Chap 40 - Developmetnal Alterations Of Musculosketal Function

Question 1

Scoliosis

Answer 1

Abnormal rotational curvature of spine
-more common in adoscleent girls than boys

Question 2

Non structural scoliosis

Answer 2

Causes other than spine itself

Question 3

Structural scoliosis

Answer 3

Cause is vertebral rotation

Question 4

Idiopathic scoliosis

Answer 4

May be genetic and accounts for 80% of cases

Question 5

Congenial scoliosis

Answer 5

Bone deformity occurring before birth

Question 6

Tetralogical scoliosis

Answer 6

Caused by another systemic syndrome such as cerebral palsy

Question 7

Idiopathic curves progress while

Answer 7

A child is growing and rapidly progress during growth spurts

Question 8

Efficiency of treatment for scoliosis is based off of

Answer 8

Total number of hours a brace is worn

Question 9

Girls are 5x mroe likely to be affected

Answer 9

WhenCurves >20%

Question 10

Bracing is required when

Answer 10

Curves >25%

Question 11

Curves >50%

Answer 11

Kyphosis
-require spinal fusion to stop progression

Question 12

Bracing is less effective in

Answer 12

Confidential and tetralogical
-surgery is usually required

Question 13

Effects of >60 degrees

Answer 13

Reduced pulmonary function

Question 14

Effects of >80%

Answer 14

Right side heart failure

Question 15

Thoracic and lumbar deformity effects

Answer 15

GI disturbances

Question 16

Muscular dystrophy: duchenne muscular dystrophy is caused by

Answer 16

X linked mutations in dystrophin gene which leads to alteration and deletion of muscle protein dystrophin

Question 17

Most common childhood dystrophy is

Answer 17

Muscular dystrophy: duchenne muscular dystrophy

Question 18

Dystrophin is involved in

Answer 18

Anchoring actin cytoskeleton of muscle fibres to basement membrane

Question 19

Poorly anchored fibres

Answer 19

Tear themselves apart during repeated contraction = free calcium enters muscle cell = cell death

Question 20

Manifestations in Muscular dystrophy: duchenne muscular dystrophy

Answer 20

-pre school children = muscle weakness
-difficulty walking
-large calves due to muscle fiber replacement with fat and connective tissue
-pelvic area weakness

Question 21

Diagnosis for Muscular dystrophy: duchenne muscular dystrophy

Answer 21

-blood creatine kinase which can be 100 times normal level
-positive result = genetic testing for dystrophin gene to confirm diagnosis

Question 22

Muscular dystrophy: myotonic muscular dystrophy is caused by

Answer 22

Mutations in one of two genes
-type 1 MMD is dmpk gene
-type 2 is CNBP gene

Question 23

Type 1 MMD display

Answer 23

A genetic mechanism called anticipation
-where children born of mothers with MMD have a more severe form of MMD

Question 24

Disease hallmark of Muscular dystrophy: myotonic muscular dystrophy

Answer 24

Myotonia (difficulty relaxing muscle after contraction, like relaxing hand grip after handshake)

Question 25

Symptoms of Muscular dystrophy: myotonic muscular dystrophy

Answer 25

Muscle weakness, cataracts, cardiac conditions, often require wheelchair

Question 26

Diagnosis for Muscular dystrophy: myotonic muscular dystrophy

Answer 26

Testing for two genes that cause MMD
-specific mutation with both genes of repeated expression of CTG triplet
-could be 50 to 2000 repeats

Question 27

TX for Muscular dystrophy: myotonic muscular dystrophy

Answer 27

Steroids are ineffective
-but range of motion exercises, bracing and surgical release of contractures are effective