Spina bifida physical examination

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

Physical examination of patients with spina bifida may be 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

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

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

HEENT examination of patients with spina bifida is usually remarkable for:^[1]^[2]

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.

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[pmid4898641-1] 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.

[pmid5327787-2] 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.

[pmid3046545-3] Berman P (September 1988). “Austin Flint–America’s Laennec revisited”. Arch. Intern. Med. 148 (9): 2053–6. PMID 3046545.

[pmid2259256-4] 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.

[pmid4362105-5] Weiden PL, Schuffler MD (April 1974). “Herpes esophagitis complicating Hodgkin’s disease”. Cancer. 33 (4): 1100–2. PMID 4362105.

[pmid3047453-6] Thier SO (October 1988). “Commentary by the current president of the Institute of Medicine”. JAMA. 260 (14): 2104. PMID 3047453.

[pmid16120229-7] 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.

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