Spina Bifida Flashcards
(26 cards)
what is spina bifida
NDT causing vertebral or SC malformation
caudal neuropore did not close in 26th day
etiology of spina bifida
females more
polygenic inheritance and environmental
mas common is meron 1st deg relatives
febrile or high temp during 1st trimester
5,10-Methyltetrahydrofolate
alteration in this enzyme alters homocysteine levels
impaired processing of folic acid
Methylenetetrahydrofolate reductase
instructions for making enzyme
reacts c folate
how much folate should women take
.4 mg/d 1 month a preg and until1st trimester
risk factors of SB
maternal obesity: BMI > 29
gestational DM
inc vit A more than normal for 2 yrs before preg
valproic acid
high concentration of disinfectants
discuss brain development
from ectoderm
3rd day nag sstart na mag develop
27th day nueral tube is being developed
primary neuralation
closure of the brain and SC
secondary neuralation
final closure of the neural tube
caudal region in 26th
discuss prenatal diagnosis of SB
AFP levels in amniotic fluid: 16-18th wk
fetal US: 16-24th wk
24th wk pwede pa i trace
30th wk bulge na sa US at LS area
discuss spina bifida occulta
closed spinal dysraphism - most mild
vertebral arch does not grow and fuse - lumbar or sacral
non fusion only but intact SC and meninges
- bifid but only one
patches and hair projections
spini bifida cystica
MC in lumbar
spine is bifid nad cyst forms
spina bifida manifesta
myeloschisis and tethering = hydrocpehalus
meningocele
defect of post elements of spine c extrusion of meninges and CSF
ok SC
myelomeningocele
MC NTD
extrusion of meninges, CSF and SC
more functional limitations
exposed SC like buntot and brain gets pulled down
myeloschisis
neural tissue is exposed to environment s sac or meninges
neurologic compli of SB
diastematomyelia
tethered cord syndrome
arnold chiari 2
abnormal ventricles
forebrain affectation
non-neuro - latex allergy
flow of CSF
choroid plexus
lat vent
monroe
sylvius aqueduct
fourth vent
luschka
magendie
arachnoid
dsicuss prognosis for SB
prenatally dx - less severe
lower anataomic level - better dev outcomes
aggressive tx c closure in neonatal - survival
higher level, hydrocephalus and chiari = worse
what level would cause neurogenic bowel and bladder
all except the lowest sacral
what level would cause cognitive impairment
cervical - higher
where is folate found
green leafy vegetables
community amb s AD
gr 4-5 glutes and TA
no complete reliance on w/c and most can com amb
gr 4-5 iliopsoas and quads
