Spina bifida physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Most patients with spina bifida have normal vital signs. Skin examination of patients with spina bifida is usually remarkable for: Spinal area discoloration or [[birthmarks]], protrusions in the [[lumbar spine]], dimples in the [[lumbar spine]] and patch along the spine. HEENT examination of patients with spina bifida is usually remarkable for: Enlarging head, bulging [[fontanelle]], enlarged [[scalp veins]], [[Cranial bones]] [[suture]] [[diastasis]] and positive [[Macewen's sign|Macewen sign]]. Cardiovascular examination of patients with spina bifida is usually normal but congenital anomalies of the spine have been associated with malformations of the cardiovascular systems. Congenital anomalies of the spine also may be associated with malformations of the genitourinary system. [[Neuromuscular]] examination of patients with spina bifida may be remarkable for: [[Paralysis]], sensation problems, [[Scoliosis]], pressure [[Ulcer|ulcers]], learning disabilities, [[Clonus]], [[Hyperreflexia]] or [[hyporeflexia]], positive (abnormal) [[Plantar reflex|Babinski]] unilaterally, [[Hypertonia|muscle rigidity]], muscle weakness unilaterally or bilaterally, abnormal gait and [[Dysmetria]]. | |||
==Physical Examination== | ==Physical Examination== | ||
*Physical examination of patients with spina bifida may be remarkable for:<ref name="pmid4898641">{{cite journal |vauthors=Bannur BB, Purandare GM |title=Microbial production of L-lysine |journal=Hindustan Antibiot Bull |volume=11 |issue=3 |pages=191–205 |date=February 1969 |pmid=4898641 |doi= |url=}}</ref><ref name="pmid5327787">{{cite journal |vauthors=Kenworthy ME |title=Introducing the American Orthopsychiatric Association's president for 1966-67: Norman V. Lourie |journal=Am J Orthopsychiatry |volume=36 |issue=4 |pages=587–9 |date=July 1966 |pmid=5327787 |doi= |url=}}</ref> | *Physical examination of patients with spina bifida may be remarkable for:<ref name="pmid4898641">{{cite journal |vauthors=Bannur BB, Purandare GM |title=Microbial production of L-lysine |journal=Hindustan Antibiot Bull |volume=11 |issue=3 |pages=191–205 |date=February 1969 |pmid=4898641 |doi= |url=}}</ref><ref name="pmid5327787">{{cite journal |vauthors=Kenworthy ME |title=Introducing the American Orthopsychiatric Association's president for 1966-67: Norman V. Lourie |journal=Am J Orthopsychiatry |volume=36 |issue=4 |pages=587–9 |date=July 1966 |pmid=5327787 |doi= |url=}}</ref> | ||
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===Genitourinary=== | ===Genitourinary=== | ||
* Congenital anomalies of the spine may be associated with malformations of the genitourinary system,. | * Congenital anomalies of the spine may be associated with malformations of the genitourinary system,. | ||
===Neuromuscular=== | ===Neuromuscular and extremities=== | ||
[[Neuromuscular]] examination of patients with spina bifida may be remarkable for:<ref name="pmid3046545">{{cite journal |vauthors=Berman P |title=Austin Flint--America's Laennec revisited |journal=Arch. Intern. Med. |volume=148 |issue=9 |pages=2053–6 |date=September 1988 |pmid=3046545 |doi= |url=}}</ref><ref name="pmid2259256">{{cite journal |vauthors=Goya RG, Lu JK, Meites J |title=Gonadal function in aging rats and its relation to pituitary and mammary pathology |journal=Mech. Ageing Dev. |volume=56 |issue=1 |pages=77–88 |date=October 1990 |pmid=2259256 |doi= |url=}}</ref><ref name="pmid4362105">{{cite journal |vauthors=Weiden PL, Schuffler MD |title=Herpes esophagitis complicating Hodgkin's disease |journal=Cancer |volume=33 |issue=4 |pages=1100–2 |date=April 1974 |pmid=4362105 |doi= |url=}}</ref><ref name="pmid3047453">{{cite journal |vauthors=Thier SO |title=Commentary by the current president of the Institute of Medicine |journal=JAMA |volume=260 |issue=14 |pages=2104 |date=October 1988 |pmid=3047453 |doi= |url=}}</ref><ref name="pmid16120229">{{cite journal |vauthors=Vermaes IP, Janssens JM, Bosman AM, Gerris JR |title=Parents' psychological adjustment in families of children with spina bifida: a meta-analysis |journal=BMC Pediatr |volume=5 |issue= |pages=32 |date=August 2005 |pmid=16120229 |pmc=1215488 |doi=10.1186/1471-2431-5-32 |url=}}</ref> | [[Neuromuscular]] examination of patients with spina bifida may be remarkable for:<ref name="pmid3046545">{{cite journal |vauthors=Berman P |title=Austin Flint--America's Laennec revisited |journal=Arch. Intern. Med. |volume=148 |issue=9 |pages=2053–6 |date=September 1988 |pmid=3046545 |doi= |url=}}</ref><ref name="pmid2259256">{{cite journal |vauthors=Goya RG, Lu JK, Meites J |title=Gonadal function in aging rats and its relation to pituitary and mammary pathology |journal=Mech. Ageing Dev. |volume=56 |issue=1 |pages=77–88 |date=October 1990 |pmid=2259256 |doi= |url=}}</ref><ref name="pmid4362105">{{cite journal |vauthors=Weiden PL, Schuffler MD |title=Herpes esophagitis complicating Hodgkin's disease |journal=Cancer |volume=33 |issue=4 |pages=1100–2 |date=April 1974 |pmid=4362105 |doi= |url=}}</ref><ref name="pmid3047453">{{cite journal |vauthors=Thier SO |title=Commentary by the current president of the Institute of Medicine |journal=JAMA |volume=260 |issue=14 |pages=2104 |date=October 1988 |pmid=3047453 |doi= |url=}}</ref><ref name="pmid16120229">{{cite journal |vauthors=Vermaes IP, Janssens JM, Bosman AM, Gerris JR |title=Parents' psychological adjustment in families of children with spina bifida: a meta-analysis |journal=BMC Pediatr |volume=5 |issue= |pages=32 |date=August 2005 |pmid=16120229 |pmc=1215488 |doi=10.1186/1471-2431-5-32 |url=}}</ref> | ||
