An abnormal opening in the vertebral column or posterior vertebral arches fail to close in the lumbo-sacral area and no organs protrude and there may be dimple in the skin present is known as?

1. A

   Spina bifida occulta

2. B

   Spina bifida cystica

3. C

   Myelomeningocele

4. D

   Meningocele

Appeared in: NORCET-7 Mains-2024

Explanation

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• Spina bifida occulta is the mildest and most common form of spina bifida, a type of neural tube defect.
• The term 'occulta' means hidden, signifying that the vertebral defect is covered by skin and not visible as an external sac.
• It involves an incomplete closure of one or more vertebrae, but crucially, there is no protrusion of the spinal cord or meninges.
• The presence of a skin dimple, a tuft of hair, or a birthmark in the lumbosacral area are classic external indicators of this underlying condition.

Why Other Options Were Wrong

• Option B: Spina bifida cystica is an umbrella term for forms of spina bifida where a cyst or sac protrudes from the back. This contradicts the question's key descriptor 'no organs protrude'.
• Option C: Myelomeningocele is the most severe form of spina bifida. The protruding sac contains the spinal cord, nerve roots, meninges, and CSF. This is incorrect because the question explicitly states 'no organs protrude'.
• Option D: Meningocele involves the protrusion of a sac containing meninges and cerebrospinal fluid (CSF) through the vertebral defect, but not the spinal cord itself. This is incorrect as it involves a protrusion, which is ruled out by the question.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types of Neural Tube Defects (Spina Bifida) as background academic context rather than a clinical decision trigger.
• Nurses must perform a thorough spinal assessment on all newborns, specifically looking for cutaneous signs like dimples, hair tufts, or nevi in the lumbosacral area, which can indicate an underlying spina bifida occulta.
• Children diagnosed with any form of spina bifida are at a high risk for latex allergies. It is a critical patient safety measure to use latex-free products in all aspects of their care.
• What if? If the question described a visible, fluid-filled sac on the infant's back associated with leg paralysis, the correct answer would become Myelomeningocele, as this indicates the spinal cord is involved in the protrusion.

How to Approach the Question

• First, break down the key descriptors in the question: 'abnormal opening in vertebral column,' 'fail to close,' 'no organs protrude,' and 'dimple in the skin.'
• The phrase 'no organs protrude' is the most critical clue. This immediately rules out any condition that involves a visible sac or cyst.
• Recall the meaning of the medical term 'occulta,' which means 'hidden.' Match this concept with the description of a non-protruding, skin-covered defect.
• Evaluate the options: 'Cystica,' 'Meningocele,' and 'Myelomeningocele' all describe conditions with a 'cyst' or protruding sac.
• Conclude that the only option fitting the description of a 'hidden' defect with no protrusion is Spina bifida occulta.

Concept Tested & Keywords

• Concept Tested: Types of Neural Tube Defects (Spina Bifida)
• Stem keywords: abnormal opening, vertebral column, posterior vertebral arches, fail to close, lumbo-sacral area, no organs protrude, dimple in the skin
• Lead-in keywords: known as

Question ID

Qk08lU9jyGR00Xts4STM4b

Copy ID

Reference Book

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1369-1371