Term
|
Definition
| defective development of any part of spinal cord during gestation (28th day) |
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|
Term
| Types of myelodysplasia (3) |
|
Definition
spina bifida occulta
lipomeningocele
spina bifida cystic/aperta |
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|
Term
| Spina bifida occulta: characteristics (5) |
|
Definition
hidden/not visible lesion
non-fusion of vertebral arches, s disturbance of underlying neural tissues
midline tuft of hair/abnormal pigmentation
assoc c tethered cord |
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|
Term
| Lipomeningocele: characteristics (4) |
|
Definition
visible 'spina bifida occulta'
superficial fatty mass in low lumbar/sacral level
abn pigmentation, dimples about gluteal cleft
high incidence of bowel/bladder probs, tethered cord (not likely LE impairments) |
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|
Term
| Spina bifida cystic/aperta: characteristics (3) |
|
Definition
visible/open lesions
external sac of meninges/spinal cord protruding dorsally
2º to defect in dorsal vertebra |
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|
Term
| Spina bifida cystic/aperta: types (2) |
|
Definition
meningocele
myelomeningocele |
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Term
|
Definition
protruding sac c meninges & CSF
nn roots/spinal cord INTACT
no deficits if fixed right away (incr risk of infection) |
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Term
|
Definition
open spinal cord defect (no skin covering)
contains meninges & nerves
may protrude ant/lat (inside body)
usually causes paralysis |
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|
Term
|
Definition
| spinal cord closing distal to S2 |
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Term
|
Definition
|
|
Term
| Embryology: closing of cranial neural tube |
|
Definition
24th day of gestation
(failure to close = anencephaly) |
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|
Term
| Embryology: closing of caudal neural tube |
|
Definition
26th day of gestation
(failure to close = spina bifida) |
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|
Term
| Spina bifida: etiology (3) |
|
Definition
assoc c other genetic abn
teratogens (excess maternal alcohol)
nutritional deficiency (inadequate folic acid) |
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|
Term
| Spina bifida: prenatal testing (4) |
|
Definition
maternal serum alpha-fetoprotein (AFP) (incr AFP = incr risk for SB)
AFP secreted by fetal liver, found in mom's blood
ultrasonography (detect neural tube defects)
amniotic fluid analysis (chromosomal error) |
|
|
Term
| Spina bifida: perinatal mgmt - sx repair in utero (3) |
|
Definition
decr need for shunt
incr LE fxn
improvement in Chiari malformation |
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|
Term
| Spina bifida: post-natal mgmt (3) |
|
Definition
immediate sterile care of lesion to prevent infection
sx closure within 72 hr
bowel/bladder care ed (intermittent catheterization) |
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|
Term
| Spina bifida: complications (5) |
|
Definition
diastematomyelia
tethered cord
Arnold Chiari malformation
hydrocephalus
neurogenic bowel/bladder |
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|
Term
| Spina bifida: diastematomyelia (3) |
|
Definition
spinal cord split into hemi-cords by cartilaginous/bony band; each cord covered by dural sac
paralysis initially; progressive weakness 2º to tethered cord |
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|
Term
| Spina bifida: tethered cord (3) |
|
Definition
may not present symptoms until adulthood (depending on severity)
**progressive** problem
bowel/bladder, sensory, motor probs emerge |
|
|
Term
| Spina bifida: Arnold Chiari malformation (3) |
|
Definition
herniation of post cerebellum & brainstem through foramen magnum
obstruction of CSF from 4th ventricle, foramen magnum
Grades I-V (V=greatest herniation) |
|
|
Term
| Spina bifida: hydrocephalus = |
|
Definition
| abnormal accumulation of CSF in cranial vault >> incr pressure on brain |
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|
Term
| Spina bifida: hydrocephalus - causes (3) |
|
Definition
overproduction of CSF
failure to absorb CSF
obstruction of CSF flow (Chiari II malformation) |
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|
Term
| Spina bifida: hydrocephalus - prevalence in children c SB |
|
Definition
| 90% chance of hydrocephalus in SB kid |
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|
Term
| Spina bifida: hydrocephalus - Rx |
|
Definition
| ventriculoperitoneal shunt (head >> peritoneum) |
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|
Term
| Spina bifida: S/Sx of shunt malfunction (9) |
|
Definition
vomiting
redness along tract
HA
personality changes
seizures
high-pitched cry
lethargy
nystagmus
infant: bulging fontanelle |
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|
Term
| Spina bifida: neurogenic bowel/bladder - goal |
|
Definition
| infection-free social continence c preservation of renal & colon fxn (kids self-cath every 4 hr) |
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|
Term
| Spina bifida: mmsk impairments |
|
Definition
motor paralysis
biomechanical malalignment
contractures |
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|
Term
| Spina bifida: motor paralysis - skip lesion |
|
Definition
| inadequate strength of mm group c higher innervation of lowest fxning group (e.g. hip flex 3/5, PF 5/5) |
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|
Term
| Spina bifida: biomechanical alignment issues (4) |
|
Definition
scoliosis (congenital 2º to vertebral anomaly, acquired 2º to spinal mm imbalance)
excessive lordosis
ant pelvic tilt
rotational deformities of hip |
|
|
Term
| Spina bifida: typical contractures - high level (T-L2) |
|
Definition
hip FABER
knee flex
ankle PF
spine lordosis |
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|
Term
| Spina bifida: typical contractures - mid/low level (L3-L5) |
|
Definition
hip/knee flex
genu/calcaneal valus
pron in WB |
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|
Term
| Spina bifida: impairments - thoracic level: cognition |
|
Definition
| incr cognitive involvement |
|
|
Term
| Spina bifida: impairments - thoracic level: sitting balance |
|
Definition
|
|
Term
| Spina bifida: impairments - thoracic level: hip flex |
|
Definition
|
|
Term
| Spina bifida: impairments - thoracic level: amb |
|
Definition
possible c RGO/HKAFO
usually w/c for most mobility |
|
|
Term
| Spina bifida: impairments - thoracic level: bowel/bladder |
|
Definition
|
|
Term
| Spina bifida: impairments - L1,L3: sitting balance |
|
Definition
|
|
Term
| Spina bifida: impairments - L1,L3: hip flex strength |
|
Definition
|
|
Term
| Spina bifida: impairments - L1,L3: amb |
|
Definition
short distance/household amb
RGO or KAFO |
|
|
Term
| Spina bifida: impairments - L1,L3: LTG |
|
Definition
|
|
Term
| Spina bifida: impairments - thoracic level: LTG |
|
Definition
| indep c self-care/mobility; usually in group home or SNF |
|
|
Term
| Spina bifida: impairments - L4...S1: sitting balance |
|
Definition
|
|
Term
| Spina bifida: impairments - L4...S1: hip flex |
|
Definition
|
|
Term
| Spina bifida: impairments - L4...S1: knee flex/DF |
|
Definition
|
|
Term
| Spina bifida: impairments - L4...S1: amb |
|
Definition
| functional (may use AFOs or Lofstrands) |
|
|
Term
| Spina bifida: impairments - L4...S1: LTG |
|
Definition
| indep living & employment (75%) |
|
|
Term
| Spina bifida: impairments - S2,S3: PF |
|
Definition
|
|
Term
| Spina bifida: impairments - S2,S3: gluteals |
|
Definition
|
|
Term
| Spina bifida: impairments - S2,S3: bowel/bladder |
|
Definition
|
|
Term
| Spina bifida: impairments - 'no loss' below S3 |
|
Definition
NORMAL bowel/bladder
possible foot orthoses to maintain STJ neutral
nearly full strength |
|
|
Term
| Spina bifida: other impairments associated (7) |
|
Definition
osteoporosis
cognitive fxn
upper limb discoordination
visual-perceptual deficits
CN palsies (VI, IX, X)
spasticity
seizures |
|
|
Term
| Spina bifida: UE discoordination - causes |
|
Definition
cerebellar ataxia (Chiari malformation)
M1/pyramidal tract damage
UE used for support rather than exploration |
|
|
Term
| Spina bifida: PT exam (9) |
|
Definition
A/PROM
mm strength (specific)
jt alignment
orthopedic deformities
mm tone
sensation (decr)
motor development
ADLs
equipment needs |
|
|
Term
| Spina bifida: PT mgmt (4) |
|
Definition
prevent deformities through bracing/positioning
monitor CNS deterioration
HEP (daily ROM, impr GMS)
keep kids MOVING (impr lung capacity, decr contractures) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
injury during labor:
large child/small birth canal
breech extraction
forceful traction & rotation of head during delivery
abn uterine positioning
congenital abn:
cervical rib
abn thoracic vertebrae
shortened scalene m |
|
|
Term
| BPI: pathphysiology - 3 types of injury |
|
Definition
neurotmesis
axonotmesis
neuropraxia |
|
|
Term
|
Definition
complete rupture of br plex
neuroma common
limited recovery |
|
|
Term
|
Definition
disruption of axon; sheath intact
better Px
axon regrowth: 1mm/day |
|
|
Term
|
Definition
temporary nn conduction block c intact axon
recovery in days/weeks (edema) |
|
|
Term
| Erb's palsy: presentation |
|
Definition
| "waiter's tip" position: shldr ex/IR/add; elbow ext; FA pron; wrist/finger flex |
|
|
Term
| Erb's palsy: areas of weakness |
|
Definition
shld ER, abd, **flex**
elbow flex
wrist sup/ext |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Erb's palsy: mech of injury |
|
Definition
| lat mvmt of head c shldr depression (br plex compressed against 1st rib) |
|
|
Term
| Klumpke palsy: prevalence |
|
Definition
|
|
Term
| Klumpke palsy: areas of weakness |
|
Definition
wrist/finger flex/ext
(Øshldr/elbow) |
|
|
Term
|
Definition
biceps intact
ABSENT grasp reflex |
|
|
Term
| Klumpke palsy: mech of injury |
|
Definition
| abd of shldr c arm traction (br plex compressed under coracoid) |
|
|
Term
| BPI: assoc impairments (9) |
|
Definition
mm imbalance
mvmt substitutions
abn posturing (shldr add/IR, FA pron, wrist flex)
torticollis (SAME side)
learned nonuse
GH sublux/dislocation
radial dislocation
elbow flex contracture
poor bone growth |
|
|
Term
|
Definition
mobility (PROM)
motor fxn (AROM) - patterns of UE
posture (supine, prone)
reflex testing
should be NO tone
Mallet classification (5-25pt; higher score = higher fxn) |
|
|
Term
|
Definition
ROM c caution
teach positioning precautions
decr compensation patterns
splint/kinesiotape
developmentally appropriate activities
feed sensory system
wrist rattles, hand puppets
splinting
constraint-induced mvmt therapy
HEP |
|
|
Term
| BPI: common compensation patterns (2) |
|
Definition
shldr flex compensated c scap elev
elbow ext compensated c trunk rot |
|
|
Term
|
Definition
carry c involved arm in flex (stretch)
play activities incr WB, sup, elbow ext, shldr flex; symmetrical mvmt |
|
|
Term
|
Definition
| neural oscillation; repetitive neural activity in CNS |
|
|
Term
|
Definition
| recurrent & unprovoked seizures |
|
|
Term
| Causes of seizure in infant (4) |
|
Definition
hydrocephalic infection encephaly
CNS infection
trauma
abnormalities in CNS |
|
|
Term
| Causes of seizure in child (3) |
|
Definition
trauma
infection
idiopathic |
|
|
Term
|
Definition
| stop the activity!! stop brain injury |
|
|
Term
| Seizures: meds immediately following/during seizure |
|
Definition
|
|
Term
|
Definition
Keppra
Trileptal
Topomax
Dilantin
Neurontin |
|
|
Term
| Seizure: side effects of common meds (6) |
|
Definition
personality changes
flat affect
tiredness
dizziness
HA
blurred vision |
|
|
Term
Case Study: R Erb's palsy
Impairments @ 3m: |
|
Definition
prone on FAs
hand to midline in supine |
|
|
Term
Case Study: R Erb's palsy
Impairments @ 4m: |
|
Definition
prone WB
reaching up in supine |
|
|
Term
Case Study: R Erb's palsy
Impairments @ 5m: |
|
Definition
prone WS (can't get off L UE)
happy baby
prop sitting |
|
|
Term
Case Study: R Erb's palsy
Impairments @ 6m: |
|
Definition
| rolling to L (away from involved UE) |
|
|
Term
Case Study: R Erb's palsy
Impairments @ 7m: |
|
Definition
| creeping (will prefer to L side-scoot) |
|
|
Term
Case Study: R Erb's palsy
Ambulation: |
|
Definition
amb earlier than typically developing child
ø reciprocal arm swing |
|
|
Term
Case Study: R Erb's palsy
reflexes: |
|
Definition
| decr/absent equilibrium rxns, protective ext |
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|
