4.1- Peds 1 Flashcards Preview

Neuro > 4.1- Peds 1 > Flashcards

Flashcards in 4.1- Peds 1 Deck (40):
0

Conception to 2 weeks

Preembrionic stage

1

Starts with egg being fertilized-after fertilization the cell divides until a sphere of cells is formed. During implememtation into the uterus, that inner layer of cells beomes the embryonic disc.

Preembrionic stage

2

14 days - 8 weeks

embryonic stage

3

Embryonic stage:

1. Edges of the ______fold towards each other forming the ________ _________
2. The folds of the _______ __________ grow toward eachother finally touching around day 21 to make the ________ __________.
3. Neural tube closure can be affected by ________/_________, lack of ______ ______etc. before a woman knows shes pregnant.

1. disc, neural groove
2. neural groove, nerual tube
3. alcohol/drugs, folic acid

4

The neural tube closes first in the cervical region and from the top to bottom like a zipper leaving open ends called?

neuropores

5

This part of the neuropore closes by day 27

superior neuropore

6

This neuropore closes about 3 days later, any later will cause abnormalities

inferior neuropore

7

The folds of the neural groove grow toward each other finally touching around day 21 to make what structure?

Neural tube

8

What forms the neural groove?

Edges of the embryonic disc

9

This occurs when the cranial end of the neural tube does not close. Brain stem forms but not the Cerebral or Cerebellar hemispheres. Skull does not form over incomplete brain leaving it exposed-fatal

Anencephaly

10

Partial failure to close cranial end of the tube causing malformation of teh cerebellum and brain stem. the structure wedge in the foramen magnum causing problems with the circulation of CSF.

Arnold-Chiari malformation

11

Increased pressure causes enlarged ventricles and increased pressure on the brain stem

hydrocephalus

12

Not as severe, symptoms often do not start until early adulthood. Causes severe headache, vomiting and lethargy

Type 1-arnold-chiari malformation

13

Obvious at birth due to enlarged cranium (result of enlarged ventricles) and the fontanel bulges.

Type 2-Arnold-Chiari malformation

14

Surgically a shunt is run from ventricle to abdomen to relieve pressure. Must watch for signs of shunt blockage.

Type 2-Arnold-Chiari malformation

15

Signs for shunt blockage:

young child:
Older child:

younger child: bulge of fontanels, thin skin/sparse hair over skull
older child: lethargy, vomiting, confusion, dizziness

16

Regardless of the type of Arnold-Chiari malformation, we must avoid what?

prolonged head down position

17

What is spina bifida?

occurs when inferior neural tube does not close

18

Posterior arch does not close

Bifida vertebrae

19

What are the 2 types of spina bifida?

1. Spina bifida occulta
2. spina bifida cystica

20

Bony defect, but neural tissue does not protrude-no neural signs-sc works normally. May have tuft of hair over

Spina bifida occulta

21

Generally lower lumbar, but can affect T-spine, no rx required

spina bifida occulta

22

Visible cyst protruding from the bony defect that may be covered by skin or meninges

spina bifida cystica

23

What are the 2 types of spina bifida cystica?

1. Meningocele
2. Myelomeningocele

24

Cyst has only CSF and meninges, may have very mild changes in sensation or motor tone below lesion, but not significant

Meningocele

25

SC is involved in the cyst

myelomeningocele

26

Myelomeningocele:
1. problems depend on the level of damage: neural deficits below the lesion may include:
a. ________ paralysis--if nerve roots are damaged
b. _________ paralysis--if part of the SC below the lesion is intact

a. Flacid
b. Spastic

27

What other problems are associated with myelomeningocele?
Hint: there are 6

1. osteoporosis-b/c no muscular force on the bone
2. scoliosis-either caused by skeletal deformity or muscle imbalance
3. foot deformity-most common club foot
4. sensory loss-can't feel for pressure relief
5. bowel and bladder incontinence
6. latex allergy

28

What is the most common foot deformity caused by myelomeningocele?

club foot

29

Caused by scarring of surgical repair-ancors cord to surgical site and as column grows, increasing neuro symptoms. Immediate report any deterioration to MD

Tethered cord syndrome

30

PT intervention: Prevent secondary problems from occurring during growth and development
1. _____ to avoid deformities
2._________
3. _________
4. Cover ______ when learning to crawl/creep
5. ________ 2-3x/day
6. _______ and _______ control

1.position
2.handling
3. orthoses
4. feet
5.ROM
6. head/neck

31

position to avoid ________

deformities

32

Position off any _______ scars initially

surgical

33

What position is important to prevent hip deformations,knee flexion contractures

Prone

34

What position also helps develop head and neck control?

prone

35

Teach family/caregivers appropriate handling techniques to allow proper ________ and _________ interaction with environment

alignment and sensory

36

Support ______ until control developes

head

37

What should be used PRN to prevent contractures?

orthoses

38

May need ________ pillow to avoid ______ dislocations. Night splints to prevent ________
contractures.
Watch _______ with any device

adduction, hip, PF, skin

39

The structures wedge in the foramen magnum causing problems with the circulation is what defect?

Arnold-Chiari malformation