Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

brs2 > childrens orthopaedics > Flashcards

childrens orthopaedics Flashcards

1
Q

how many bones does a child skeleton have

A

270

is a system that is a continuous change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how are flat bones e.g cranial/clavicle bones formed

A

intramembranous

mesenchymal cells -> bones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how are long bones formed

A

endochondral

mesenchymal -> cartilage -> bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what happens in intramembranous ossification

A

condensation of mesenchymal cells which differentiate to osteoblasts
these secrete osteoids which trap osteoblasts becoming osteocytes
trabecular matrix and periosteum form
compact bone develops superficial to cancellous bone
crowded blood vessels condense into red bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

where does endochondral ossification occur

A

1.primary ossification centres- sites of pre natal bone growth through endochondral ossification from central part of bone
2.secondary - occurs post natal after primary ossification centre
long bones often have several. (physis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are some primary ossification centres

A

middle of diaphysis
or shaft of bone
occurs in prenatal period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe primary ossification

A

mesenchymal differentiation of primary centre
cartilage model of bony skeleton forms
capillaries penetrate cartilage
calcification - spongy bone forms
cartilage and chondrocytes continue to form end of bone
secondary ossification centres form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe secondary ossification

A

happens at physis

proliferation of chondrocytes and calcification of cartilage which dies and is replaced by bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

why can childrens bone bend more

increased elasticity

A

increased density of haversian canals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what can an increased elasticity in childrens bones cause

A
  1. plastic deformity - bends before breaks
  2. buckle fracture -
  3. greenstick - like tree, one cortex fractures but does not break other side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when does growth stop in children

A

when physis closes

depends on gradual physeal closure, puberty, menarche, parental height

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what can physeal injuries lead to

A

growth arrest

which can form deformities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the speed and remodelling potential dependent on

A

location
and age of patient
younger child heals more quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is developmental dysplasia of hip

A

group of disorders of neonatal hip where head of femur is unstable/incongruous in relation to acetabulum
e.g. subluxation, dislocation, dysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are some risk factors for developmental dysplasia of hip

A

female 6:1
first born
fh
oligohydramnios

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how to examine for developmental dysplasia of hip

A

usually picked up on baby check - screening in uk

range of motion of hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what would you see in the examination of baby with ddh

A

usually limitation in hip abduction
leg length - galeazzi
in those 3mnths+ barlow and ortalani are non-sensitive

18
Q

what are the investigations for developmental dysplasia of hip

A

ultrasound - effective and sensitive from 0-4mnths

measures acetabular dysplasia and position of hip

19
Q

what is the treatment of ddh

A

reducible hip for <6mnths
pavlik harness is 92% effective
if failed pavlik harness/6-18mnths
mua and closed reduction and spica

20
Q

what is congenital talipes equinovarus

A

congenital deformity of foot
highest in hawaiians
50% are bilateral
genetic - pitx1 gene

21
Q

what are the features of congenital talipes equinovarus

A 
cave deformity due to muscle contracture
cavus - high arch, tight intrinsic muscles
adductus of foot
varus - tight tendoachillies, 
equinous - tight tendoachilles
clubfoot
22
Q

treatment for clubfoot

A

ponseti method - gold standard

  1. series of casts to correct deformity
  2. many require operative treatment usually in form of soft tissue release
  3. foot orthosis brace
  4. some require further operative intervention
23
Q

what is achondroplasia

A

most common skeletal dysplasia
autosomal dominant - g380 mutation of fgfr3
inhibition of chondrocyte proliferation in proliferative zone of physis
- results in defect in endochondral bone formation

24
Q

what is rhizomelic dwarfism

A

humerus shorter than forearm
femur shorter than tibia
normal trunk

25
Q

what is osteogenesis imperfecta

A

brittle bone disease
hereditary - autosomal dominant/recessive
decreased type 1 collagen due to decreased secretion/production of abdominal collagen
- insufficient osteoid production

26
Q

effects of osteogenesis imperfecta

A

bones:
fragility fractures, short stature, scoliosis
non orthopaedic manifestations: heart, blue scalera, dentinogenesis imperfecta, wormian skull, hypermetabolism

27
Q

how can you describe a paediatric fracture

A 
Pattern
Anatomy
Intra/extra articular
Displacement
Salter-Harris(affects physis)
28
Q

how does primary bone healing occur

A

heals by direct union
no callus formation
preferred healing pathway in intraarticular fracture as minimises risk of post traumatic arthritis

29
Q

how does secondary bone healing occur

A

bone healing by callus

remember physis!

30
Q

what is salter harris

A

classification of physeal injuries(salt)

  1. physeal separation
  2. fracture transverses physis and exits metaphysis
  3. fracture tranverses physis and exits epiphysis
  4. fracture passes through epiphysis, physis and metaphysis
  5. crush injury to physis
31
Q

what is growth arrest

A

injuries to physis can cause growth arrest
location and timing is key
whole physis - limb length discrepancy
partial - angulation as non affected side keeps growing

32
Q

treatment for growth arrest

A

aim is to correct deformity
minimise angular deformity
minimise limb length difference

33
Q

4 Rs for fracture management

A

resuscitate
reduce
restrict
rehabilitate

34
Q

how do you reduce fracture

A

correct deformity and displacement

reduce secondary injury to soft tissue

35
Q

how to restrict a fracture

A

external - splints and plasters
internal - plate and screws
intramedullary device

36
Q

what are some differentials for limping child

A

septic arthritis
transient synovitis
perthes
sufe

37
Q

what is septic arthritis

A

orthopaedic emergency
can cause irreversible long term problems in joint
kochers classification can help score probability
history is key - duration,other recent illness, associated joint pain

38
Q

what is transient synovitis

A

diagnosis once septic arthritis has been excluded
inflmaed joint in response to systemic illness
supportive treatment with antibiotics

39
Q

what is perthes diseases

A

idiopathic necrosis of proximal femoral epiphysis
usually in those 4-8yrs old
male : female 4:1
septic arthritis needs to be excluded first
treatment usually supportive in first instance

40
Q

what is sufe

A

slipped upper femoral epiphysis
proximal epiphysis slips in relation to metaphysis
usually in obese adolescent males during rapid growth
septic arthritis must be excluded
can be acute/chronic

41
Q

what is the treatment for sufe

A

operative fixation with screw to prevent further slip and minimise long term growth problems

brs2 (65 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions