B

Spina Bifida & MD for exam II

QuestionAnswer
What is Spina Bifida? A neural tube defect (NTD) in which a portion of the spinal cord & nerves protrude through an opening in the vertebral arches
Describe the 3 types of spina bifida: 1) spina bifida occulta - most common, opening in vertebrae, no protrusion, no defects; 2) meningocele - meninges & CSF in sack, some limits; 3) myelomeningocele - meninges & spinal nerves protruding into sack, significant limits
contributing factors to spina bifida lack of folic acid during pregnancy, alcohol or drugs, genetics, environmental factors or toxins, maternal health - diabetes link
frequency of spina bifida 1 in 1000; 7 in 10K
tests for spina bifida ultra sound, mother serum alphfeto protein (MSAFP) test , acetylcholinesterase
what are common medical treatments for spina bifida? surgery soon after birth to close skin, protect cyst or install shunt in cases of hydrocephalus (80% of cases)
signs of hydrocephalic shunt malfunction headache, nausea, vomiting, change in cognition or alertness
what is Alfred Chiari syndrome? when CSF is blocked between skull & SC due to malformation resulting in brain getting pushed down through occipital area
what is a neurogenic bladder? a bladder that has tone but cannot release
what are the effects on children with meningocele SB? sensory and motor disturbances below level of lesionsis - LE paraly& loss of sensation; hip, spinal or foot deformities in some cases; bowel & bladder incontinence, cognitive impairments, learning issues
OT Roles: family ed on shunt, bowel, bladder care; positioning for ADLs, hygiene, fine motor (writing), independence in self care, transfers, UE strengthening, safety for sensory loss, perceptual
What is the rehabilitative model vs. the compensatory model? Rehabilitative model: brain plasticity allows relearning of loset functions; Compensatory model: use external assistance to perform lost functions - AE, environ modification, compensatory strategies
What is the most common type of MD? Duchenne's
Causes of MD genetic - mutation is passed on by mom;
What is the MD disease process? Muscle tissue becomes necrotic; regenerates with variable muscle fiber size, then degenerates again - cycle. Eventually replaced with fat & connnective tissue
What is the usual ultimate cause of death for MD patients? respiratory infection or complication due to muscle deterioration
When is MD usually detected? between 2 to 6 years old
What are general symptoms of MD? toe walking, lordosis, clumsiness, falls, waddling, unsteady gait, regression in ability to climb stairs
what is Gower's sign? when a child uses their LE to brace UE to stand up from sitting position
what are some complications of MD? scoliosis - due to decreased trunk muscle control; contractures due to imbalance from uneven muscle loss; respiratory problems due to inability to cough; MR/LD
Tests to diagnose MD CPK (creatine phosphokinase) enzyme in blood; muscle biopsy; electromyography; choronic villus sample; famiy history
OT roles in MD positioning; equipment/adaptations; ADLs; exercise - to maintain but care to not overdo as in MS; nutrition; stretch, splints; school devices; fam training; transfer training; self-esteem; death & dying; companion animals; MAS; standing activities
diadochokinesia the ability to make antagonistic movements such as pronation/supination in quick succession
Created by: sherryama
 

 



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