* [[Paralysis]] | * [[Paralysis]] | ||
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*Abnormal gait | *Abnormal gait | ||
*[[Dysmetria]] | *[[Dysmetria]] | ||
==References== | ==References== | ||
Latest revision as of 18:56, 31 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
Most patients with spina bifida have normal vital signs. Skin examination of patients with spina bifida is usually remarkable for: Spinal area discoloration or birthmarks, protrusions in the lumbar spine, dimples in the lumbar spine and patch along the spine. HEENT examination of patients with spina bifida is usually remarkable for: Enlarging head, bulging fontanelle, enlarged scalp veins, Cranial bones suture diastasis and positive Macewen sign. Cardiovascular examination of patients with spina bifida is usually normal but congenital anomalies of the spine have been associated with malformations of the cardiovascular systems. Congenital anomalies of the spine also may be associated with malformations of the genitourinary system. Neuromuscular examination of patients with spina bifida may be remarkable for: Paralysis, sensation problems, Scoliosis, pressure ulcers, learning disabilities, Clonus, Hyperreflexia or hyporeflexia, positive (abnormal) Babinski unilaterally, muscle rigidity, muscle weakness unilaterally or bilaterally, abnormal gait and Dysmetria.
Physical Examination
- Spinal area discoloration or birthmarks may be the only sign in the newborns with spina bifida occulta
- Protrusions in the lumbar spine
- Dimples in the lumbar spine
- Hair patch along the spine
- Hydrocephalus signs may be present:
- Enlarging head
- Bulging fontanelle
- Enlarged scalp veins
- Cranial bones suture diastasis
- Positive Macewen sign
- Paralysis
- Sensation problems
- Scoliosis
- Pressure ulcers
- Learning disabilities
- Hydrocephalus signs may be present:
Vital Signs
- Most patients with spina bifida have normal vital signs.
Skin
- Skin examination of patients with spina bifida is usually remarkable for:[1][2]
- Spinal area discoloration or birthmarks may be the only sign in the newborns with spina bifida occulta
- Protrusions in the lumbar spine
- Dimples in the lumbar spine
- Hair patch along the spine
HEENT
- Enlarging head
- Bulging fontanelle
- Enlarged scalp veins
- Cranial bones suture diastasis
- Positive Macewen sign
Lungs
- Pulmonary examination of patients with spina bifida is usually normal.
Heart
- Cardiovascular examination of patients with spina bifida is usually normal but congenital anomalies of the spine have been associated with malformations of the cardiovascular systems.
Abdomen
- Abdominal examination of patients with spina bifida is usually normal.
Genitourinary
- Congenital anomalies of the spine may be associated with malformations of the genitourinary system,.
Neuromuscular and extremities
Neuromuscular examination of patients with spina bifida may be remarkable for:[3][4][5][6][7]
- Paralysis
- Sensation problems
- Scoliosis
- Pressure ulcers
- Learning disabilities
- Clonus
- Hyperreflexia or hyporeflexia
- Positive (abnormal) Babinski unilaterally
- Muscle rigidity
- Muscle weakness unilaterally or bilaterally
- Abnormal gait
- Dysmetria
References
- ↑ 1.0 1.1 1.2 Bannur BB, Purandare GM (February 1969). "Microbial production of L-lysine". Hindustan Antibiot Bull. 11 (3): 191–205. PMID 4898641.
- ↑ 2.0 2.1 2.2 Kenworthy ME (July 1966). "Introducing the American Orthopsychiatric Association's president for 1966-67: Norman V. Lourie". Am J Orthopsychiatry. 36 (4): 587–9. PMID 5327787.
- ↑ Berman P (September 1988). "Austin Flint--America's Laennec revisited". Arch. Intern. Med. 148 (9): 2053–6. PMID 3046545.
- ↑ Goya RG, Lu JK, Meites J (October 1990). "Gonadal function in aging rats and its relation to pituitary and mammary pathology". Mech. Ageing Dev. 56 (1): 77–88. PMID 2259256.
- ↑ Weiden PL, Schuffler MD (April 1974). "Herpes esophagitis complicating Hodgkin's disease". Cancer. 33 (4): 1100–2. PMID 4362105.
- ↑ Thier SO (October 1988). "Commentary by the current president of the Institute of Medicine". JAMA. 260 (14): 2104. PMID 3047453.
- ↑ Vermaes IP, Janssens JM, Bosman AM, Gerris JR (August 2005). "Parents' psychological adjustment in families of children with spina bifida: a meta-analysis". BMC Pediatr. 5: 32. doi:10.1186/1471-2431-5-32. PMC 1215488. PMID 16120229.