Spina Bifida and HYdrocephalus
Cards (11)
- Spina Bifida (split/open spine)
- defect in one or more vertebrae that allow spinal cord contents to protrude
- occur anywhere in the vertebral column
- most common in the lumbar/ sacral portion of spine
- Risk factors of spina bifida:
- chemicals - excessive usage of alcohol
- medications - seizures, acne
- genetic
- maternal health conditioins
- Spina Bifida Occulta
- not visible externally
- rare neurological problems
- seen at lumbar-sacral area between lumbar 5 and sacral 1
- Spina Bifida Cystica
- visible defect with an external saclike protrusion
- 2 forms: meningocele & myelomeningocele
- meningocele
- meninges and spinal fluid
- not associated with neurologic deficit
- few or no symptoms to paralysis
- myelomeningocele
- both meninges and spinal fluid
- contains nerve tissues
- exposes nerves
- partial or complete paralysis
- Clincal Manifestations based on loc of defect:
- thoracic level : paralysis of legs, weakness and sensory loss
- lumbar 1-2 level : hip flexion and adduction, cant extent knees
- lumbar 3 level : flex hips and extend knees, paralyzed ankles and toes
- lumbar 4-5 level : flex hips, extend knees: weak or absent ankle extension, toe and hip extension
- sacral level : mid weakness in ankles
- Nursing Considerations for Spina Bifida:
- diet (calcium and vit. d)
- place in prone position and head to one side
- measure head circumference
- Hydrocephalus is congenital/ acquired
- imbalance production and absorption of CSF in ventricular system
- CSF volume: 60-100mL
- Hydrocephalus types:
- Communicating - problem with absorption and non-obstructive
- Noncommunicating - obstruction of CSF flow within ventricular system
- Hydrocephalus treatment:
- Ventriculoperitoneal shunt (VP shunt) - ventricles
- Ventriculoatrial shunt (VA shunt) - right atrium
- Ventriculopleural shunt - pleural cavity
- Ventriculostomy (non-shunting procedure)
- Med: Acetazolamide ( anti-convulsant and diuretic which reduce CSF)