Brainscape's Knowledge GenomeTM

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


See full index

MCN 109 Midterms > Disorders of Skeletal Structure > Flashcards

Disorders of Skeletal Structure Flashcards

1
Q

Scoliosis

A
  • spinal deformity that manifests as lateral curvature of spine
  • most common in adolescent girls (due to release of hormones)
  • familiar pattern; neuromuscular condition
  • idiopathic majority (unknown)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of Scoliosis

A
  1. thoracic
  2. lumbar
  3. thoraco-lumbar
  4. combined
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Scoliosis Assessment

A
  • failure of curve to straighten when bending forward with knees straight and arms hanging down feet
  • uneven bra strap marks
  • uneven hips
  • uneven shoulder
  • asymmetry of rib cage
  • xray reveals curvature
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Scoliometer

A
  • inclinometer that measures trunk asymmetry or axial trunk rotation
  1. upper thoracic (T3-T4)
  2. middle thoracic (T5-T12)
  3. thoraco-lumbar (T12-L1 or L2-L3)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Scoliosis Management: Less than 20 Degrees

A

no therapy required

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

Scoliosis Management: More than 20 Degrees

A

treatment can consist of conservative non-surgical approach

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

Scoliosis Management: More than 40 Degrees

A

surgery with spinal fusion

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

Scoliosis Management

A

wear Milwaukee brace for 3 years

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

Scoliosis Nursing Interventions

A
  • teach/ encourage exercise
  • provide care for child with Milkauwee brace
    ○ wear brace 23 hours/ day
    ○ monitor pressure joint
    ○ promote positive body image
  • cast care
  • assist with modifying clothing for immobilization devices
  • adjust diet with decreased activity
  • provide client teaching with discharge instructions
    ○ exercise
    ○ cast care
    ○ correct body mechanics
    ○ alternative education (long term hospitalization)
    ○ availability of community agencies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lordosis

A

inward curve of lumbar spine (above buttocks)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Kyphosis

A

forward rounding of upper back

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

Developmental Dysplasia of Hip

A
  • congenital hip dysplasia
  • improper formation of hip socket
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Congenital Hip Dislocation

A
  • displacement of head of femur form acetabulum
  • present at birth although not always diagnosed
  • familiar disorder
  • unknown cause: may be fetal position in utero
  • acetabulum is shallow and the head of femur is cartilaginous at birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Congenital Hip Dislocation Assessment

A
  • unilateral or bilateral
  • limitation of abduction (cannot spread legs top change diaper)
  • one leg is shorter than the other
  • unequal number of skin fold on posterior thigh
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

CHD Barlow’s Test

A
  • infant on back, bend knees
  • affected knee: lower (head of femur dislocates towards the bed of gravity)
  • additional skin folds with knees bent
  • lying on abdomen = buttocks of affected side: lower
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Positive Barlow’s Test

A
  • femoral head dislocated posteriorly from acetabulum
  • dislocation is palpable as head slips out of acetabulum
  • dx confirmed with Ortolani test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

CHD Ortolani’s Test

A
  • supine position, bend knees and place thumb on bent knees, fingers
  • bring femur 90 degrees to hip then abduct
  • palpable click = dislocation
18
Q

Positive Ortolani’s Test

A
  • femoral head reduces into acetabulum
  • palpable and audible clunk as hip reduces
19
Q

Trendelenburg Test

A

IF PATIENT CAN WALK:
- have child stand on affected leg only
- pelvis will dip on normal side as child attempts to stay erect

20
Q

CHD Management

A

GOAL: enlarge and deepen socket
EARLY TREATMENT: positioning hip in abduction with head of femur in acetabulum and maintain in position for several months

  • traction and casting (hip spica)
  • surgery
  • Pavlik harness
  • hip spica cast
21
Q

CHD Intervention

A
  • proper positioning: legs abducted
  • trial diapering
  • use Frejka pillow splint (jumperlike suit to keep legs abducted)
  • place on abdomen with legs in frog position
  • immobilization devices
22
Q

Osteogenesis Imperfecta

A
  • “brittle bone disease”
  • connective tissue (collagen) disorder in which fragile bone formation leads to recurring pathologic fractures
  • rare genetic disorder: autosomal dominant (50% chance of passing
  • error in collagen synthesis
23
Q

Defect of Type I Collagen Production Might Lead To:

