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36 Cards in this Set
- Front
- Back
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Abnormal development of any part of the spinal cord (specially the lower segments)
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Myelodysplasia
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T/F _ Spina bifida aperta is a hidden or not visible lesion.
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False: It is an open or visible lesion
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myelomeningocele
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type of spina bifida aperta involves an open spinal cord with meninges and nerves protruding dorsally, laterally, or anteriorly; usually associated with paralysis
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Signs of spina bifida occulta
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- an abnormal tuft of hair
- a collection of fat - a small dimple birthmark on the newborn's kin above the spinal defect - usually no S&S; many ppl dont even know it unless the condiiton is discovered during an x-ray or other imaging test |
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Level of impairment may increase over time due to ________________ & ________________
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1. abnormal tissue growth causing pressure on nerves
2. lack of proper growth of connective tissue around the malformed spinal cord causing tethering of the spinal cord |
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What is a lipoma?
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- a distinct subcutaneous mass of fat
- abnormal pigmentration, hirtuism, skin appendages may be visable on skin - fat or fibrous tissue descends into subdural space - may or may not be associated with bifid vertebrae - most common form of myelodysplasia |
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Lipomeningoceles
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are not associated with paralysis
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Lipomeylomeningoceles
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Have fat cells that can intrude into the spinal cord itself; usually associated with paralysis
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Lipomas of cauda equina or conus medullaris
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may or may not have paralysis at birth; they WILL get worse over time
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________________ is a fibrous, cartilaginous, or boney band separating the spinal cord into hemicords.
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Diastematomyelia. (may or may not be in conjuction with other myelodyspasias; may have paralysis initally or may tether and weaken over time)
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What are the 2 types of meylocystocele?
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1. extrophy of the cloaca (has a primitive gut or abdomen)
2. sacral agenisis (bony elements of the sacrum are missing) |
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Which of the following is NOT true about myelocystoceles?
a. is an open defect b. least common myelodyspasia c. not in canal of spinal cord or subarachnoid space d. occur in low lumbar and sacral area |
A. is an open defect
***the skin is covered |
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What is the cause of meylodysplasias from the skull to the spinal cord vertebrae (C1-S2)?
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Due to abnormal neurulation or "folding of the ectoderm"
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What is the cause of myelodyspasias from S2-distal?
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Due to abnormal canalization
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etiologies of myelodysplasias (3)
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- genetics
- teratogens (excess maternal alcohol, anticonvulsant medication, possibly street drugs) - nutritional deficiencies (folic acid) |
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What are diagnostic tests used for MM?
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alpha fetoprotein (AFP), amniocentesis, ultrasound
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What are some musculoskeletal deformities seen with myelodysplasias?
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forward head posture, rounded shoulders, kyphosis, scoliosis, excessive lordosis, ant pelvic tilt, in-toeing, out-toeing or windswept position, flexed hip and knees, pronated feet, hips should be checked for dislocation
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why is osteoporosis common?
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due to hypotonic muscles combined with decreased loading of long bones from altered mobility
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How do MM kids get hydrocephalus?
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may be born with hydrocephalus or may develop it after surgical closure of the lesion.
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What position should be avoided with hydrocephalus patients?
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Head down should be avoided!!!
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what are some factors that decraese the chance of cognitive dysfunction?
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The earlier the lesion is closed, the less infection, and the lower the lesion.
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What is the usual intelligence level?
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majority of children without hydrocephalus or with uncomplicated hydrocephalus have normal intelligence level
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What are these kids usually allergic to?
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latex (18-40% are allergic)
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What are cuases of cranial nerve palsies in children with MM? (3)
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Arnold-Chiari malformation, Hydrocephalus, Dysplasia of brainstem
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Do kids with MM develop voluntary control of their urinary or anal sphincters?
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Not usually; less than 5% do :(
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What are some of the reasons for skin breakdown? (3)
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difficulties with urine, friction on knees and feet from scooting, and bc they are unaware of body parts that do not have sensation
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What are some musculoskeletal problems associated with Down's Syndrome?
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- decraesed muscle strength
- ligamentous laxity, jt hypermobility - hypermobility of atlantoaxial jt (C1-C2); risk for dislocation - hip subluxation and dislocation in 10% of them - pes planus - patellar instability - metatarsus primus varus - diastasis recti - muscles of facial expression lack differentiation of distinct muscle bellies - hypoplasia of middle phalanx of 5th finger with clinodactyly |
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T/F _ Most children with DS have moderate-severe mental retardation.
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False. They have mild to mod retardation (IQ 30-60)
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common cardiopulmonary anomality in DS
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Tetralogy of Fallot, Patent Ductus Arteriosus, Ventricular septal defect
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common visual disorders with DS (3)
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strabismus, nystgamus, myopia
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What are feeding problems in DS?
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- poor suck and swallow in early infancy
- poor tongue and lip control - chewing difficulty - small oral cavity |
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What should PT treatment for DS include?
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- increase level of arousal through vestibular system
- increase proprioceptive awareness (thera-tog suit, lycra shorts) - increase muscle strength - improve muscle length-tension relationship - improve biomechanical alignment (orthotics, thera-tog suit) - postural control - increase speed of movement |
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Meningoceles
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the skin is covered, contains only membranes or nonfunctional nerves; initially associated with no paralysis
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Muscle tone in MM?
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children with MM have tone ranging from flaccid to spastic (25% have some spasticity)
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reasons for upper limb dyscoordination (4)
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cerebellar ataxis (arnold chiari type II); motor cortex or pyramidal tarct damage 2ndary to hydrocephalus; motor learnign deficits due to UE being yoked to balance; delayed development of hand dominance
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causes of seizures (3)
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brain malformation, shunt malfunction, infection
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