Spina bifida is a birth defect where the spine and spinal cord do not form properly. It occurs when the neural tube fails to close fully during early embryonic development. The most common type is myelomeningocele, where parts of the spinal cord and meninges protrude out of an opening in the spine. This can cause paralysis, loss of feeling, and problems with bladder and bowel control below the level of the defect. Treatment involves surgery to close the opening and manage any related complications like hydrocephalus. Prevention focuses on adequate folic acid intake before and during early pregnancy.
The document discusses Spinal Bifida, beginning with the group members presenting and objectives of the presentation. It defines Spinal Bifida as a birth defect involving failure of vertebral arch fusion. It describes the types (Occulta, Cystica with Meningocele and Myelomeningocele forms) and discusses etiology, pathophysiology, clinical manifestations, diagnostic tests, medical and nursing management, and complications of Spinal Bifida. The presentation aims to provide knowledge on Spinal Bifida and its characteristics to students.
Spina bifida is a birth defect where the spine and spinal cord do not form properly, leaving an opening in the spine. It occurs in about 1-2 per 1000 live births. There are three main types: spina bifida occulta which has no symptoms, meningocele which is a sac protruding from the spine containing fluid and membranes, and myelomeningocele which is the most severe form where the spinal cord and membranes protrude out. Treatment depends on the type but may include surgery to close the opening after birth along with management to prevent infections and complications.
Central nervous system defects include disorders caused by an imbalance of cerebrospinal fluid (as in hydrocephalus) and a range of disorders resulting from malformations of the neural tube during embryonic development (often called “neural tube defects”). These defects vary from mild to severely disabling.
Spina bifida is a birth defect where there is an incomplete closing of the backbone and membranes around the spinal cord. It is a developmental congenital anomaly
This document discusses spina bifida, including:
- Defining spina bifida as an incomplete closure of the neural tube, usually in the lumbar or sacral region.
- Describing the different types from spina bifida occulta to myelomeningocele.
- Detailing the various clinical presentations depending on the location and severity, including neurological deficits, hydrocephalus, orthopedic issues.
- Explaining that treatment involves surgery to cover or untether the spinal cord, along with medications, physical/occupational therapy, and follow-up to address complications.
- Emphasizing prevention through adequate folate intake before and during pregnancy to reduce the risk of spina bifida
Spina bifida is a birth defect where the spinal cord fails to close properly, leaving it exposed. There are three main types: spina bifida occulta, which has no protrusion and is usually asymptomatic; meningocele, which involves protrusion of meninges and cerebrospinal fluid in a sac; and myelomeningocele, the most severe form, which involves protrusion of meninges, spinal cord, and cerebrospinal fluid. Treatment involves surgery to close the defect as well as management of any related conditions like hydrocephalus or paralysis. Parents are counseled and trained to care for the child's lifelong medical needs.
Spina bifida is a birth defect where the spinal column does not fully close around the spinal cord. It occurs when the neural tube fails to close properly during early embryonic development. The main types are spina bifida occulta (mildest), meningocele (meninges protrude through opening), and myelomeningocele (most severe where spinal cord and membranes protrude). Symptoms range from minor skin marks to paralysis depending on location and severity of the defect. Treatment involves surgery to cover the exposed tissues and may include shunts to drain excess cerebrospinal fluid. Lifelong management focuses on rehabilitation, prevention of infections and complications, and addressing mobility, bladder, and bowel issues.
This document discusses arthrogyposis multiplex congenita (AMC), which affects joint development in fetuses, resulting in limited mobility and physical deformities at birth. AMC is caused by lack of fetal movement in the womb, which allows extra connective tissue and joint fixation to form. It has a genetic basis or can be caused by neurological or muscular disorders that impact motor function in utero. Children with AMC exhibit characteristic symmetric and rigid joint contractures at multiple sites. Management involves stretching, splinting, surgery and adaptive equipment to improve range of motion and functional skills at each stage of development.
Cerebral palsy is an umbrella term for physical disabilities caused by damage to the brain before or at birth. It is characterized by impaired muscle coordination and other disabilities. The prevalence is about 4 per 1000 live births. There are several types classified by motor deficit, including spastic (the most common), dyskinetic, atonic, and mixed forms. Management involves medical treatment to alleviate symptoms, physical and occupational therapy, and sometimes surgery to correct issues like scoliosis.
The document discusses Spinal Bifida, beginning with the group members presenting and objectives of the presentation. It defines Spinal Bifida as a birth defect involving failure of vertebral arch fusion. It describes the types (Occulta, Cystica with Meningocele and Myelomeningocele forms) and discusses etiology, pathophysiology, clinical manifestations, diagnostic tests, medical and nursing management, and complications of Spinal Bifida. The presentation aims to provide knowledge on Spinal Bifida and its characteristics to students.
Spina bifida is a birth defect where the spine and spinal cord do not form properly, leaving an opening in the spine. It occurs in about 1-2 per 1000 live births. There are three main types: spina bifida occulta which has no symptoms, meningocele which is a sac protruding from the spine containing fluid and membranes, and myelomeningocele which is the most severe form where the spinal cord and membranes protrude out. Treatment depends on the type but may include surgery to close the opening after birth along with management to prevent infections and complications.
Central nervous system defects include disorders caused by an imbalance of cerebrospinal fluid (as in hydrocephalus) and a range of disorders resulting from malformations of the neural tube during embryonic development (often called “neural tube defects”). These defects vary from mild to severely disabling.
Spina bifida is a birth defect where there is an incomplete closing of the backbone and membranes around the spinal cord. It is a developmental congenital anomaly
This document discusses spina bifida, including:
- Defining spina bifida as an incomplete closure of the neural tube, usually in the lumbar or sacral region.
- Describing the different types from spina bifida occulta to myelomeningocele.
- Detailing the various clinical presentations depending on the location and severity, including neurological deficits, hydrocephalus, orthopedic issues.
- Explaining that treatment involves surgery to cover or untether the spinal cord, along with medications, physical/occupational therapy, and follow-up to address complications.
- Emphasizing prevention through adequate folate intake before and during pregnancy to reduce the risk of spina bifida
Spina bifida is a birth defect where the spinal cord fails to close properly, leaving it exposed. There are three main types: spina bifida occulta, which has no protrusion and is usually asymptomatic; meningocele, which involves protrusion of meninges and cerebrospinal fluid in a sac; and myelomeningocele, the most severe form, which involves protrusion of meninges, spinal cord, and cerebrospinal fluid. Treatment involves surgery to close the defect as well as management of any related conditions like hydrocephalus or paralysis. Parents are counseled and trained to care for the child's lifelong medical needs.
Spina bifida is a birth defect where the spinal column does not fully close around the spinal cord. It occurs when the neural tube fails to close properly during early embryonic development. The main types are spina bifida occulta (mildest), meningocele (meninges protrude through opening), and myelomeningocele (most severe where spinal cord and membranes protrude). Symptoms range from minor skin marks to paralysis depending on location and severity of the defect. Treatment involves surgery to cover the exposed tissues and may include shunts to drain excess cerebrospinal fluid. Lifelong management focuses on rehabilitation, prevention of infections and complications, and addressing mobility, bladder, and bowel issues.
This document discusses arthrogyposis multiplex congenita (AMC), which affects joint development in fetuses, resulting in limited mobility and physical deformities at birth. AMC is caused by lack of fetal movement in the womb, which allows extra connective tissue and joint fixation to form. It has a genetic basis or can be caused by neurological or muscular disorders that impact motor function in utero. Children with AMC exhibit characteristic symmetric and rigid joint contractures at multiple sites. Management involves stretching, splinting, surgery and adaptive equipment to improve range of motion and functional skills at each stage of development.
Cerebral palsy is an umbrella term for physical disabilities caused by damage to the brain before or at birth. It is characterized by impaired muscle coordination and other disabilities. The prevalence is about 4 per 1000 live births. There are several types classified by motor deficit, including spastic (the most common), dyskinetic, atonic, and mixed forms. Management involves medical treatment to alleviate symptoms, physical and occupational therapy, and sometimes surgery to correct issues like scoliosis.
This document provides an overview of spinal cord injury (SCI) management. It describes a case of a 47-year-old male who suffered a cervical spine injury in a motor vehicle accident 4 months ago and is now presenting with paraplegia and paraparesis. The document then outlines key topics related to SCI, including anatomy, causes, types, pathophysiology, clinical syndromes, diagnosis, neurological assessment classification, and management. Tables and diagrams are provided to illustrate spinal cord anatomy and tracts, dermatomes, myotomes, and the American Spinal Injury Association classification system.
