Questions and Answers
Which type of spina bifida is characterized by the protrusion of the meninges and a sac containing cerebrospinal fluid?
What is a common characteristic of Spina Bifida Occulta?
Which medication group has been linked as a risk factor for the development of spina bifida?
How does myelomeningocele differ from other types of spina bifida?
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Which factor is NOT associated with the epidemiology of spina bifida?
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What is a primary consequence of hydrocephalus?
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Which condition is characterized by loss of bladder and bowel control?
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What orthopedic issue may result from spina bifida?
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Which complication is a life-threatening infection surrounding the brain and spinal cord?
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What is a common psychosocial aspect faced by individuals with spina bifida?
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Which of the following is NOT a potential physical complication of spina bifida?
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What type of movement restriction is caused by Tethered Cord Syndrome?
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How does spina bifida impact development?
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What is a characteristic clinical sign of myelomeningocele?
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Which treatment option is not typically associated with managing spina bifida?
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Which investigation is crucial for diagnosing spina bifida?
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What psychosocial aspect commonly affects individuals with spina bifida?
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Which of the following symptoms is associated with hydrocephalus in spina bifida?
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The Lemon and Banana signs are diagnostic indicators of which condition?
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A common developmental impact of myelomeningocele is which of the following?
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Which deformity is commonly associated with spina bifida?
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Study Notes
Neurological Complications
- Hydrocephalus: Accumulation of cerebrospinal fluid in the brain leading to increased intracranial pressure and potential brain damage.
- Tethered Cord Syndrome: Abnormal attachment of the spinal cord to the spine creates mobility limitations and neurological symptoms.
Physical Complications
- Mobility Issues: Muscle weakness or paralysis, primarily affecting the legs, contributing to challenges in walking and movement.
- Orthopedic Problems: Includes deformities like scoliosis (spinal curvature), hip dislocation, and foot deformities.
Bladder and Bowel Complications
- Incontinence: Loss of control over bladder and bowel functions, commonly resulting from nerve damage.
- Frequent Infections: Increased incidence of urinary tract infections due to dysfunctional bladder.
Other Complications
- Meningitis: Infection of the protective tissues surrounding the brain and spinal cord; poses serious health risks.
- Skin Problems: Increased risk for pressure sores and skin issues, typically due to reduced mobility and sensation.
Background on Spina Bifida
- Definition: A neural tube defect characterized by incomplete closure of neural arches and layers surrounding the spinal cord, resulting in a congenital anomaly.
Etiology
- Risk Factors: Includes family history, folic acid deficiency, uncontrolled diabetes, obesity, hyperthermia during pregnancy, and certain medications, especially anticonvulsants.
Epidemiology
- Most common neural tube defect, occurring in 1-2 per 1000 births.
- More prevalent in females compared to males, often of idiopathic origin.
Types of Spina Bifida
- Spina Bifida Occulta: The most common, least severe form; no protrusion of meninges and often asymptomatic.
- Meningocele: Meninges protrude with accompanying cerebrospinal fluid; covered by normal skin, spinal cord is unaffected. Lumbosacral area is often involved.
- Myelomeningocele: Most severe; a cystic sac with spinal tissue and CSF herniates through a vertebral defect. Subtypes include open-myelocele and closed-myelomeningocele.
Clinical Pictures
- Occulta: Presents with a lesion over defect, tuft of hair, dimples, birthmarks, lipomas, foot deformities, and changes in gait or micturition.
- Meningocele: Symptoms include hydrocephalus, macrocephaly, spastic weakness, uncoordinated movements, delayed milestones, vision issues, and seizures.
- Myelomeningocele: Symptoms encompass flaccid paralysis, absent sensation, drop reflex, postural abnormalities, and recurrent hydrocephalus.
Chiari Malformation Type II
- A common brain anomaly in myelomeningocele characterized by an elongated brainstem positioned lower than normal, leading to respiratory and swallowing difficulties.
Investigations
- Diagnostic methods include X-rays, MRI, myelograms, CT scans, and prenatal screening through blood tests, ultrasounds, and amniocentesis.
Signs Indicating Spina Bifida
- Lemon Sign: Inward curvature of the fetal skull.
- Banana Sign: Shape of the cerebellum herniating through the foramen magnum resembling a banana; the presence of both signs indicates an open spinal defect.
Differential Diagnosis
- Potential conditions resembling symptoms of spina bifida include sacrococcygeal teratoma, tethered cord syndrome, diastematomyelia, Chiari malformation, syringomyelia, congenital dermal sinus, and spinal cord tumors.
Management
- Treatment strategies for spina bifida vary based on severity of the condition and may involve surgical and non-surgical approaches.
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Description
This quiz covers various neurological and physical complications, including Hydrocephalus and Tethered Cord Syndrome. Additionally, it addresses mobility issues and orthopedic problems related to these conditions. Test your knowledge on the symptoms and impacts of these complications.
