Spina Bifida
NPTE Clinical Files | Physical Therapy
Kyle Rice
4.9 • 631 Ratings
🗓️ 13 February 2019
⏱️ 13 minutes
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Summary
Jimmy is a three-year-old child with L2 myelomeningocele. The patient requires the use of orthotics for home ambulation.
The physical therapist is challenged with determining which orthotic would be the best to assist with household ambulation.
How well do you know your orthotics? Can you tell me what spina bifida is and what impairments are associated with an L2 myelomeningocele? Let's test your ability in this excellent episode about Spina Bifida
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Transcript
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| 0:00.0 | You are now tuning in to the MPTE Clinical Files to mock MPTE-based questions told and solved |
| 0:07.0 | week by week. Thank you for tuning in to the MPT Clinical Files. My name is Kyle Rice, the MPT |
| 0:12.3 | PrEPP Coach, the founder of the PT Hustle and the creator of the MPT Prep Success Coaching |
| 0:17.3 | Program. And if you would like a free cheat sheet that goes along with this specific |
| 0:22.4 | question, tune in to the end of this episode. And I'm going to give you more information on how to |
| 0:27.7 | get that. All right. So for our next MPT clinical file, we have our patient, Jimmy. And Jimmy is a |
| 0:33.5 | three-year-old child who presents with L2 myelomino-sil and significant cognitive impairment. |
| 0:41.0 | The therapist would like to select the best orthotic for home ambulation. |
| 0:45.3 | Which of the following orthotics would best address the therapist's goal? |
| 0:50.3 | All right. |
| 0:50.5 | So we got A, reciprocal gait orthosis, B, bilateral ankle foot orthoses, C, hip, knee, ankle foot orthosis, and then D is the parapodium. All right. So let's go ahead, check this one out. Super important. All right, let's start off at the top. So we got Jimmy. And Jimmy is a three-year-old child who presents with L2 Milo Menindial Sil. All right. So I want to slow up for a moment because it's really important for us to understand what's kind of going on here. What is this whole myelomino-miniol cell? What does that mean for us? All right? So myel menigial sill is what we call a neurotubule defect. |
| 1:31.6 | All right. |
| 1:32.4 | In a sense, we're talking about the spine. |
| 1:35.3 | And oftentimes the posterior aspect of the spine does not form. |
| 1:41.5 | And so what happens is the spinal cord starts to protrude through the meninges |
| 1:46.8 | into this meningial sac. All right? So you know that the spinal cord is supposed to be |
| 1:51.4 | encapsulated by the meninges, right? But you also note it's supposed to be living in the spinal |
| 1:57.2 | canal and then within the vertebra, right? |
| 2:01.7 | All right. |
| 2:02.0 | So we know that that's supposed to be the case. |
| 2:03.9 | But with malo meningial sill, the back of the spinal column, the posterior part of the vertebrae does not form correctly. |
| 2:12.1 | So the spinal cord starts to protrude outward. |
... |
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