This document discusses arachnoiditis, an inflammatory disease of the arachnoid membrane surrounding the spinal cord. It develops in three stages: initial nerve inflammation, scar tissue formation causing nerve adhesion, and complete nerve root encapsulation. Causes include trauma from surgery, chemical exposure, and infection. Symptoms include pain, paresthesia, sensory loss, and muscle weakness. Diagnosis involves MRI or CT myelography. Treatment includes corticosteroids, NSAIDs, rhizotomy for pain, and decompression surgery to remove cysts. Physical therapy techniques like exercises, heat, TENS, and neural mobilization can help manage symptoms.
Hydrocephalus is characterized by an abnormal accumulation of cerebrospinal fluid in the brain ventricles. It can be caused by increased CSF production, decreased absorption, or blockage of CSF flow pathways. The document discusses the types, causes, signs and symptoms, diagnostic tests, treatment including shunt surgeries, and nursing management of hydrocephalus.
This document discusses spinal cord injuries, including causes such as trauma from accidents, most common vertebral levels injured, types of injuries, symptoms depending on injury level, complications, assessment, management including initial care, drug therapy, and long term care needs. Key points include trauma as the main cause, cervical vertebrae most commonly affected, complete versus incomplete injuries determined by degree of sensation and motor function loss below injury level, and management focusing on respiratory, cardiovascular, bladder, bowel and skin integrity issues.
Syringomyelia is a condition where a cyst, called a syrinx, develops in the spinal cord. It most commonly affects the lower cervical spine. It is often associated with abnormalities of the skull or spinal column. The majority of cases are linked to Chiari malformation type 1, where the cerebellar tonsils are displaced into the spinal canal. Symptoms vary depending on the location of the syrinx but can include pain, loss of sensation, muscle weakness or atrophy, and autonomic dysfunction. Diagnosis is made using imaging like MRI. Treatment involves surgery to decompress pressure on the spinal cord like laminectomy with the goal of resolving the syrinx.
Klippel-Feil syndrome is a congenital condition where two or more cervical vertebrae are fused. It is caused by mutations in genes GDF6 and GDF3 which regulate bone growth. People with Klippel-Feil syndrome have a short neck, limited neck movement, and sometimes scoliosis. Diagnosis involves x-rays and MRIs showing fused vertebrae. Treatment focuses on pain management through medications, physical therapy, and sometimes surgery to correct spinal abnormalities.
This document provides an overview of cerebral palsy (CP), including its definition, causes, classifications, clinical manifestations, diagnosis, treatment, and prognosis. CP is a permanent motor disability caused by non-progressive damage to the developing brain. It is classified based on motor type (spastic diplegia, hemiplegia, etc.). Treatment involves a multidisciplinary approach including physiotherapy, orthotics, pharmacotherapy, and surgery to improve mobility and function. Prognosis depends on the type and severity of CP, but a team-based approach aims to maximize development and independence.
Developmental dysplasia of the hip (DDH) refers to a spectrum of hip abnormalities ranging from shallowness of the hip socket to dislocation of the femoral head. It was previously known as congenital dislocation of the hip but the term developmental dysplasia is now preferred as it can develop after birth. Left untreated, DDH can cause limping, leg length discrepancies, and hip arthritis. Treatment depends on the child's age and severity of dysplasia, ranging from splinting or bracing for mild cases to osteotomy surgery for more advanced cases. Early diagnosis before walking begins is important to allow for effective nonsurgical treatment.
Quadriplegia is caused by damage to the brain or spinal cord at a high cervical level (C1-C5). It can result from traumatic spinal cord injury, infection, tumors, or vascular accidents affecting the spinal cord in the neck region. Quadriplegia is classified as complete or incomplete based on the preservation of motor and sensory function below the neurological level according to the American Spinal Injury Association scale. Management involves immobilization, imaging, steroids, surgery if needed for decompression, and long-term rehabilitation and physiotherapy.
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
Dystonia is a movement disorder in which a person's muscles contract uncontrollably. The contraction causes the affected body part to twist involuntarily, resulting in repetitive movements or abnormal postures. Dystonia can affect one muscle, a muscle group, or the entire body.
Cervical disc prolapse occurs when a cervical disc herniates and compresses the nerve root. The cervical spine has 7 vertebrae and 6 intervertebral discs that act as shock absorbers and allow motion. A disc is composed of an inner nucleus pulposus surrounded by the outer annulus fibrosus. Common sites of prolapse are C5-C6 and C6-C7. Clinical features include neck pain radiating to the arm. Imaging like MRI or CT is used to confirm prolapse. Treatment involves rest, medications, traction and surgery like anterior cervical discectomy if non-operative measures fail.
This document provides an overview of syringomyelia, including its pathogenesis, pathology, classification, clinical features, and natural history. Syringomyelia is a condition characterized by fluid-filled cavities within the spinal cord. It most commonly affects the cervical and thoracic regions. Clinical features include pain and sensory loss. The natural history varies, but symptoms typically progress slowly over years, with some patients experiencing stabilization or spontaneous resolution in rare cases.
Hydrocephalus is a condition characterized by the excessive accumulation of cerebral spinal fluid in the ventricles of the brain, causing their enlargement. It occurs due to an imbalance between CSF production and absorption. CSF is produced by the choroid plexus within the ventricles and circulates through the ventricular system before being absorbed into the venous system. Hydrocephalus can be obstructive, caused by a blockage in CSF flow within the ventricles, or communicating, caused by impaired absorption of CSF out of the ventricles. It is diagnosed through imaging like CT scans and MRIs showing ventricle dilation and treated through surgical implantation of shunts to drain CSF or endoscopic procedures to open blockages.
This document discusses spinal muscular atrophy (SMA), including its causes, types, signs and symptoms, diagnosis, and treatment. SMA is caused by a mutation in the SMN1 gene that results in a lack of survival motor neuron protein and the degeneration of alpha motor neurons in the spinal cord. It is classified into five types based on age of onset and severity. There is currently no cure for SMA, but treatment focuses on managing symptoms through rehabilitation, assistive devices, ventilation support, and gene therapy research shows promise for slowing disease progression.
This document describes Chiari malformation, specifically Chiari type I and II. It discusses the presentation, diagnosis, and treatment of a 34-year-old female patient presenting with progressive arm weakness, shoulder pain, and headaches exacerbated by coughing. Examination found reduced sensitivity in her arms. MRI confirmed Chiari type I malformation with tonsillar herniation. The patient underwent posterior fossa decompression surgery, with improvement in symptoms at 6-month follow up. Chiari malformations cause hindbrain herniation and obstruction of CSF flow, often requiring surgery to enlarge the posterior fossa.
This document defines and describes different types of movement disorders including chorea, athetosis, and ballism. It discusses the etiology and characteristics of various forms of chorea including vascular chorea, autoimmune chorea, drug-induced chorea, metabolic chorea, and infectious chorea. The roles of structures like the globus pallidus and subthalamic nucleus in causing hyperkinetic movements are mentioned. Treatment options vary depending on the underlying cause but may include medications, surgery, or management of any precipitating conditions.
Quadriplegia is paralysis of both arms and legs caused by injury to the cervical spinal cord. Paraplegia is paralysis of the lower half of the body caused by injury to the thoracic, lumbar, or sacral spinal cord. Management of spinal cord injuries involves immobilization, medications like methylprednisolone, and surgery to stabilize the spine. Physical therapy focuses on range of motion, strengthening, pain management, and retraining bladder and bowel function to prevent complications like pressure sores. Functional electrical stimulation has also been used to facilitate walking.
This document provides information about hydrocephalus. It begins with definitions, noting that hydrocephalus is an excessive accumulation of cerebrospinal fluid in the brain resulting in abnormal widening of brain spaces. It describes the anatomy of the ventricles and circulation of cerebrospinal fluid. It discusses the causes of hydrocephalus, including conditions that block normal fluid flow or absorption. It outlines the main types - congenital, acquired, communicating, and non-communicating hydrocephalus - and their causes. Images are included showing examples of hydrocephalus, obstructions, treatments like VP shunts, and various conditions that can cause hydrocephalus like aqueduct stenosis and tumors.
Neurogenic bladder refers to urinary bladder dysfunction caused by diseases of the central or peripheral nervous system that control urination. There are two main types: a flaccid bladder that does not contract fully, causing urine to dribble out continuously, and a spastic bladder with involuntary contractions causing frequent urination. Common causes include stroke, Parkinson's, MS, spinal cord injuries, and neurological disorders from conditions like diabetes. Symptoms include frequent urination, incontinence, and urinary retention. Treatment involves medications to relax or stimulate the bladder along with exercises and sometimes surgery.
neurosurgery.Congenital anomalies of the cns,(dr.mazn bujan)student
1. Congenital anomalies of the central nervous system can result from genetic malformations during organ formation, environmental deformities during development, or tissue disruption.
