Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

N305 > F MSK > Flashcards

F MSK Flashcards

1
Q

Ossification complete when
Bones compared to adults
Epiphyseal (growth) plate?

A

Ossification complete by late adolescence into early 20s

Bones are less dense than adults

Epiphyseal plate: injury here is a problem
(effects growth)

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

Muscle differences (2)

Ligaments and tendons (2)

A

Muscles:
-muscles do not increase in #
-length and circumference increase as child grows

Ligaments and tendons:
-ligaments and tendons are strogner than bones until puberty
-Full ROM but no purposeful movement when born

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

Genu Varum vs Genu Valgum

(What is it)
When it resolves
Outside of these ranges =?

A

Genu varum: Bow legs
-Infants and toddlers: usually resolves by 2-3y/o

Genu valgum: “knock-knees”
-appears around 2-3 y/o, usually resolves by 7-8 y/o

Outside of these ranges = specialist referral

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

Neuromuscular & MSK congenital disorders

A

Metatarsus adductus
Club foot (talipes equinovarus)
Hip dysplasia
Osteogenesis imperfecta
Spina bifida
Muscular dystrophy
Cerebral palsy

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

Metatarsus adductus (most common foot deformity)

What is it
Causes

Degree of flexibility is important for determining what?

A

Forefoot is adducted

Intrauterine positioning

Degree of flexibility = determining tx

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

Metatarsus adductus

Diagnosis and tx

A

Physical assessment/xray

Tx:
-PT/ observation in mild cases

-passive stretching with serial cast/braces if >15 degree angle or if there is no flexibilty in foot
—casts changed weekly
—braces and orthopedic shoes

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

Club Foot (talipes equinovarus)

Categories
Can effect what or what
Can be what or what

A

Categories:
-positional: intrauterine crowding
-congenital: (idiopathic)
-syndromic: occurs in associations with other syndromes

Can be unilateral or bilateral

Can be isolated defect or associated with other disorders (CP, Spina Bifida)

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

Club foot s/s

A

Talipes varus: inversion of the heel

Talipes equinus: plantar flexion

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

Club foot

Tx (goal is a functional foot)

A

Serial casting (every 1-2 wks)

Weekly manipulations/stretching

Sx with casting (heel cord tenotomy)

Braces/orthotics (for some kids)

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

Club foot care and assessments

A

Assess: neurovascular, motor development

Cast care

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

Hip dysplasia

What is it

RF

A

Improper alignment of the femoral head and the acetabulum

RF:
-first born
-females
-family hx
-breech position
-LGA (large for gestational age)

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

Hip dysplasia

Screen when
S/s

A

Screen infants until 1 y/o

-asymmetrical gluteal and thigh folds
-positive allis sign (1 knee lower than other when flexed)

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

Hip dysplasia

Diagnosis

Other test

A

US: until 6mo old
Xray: once 6 mo old

Other test:
-ortolani-barlow maneuver:
-Barlow: diuslocation of femoral head by adduction
-Ortolani: reduction back into acetabulum by abduction

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

Hip dysplasia tx

Newborn-6month

A

Starts as soon as diagnosed
pavlik harness (6-12wks)
-typically corrected after 3 months of use

What pavlik harness does:
-ensures hip flexion and abduction but does not allow hip extension or adduction

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

Hip dysplasia
Nursing management of pavlik harness

A
  1. Peform neurovascular/skin integrity checks
  2. Change diaper with harness on
  3. Do not adjust straps without consulting provider
  4. If removal of straps is ordered understand how to reapply
  5. Skin care to include use of undershirt, knee socks, avoid lotions and powders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hip dysplasia tx

Older than 6months or if pavlik harness unsuccessful

Tx and care included

A

Surgical reduction with spica cast:
-Spica cast-stays on about 12 wks

Care includes:
-neurovacular checks
-frequent skin assessment
-cast care
-pain management

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

Osteogenesis imperfecta

What is it
Aka

A

Inherited connective tissue condition that results in bone fx and deformity along with restrictive growth

Aka: brittle bone disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Osteogenesis imperfecta s/s

A

Freq fx
Blue sclera
Short stature
Small discolored teeth
Early conductive hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Osteogenesis imperfecta

Tx

A

Tx is supportive:

Med: pamidronate
-bisphophate (give IV infusion)
—increases bone density and corrects imbalance between bone resorption and bone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Osteogenesis imperfecta

Teaching for tx

A

Low impact exercises (swimming)