A
  • congenital osteopenia (low bone mass) with increased bone fragility
  • other connective tissue manifestations (dental abnormalities, las joints, thin skin)
24
Q

OI Pathophysiology

A
  • caused by dominant mutation in COL1A1 or COL1A1 genes that encode type I collagen
  • fewer 10% believed to be caused by recessive mutations
  • results from mutations in the loci coding for pro-α 1 and pro-α 2 chains which form the helical
    structure of collagen 1
25
Q

OI Radiographic Features

A
  • bones are thin and undertabulated (gracile)
  • normal in length or shortened, thickened, and deformed by multiple fractures
  • intra-sutural (wormian) bones on skull radiograph
  • cranial enlargement
  • shortening of limbs due to intrauterine fractures
26
Q

Osteogenesis Imperfecta and Eyes

A
  • thinning of sclera
  • consequent showing of underlying veins through whites of eyes
  • blue sclera (major symptoms, helps in dx)
27
Q

Congenital OI

A

life expectancy is short

28
Q

Tarda OI

A

life expectancy is normal

29
Q

Types According to Silence Classification System

A

based on inheritance as autosomal recessive or dominant

30
Q

Type I and IV OI

A
  • more mold manifestation
  • can persist to adulthood
31
Q

Type II and III

A
  • more severe
  • can result in fracture (birthing or childhood)
  • associated with high mortality rate
32
Q

Type I OI

A
  • most common
  • reach normal height
  • few obvious skeletal deformities
  • causes more fractures during childhood > adulthood
  • hearing loss pronounced and begins early in childhood
33
Q

Type II OI

A
  • most rare
  • most severe
  • produce numerous deformities
  • often fatal in infancy
  • profoundly affects lungs (causes significant breathing problem
  • CO2 high compared to O2
  • fractures in all long bones
  • multiple fractures in ribs (shortened, “beaded”)
  • poor ossification of skull
34
Q

Type III OI

A
  • obvious deformities
  • fractures before birth
  • UTZ can detent in fetus
  • also affects lungs and muscles
  • hearing loss in early childhood = complete in adolescence
35
Q

Type IV OI

A
  • more severe than type I
  • less severe than type III
  • hearing loss begins in early childhood (often profound)
36
Q

OI Signs and Symptoms

A
  • weak bones
  • below average ht
  • hx multiple fracture
  • bone deformity
  • increased serum alkaline phosphatase
  • poor skeletal development
  • soft brownigh teeth
  • hearing loss
  • blue sclera
  • loose joints (hypermobility) and flat feet
37
Q

OI Management

A
  • genetic counseling
  • rehabilitation: lightweight leg brace, alignment, casting of fracture
  • orthopedic surgery: intramedullary rod insertion
  • biphosphonates = increase bone mineral density
  • lightweight leg braces = aid in mobility and ambulation
38
Q

OI NDx: Potential for Alteration in Tissue Perfusion r/t to Construction of Cast

A
  • check color, sensation, and motion distal to cast q15
  • check pedal or radial pulse
  • check for tightness by slipping finger under edge (impossible = too tight)
  • ask child to move toes or fingers
  • elevate casted extremity
39
Q

OI NDx: Potential for Alteration in Skin Integrity

A
  • remove plaster flakes
  • handle wet cast carefully (not cause indentation)
  • expose wet cast to air (hasten drying)
  • support heavy cast with sling/ pillow (decrease pressure of cast edges)
  • check cast for foul/ musty odor
40
Q

OI NDx: Potential for Fear and Loneliness

A
  • encourage expression of feelings
  • diversional play
  • encourage fam and friends to visit often
  • provide educational opportunities (long term hospitalization)
41
Q

OI NDx: Potential for Knowledge Deficit of Family

A
  • encourage discussion of feelings and fears
  • provide info and reassurance
  • involve family in child’s care in hospital
  • prepare family for some emotional regression
42
Q

Care of Child with Cast

A
  • plaster: will remain wet for atleast 24 hours
  • cast must remain open to air until dry
  • casted extremities: elevated = help blood return and reduce swelling
  • initial chemical hardening reaction = change in infant’s body
  • choose toys too big to fit in cast
  • do not use baby powder near cast = medium for bacteria
  • prepare for anticipated casting = having child help apply cast in doll

MCN 109 Midterms (12 decks)

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