2. Normal central nervous system development occurs through 23 stages from week 4 to week 8 of gestation, during which the brain and spinal cord regions form and neural cell types develop.
3. Common types of central nervous system anomalies include arachnoid cysts, neuroenteric cysts, craniosynostosis, encephaloceles, Chiari malformations, Dandy-Walker malformations, aqueductal stenosis, neural tube defects, tethered cord syndrome, split cord syndrome, intracranial lipomas, and
This document provides an overview of spinal cord injury (SCI) management. It describes a case of a 47-year-old male who suffered a cervical spine injury in a motor vehicle accident 4 months ago and is now presenting with paraplegia and paraparesis. The document then outlines key topics related to SCI, including anatomy, causes, types, pathophysiology, clinical syndromes, diagnosis, neurological assessment classification, and management. Tables and diagrams are provided to illustrate spinal cord anatomy and tracts, dermatomes, myotomes, and the American Spinal Injury Association classification system.
This document discusses arachnoiditis, an inflammatory disease of the arachnoid membrane surrounding the spinal cord. It develops in three stages: initial nerve inflammation, scar tissue formation causing nerve adhesion, and complete nerve root encapsulation. Causes include trauma from surgery, chemical exposure, and infection. Symptoms include pain, paresthesia, sensory loss, and muscle weakness. Diagnosis involves MRI or CT myelography. Treatment includes corticosteroids, NSAIDs, rhizotomy for pain, and decompression surgery to remove cysts. Physical therapy techniques like exercises, heat, TENS, and neural mobilization can help manage symptoms.
Hydrocephalus is characterized by an abnormal accumulation of cerebrospinal fluid in the brain ventricles. It can be caused by increased CSF production, decreased absorption, or blockage of CSF flow pathways. The document discusses the types, causes, signs and symptoms, diagnostic tests, treatment including shunt surgeries, and nursing management of hydrocephalus.
This document discusses spinal cord injuries, including causes such as trauma from accidents, most common vertebral levels injured, types of injuries, symptoms depending on injury level, complications, assessment, management including initial care, drug therapy, and long term care needs. Key points include trauma as the main cause, cervical vertebrae most commonly affected, complete versus incomplete injuries determined by degree of sensation and motor function loss below injury level, and management focusing on respiratory, cardiovascular, bladder, bowel and skin integrity issues.
Syringomyelia is a condition where a cyst, called a syrinx, develops in the spinal cord. It most commonly affects the lower cervical spine. It is often associated with abnormalities of the skull or spinal column. The majority of cases are linked to Chiari malformation type 1, where the cerebellar tonsils are displaced into the spinal canal. Symptoms vary depending on the location of the syrinx but can include pain, loss of sensation, muscle weakness or atrophy, and autonomic dysfunction. Diagnosis is made using imaging like MRI. Treatment involves surgery to decompress pressure on the spinal cord like laminectomy with the goal of resolving the syrinx.
Klippel-Feil syndrome is a congenital condition where two or more cervical vertebrae are fused. It is caused by mutations in genes GDF6 and GDF3 which regulate bone growth. People with Klippel-Feil syndrome have a short neck, limited neck movement, and sometimes scoliosis. Diagnosis involves x-rays and MRIs showing fused vertebrae. Treatment focuses on pain management through medications, physical therapy, and sometimes surgery to correct spinal abnormalities.
This document provides an overview of cerebral palsy (CP), including its definition, causes, classifications, clinical manifestations, diagnosis, treatment, and prognosis. CP is a permanent motor disability caused by non-progressive damage to the developing brain. It is classified based on motor type (spastic diplegia, hemiplegia, etc.). Treatment involves a multidisciplinary approach including physiotherapy, orthotics, pharmacotherapy, and surgery to improve mobility and function. Prognosis depends on the type and severity of CP, but a team-based approach aims to maximize development and independence.
Developmental dysplasia of the hip (DDH) refers to a spectrum of hip abnormalities ranging from shallowness of the hip socket to dislocation of the femoral head. It was previously known as congenital dislocation of the hip but the term developmental dysplasia is now preferred as it can develop after birth. Left untreated, DDH can cause limping, leg length discrepancies, and hip arthritis. Treatment depends on the child's age and severity of dysplasia, ranging from splinting or bracing for mild cases to osteotomy surgery for more advanced cases. Early diagnosis before walking begins is important to allow for effective nonsurgical treatment.
Quadriplegia is caused by damage to the brain or spinal cord at a high cervical level (C1-C5). It can result from traumatic spinal cord injury, infection, tumors, or vascular accidents affecting the spinal cord in the neck region. Quadriplegia is classified as complete or incomplete based on the preservation of motor and sensory function below the neurological level according to the American Spinal Injury Association scale. Management involves immobilization, imaging, steroids, surgery if needed for decompression, and long-term rehabilitation and physiotherapy.
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
Dystonia is a movement disorder in which a person's muscles contract uncontrollably. The contraction causes the affected body part to twist involuntarily, resulting in repetitive movements or abnormal postures. Dystonia can affect one muscle, a muscle group, or the entire body.
Cervical disc prolapse occurs when a cervical disc herniates and compresses the nerve root. The cervical spine has 7 vertebrae and 6 intervertebral discs that act as shock absorbers and allow motion. A disc is composed of an inner nucleus pulposus surrounded by the outer annulus fibrosus. Common sites of prolapse are C5-C6 and C6-C7. Clinical features include neck pain radiating to the arm. Imaging like MRI or CT is used to confirm prolapse. Treatment involves rest, medications, traction and surgery like anterior cervical discectomy if non-operative measures fail.
This document provides an overview of syringomyelia, including its pathogenesis, pathology, classification, clinical features, and natural history. Syringomyelia is a condition characterized by fluid-filled cavities within the spinal cord. It most commonly affects the cervical and thoracic regions. Clinical features include pain and sensory loss. The natural history varies, but symptoms typically progress slowly over years, with some patients experiencing stabilization or spontaneous resolution in rare cases.
Hydrocephalus is a condition characterized by the excessive accumulation of cerebral spinal fluid in the ventricles of the brain, causing their enlargement. It occurs due to an imbalance between CSF production and absorption. CSF is produced by the choroid plexus within the ventricles and circulates through the ventricular system before being absorbed into the venous system. Hydrocephalus can be obstructive, caused by a blockage in CSF flow within the ventricles, or communicating, caused by impaired absorption of CSF out of the ventricles. It is diagnosed through imaging like CT scans and MRIs showing ventricle dilation and treated through surgical implantation of shunts to drain CSF or endoscopic procedures to open blockages.
This document discusses spinal muscular atrophy (SMA), including its causes, types, signs and symptoms, diagnosis, and treatment. SMA is caused by a mutation in the SMN1 gene that results in a lack of survival motor neuron protein and the degeneration of alpha motor neurons in the spinal cord. It is classified into five types based on age of onset and severity. There is currently no cure for SMA, but treatment focuses on managing symptoms through rehabilitation, assistive devices, ventilation support, and gene therapy research shows promise for slowing disease progression.
This document describes Chiari malformation, specifically Chiari type I and II. It discusses the presentation, diagnosis, and treatment of a 34-year-old female patient presenting with progressive arm weakness, shoulder pain, and headaches exacerbated by coughing. Examination found reduced sensitivity in her arms. MRI confirmed Chiari type I malformation with tonsillar herniation. The patient underwent posterior fossa decompression surgery, with improvement in symptoms at 6-month follow up. Chiari malformations cause hindbrain herniation and obstruction of CSF flow, often requiring surgery to enlarge the posterior fossa.
This document defines and describes different types of movement disorders including chorea, athetosis, and ballism. It discusses the etiology and characteristics of various forms of chorea including vascular chorea, autoimmune chorea, drug-induced chorea, metabolic chorea, and infectious chorea. The roles of structures like the globus pallidus and subthalamic nucleus in causing hyperkinetic movements are mentioned. Treatment options vary depending on the underlying cause but may include medications, surgery, or management of any precipitating conditions.
Quadriplegia is paralysis of both arms and legs caused by injury to the cervical spinal cord. Paraplegia is paralysis of the lower half of the body caused by injury to the thoracic, lumbar, or sacral spinal cord. Management of spinal cord injuries involves immobilization, medications like methylprednisolone, and surgery to stabilize the spine. Physical therapy focuses on range of motion, strengthening, pain management, and retraining bladder and bowel function to prevent complications like pressure sores. Functional electrical stimulation has also been used to facilitate walking.
