Neurologic Disorders: Cranial Defects and Malformations
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Questions and Answers

What is the primary cause of craniosynostosis?

  • Chromosomal defect or from drugs, toxins or radiation
  • One or more of the sutures close too soon (correct)
  • Imbalance of CSF absorption or production
  • The brain fails to grow

    • What is the primary characteristic of microcephaly?

  • One or more of the sutures close too soon
  • The brain fails to grow (correct)
  • Malformations of the neural tube
  • Imbalance of CSF absorption or production

    • What is the goal of surgical implementation for hydrocephalus?

  • To bypass the blockage and drain CSF from the ventricles to a location where it can be reabsorbed (correct)
  • To reduce intracranial pressure
  • To increase CSF production
  • To close the neural tube

    • What is the most common type of shunt used for hydrocephalus?

    <p>VP shunt</p> Signup and view all the answers

    What is the earliest common sign of shunt malfunction in toddlers?

    <p>Headache and anorexia</p> Signup and view all the answers

    What is the primary cause of spina bifida?

    <p>Neural tube failure to close during embryonic development</p> Signup and view all the answers

    What is the primary assessment for hydrocephalus in infants?

    <p>Increased HC</p> Signup and view all the answers

    What is the primary postoperative care for hydrocephalus?

    <p>All of the above</p> Signup and view all the answers

    What is the characteristic of Spina bifida occulta?

    <p>Posterior vertebral arches fail to close in the lumbosacral area</p> Signup and view all the answers

    What is a sign of myelomeningocoele?

    <p>Flaccid paralysis of legs</p> Signup and view all the answers

    What is the primary goal of assessment in a patient with Spina bifida?

    <p>To evaluate the extent of spinal cord involvement</p> Signup and view all the answers

    What is the primary method of diagnosis for Meningitis?

    <p>Lumbar puncture and CSF analysis</p> Signup and view all the answers

    What is the definition of Seizure Disorders?

    <p>Sudden transient alterations in brain function resulting from excessive levels of electrical activity in the brain</p> Signup and view all the answers

    What is the primary goal of implementation in a patient with Meningitis?

    <p>To administer antibiotics as prescribed</p> Signup and view all the answers

    What is the purpose of administering anticholinergics in a patient with Spina bifida?

    <p>To improve urinary continence</p> Signup and view all the answers

    What is the primary goal of placing a patient with Spina bifida in a prone position?

    <p>To facilitate feeding</p> Signup and view all the answers

    What is the primary purpose of assessing the time of onset, precipitating events, and behavior before and after a seizure?

    <p>To obtain information from parents about the seizure</p> Signup and view all the answers

    Which of the following is a seizure precaution?

    <p>Instructing the child to swim with a companion</p> Signup and view all the answers

    What is the primary goal of emergency treatment for seizures?

    <p>To ensure the patency of airways</p> Signup and view all the answers

    What is the characteristic of spastic cerebral palsy?

    <p>Abnormality in the extrapyramidal motor system</p> Signup and view all the answers

    What is the purpose of assessing the child's developmental level and intelligence in cerebral palsy?

    <p>To develop an intervention plan</p> Signup and view all the answers

    What is the result of defects in the structures of the eye?

    <p>Vision disturbance</p> Signup and view all the answers

    What is the purpose of providing a safe environment for a child with cerebral palsy?

    <p>To prevent injuries and accidents</p> Signup and view all the answers

    What is the focus of early intervention in cerebral palsy?

    <p>Encouraging communication and interaction on a functional level</p> Signup and view all the answers

    Study Notes

    Malformations of the Nervous System

    Cranial Defects

    • Craniosynostosis: one or more sutures close too soon, increasing ICP and interfering with normal brain growth, leading to MR
    • Assessment:
      • Suture lines of the skull manually palpated
      • Radiographs taken to confirm diagnosis
    • Microcephaly: brain fails to grow, may be due to chromosomal defect, drugs, toxins, or radiation, leading to MR
    • Hydrocephalus:
      • Imbalance of CSF absorption or production
      • Caused by malformations, tumors, hemorrhage, infection, or trauma
      • Types: communicating (impaired absorption in arachnoid space) and non-communicating (obstruction of CSF flow in ventricular system)
      • Assessment:
        • Infant: increased HC, Macewen's sign, tense and bulging anterior fontanel, dilated scalp veins, frontal bossing, and sunsetting eyes
        • Child: behavior changes, headache, nausea, vomiting, ataxia, and nystagmus
    • Surgical Implementation: VP shunt (CSF drains into peritoneal cavity) or AV shunt (CSF drains into right atrium)