Assist with braces/splints

Assist with PT/OT

Safety!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Spina bifida 3 forms

A

Occulta

Meningocele

Myelomeningocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Spina bifida (occulta)

What is it/location
Usually what

A

Mildest form: lumbosacral area

-defect of vertebral bodies
-no protrusion of spinal cord/meninges

-often asymtpomagtic and goes undetected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Spinal bifida (occulta)

S/s

A

Sacral dimple
Tuft of hair
Discoloration of skin at site
(tethered cord/walk on tiptoes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Spina bifida (occulta)

Tx

A

Usually not require interventions if asymptomatic

BUT may require sx for tethered cord/symptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Spina bifida cystica (meningocele) What is it
Sac like protrusion containing meninges and CSF Spinal cord in normal position
26
Spina bifida cystica (meningocele) Tx
Assess neuro status Monitor for leaking CSF/ increased ICP Surgical correction REQUIRED
27
Spina bifida cystica (myelomeningocele) What is it/ s/s
Sac like protrusion contains meninges/CSF/nerves Spinal cord often ends at the point of defect (higher defect has more affects): -absent motor/sensory function -bowel/bladder incontinence
28
Spina bifida cystica: Infection prevention & injury prevention (4)
Sterile saline-soaked gauze to keep sac moist: -monitor for leakage of CSF/increased ICP Place in prone position/supported side position Use infant wamrer/isolette (monitor for drying of sac) (no clothes allowed on sac) Proper diapering (keep free of feces/urine
29
Increased ICP signs
Increased HC Bulging fontannel LOC change High pitched cry Cushing triad (brady cardia/ widening pulse pressures/ chyne stokes respirations)
30
Spina bifida cystica: complications and needs
Paralysis (wheelchair, walker needed) Bowel/bladder incontinence: -straight cath -vesicostomy (Monit) -appendicostomy (MACE) Hydrocephalus Chiari malformation (brain tissue protrudes into spinal cord)
31
Spina bifida: multidisciplinary approach
NICU/PICU stays Neurology Neurosurgery Urology GI Orthopedics PT/OT/ST
32
(Vesicostomy) MONTI vs (Appendicostomy) MACE DONT HAVE TO KNOW JUST IDEA
MONTI: stoma sutured to body wall Urethra sutured MACE: In colon use appendix so we can do an enema to clean out colon and empty it
33
Muscular dystrophy What is it Type
Inherited disorder w/ progressive degeneration of skeletal muscles (causing muscle weakening/wasting Type: Duchenne muscular dystrophy (most common) Limb-girdle muscular dystrophy Facioscapulohumeral dystrophy
34
Duchenne’s muscular dystrophy What is it/mostly affects who Onset? Life expectancy
X-linked recessive (affects mostly males) Early childhood onset (3-6y/o) Progressive Life expectancy (early adulthood)
35
Duchenne muscular dystrophy S/s 3 3 toddler/preschool 5 school age
Fatigue Muscle weakness (beginning in lower extremity) Late walkers (12mo usually) Toddler/preschool (unsteady gait/fall often) Large calf muscles (fat deposits) Gowers sign School age (walk on toes/balls of feet, waddling gait) 12y/o will lose ability to walk Muscle atrophy of face/chest/neck Respiratory/cardiac difficulties Mild congitive delays
36
Gowers sign
Muscular dystrophy sign: Have to use entire upper body to get off floor
37
Duchenne muscular dystrophy Diagnosis
Genetic analysis (inherited) Muscle biopsy Elevated CK levels (creatinine kinase = muscle damage)
38
Duchenne muscular dystrophy Tx
No cure -Corticosteroids (slow pregression) -Mobility/ROM/ADLs -Respiratory assistance (IS/positioning/cough assist/nebulizers/CPT/CPAP/BiPAP) -Gtube/tube feedings -end of life discussion/comfort care
39
Cerebral palsy What is it
Nonprogressive impairment of motor function Lack muscle control/coordination Can cause visual/hearing/speech impairment
40
Cerebral palsy risk factors (baby)
Head trauma (shaken baby) Maternal infction Maternal chorioamionitis Premature birth Very low birth wt Interruption of oxygen delivery to fetus during birth Direct injury to neonate during birth Maternal drug use
41
Cerebral palsy s/s
