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PEDS 2B
Spina Bifida & MD for exam II
| Question | Answer |
|---|---|
| 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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