Peds neuro.txt

prolonged pressure on one side of skull (kid lying on bed)

failure of brain development

anterior fontanel completely closed, bluging eyes, wide-set eyes, underdeveloped jaw, cleft lip/palate

8 weeks-posterior fontanel closed; 6 months-fibrous union of suture lines and interlocking of serrated edges; 18 months-anterior fontanel closed; after 12 years-sutures unable to be separated by increased ICP

1-2 months after placement

only last 2 years, infection, developmental delays, vision impairment, vomiting, setting-sun sign, enlarged head, dilated scalp veins

caused by imbalance of production and absorption of CSF in the ventricular system; when production is greater than absorption, CSF accumulates within the ventricular system usually under increased pressure which produces passive dilation of the ventricles

abnormal head growth, bulging fontanels, dilated scalp veins, separated sutures, macewen’s sign (cracked pot sound on percussion), thinning of skull sbones

depressed eyes, sclera above iris, sluggish pupils with unequal response to light, frontal enlargement (bossing)

irritability, lethargy, cries when picked up, quiet when left still, change is LOC, vomiting, lower extremity spasicity, difficulty in suckling and feeding, shrill cry, cardiopulmonary embarrassment

headache on awakening, (improvement after emesis or upright), papilledema, strabismus, EPS, irritability, lethargy, apathy, confusion, incoherence, vomiting

malfunction and infection; great risk 1-2 months after placement

look for increased ICP, do not place IV lines in scalp vein; don’t arbitrarily pump shunt; post op keep child flat; pain relief with acetaminophen w or w out codeine or opioids for severe pain

elevation of HOB

potential for infection

ruptured myelo, meningitis, risk for infection, needs braces and walker, PT/OT

encases meninges and spinal fluid but no nerve elements

contains meninges, spinal fluid and nerves

may have genetic component

urinary dysfunction, may have to cath, fecal incontinence

especially if diaper remains dry may indicate urinary retention; ABD assessment revealing bladder distention even with wet diaper may indicate urinary overflow in retentive bladder; head circumference is monitored daily

sterile normal saline, changed frequently (2-4 hours) and sac is closely inspected for leaks, abraisons, irritation and any signs of infection

prone, abduction, head turned to one side for feeding, CIC is used for urinary retention, no cuddling, caress or stroke ; prone, side lying or partial side lying

keep mother pumping until infant is stable to try breastfeeding

autosomal dominant disorder with onset in early adolescence; difficulty in raising the arms over the head, lack of facial mobility and forward slope of shoulders; slow progression and normal lifespan

heterogenous group of disorders with autosomal dominant and recessive inheritance whose manifestations often appear in later childhood, adolescence or early adulthood with variable but usually slow progression; weakness of proximal muscles of pelvis and shoulder girdle

most severe, most common, X-linked recessive trait, single gene defect on short arm of X chromosome; dystrophin is absent

early onset (37- years old); progressive muscular weakness, wasting and contractures, calf muscle hypertrophy; loss of independent ambulation by 9-12 years old; slow progression; gower’s sign (walk hands up body to get up)

impaired physical mobility related to muscle destruction

obesity; mild to moderate cognitive impairment

relentless progression of muscle weakness; waddling gait; lordosis, frequent falls, enlarged muslces, mental deficiency; complications-contractures of hips, ankles and knew, cardiomyopathy, obesity/undernutrition, respiratory compromise and cardiac failure

motor abnormalities, associated impairments, anatomic and radiologic findings, causation and timing

spastic, dyskinetic, ataxic and mixed

70-80% of all CP, persistent primitive reflexes, positive Babinski sign, ankle clonus, exaggerated stretch reflexes, impairment of fine and gross motor skills

jerking movements characterized by dlow, wormlike movements, dystonic-slow twisting of trunk, drooling, dysarthria

wide based gait, rapid repetitive movements performed poorly

delayed gross motor development, abnormal motor performance, alterations of muscle tone, abnormal posture, reflex abnormalities, associated disabilities (seizures, sensory impairment), crouched gait, intoeing, late crawling, late sitting up, arched back, stiff posture, knee contractures, hip dislocation

NO

impaired physical mobility, risk for injury, pain