This document provides information about hydrocephalus. It begins with definitions, noting that hydrocephalus is an excessive accumulation of cerebrospinal fluid in the brain resulting in abnormal widening of brain spaces. It describes the anatomy of the ventricles and circulation of cerebrospinal fluid. It discusses the causes of hydrocephalus, including conditions that block normal fluid flow or absorption. It outlines the main types - congenital, acquired, communicating, and non-communicating hydrocephalus - and their causes. Images are included showing examples of hydrocephalus, obstructions, treatments like VP shunts, and various conditions that can cause hydrocephalus like aqueduct stenosis and tumors.
Neurogenic bladder refers to urinary bladder dysfunction caused by diseases of the central or peripheral nervous system that control urination. There are two main types: a flaccid bladder that does not contract fully, causing urine to dribble out continuously, and a spastic bladder with involuntary contractions causing frequent urination. Common causes include stroke, Parkinson's, MS, spinal cord injuries, and neurological disorders from conditions like diabetes. Symptoms include frequent urination, incontinence, and urinary retention. Treatment involves medications to relax or stimulate the bladder along with exercises and sometimes surgery.
neurosurgery.Congenital anomalies of the cns,(dr.mazn bujan)student
1. Congenital anomalies of the central nervous system can result from genetic malformations during organ formation, environmental deformities during development, or tissue disruption.
2. Normal central nervous system development occurs through 23 stages from week 4 to week 8 of gestation, during which the brain and spinal cord regions form and neural cell types develop.
3. Common types of central nervous system anomalies include arachnoid cysts, neuroenteric cysts, craniosynostosis, encephaloceles, Chiari malformations, Dandy-Walker malformations, aqueductal stenosis, neural tube defects, tethered cord syndrome, split cord syndrome, intracranial lipomas, and
1) The document discusses various pathologies that can affect the clivus region, including congenital malformations, acquired conditions, and primary and secondary neoplasms.
2) Examples of discussed pathologies include proatlas segmentation failure, neuroenteric cysts, basilar invagination, fibrous dysplasia, chordoma, plasmacytoma, and meningioma.
3) The pathologies are described in terms of their etiology, clinical presentation, diagnostic evaluation, and treatment options.
a comprehensive presentation on the subject of spinal dysraphism and spina bifida and its neurosurgical management as well as the management of its various other types
1. Congenital hemivertebrae occur due to failure of somite formation during embryonic development and can cause spinal curvature or neurological problems by narrowing the spinal canal.
2. Tethered cord syndrome occurs when the spinal cord is attached at the caudal end, most commonly due to defective degeneration of the caudal cell mass.
3. Conditions that can lead to tethered cord include lipomyelomeningocele, diastematomyelia, anterior sacral meningocele, and dermal sinus, which may require surgical intervention such as laminectomy and cord release to prevent neurological problems.
Disorders of neural tube closure and neuronal migrationdrnaveent
This document discusses various neural tube closure disorders and disorders of neural migration during embryonic development. It provides an overview of embryology and describes specific disorders including anencephaly, spina bifida, callosal dysgenesis, Dandy-Walker malformation, Joubert syndrome, holoprosencephaly, heterotopic gray matter, lissencephaly, schizencephaly, hemimegalencephaly, and polymicrogyria. For each disorder it discusses features on imaging and clinical presentations.
This case presentation describes a 22-month-old girl with tuberous sclerosis complex (TSC) who was admitted with uncontrolled seizures. She has a history of TSC, cardiac rhabdomyoma, and seizure disorder. Examination found multiple hypopigmented skin lesions characteristic of TSC. Imaging showed brain lesions also consistent with TSC including subependymal nodules and tubers. TSC is a multisystem genetic disorder affecting multiple organs. It is diagnosed based on major and minor clinical features. Seizures are a common manifestation and treatment involves antiepileptic drugs. Long-term monitoring of brain, kidney, and other organ involvement is required in managing TSC.
This document discusses various congenital anomalies that affect the central nervous system, including neural tube defects (NTDs) such as spina bifida occulta, meningocele, meningomyelocele, encephalocele, and anencephaly. It describes the embryology of neural tube formation and risk factors for NTDs such as folic acid deficiency. The document also discusses craniosynostosis, which is the premature fusion of skull sutures, and the various types including plagiocephaly, scaphocephaly, and trigonocephaly. It notes treatment may involve surgery to correct skull growth abnormalities.
This document discusses various malformations of the posterior fossa, including Chiari malformations, Dandy-Walker malformation, Joubert syndrome, and Rhomboencephalosynapsis. It provides details on the anatomy and development of the posterior fossa. Chiari type 1 malformation is described as the most common, characterized by caudal descent of the cerebellar tonsils through the foramen magnum. Chiari type 2 malformation is associated with myelomeningocele and involves descent of the brainstem into the spinal canal through an abnormally small posterior fossa. Imaging and treatment options are discussed for evaluating and managing these posterior fossa malformations.
The document provides information on several neuropathology topics including glioblastoma multiforme, recent infarct, meningioma, Alzheimer's disease, spinal bifida, astrocytoma, and cerebral atrophy. It describes the etiology, pathogenesis, epidemiology, gross and microscopic features, and clinical correlations for each condition over multiple paragraphs.
Spina bifida is a neural tube defect that occurs when the spine and spinal cord do not form properly in an embryo. It results from defective closure of the neural tube during the first month of development. There are several types of spina bifida ranging from mild cases with no protrusion to more severe cases involving protrusion of membranes or spinal tissue. Management involves surgery to close the defect along with a multidisciplinary approach to minimize physical and intellectual impairments.
Disorders of neural tube closure and neuronal migrationdrnaveent
This document provides an overview of neural tube closure disorders and disorders of neural migration and development. It discusses various neural tube defects including spina bifida, anencephaly, and cranial defects. It also summarizes disorders of cerebral cleavage and neural migration including callosal dysgenesis, Dandy-Walker malformation, Joubert syndrome, holoprosencephaly, heterotopic gray matter, lissencephaly, schizencephaly, hemimegalencephaly, and polymicrogyria. For each condition, it provides descriptions of features seen on imaging and clinical presentations.
Error of Dorsal Induction
Results in defect of closure of neural tube which leads to various anomalies like anencephaly, encephalocoele, spinal dysraphism and chiari malformations.
Congenital diseases causing Spinal Cord CompressionRAMA UNIVERSITY
Compression of spinal cord is a serious anomaly which gives rise serious comorbidities with respect to the site of its occurrence. There can be varies reasons for compression of spinal cord which can be either acquired during the life processes or can be congenital. Diseases which lead to congenitally compressing the spinal cord have been explained in brief.
Some conditions are the most important factor for compression of spinal cord at various levels and earlier diagnosis of which can not only prevent but also make the patients liable for early rehabilitative regimes. Conditions like Spina Bifida, Tethered Cord, fault at notochord formation, etc. can be summarised to understand the basic concept and knowledge regarding the conditions.
Neural tube defects occur when the neural tube, which develops into the brain and spinal cord, fails to close properly between the 17th and 30th day after conception. The two most common neural tube defects are anencephaly and spina bifida. Spina bifida is a malformation of the spine where the posterior portion of the vertebrae fail to close, sometimes with an associated defect of the spinal cord. It most commonly occurs in the lumbosacral region. Spina bifida can range from occulta, which has no external symptoms, to myelomeningocele, the most severe form where the spinal canal remains open along several vertebrae, exposing the spinal cord and membranes in a sac
Dr. Soe Moe Aung discusses normal spinal cord development and various spinal malformations. There are three stages of normal spinal cord development: gastrulation, primary neurulation, and secondary neurulation. Spinal dysraphisms result from abnormalities during these stages and include spina bifida (failure of posterior spinal fusion), tethered cord syndrome, and open or closed spinal defects. Closed defects such as lipomyeloceles involve an intraspinal lipoma. Other malformations discussed include diastematomyelia, neurenteric cysts, caudal agenesis, and segmental spinal dysgenesis. Imaging plays an important role in evaluating these various spinal cord malformations.
This document discusses neural tube defects (NTDs), which are birth defects where an opening remains in the spine or skull early in development. The main types are open defects like spina bifida and anencephaly, and closed defects. NTDs can be caused by folic acid deficiency, genetics, medications, and other factors. Symptoms vary depending on the specific defect. Diagnosis may involve ultrasounds and alpha-fetoprotein testing. Treatment ranges from surgery to palliative care, while prevention focuses on adequate folic acid intake before and during pregnancy.
This document discusses various congenital abnormalities including neural tube defects. It begins by defining congenital abnormalities as defects present at birth or in early life. It then discusses specific defects like anencephaly, microcephaly, and megalencephaly in more detail, covering their causes, symptoms, diagnosis, and management. It also covers other central nervous system abnormalities like septal-optic dysplasia, diastematomyelia, polymicrogyria, encephalocele, hydrocephalus, and several types of spina bifida. The document provides an overview of major congenital abnormalities and their characteristics.
Central nervous Pathology by dr sadaf hussainDureSameen19
The central nervous system (CNS) comprises the brain and spinal cord and is the most complex organ system in the human body. The CNS differs from other organ systems in the variety of functions that it provides and in the localization of these functions to specialized areas of the CNS. The localization of specialized functions means that a relatively small, focal lesion in the CNS can produce a profound deficit, for example, loss of speech. This localization also results in the various populations of neurons within the CNS having unique capabilities and also unique vulnerabilities to disease. For example, Parkinson disease (PD) preferentially affects the neurons of the substantia nigra in the brain stem, while Alzheimer disease (AD) preferentially affects the neurons of the cerebral cortex.
Hydrocephalus is a condition caused by an imbalance in cerebrospinal fluid circulation and absorption in the brain, which leads to excessive accumulation of fluid in the ventricles and increased intracranial pressure. It can be congenital due to malformations or acquired from infections, tumors, or hemorrhages. The excess fluid causes ventricle dilation and brain compression. Treatment involves surgical placement of a shunt to drain fluid from the ventricles to the abdominal cavity or heart. Complications include shunt malfunction and infection. Spina bifida is a neural tube defect where the spine fails to close, often with a visible sac-like protrusion of membranes and spinal cord. It can cause paralysis, in
This document discusses surgical site infections (SSIs). It begins by outlining the learning objectives, which include understanding common surgical pathogens, factors that determine infection risk, classifying infection sources and severity, clinical presentations, prophylactic antibiotic use, and infection management principles. It then provides details on the history of understanding and treating surgical infections, relevant microbiology, infection sources and presentations, and local infection types like abscesses, cellulitis, and gas gangrene. The goal is to educate on preventing and appropriately managing surgical infections.
Fluid, electrolyte balance & acid base disorderDr KAMBLE
This document discusses fluid, electrolyte, and acid-base disorders. It covers the physiological response to starvation and trauma/sepsis. Methods of nutritional assessment like laboratory tests, body weight, and clinical assessment are described. Daily fluid and electrolyte requirements are provided. The document outlines total enteral/parenteral nutrition needs including macronutrients, vitamins, minerals, and water. Overfeeding is identified as a common cause of complications regardless of enteral or parenteral delivery.
This document summarizes information about blood products and transfusion. It discusses how blood is collected from donors and tested before being separated into components like packed red blood cells, fresh frozen plasma, cryoprecipitate, and platelets. It describes the storage and uses of these components. The document also covers blood groups, cross-matching, transfusion reactions, complications of transfusion, indications for transfusion, and blood substitutes currently under investigation.
This document provides an overview of the key developments that advanced modern surgery, including improved knowledge of anatomy beginning with Vesalius' work in the 1500s, Ambroise Pare's introduction of ligatures to control bleeding in the 1500s, the discovery of anesthesia allowing for pain-free operations starting with Morton's public demonstration in 1846, and later advances in controlling infection. It traces the slow rise of surgery over thousands of years from a frightening and often fatal practice to the establishment of scientific surgery through standardized training programs and experimental research in the late 19th century.
This document discusses day case surgery (DCS). It begins with an introduction on the prevalence of DCS internationally. It then covers the definition, history, merits and demerits of DCS. Key aspects of setting up and running a successful DCS unit are described, including space requirements, staffing, suitable procedures, pre-op preparation, and discharge criteria. The document concludes with a discussion on audit and special considerations for DCS in children and emergencies.
This document provides an overview of various types of non-specific ulcers, including their causes, characteristics, and treatments. It discusses ulcers caused by trauma, arterial issues, venous issues, pressure, infection, tropical conditions, frostbite, hypertension, diabetes, mycobacteria, cancer, and more. For most ulcer types, it outlines key features like location, appearance, complications, investigations needed, and management approaches involving wound care, antibiotics, surgery, or other therapies.
This document discusses ulcers, including their definition, parts, classifications, investigations, and management. It defines an ulcer as a break in the skin or mucous membrane epithelium due to cell death. The key parts of an ulcer are the margin, edge, floor, and base. Ulcers can be classified clinically based on healing status, duration, or etiology. Investigations may include wound cultures, biopsies, and imaging. Management involves treating the underlying cause, wound cleaning, debridement, dressings, and therapies like vacuum-assisted closure or maggot debridement to promote healing.
This document discusses lymphatic disorders and lymphoedema. It begins with an introduction to the lymphatic system and its functions. It then discusses causes of lymphatic swelling including acute lymphangitis, filariasis, and elephantiasis. It defines primary and secondary lymphoedema and covers the clinical features, investigations and treatments for lymphoedema including manual lymphatic drainage, compression garments, and surgery. Surgical procedures for lymphoedema including bypass operations, liposuction, and limb reduction techniques are described. The document concludes by discussing chylous ascites, chylothorax, and chyluria.
This document provides information on various bone tumours and conditions. It discusses benign tumours like osteoma, osteoid osteoma, aneurysmal bone cyst, fibrous dysplasia and malignant tumours like osteosarcoma, Ewing's sarcoma, and multiple myeloma. For each tumour, it describes clinical features, diagnosis using imaging tests, pathology and treatment approaches. Common benign tumours include osteochondroma and giant cell tumour. Osteosarcoma is the most common primary malignant bone tumour and has a poor prognosis without chemotherapy and surgery.
Fractures & dislocations general principlesDr KAMBLE
This document provides an overview of fractures and dislocations, including:
- A fracture is a break in the continuity of a bone, while a dislocation is the complete displacement of articular surfaces from one another.
- Fractures can be classified based on etiology (traumatic, pathological, stress), displacement, relationship to external environment (closed, open), complexity of treatment (simple, complex), and pattern (transverse, oblique, etc.).
- Pathological fractures occur through weakened bone from underlying disease. Treatment involves addressing the underlying cause and stabilizing the fracture.
- Dislocations can cause immediate complications like neurovascular injury or long-term issues like recurrence, stiffness and arthritis.
This document discusses amputation as a surgical procedure. It begins by outlining the different circumstances that may necessitate amputation, including when a limb is dead, deadly, or a dead loss due to conditions like gangrene, infection, or trauma. It then describes different types of amputations including distal, transmetatarsal, below-knee, and above-knee procedures. For each type of amputation, it details how the operation is performed and important postoperative considerations like wound care, mobilization, and complications.
This document discusses the salivary glands, including their anatomy and common disorders. It describes the major salivary glands - parotid, submandibular and sublingual glands, as well as the 800 minor salivary glands in the oral cavity. Common disorders of the minor salivary glands include cysts and tumors. Inflammatory disorders of the major salivary glands like sialadenitis are also discussed. Specific conditions involving each gland like sialolithiasis of the submandibular gland, ranula of the sublingual gland and Sjogren's syndrome are explained. The document concludes with discussing xerostomia, sialorrhea
Adrenal gland tumors can arise from either the adrenal cortex or medulla. Tumors of the cortex include Cushing's syndrome, primary hyperaldosteronism (Conn's syndrome), adrenogenital syndrome, adrenal carcinoma, and incidentalomas. Cushing's syndrome is characterized by excessive cortisol secretion and symptoms include weight gain, diabetes, and hypertension. Primary treatments involve surgical removal of pituitary tumors or adrenal tumors. Pheochromocytomas arise from the adrenal medulla and are characterized by excessive catecholamine secretion.
This document provides information about prolapse of the rectum (rectal prolapse). It discusses the embryology, anatomy, physiology, etiology, clinical features, diagnosis and differential diagnosis of rectal prolapse. Some key points:
- Rectal prolapse is the circumferential descent of the rectum through the anus, either partially (mucosa and submucosa protrude) or completely (full thickness protrusion).
- Risk factors include straining from constipation/diarrhea, pregnancy, prior operations, and neurological/psychiatric conditions.
- Physiologically, it can cause fecal incontinence due to internal sphincter relaxation or damage. Reduction
Gastric cancer is a major cause of cancer mortality worldwide. Risk factors include H. pylori infection, older age, smoking, and diets high in smoked/salted foods. Diagnosis involves endoscopy with biopsy. Staging uses TNM classification and evaluates tumor invasion depth, lymph node involvement, and distant metastasis. Treatment depends on stage but may include surgery, chemotherapy, and radiation. Prognosis is best for early stage cancers that can be completely surgically resected.
This document discusses the use of lasers in oncosurgery. It begins with a brief history of lasers and their clinical applications. It then describes the components, properties, and classifications of laser devices. The mechanisms of laser tissue interactions like photothermal, photomechanical, and photodynamic effects are explained. Different types of lasers used in surgery like CO2, KTP-argon, and Nd:YAG lasers are outlined. Applications of lasers in oncology, gastrointestinal cancers, liver surgery, neurosurgery, and selective cancer therapy using gold nanorods are summarized.
This document summarizes several specific types of ulcers, including their causes, characteristic features, locations, investigations, and treatments. It discusses tuberculous ulcers, syphilitic ulcers, chancroid ulcers, actinomycosis ulcers, Meleney's ulcer, and Bairnsdale ulcer. For each type of ulcer, it provides details on etiology, appearance, distinguishing characteristics, affected body sites, diagnostic tests, and management approaches.
Fit to Fly PCR Covid Testing at our Clinic Near YouNX Healthcare
A Fit-to-Fly PCR Test is a crucial service for travelers needing to meet the entry requirements of various countries or airlines. This test involves a polymerase chain reaction (PCR) test for COVID-19, which is considered the gold standard for detecting active infections. At our travel clinic in Leeds, we offer fast and reliable Fit to Fly PCR testing, providing you with an official certificate verifying your negative COVID-19 status. Our process is designed for convenience and accuracy, with quick turnaround times to ensure you receive your results and certificate in time for your departure. Trust our professional and experienced medical team to help you travel safely and compliantly, giving you peace of mind for your journey.www.nxhealthcare.co.uk
Research, Monitoring and Evaluation, in Public Healthaghedogodday
This is a presentation on the overview of the role of monitoring and evaluation in public health. It describes the various components and how a robust M&E system can possitively impact the results or effectiveness of a public health intervention.
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTblessyjannu21
Prepared by Prof. BLESSY THOMAS, VICE PRINCIPAL, FNCON, SPN.
Emphysema is a disease condition of respiratory system.
Emphysema is an abnormal permanent enlargement of the air spaces distal to terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis.
Emphysema of lung is defined as hyper inflation of the lung ais spaces due to obstruction of non respiratory bronchioles as due to loss of elasticity of alveoli.
It is a type of chronic obstructive
pulmonary disease.
It is a progressive disease of lungs.
Test bank clinical nursing skills a concept based approach 4e pearson educati...rightmanforbloodline
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
At Malayali Kerala Spa Ajman, Full Service includes individualized care for every client. We specifically design each massage session for the individual needs of the client. Our therapists are always willing to adjust the treatments based on the client's instruction and feedback. This guarantees that every client receives the treatment they expect.
By offering a variety of massage services, our Ajman Spa Massage Center can tackle physical, mental, and emotional illnesses. In addition, efficient identification of specific health conditions and designing treatment plans accordingly can significantly enhance the quality of massaging.
At Malayali Kerala Spa Ajman, we firmly believe that everyone should have the option to experience top-quality massage services regularly. To achieve that goal we offer cheap massage services in Ajman.
If you are interested in experiencing transformative massage treatment at Malayali Kerala Spa Ajman, you can use our Ajman Massage Center WhatsApp Number to schedule your next massage session.
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Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
At Malayali Kerala Spa Ajman we providing the top quality massage services for our customers.
Our massage center prioritizes efficiency to ensure a quality massage experience for our clients at Malayali Kerala Spa Ajman. We offer a convenient appointment system and precise massage services.
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Basics of Electrocardiogram
CONTENTS
●Conduction System of the Heart
●What is ECG or EKG?
●ECG Leads
●Normal waves of ECG.
●Dimensions of ECG.
● Abnormalities of ECG
CONDUCTION SYSTEM OF THE HEART
ECG:
●ECG is a graphic record of the electrical activity of the heart.
●Electrical activity precedes the mechanical activity of the heart.
●Electrical activity has two phases:
Depolarization- contraction of muscle
Repolarization- relaxation of muscle
ECG Leads:
●6 Chest leads
●6 Limb leads
1. Bipolar Limb Leads:
Lead 1- Between right arm(-ve) and left arm(+ve)
Lead 2- Between right arm(-ve) and left leg(+ve)
Lead 3- Between left arm(-ve)
and left leg(+ve)
2. Augmented unipolar Limb Leads:
AvR- Right arm
AvL- Left arm
AvF- Left leg
3.Chest Leads:
V1 : Over 4th intercostal
space near right sternal margin
V2: Over 4th intercostal space near left sternal margin
V3:In between V2 and V4
V4:Over left 5th intercostal space on the mid
clavicular line
V5:Over left 5th intercostal space on the anterior
axillary line
V6:Over left 5th intercostal space on the mid
axillary line.
Normal ECG:
Waves of ECG:
P Wave
•P Wave is a positive wave and the first wave in ECG.
•It is also called as atrial complex.
Cause: Atrial depolarisation
Duration: 0.1 sec
QRS Complex:
•QRS’ complex is also called the initial ventricular complex.
•‘Q’ wave is a small negative wave. It is continued as the tall ‘R’ wave, which is a positive wave.
‘R’ wave is followed by a small negative wave, the ‘S’ wave.
Cause:Ventricular depolarization and atrial repolarization
Duration: 0.08- 0.10 sec
T Wave:
•‘T’ wave is the final ventricular complex and is a positive wave.
Cause:Ventricular repolarization Duration: 0.2 sec
Intervals and Segments of ECG:
P-R Interval:
•‘P-R’ interval is the interval
between the onset of ‘P’wave and onset of ‘Q’ wave.
•‘P-R’ interval cause atrial depolarization and conduction of impulses through AV node.
Duration:0.18 (0.12 to 0.2) sec
Q-T Interval:
•‘Q-T’ interval is the interval between the onset of ‘Q’
wave and the end of ‘T’ wave.
•‘Q-T’ interval indicates the ventricular depolarization
and ventricular repolarization,
i.e. it signifies the
electrical activity in ventricles.
Duration:0.4-0.42sec
S-T Segment:
•‘S-T’ segment is the time interval between the end of ‘S’ wave and the onset of ‘T’ wave.
Duration: 0.08 sec
R-R Interval:
•‘R-R’ interval is the time interval between two consecutive ‘R’ waves.
•It signifies the duration of one cardiac cycle.
Duration: 0.8 sec
Dimension of ECG:
How to find heart rhytm of the heart?
Regular rhytm:
Irregular rhytm:
More than or less than 4
How to find heart rate using ECG?
If heart Rhytm is Regular :
Heart rate =
300/No.of large b/w 2 QRS complex
= 300/4
=75 beats/mins
How to find heart rate using ECG?
If heart Rhytm is irregular:
Heart rate = 10×No.of QRS complex in 6 sec 5large box = 1sec
5×6=30
10×7 = 70 Beats/min
Abnormalities of ECG:
Cardiac Arrythmias:
1.Tachycardia
Heart Rate more than 100 beats/min
Simple Steps to Make Her Choose You Every DayLucas Smith
Simple Steps to Make Her Choose You Every Day" and unlock the secrets to building a strong, lasting relationship. This comprehensive guide takes you on a journey to self-improvement, enhancing your communication and emotional skills, ensuring that your partner chooses you without hesitation. Forget about complications and start applying easy, straightforward steps that make her see you as the ideal person she can't live without. Gain the key to her heart and enjoy a relationship filled with love and mutual respect. This isn't just a book; it's an investment in your happiness and the happiness of your partner
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVedanta A
Air Ambulance Services In Rewa works in close coordination with ground-based emergency services, including local Emergency Medical Services, fire departments, and law enforcement agencies.
More@: https://tinyurl.com/2shrryhx
More@: https://tinyurl.com/5n8h3wp8
Satisfying Spa Massage Experience at Just 99 AED - Malayali Kerala Spa AjmanMalayali Kerala Spa Ajman
Our Spa Massage Center Ajman prioritizes efficiency to ensure a satisfying massage experience for our clients at Malayali Kerala Spa Ajman. We offer a hassle-free appointment system, effective health issue identification, and precise massage techniques.
Our Spa in Ajman stands out for its effectiveness in enhancing wellness. Our therapists focus on treating the root cause of issues, providing tailored treatments for each client. We take pride in offering the most satisfying Pakistani Spa service, adjusting treatment plans based on client feedback.
For the most result-oriented Russian Spa treatment in Ajman, visit our Massage Center. Our Russian therapists are skilled in various techniques to address health concerns. Our body-to-body massage is efficient due to individualized care and high-grade massage oils.
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...DrDevTaneja1
Digital India will need a big trained army of Health Informatics educated & trained manpower in India.
Presently, generalist IT manpower does most of the work in the healthcare industry in India. Academic Health Informatics education is not readily available at school & health university level or IT education institutions in India.
We look into the evolution of health informatics and its applications in the healthcare industry.
HIMMS TIGER resources are available to assist Health Informatics education.
Indian Health universities, IT Education institutions, and the healthcare industry must proactively collaborate to start health informatics courses on a big scale. An advocacy push from various stakeholders is also needed for this goal.
Health informatics has huge employment potential and provides a big business opportunity for the healthcare industry. A big pool of trained health informatics manpower can lead to product & service innovations on a global scale in India.
2024 Media Preferences of Older Adults: Consumer Survey and Marketing Implica...Media Logic
When it comes to creating marketing strategies that target older adults, it is crucial to have insight into their media habits and preferences. Understanding how older adults consume and use media is key to creating acquisition and retention strategies. We recently conducted our seventh annual survey to gain insight into the media preferences of older adults in 2024. Here are the survey responses and marketing implications that stood out to us.
2. • Definition
• Incidence and prevalence
• Causes
• Risk factors
• Embryology
• Classification
• Screening and diagnosis
• Treatment
• Physical therapy
• Prevention
• Prognosis
• Take home message
3. • Spina bifida is a developmental abnormality
caused by a failure of fusion of the vertebral
arches and possibly the underlying neural
tube,characterised by the incomplete
development of the brain,spinal
cord,meninges.(2,7)
• Spina bifida is a primary neurological
disorder.(7)
4. Incidence and Prevalence
• Spina bifida cystica-1:300 live births.(7)
• Associated with hydrocephalus.
• More common in hispanics and caucasians.
• Worldwide incidence 400,000 per annum.
• Folic acid use has reduced incidence by 70% in
the past 20 yrs.
• Ireland
• 1979-32 per 10,000
• 1982-22 per 10,000(2)
5. Causes
• Not known.
• Genetic , nutritional,
and environmental
factors play a role.
• Deficiency of folic acid.
6. Risk factors
A. Couples who already had an affected baby
B. Obese women
C. Diabetes
D. Anti-seizure medicines
E. Folic acid deficiency
F. Mutation in methylenetetrahydrofolate
reductase gene
7. Embryology
• Formation of notochord
• Origin : primitive node/pit
• Like the primitive streak , the primitive pit
cells proliferate and then migrate cranially in
the midline , towards the buccopharyngeal
membrane , and form a rod like notochordal
process.(3)
8. Neurulation
• It is the process by which the neural tube is
formed.
• The stages of neurulation include the formation
of:
• Neural plate
• Neural groove
• Neural folds and their fusion
• Neural crest cells
• Neural tube
9. • Begins during early part of the 4th week(22-23
days).
• Ends by the end of 4th week(27 days).
• Is induced by the notochord.
10. • Under the inducing
effect of the developing
notochord, the
overlying ectodermal
cells thickens to form
the neural plate.
11. • The neural tube
broadens and extends
cranially as far as the
buccopharyngeal
membrane , and later
on grows beyond it.
12. • On 18th day : the neural
plate invaginates to
form neural groove and
neural folds.
13. • By the end of 3rd week ,
the neural folds move
to the midline and fuse
to form the neural tube.
• The fusion begins in
cervical region and then
extends both in cranial
and caudal direction.
14. • The neural tube
separates from the
surface ectoderm , lies
in the midline ,dorsal to
the notochord.
15. • Neural tube is open at
both ends
communicating freely
with the amniotic
cavity.
• The cranial opening ,
the rostral neuropore
closes at about 25th day
and the caudal
neuropore closes at
about the 27th day.
16. • The cranial 1/3 of the
neural tube represent
the future brain.
• The caudal 2/3
represents the future
spinal cord.(6)
17.
18. Neural Tube Development
• Neural plate
development-18th day
• Cranial closure-24th
day(upper spine)
• Caudal closure-26th
day(lower spine)
19. Types of Neural Tube Defects
ANENCEPHALY Brain and skull poorly
developed
Death inevitable
Failure of skin and muscle
formation
Variable outcome
Urgent closure
Exposed neural tissue 90% need VP shunt
Distal limb innervation
affected
Neuropathic bladder
MENINGOCELE Failure of spinal fusion
Dural sac protrudes
Usually no neural
consequences
Rarely bladder function
affected
Skin covered defect
20. ENCEPHALOCELE Usually occipital
Defect in cranial bone
Herniation of meninges
and brain to varying
degree
Variable outcome
Sometimes shunt needed
SPINA BIFIDA Occulta Hamartoma at site
Sinus occasionally
Skin intact
Bony vertebral arch
deficient
Excellent outcome
22. Spinal Rachischisis
• Developmental birth defect involving the neural
tube.
• In utero, the neural tube fails to close completely.
• This anomaly originates when the posterior
neuropore fails to close by the 27th intrauterine
day.
• As a consequence the verterbrae overlying the
open portion of the spinal cord do not fully form
and remain unfused and open , leaving the spinal
cord exposed .
23. • Patients with rachischisis have motor and
sensory deficits, chronic infections, and
disturbances in bladder function.
• This defect often occurs with anencephaly.
24. Encephalocele
• Midline defect in the
bones of the skull, which
allows protrusion of
meninges only or gross
herniation of brain tissue.
• 10% of neural tube
defect.
• Common in female.
• The usual bony site is the
occipit but frontal
encephaloceles are more
common and only seen in
Asia.
25. Associated
• Microcephaly
• Cerebral anomalies
• Dandy-Walker Cyst formation
• Hydrocephalus
• Dysplasia of cerebellum and optic pathway
• Congenital lesions such as cleft palate ,cardiac
,lung and renal anomalies.
28. • Uncommon
• Presents as swelling
along the spinal cord.
• Site;lumbar region
• No neurological defect.
• Spinal cord is normal.
• Lower limbs are normal.
29. Myelomeningocele
• The unfused portion of
the spinal column allows
the spinal cord to
protrude through an
opening.
• The meningeal
membranes that cover
the spinal cord form a sac
enclosing the spinal
elements.
• Commonest form.
• Most severe.
30. • Most common site-
lumbar and sacral
areas.
• Presents as swelling
along the spinal
columns.
31.
32. Associations
• Hamartomatous lesions : Hemangioma ,lipoma or
a naevus
• Deformities of the lower limbs
Hip dislocation or subluxation
Hypoplastic lower limbs
Genu recurvatum
Talipes deformities of feet
Hydrocephalus
Severe kyphosis
33. • Neurological deficits:
Motor and sensory loss to the lower limbs
Paralysis of lower limb muscle
• Rectal prolapse
• At least 90% of patients have a neuropathic
bladder with disturbances of detrusor and
sphincter muscle activity.
34. Spina Bifida Occulta
• Occulta in Latin means “Hidden”
• Mildest form of spina bifida.
• Incidence-10%
• There is a small defect or gap in one or more
vertebrae of the spine.
• Spinal cord does not protrude.
• Spinal cord and nerves are normal.
35. • Skin at the site of the
lesion may be normal or
it may have some hair
growing from it,there
may be a dimple in the
skin, or a birth mark.
• Asymptomatic.
37. Diastematomyelia
• Split cord malformation(SCM).
• Presents as tethered cord syndrome.
• Common-lower thoracic or upper lumbar spine.
• Most patients have midline cutaneous
abnormality , but it does not necessarily
correspond to the level of cleft.
• Kyphoscoliosis eventually develops.
• Symptoms-Back pain, gait disturbance , muscular
atrophy , urologic complaints.
38. Type I SCM(Split cord malformation)
• Consists of two hemicords seperated by a bony or
cartilagenous median septum,with each housed
in its own dural sheath.
Type II SCM
• Consists of two hemicords enveloped in the same
dural sheath , and seperated by a fibrous septum.
• Both are associated with tethering.
• Surgery indicated for progressive neurological
deficit and scoliosis.
39. Lipomyelomeningocele
• Here lipomatous tissue
inserts into the conus ,
and herniates through the
bony defect dorsally to
attach to a subcutaneous
mass.
Two varieties
• One that inserts caudally
into the conus,and
• One those attach to
dorsal surface of spinal
cord.
40.
41.
42.
43. Tethered Filum Terminale
• Filum terminale gets
thickened and adhered to
the spinal canal.
• Failure of ascent of spinal
cord during growth.
• Leads to Arnold Chiari
malformation(type
I),syringomyelia,
scoliosis,incontinence.
• Diagnosis-MRI
• Treatment-Division of filum
terminale to release the
tension in spinal cord.
44. Caudal regression syndrome
• Heterogenous costellation of
congenital caudal anomalies
affecting the caudal spine and
spinal cord, the hindgut ,the
urogenital system, and the lower
limbs.
• Partial agenesis of the
thoracolumbosacral spine,
• Imperforate anus,
• Malformed genitalia,
• Bilateral renal dysplasia or
aplasia,
• Pulmonary hypoplasia , and
• Extreme external rotation and
fusion of the lower
extremities(syringomyelia).
45. Caudal Regression Syndrome
• Welch and Aterman classified congenital sacral
anomalies into 4 distinct clinical types.
1. A non-familial type associated with maternal diabetes
mellitus showing complete absence of the sacrum and
lower vertebrae with multiple congenital anomalies.
2. Agenesis of the distal sacral or coccygeal segments.
3. Hemisacral dysgenesis with presacral teratoma and
4. Hemisacral dysgenesis with anterior meningocele.
• Autosomal dominant inheritance was suggested for the
last three types.
47. Complications
Factors that affect severity of complications include:
• The size and location of the neural tube defect.
• Whether skin covers the affected area.
• Whether spinal nerves come out of the affected
area of the spinal cord.
• Children with myelomeningocele may experience
physical and neurological problems,including lack
of normal bowel and bladder control, and or
partial or complete paralysis of their legs.
48. Physiological changes below the lesion
Abnormal nerve conduction resulting in
• Somatosensory losses
• Motor paralysis, including loss of bowel and bladder
control
Abnormal nerve conduction resulting in
• Changes in muscle tone
• Note- Muscle tone can range from flaccid to normal to
spastic ; may have UMN signs with/without true spastic
paraperesis.
• Progression of neurologic dysfunction or change in
neurologic status more concerning.
49. Anatomical changes below the lesion
• Musculoskeletal deformities(scoliosis)
• Joint and extremity deformities(joint
contractures ,club foot, hip subluxations,
diminished growth of non-weight bearing
limbs)
• Osteoporosis
• Abnormal or damaged nerve tissue.
50. Other medical problems that occur
• Hydrocephalus(70-90%)
• Chiari II malformation(change the brain’s
position)
• Tethered spinal cord(held in place by
connective tissue)
• Urinary tract disorders
• Latex allergy(73%)
• Learning disabilities(20%)
52. Screening and Diagnosis
(1) Blood tests
• Second trimester maternal serum alpha
fetoprotein(MSAFP)
• Alpha-feto protein(AFP) is made naturally by the
fetus and placenta.
• But if abnormally high levels of this protein
appear in the mother’s bloodstream it may
indicate that the fetus has a neural tube defect.
• The MSAFP test, however, is not specific for spina
bifida(positive predictive value 2-4%).
53. (2) Ultrasound
• An advanced ultrasound can also detect signs of spina
bifida(sensitivity 96%,specificity 100%)
(3) Amniocentesis
• An analysis indicates the level of AFP present in the
amniotic fluid.
• A small amount of AFP is normally found in amniotic fluid.
• When an open neural tube defect is present , the amniotic
fluid contains an elevated amount of AFP because the skin
surrounding the baby’s spine is gone and AFP leaks into the
amniotic sac.
(4)MRI
57. Treatment
• There is no cure for spina bifida.
• The nerve tissue that is damaged or lost
cannot be repaired or replaced.
• Treatment depends on the type and severity
of the disorder.
• Children with the mild form need no
treatment.
• Moderate to severe cases, surgical closure of
back lesion within 6 months.
58. • There is no known cure for nerve damage
caused by spina bifida.
• To prevent further damage of the nervous
tissue and to prevent infection , surgeon
operate to close the opening on the back.
• The spinal cord and its nerve roots are placed
back into the spinal canal and covered with
meninges.
59. • In addition , a shunt may be surgically installed
to provide a continuous drain for the excess
CSF produced in the brain , as happens with
hydrocephalus.
60. Surgery for meningomyelocele
• A.Position of the
patient on the
operating table ad an
elliptical incision at the
junction of the
membrane and the
skin.
69. Physical Therapy Management
Pre-closure
• ROM assessment,therapeutic positioning for
sleeping.
Post-closure
• Sensory assessment , home programme
instruction(ROM exercises, handling and
carrying positions, and therapeutic positioning
for sleeping).
71. The Young Toddler
• Typically seen in a transdisciplinary management
of multiple and varied medical, surgical
needs,and therapeutic needs.
• Transdisciplinary teamwork enhances
communication ,prevents delays in care,
coordinates management.
• Transdisciplinary team consists of
;Neurosurgeon,Orthopedician,Urologist,Physioth
erapist,Nurse,Social worker, and may include
others.
72. Concerns for the Young Toddler
Developmental delay
• Delayed and abnormal head and trunk
control, righting,and equillibrium responses.
Handling/Positioning
• The child needs to develop upright head
control in many positions.
73. Structural Problems:Club Foot
• Congenital deformity
with the following
components;
• Adductus
• Equinus
• Varus,and
• Medial rotation
75. Structural Problems:Sloppy Knees
• Low lumbar paralysis;
• “sloppy knees”from
absent lateral
hamstrings(and active
medial hamstrings and
quadriceps).
76. Orthoses and Equipment Typical for
Children with Spina Bifida
Total contact arthrosis HKAFO(hip-knee-ankle-foot-orthosis
A-frame (Toronto standing frame) Roliator walker
Parapodium(orlau swivel walker) Floor reaction AFO(A.K.A.anti-crouch
arthrosis)
Start cart Articulating ankle joints in S1-level lesions
Reciprocating gait orthosis ( new
isocentric RGO)
Twister cables
77. Example of Parapodium
• Commonly used for
children with high
lesions(T12-L3)
• Offers support to the
hips, knees,and ankles.
78. The Activities for the Young Toddler
• Stimulate automatic balance responses against
gravity in all positions to activate responses in the
lower extremities.
• Encourage brief periods of well-aligned weight-
bearing throughout the day to stimulate
acetabular development(reducing likelihood for
hip dysplasia) and prevent osteoporosis.
• Avoid infant walkers,jumper seats, swings,
bouncer chairs, excessive use of infant car seats.
79. The Adolescent
Psychosocial issues
• Dependency on parents or caretakers
• Poor hygiene form lack of independence and
motivation
• Need for vocational training
• Loss of “cure fantasy”during adolescence
80. Wheelchair Issues
• Many disagree with the statement that the family
should wait until the child age of 5 or 6 yrs to
obtain the first wheelchair.
• Consider the child’s health and quality of life with
and without wheelchair.
• Consult with the family and interdisciplinary team
experts(physicians, seating clinical staff,
physiotherapist with seating experience,vendors)
before making wheelchair decisions.
• Errors are costly.
81. The Adult
• Need to focus on health promotion and
fitness.
• Watch for overuse syndrome, especially in
upper extremities and also, low back pain.
• Monitor for safe and properly fitting
equipment (wheelchair, bathroom devices,
supportive and protective shoes).
• Model advocacy to improve access to
community based resources.
82. The Adult
Need to change the status quo
• Despite 21st century medicine and treatment
advances, many children with spina bifida
never achieve independence - Many never
marry , never live away from parents.
• There is not necessarily correaltion between
the level of independence and level of lesion.
83. Prevention
• Folic acid reduces the
risk of having a child
with a neural tube
defect,such as spina
bifida.
• Dose-400micrograms
daily.
• Source-dark green
vegetables,egg
yolks,fruits like orange.
84. Prognosis
Spina bifida is a:
• Static
• Nonprogressive defect.
• With worsening from secondary problems.
• The prognosis for a normal life span is
generally good for a child with good habits
and a supportive family caregiver.
85. Take Home Message
• Due to folic acid intake 70% of cases are not
seen now-a days.
• There is no known cure for nerve damage
caused by spina bifida.
• Role of physiotherapy is important in spina
bifida patients.
86. References
1.Principles of Neurosurgery by Setti S.Rangachari
2.Pediatric Surgery by Prem Puri and Michael
Hollwarth
3.Human Embryology by Inderbir singh-7th edition
4.Rob and Smith’s pediatric surgery
5.Avery’s Diseases of the newborn-9th edition
6.Langman’s Embryology-12th edition
7.Bailey and Love Short Practice of Surgery -26th
edition