Failure to meet developmental milestones/Persistent primitive reflexes (dont go away) Gagging/choking w/ feeding/poor suck reflex Poor head control Sz Vision/speech/hearing impairment Arching back/Rigid posture Toe walking
42
Cerebral palsy Tx
Individualized to meet client -promote independence (self care is goal) -monitor airway (position/suciton/aspiration/reflux precautions) -skin care (assess under braces/aplints/turning) -nutrition (PO, Gtube, high calorie/protein, fiber)
43
Cerebral palsy Tx (MEDS)
-Baclofen: PO or intrathecal (pump) -Diazepam (valium) Antiepileptics: -levetiracetam (Keppra) -valporic acid
44
Acquired MSK deformities/disorders
Legg-Calve Perthes disease Scoliosis Injuries (FX)
45
Legg-calve-perthes disease What is it RF
Aseptic necrosis of the femoral head (unilateral or bilateral) RF: Age 2-12y/o (but mostly 4-8y/o) Males Trauma/decreased circulation
46
Legg-calve-perthes disease Healing
New blood vessels are formed w/ bone resorptions and deposition for up to 18-24 months During this time bone very soft and more likely to fx
47
Legg-calve-perthes disease Diagnostics
Xray/MRI
48
Legg-calve-perthes disease Onset S/s
Insidious onset Intermittent limp Limited ROM Stiffness of hip Mild pain: Groin/thigh/knee Shortening of affected leg
49
Legg-calve-perthes disease Prognosis Tx
Self-limiting disease (depends on stage/severity) Tx: Nsaids -Rest/limited wt baring -Possible brace -PT/advance to active motion as perscribed -Avoid contact/high impact sports (Swimming/bicycling help ROM and are low impact)
50
Scoliosis What is it Cause
Lateral curvature of spine (exceeds 10degrees) -spinal rotation also causes rib asymmetry Cause: Acquired (neuromuscular disorders)
51
Scoliosis RF
Genetic tendency Females Highest incidence between 8-15y/o
52
Scoliosis Screened when (how to do it) assessment findings Diagnostics
Screen preadolescence Have child bend forward at waist w/ arms hanging -asymmetry of scapula/ribs/shoulders/hips -improperly fitting clothes (one leg shorter) Diagnostics: tells us degree of curvature -xray/CT/MRI
53
Scoliosis tx
Under 10 degrees we do nothing Needs to be corrected before 40degrees -brace Surgery: spinal fusion -for severe cases (>45degrees)
54
Scoliosis nursing management Brace education
Bracing prevents further curvature (doesnt correct current curve) Worn up to 23 hours per day Lengthy treatment (months to years)
55
Scoliosis (post surgical education) What to do Restrictions
Pain control (PCA pump) Monitor incision & drainage (JP drain) Log roll to prevent flexion of spine Early mobility w/ PT Activity restriction for 6-8 months: -cannot lift more than 10lbs -sports (except swimming/walking)
56
Injuries: fractures More frequent in who Risk factores
More frewuent in children than adults (but heals fast RF: -Obesity, nutrition, ordinary play activities -recreations place children at risk (running/climbing/skateboarding/skiing/bicycle accidents/sports)
57
Salter-harris classification system for fractures
Type 1 & 2: -do not have growth plate disturbances (Wont affect growth) Types 3, 4 & 5: -can cause distubances in growth plates (Issues with growth)
58
Fracture Diagnostics Tx Open fx?
Xray/CT Monitor VS/Pain/neurovascular Stabilize area/limit movement RICE Pain meds *Tetanus vaccine/ABX if open fracture*
59
Fracture Ways to immobilization
Splinting Bracing Casting Traction Closed reduction (no sx) Open reduction (rods/screws in) (external fixation) (Sx) (pin care)
60
Fracture cast care Tx Avoids Notify if
-elevate limb after cast applied (Some swelling is normal) -circle/monitor drainage -assess pulse/neurovascular -keep clean/dry -report severe pain or pain not relieved by meds Avoids: Nothing put in cast No lotion or powders If wet inside do not use hot blow dryer (burns) If itching (use blow dryer on cold setting)
61
Fracture complications
Compartment syndrome: -compression of nerve/blood vessels/muscle inside confinded space results in neuromuscular ischemia (Usually forearm/tibial fractures) Osteomyelitis Embolism -fat embolism/PE
62
Assessment of fracture (5 P’s)
Pain (unrelieved w/ elevation and analgesics) Pulselessness (distal to fx site) Pallor Paresthesia (distal to fx site) Paralysis (movement distal to fx site)

N305 (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions