Child with Musculoskeletal Condition Flashcards
Children’s bones have a lower ____ content & greater ____ increasing their bone strength.
- Mineral
2. Porosity
4 things making pediatric skeletal system different from an adult’s:
- Bones aren’t completely ossified
- Epiphyses are present
- Thicker periosteum
- Callus produces quicker
Bone overgrowth is common in healing fracture of children under 1.__, due to the presence of 2.__ and 3.__.
- 10
- Epiphysis
- Hyperemia
The general curvature of a newborn’s spine is a _ shape from the thoracic to pelvic level
C
Observing muscle tone:
Assess symmetry of movement
The strength and contour of the body and extremities
Test by having child push away the examiner’s hand with his/her foot
Neuro exam:
Assess reflexes, sensory, and note presence/absence of spasms
Bone scans are helpful in identifying:
Septic arthritis and tumors
Ultrasound, in relationship to the skeleton is used for ruling out:
Foreign bodies, joint effusions and developmental dysplasia
Contusion
Tearing of sub-q tissue resulting in hemorrhage, edema, and pain
Treating soft tissue injuries:
Apply a cold pack and elastic wrap to reduce swelling, bleeding, and relieve pain
Apply at alternating 30-minute intervals
Spiral femur fracture in a child may indicate:
Abuse
Bryant’s traction:
For treating femur fractures in children under 2 or under 20-30 lbs
Legs are suspended vertically
When is traction used?
When the cast cannot maintain alignment of the two bone fragments
Russel traction
Similar to Buck’s
Sling is positioned under the knee suspending the distal thigh above the bed
Checklist for a traction apparatus:
Weights hanging freely Weights out of reach of the child Ropes on the pulleys Knots not resting against pulleys Bed linens not on traction ropes Counter traction in place Apparatus does not touch foot of bed
Neuro vascular check for tissue perfusion performed on toes or fingers distal to the injury includes:
Peripheral pulse rate and quality Color Capillary refill time Warmth Movement and sensation
Checklist for patient in traction:
Body in alignment
HOB no higher than 20*
Heels of feet elevated from bed
ROM of unaffected limbs check at regular intervals
Anti embolism stocking in place as ordered
Neuro vascular checks performed regularly
Skin integrity monitored regularly
Pain and it’s relief by medication recorded
Measures to prevent constipation
Use of trapeze for change of position encouraged
Compartment syndrome
Progressive loss of tissue perfusion caused by an increase in pressure caused by edema or swelling that presses on vessels and tissues
Circulation is compromised
Checking for nerve damage in a humeral fracture:
Check for sensation over the sprain of the index finger
Can damage the radial nerve
Checking motor function in humeral fracture:
Ask patient to hyperextended the thumb
Checking for sensory function in radial fracture:
Can damage medial and radial nerve
Check for sensation on the palmar surface of the fingers and the thumb half if the palm
Checking motor function of radial fracture
Ask patient to touch thumb to tip of the pinky
Checking sensation in ulnar fracture
Check on border of hand from little finger to ring finger
Can damage the ulnar nerve
Checking motor function of an ulnar fracture
Ask the patient to abduct, or spread, his or her fingers
Checking sensation of femoral fracture
Check over top of foot between the 1st and 2nd toes
Can damage the peroneal nerve
Checking motor function for femoral fracture
Ask patient to dorsiflex the foot, pointing his or her toes towards the head
Checking for sensation of fibular fracture
Lack of sensation between 1st and 2nd toes on top of the foot of inability to dorsiflex the foot is a sign of peroneal nerve damage
Checking for sensory damage in tibial fracture
Ask patient of medial side of the sole of his foot feels warm
Can damage tibial nerve
Checking motor function in tibial fracture
Ask patient to plantarflex the foot, pointing toes down
Osteomyelitis
Infection of the bone
Generally occurs in children younger than 1 and those between 5-14
Duchenne’s or Becker’s muscular dystrophy pathopysiology
Progressive muscle degeneration occurs
Sex-linked inherited to boys only
Manifestations of Duchenne’s or Becker’s muscular dystrophy
Calf muscles become hypertrophied Progressive weakness Frequent falling Clumsiness Contractures of ankles and good Gower's maneuver
Treatment of Duchenne’s or Becker’s muscular dystrophy
Prednisone
Glutamine and creatinine (for muscle weakness)
Enzyme transferase (block muscle wasting)
Urotrophin (replace missing dystrophin)
Slipped femoral capital epiphysis
“Coxa vara”
Spontaneous displacement of the epiphysis of the femur
Bruise 1-2 days old
Swollen
Tender
Bruise 0-5 days old
Red or purple
Bruise 5-7 days old
Green
Bruise 7 to 10 days old
Yellow
Bruise 10 to 14 days old
Brown
Bruise 14 to 28 days old
Clear
Battered Child Syndrome
Clinical condition in young children who have received serious physical a use generally from parent or foster parents
Concussion
Any blow to the head followed by alterations in mental functioning should be treated as a possible concussion
Observe for sequelae
Stingers or Burners
Common neck injury when a player hits another in the head
Caused by brachial plexus trauma
Feels like electrical jolt
Usually mild and disappears suddenly
Injured Knee
Usually a result of stress on knee ligaments
Potentially serious
May necessitate arthroscopic surgery
Sprain or strained ankle
May injure growth plate
Muscle cramps
Caused by injury Alters blood flow Electrolyte deficiencies Important to warm up before activity Ensure fluid intake is adequate
Shin splints
Pain and discomfort in lower leg caused by repeated running on hard surface
Scoliosis pathopysiology
Skeletal abnormality
S-shaped curve of the spine
More common in adolescent girls
May lead to back pain, fatigue, discomfort and heart & lung complications
S&S of scoliosis
Usually found during screening
Symptoms develop slowly and non painful
Juvenile Idiopathic Arhtritis
JRA
Systemic autoimmune disease involving the joints, connective tissues, and viscera.
Differs from RA