    Post-Operative Care

    • Otitis media
    • Observe for increased ICP and elevate HOB 15-30 degrees if present
    • Monitor for infection
    • Measure HC and I&O
    • Provide comfort measures and administer medications (diuretics, antibiotics, or anticonvulsants)

    Spina Bifida

    • CNS defect due to neural tube failure to close during embryonic development
    • Types:
      • Spina bifida occulta: posterior vertebral arches fail to close in lumbosacral area, spinal cord intact and not visible
      • Meningocoele: protrusion involves meninges and a sac-like structure
      • Myelomeningocoele: protrusion of meninges, CSF, nerve roots, and portion of spinal cord
    • Assessment:
      • Depends on spinal cord involvement
      • Visible spinal defect
      • Flaccid paralysis of legs and altered bladder and bowel function
    • Implementation:
      • Evaluate sac and measure lesion
      • Monitor for increased ICP and measure HC
      • Protect the sac with a sterile, moist dressing
      • Place in prone position and turn head to one side for feeding
      • Administer antibiotics, anticholinergics, and laxatives
      • Monitor for early signs of infection

    Meningitis

    • Infectious process of the CNS caused by bacteria and viruses
    • Diagnosis: CSF analysis (increased pressure, cloudy CSF, high protein, and low glucose)
    • Assessment:
      • Fever, chills, vomiting, diarrhea, poor feeding or anorexia, and altered LOC
      • Bulging anterior fontanel and nuchal rigidity
    • Implementation:
      • Isolation for at least 24 hours after antibiotics are initiated
      • Administer antibiotics as prescribed
      • Monitor VS and neuro status
      • Monitor I and O and assess nutritional status
      • Determine close contacts of the child with meningitis

    Seizure Disorders

    • Sudden, transient alterations in brain function due to excessive electrical activity in the brain
    • Assessment:
      • Obtain information from parents about the time of onset, precipitating events, and behavior before and after the seizure
    • Seizure Precautions:
      • Raise side rails and pad them
      • Place a waterproof mattress on the bed
      • Instruct the child to swim with a companion
      • Alert caregivers to the need for special precautions
    • Emergency Treatment for Seizures:
      • Ensure patency of airways
      • Ease the child to the floor if standing or sitting
      • Place a pillow or folded blanket under the child's head
      • Loosen restrictive clothing
      • Clear the area of hazards
      • Turn the child to one side if vomiting occurs
      • Do not restrain the child or place anything in their mouth
      • Remain with the child until fully recovered
      • Prepare to administer medications

    Cerebral Palsy

    • Disorder characterized by impaired movement and posture due to an abnormality in the extrapyramidal motor system
    • Assessment:
      • Extreme irritability and crying
      • Feeding difficulties
      • Stiff and rigid arms and legs
      • Delayed gross development
      • Abnormal motor performance
      • Alterations of muscle tone
      • Abnormal posturing
      • Persistence of primitive reflexes
    • Implementation:
      • Early recognition and intervention
      • PT, OT, speech therapy, education, and recreation
      • Assess the child's developmental level and intelligence
      • Encourage communication and interaction with the child on a functional level
      • Provide a safe environment
      • Position upright after meals
      • Provide safe, appropriate toys for age and developmental level

    EENT Disorders

    • Diplopia (Double Vision):
      • Vision occurs due to light rays reflecting from an object through the cornea, aqueous humors, lenses, and vitreous humors to the retinas
      • Defects in these structures cause vision disturbance

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    Description

    This quiz covers cranial defects and malformations of the nervous system, including craniosynostosis, microcephaly, and hydrocephalus. Learn about the causes, symptoms, and assessments for these neurological disorders.

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