ATI Unit 2 - Musculskeletal Disorders (Josh) Flashcards
Types of Fractures:
bone fragments are separated
Complete
Ortalini Test?
Barlow Test?
Trendelenberg Test?
Infant Test for DDH
- Ortalini Test abducts hip (positive if hip is reduced and means DDH)
- Barlow Test adducts hip (positive if hip is dislocated and means DDH)
Child Test for DDH
- Trendelenberg Sign (while bearing weight on affected side, the pelvis tilts downward)
Types of Fractures:
bone fragments are attached
Incomplete
Types of Fractures:
fracture results in injury to other organs
Complcated
Why elevate the cast the first 24-48 hrs?
elevate above heart level to prevent swelling
- also apply ice first 24 hrs to prevent swelling
Types of Fractures:
break is diagonal across the bone
Oblique
Why do an eye examination w/ Juvenile Idiopathic Arthritis?
diagnoses uveitis (inflammation of middle eye)
JIA increases risk for uveitis
Back curve needs to be at least — degrees for diagnosis of scoliosis.
10
mile curves less than 25o are monitored
Kernicterus in the neonate can cause Cerebral Palsy. What causes Kernicterus?
high levels of bilirubin
What is DDH?
Developmental Dysplasia of the Hip
- variety of disorders resulting in abnormal development of the hip structures
Why are respiratory infections common w/ Down’s Syndrome?
decreased muscle tone and poor drainage of mucous b/c of hypotonicity and associated underdeveloped nasal bone
What is Chorioamnionitis?
risk factor for CP
Chorioamnionitis also known as intra-amniotic infection (IAI) is an inflammation of the fetal membranes (amnion and chorion) due to a bacterial infection. It typically results from bacteria ascending into the uterus from the vagina and is most often associated with prolonged labor.
S/S of Cerebral Palsy
Persistent primitive reflexes
Gagging/Choking w/ feeding
Tongue thrust
Poor head control
Rigid posture and extremities
Asymmetric crawl
Hyerreflexia
S/S of Juvenile Idiopathic Arthritis
Joint swelling, warmth, redness (worse in AM and after naps)
Limited mobility
Fever / Rash
Limp in morning
Enlarged Lymph nodes
Delayed growth
Meds for JIA
NSAIDS
- ibuprofen
- naproxen
- tolmetin
Methotrexate (DMARD)
Corticosteroids (only for life-threatening complications)
- eye solution, oral, IV
Etanercept (TNF-a blocker)
- if methotrexate is not working
When is spinal fusion used for Scoliosis?
curvature greater than 45o
- get self-donated blood before surgery
Medications for Cerebral Palsy
Baclofen (muscle relaxer)
- administer orally or entrathecally w/ specialized, surgically implanted pump
Diazepam (decreases muscle spasms)
- older children
Botulinum Toxin (reduces spasticity)
- used in lower extremities
- 24-72 hrs to work
- peak of 2 weeks
- lasts 3-6 mths
Lab tests for DMD
Serum Polymerase Chain Reacion (PCR)
Creatinine Kinase (elevated)
– is a chronic autoimmune inflammatory disease affecting joints and other tissues.
Juvenile Idiopathic Arthritis
—is a group of inherited disorders w/ progressive degeneration of symmetric skeletal muscle groups.
Muscular Dystrophy (MD)
Meds for Osteogensis Imperfecta
Pamidronate (increases bone density)
- monitor for hypkalemia, hypomagnesemia, hypocalcemia, hypophosphatemia, general malaise
S/S of Osteogenesis Imperfecta
multiple bone fractures
BLUE SCLERA
EARLY HEARING LOSS
bowed legs
kyphosis (hunch back)
scoliosis
What is Ostemyelitis?
infection within the bone secondary to a bacterial infection from an outside source
Compartment Syndrome S/S
increased pain that is unrelieved w/ elevation or analgesics
intense pain when passively moved
paresthesia
pulselessness
inability to move digits
warm digits w/ skin that is tight and shiny
pallor
Why are mucous membranes so dry w/ Down’s Syndrome?
constant mouth breathing
- rinse w/ water after meals and periodically thu day
A child presents w/ persistent priminitive reflexes like Moro and Tonic Neck. Which dx?
Cerebral Palsy
When do respiratory and cardiac difficulties start w/ DMD?
age 20
Types of Cerebral Palsy
Spastic (Pyramidal)
Dyskinetic (Nonspastic, Extrapyramidal)
Ataxic (Nonspastic, Extrapyramidal)
Types of Fractures:
fracture occurs w/ open wound and bone protruding
Open or Compound
Types of Fractures
bone is bent no more than 45o
Plastic Deformation (bend)
Types of Fractures:
break is straight across the bone
Transverse
Before symptoms of Juvenile Idiopathic Arthritis are detected, what can be found in the lab?
Anticyclic Citrullinated Peptide (anti-CCP) antibodies
Types of Fractures:
incomplete fracture of bone
Greenstick
Types of Fractures:
tiny cracks in bone
Stress
Types of Fractures:
fracture occurs w/out skin break
Closed or Simple
Types of Fractures:
break spirals around the bone
Spiral
What is the most common form of MD?
Duchenne Muscular Distrophy (DMD)
- lifespan only into early adulthood
What is Cerebral Palsy?
a nonprogressive impairment of motor function, especially of muscle control, coordination, and posture
Types of Fractures:
injury to end of the long bone on growth plate
Growth Plate
Treatment for Clubfoot?
serious of casting started shortly after birth and continuing until maximum correction is accomplished
Types of Fractures:
compression of bone resulting in a bulge or raised area at the fracture site
Buckle (torus)
