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Peds > Developmental biomechanics > Flashcards

Developmental biomechanics Flashcards

1
Q

What is developmental biomechanics the study of?

A

Study of how forces affect the MSK system over the life span

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2
Q

Main forces impacting developmental biomechanics

A

Body weight/gravity (external)
Alignment + pull/force of muscles (internal)

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3
Q

Why is developmental biomechanics important

A

Development of MSK system is part of tx and dx

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4
Q

When does formation of MSK system occur

A

2nd - 8th week of post conception (embryonic period)

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5
Q

When do limb buds appear?

A

4th week (upper limb slightly before lower limb)

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6
Q

Up to what week do major congenital abnormalities occur?

A

8 weeks (start of the fetal period)

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7
Q

Categories of congenital abnormalities and what phase they occur in

A

Malformations (embryonic)
Deformations (fetal)
Disruptions (fetal)
Dysplasias (fetal)

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8
Q

During what period do malformations arise?

A

Period of organogenesis (weeks 2-8)

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9
Q

Of what origin are malformations?

A

Teratogenic
Genetic
Idiopathic

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10
Q

Examples of malformations

A

Phocomelia
Limb hypoplasis

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11
Q

Terotogenic origin

A

Something external (meds, radiation, illness/fever)

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12
Q

Genetic origin

A

Mutation

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13
Q

Is lower or upper limb more susceptible to congenital limb loss

A

Lower

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14
Q

What is a key difference between infant + children bones and adult bones

A

Bones are softer in infants/children because they haven’t been ossified

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15
Q

When do deformations occur in development?

A

Occur at the end of gestation (fetal stage)

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16
Q

Cause of deformations

A

Intrauterine crowding
Position

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17
Q

Examples of deformation

A

Torticollis
Club foot

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18
Q

t/f deformations are more common in multiples

A

true

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19
Q

When do disruptions occur

A

Later in gestation (fetal stage)

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20
Q

Cause of disruptions

A

Teratogenic, traumatic, or other physical insults to the fetus interfere with growth

21
Q

Examples of disruptions

A

Congenital/amniotic constriction bands

22
Q

Why do dysplasias occur

A

Result from altered growth that occurs before and/or after birth

23
Q

Examples of dysplasias

A

Achondroplasia
Developmental hip dysplasia

24
Q

Are dysplasias isolated?

A

They can be, but can also be more widespread

25
Q

2 distinct processes of bone formation

A

Endochondral ossification
Intramembranous ossification

26
Q

Role of ossification

A

Form bone by replacing cartilage, but differing in method

27
Q

What type of ossification is more common and what bones do not follow this method

A

Endochondral ossification is more common

Clavicle, mandible and skull are formed by intramembranous

28
Q

Primary ossification center

A

Midportion of long bones

Ossify outward until entire shaft are ossified at birth

29
Q

Secondary ossification centers

A

Develop during infancy and early childhood at the end of bones

30
Q

Growth plate

A

Cartilage between 1st and 2nd ossification centers

31
Q

Directions bones grow

A

Length: long bones grow in length at epiphyseal plate

Girth: bones increase in size through addition and accumulation of new bone on the bone surface

32
Q

When is the most rapid period of growth in long bone girth

A

Prenatally

33
Q

What is necessary for bones to growth

A

WB + muscle forces

34
Q

2 ways that muscle fibers increase

A

Hyperplasia: Prenatally increase in # of muscle cells
Hypertrophy: after birth increase in size of muscle cells

35
Q

How to stimulate growth of muscle fibers

A

Resistance training

36
Q

Directions of muscle growth

A

Diameter: related to intensity of activity during growth
Length: addition of sarcomeres and lengthening of sarcomeres

37
Q

Clinical implications of the MSK system development

A

-immature MSK system is vulnerable to abnormal mechanical forces + pressures
-Compliance of MSK system procides for successful response to tx intervention (plasticity)

38
Q

Wolff Law of bone transformation

A

Mechanical stresses modulate bone shape + internal architecture

Proportional: High strength = high stress

39
Q

Skeletal molding mechanism

A

Strain

40
Q

Components of strain

A

Compression
Tension
Torsion

41
Q

Tension modeling effects

A

Tendon + ligament attachments are loaded in tension, resulting in trochanters, tubercles, prominences and ridges

42
Q

Compression modeling effects

A

WB results in increase in growth rate at the compression sites of epiphyseal plate and increase in cross sectional diameter

43
Q

Torsion modeling effects

A

Twisting thru the shaft or longitudinal axis of a bone (tibial torsion)

44
Q

Clinical significance of adaptations of muscles and bone

A

Mechanical forces affect the shape of the maturing skeleton which in turn affect the biomechanical function of the MSK system

45
Q

Norma developmental progression of the knees

A

Genu varum earlier on
straight limbs due to WB
Genu valgum; development of more mature gait pattern

46
Q

Clinical implications of tension

A

Spasticity provides asymmetric pull risk of subluxation/dislocation

Ilizarov disease

47
Q

Clinical implications of compression

A

Ankle and genu varum/valgum
Flattening of femoral head resulting in slipped capital femoral epiphysis + osteopenia

48
Q

Clinical implication of torsion

A

Femoral anteversion results in in toeing

Peds (11 decks)

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