Spina bifida occurs due to?

Appeared in: IGNOU PB Bsc Nsg Entrance-2017

Explanation

Spina bifida is a congenital birth defect characterized by the incomplete development of the brain, spinal cord, or their protective coverings.
It is correctly classified as a Neural Tube Defect (NTD), which are defects of the brain, spine, or spinal cord.
The condition occurs when the neural tube, an embryonic structure that develops into the brain and spinal cord, fails to close completely during the first month of pregnancy.
This failure of closure can happen anywhere along the spine, leading to different types of spina bifida with varying severity.

Option A: This describes an intracranial hemorrhage or hematoma, which involves bleeding within the skull. It is a vascular event, not a congenital structural defect of the spine.
Option C: The myometrium is the muscular layer of the uterus. Its function is related to pregnancy and childbirth, not the embryological development of the fetal nervous system.
Option D: The pericranium is the periosteum, or outer membrane, of the skull bones. A defect here would relate to the cranium, not the spinal column.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Etiology of Spina Bifida as background academic context rather than a clinical decision trigger.
A primary nursing intervention is educating women of childbearing age about the importance of daily folic acid supplementation (at least 400 mcg) before conception and during early pregnancy to significantly reduce the risk of NTDs.
Nurses provide critical post-operative care for infants with spina bifida, which includes protecting the surgical site from infection and contamination, managing pain, and monitoring for signs of hydrocephalus (a common complication).
Long-term care involves a multidisciplinary team to manage bladder and bowel dysfunction, mobility issues, and potential learning disabilities.

How to Approach the Question

First, identify the key term in the question, which is "Spina bifida".
Recall the fundamental definition and classification of this condition. Spina bifida is a classic example of a congenital anomaly taught in nursing curricula.
Systematically evaluate each option based on your medical knowledge.
Recognize that "Neural tube defect" is the broad category to which spina bifida belongs.
Eliminate the other options by identifying the anatomical structures they refer to: 'brain' (for blood accumulation), 'myometrium' (uterus), and 'pericranium' (skull). None of these are the primary site of a spina bifida defect.

Concept Tested & Keywords

QtrQZfxSFKxPdJquGweV18

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1367-1369

E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 575-577, 574-576

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