Exam 4 - Musculo Flashcards by Ashley Burkhalter

when is the greatest time of growth

infancy

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example of immobilization devices

splints
casts
traction (skin, skeletal)
external fixation devices

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used for immobilization to promote healing, ensure proper alignment

splint

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what does CSM stand for r/t neurovascular assessment

circulation
sensation
motion

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what to assess with cast care

skin integrity
circulation distally
neurovascular status

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parent educate re: cast care

pain management
elevation
hygiene
nothing goes inside the cast

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purpose of traction

reduce muscle spasms
realignment
immobilization
prevent/improve contracture deformity

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2 types of traction

skin
skeletal

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nursing care for traction

immobilized pt
do not release traction
assess pin site
provide pin site care
neurovascular assessment
support family

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when is a buck traction used

fractures, hip disorders

boot or wrap applied to the skin

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when is bryant traction used

femur facture
children until 2 y/o
developmental dysplasia of the hips

hip will be flexed 90 degrees, butt floated off the bed

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when is a halo traction used

fractured or displaced vertebrae

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what are the 5 P’s of ischemia

pain
pallor
pulselessnes
parathesia
paralysis

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most frequently broken bone in children < 10

clavicle

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open vs. closed fracture risks

O: infection, bleeding

C: hemorrhage, neurovascular compromise, compartment syndrome

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what are the 5 different types of breaks

greenstick
spiral
oblique
transverse
comminuted

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describe greenstick fracture

break through periosteum on 1 side, bowing or buckling on the other size

most common in forearm

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describe spiral fracture

twisted or circular break
affects length
common in child abuse

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describe oblique fracture

diagonal or slanting between horizontal and perpendicular planes

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describe transverse fracture

occurs at R angles to the long axis of the bone

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describe comminuted fracture

bone is splintered in pieces

rare occurrence in children

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reduction method for fractures

reposition bone into normal alignment
closed or open

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retention method for fractures

site must be protected after re-alignment

splint, cast, traction, or external fixation device

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what are hot spots on a cast

painful areas when touched

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what is the healing periods for neontes

2-3 weeks

what is the healing period in early childhood

4 weeks

what is the healing period in later childhood

6-8 weeks

what is the healing period in adolescence

8-12 weeks

what occurs a a sprain

ligaments are stretched or torn

what occurs with a strain

pull, tears, or rupture - results from excessive stretch of muscle

what is a contusion

soft tissue or muscle damage

what is a dislocation

joint is disrupted so that articulating surfaces are no longer in contact

s/sx of sprains and strains

rapid onset with disability pain swelling localized tenderness limited ROM poor weight bearing

what can occur with a hip dislocation

potential loss of blood supply to head of femur

most common dislocation in peds

nursemaids elbow

RICE ICES

rest ice compression elevation ice compression elevation support

osteomyelitis is commonly from ___

staph

common location of osteomyelitis in children

femur tibia

when is osteomyelitis considered chronic

> 1 month or did not respond to abx therapy and now it has to be changed

what should be increased with osteomyelitis

protein, calorie intake

how to prevent kyphosis

proper posture abdominal strengthening

what will help with lordosis

postural exercises

most common spinal deformity

scoliosis

cause of scoliosis

idiopathic, genetic

when is scoliosis dx

early adolescence commonly occurs during during puberty/growth spurt c/o ill fitting clothes

s/sx of scoliosis

unequal shoulders and hips rib asymmetry promonate scapula can visually see the curve in spine

how long does a brace have to be worn with scoliosis

23 hours/day

what is done if spinal curvature is >45 degree

surgical intervention with rods

with scoliosis there is often a ___ curve and a ___ curve to align head with gluteal cleft

primary; compensatory

what to educate with a scoliosis brace

turn, cough, deep breathe monitor bowels wear clothes under the brace

what 2 test are done to assess for dysplasia of the hip (DDH)

ortolani (abduct legs, clunking sound) barlow (adduct knee, pushed down)

dysplasia of the hip is often associated with what kind of birth

breech

what are the 3 forms of DDH

mild: acidabular dysplasia moderate: subluxation (most common) severe: dislocation

how long is a pavlik harness worn with DDH

6-12 weeks

how often should pavlik harness straps be evaluated

q1-2 weeks

what to assess for with pavlik harness

skin breakdown blood flow place diaper under the straps

what occurs with legg-calve-perthes disease

avascular necrosis of femoral head

legg-calve-perthes disease common age

3-12 more common in males 4-8

most common symptom with legg-calve-perthes disease

persistent pain of the hip that worsens with movement

what is common in children with legg-calve-perthes disease

arthritis, DJD

how is legg-calve-perthes disease managed

NSAID bedrest joint exercises

what is slipped capital femoral epiphysis (SCFE)

spontaneous displacement of the proximal femoral epiphysis in a posterior and inferior direction

when does SCFE commonly occur

before or during accelerated growth periods or puberty

who is SCFE commonly seen in

overweight males, adolescents

s/sx of SCFE

c/o pain in hip, groin area walk with a limp

SCFE goal

keep head of femur in acetabulum

how long to avoid weight bearing initially with SCFE

4-6 weeks

how to treat clubfoot

daily stretching, movement ponseti casting surgical correction

clubfoot is commonly seen in ____

Hawaiians

ponseti casting method last for how long

4-6 weeks

most common form of muscular dystrophy

duchenne muscular dystrophy (DMD)

what is muscular dystrophies

progressive muscle atrophy and weakness

when is walking ability usually lost with muscular dystrophies

9-12 years

when does death usually occur with muscular dystrophies

15-18 years

what can be seen prior to a muscular dystrophy dx

motor development delay clumsy falls difficulty walking, running, riding a bike

common onset of duchenne's muscular dystrophy

3-5 years

what is juvenile idiopathic arthritis

autoimmune inflammatory disease with no known cause

onset of juvenile idiopathic arthritis is what age range

2-4 years old more common in girls

s/sx of juvenile idiopathic arthritis

stiffness swelling loss of mobility in affected joint warm to touch (no erythema) tender to touch symptoms increase with stressors growth retardation

what are the 4 criteria for JIA by the American College of Rheumatology

onset < 16 years 1+ affected joints duration > 6 weeks exclusion of other forms of arthritis

JIA medications

NSAIDS biologics corticosteriods disease modifying antirheumatic drugs (DMARDS)

what is osteogenesis imperfecta (OI)

inherited disorders of connective tissue characterized by excessive fragility and bone defects

s/sx of osteogenesis imperfecta (OI)

short, long bone deformities osteoporosis blue discoloration of sclera discolored teeth hearing loss

syndactyly vs. polydactyly

s: webbing p: extra digits

genu valgum vs. genu varum

valgum: knock knees varum: bowlegs