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Paediatric Interventions > Growth and Development > Flashcards

Growth and Development Flashcards

1
Q

How is growth achieved?

A
  • Hyperplasia (increase in cell number)
  • Hypertrophy (increase in cel size)
  • Accretion (increase in intercellular substances)
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2
Q

What skills are acquired during child development?

A
  • Gross motor (movement & postural control)
  • Fine motor & play
  • Speech & language
  • Cognition & learning
  • Psychosocial & emotional
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3
Q

What are some of the factors affecting growth & development?

A
  • Genes
  • Hormones (growth hormone, puberty)
  • Nutrition (failure to thrive)
  • Mechanical factors (fractures, spasticity)
  • Environmental factors
  • Physical activity (development of skills, M/S growth)
  • Illness
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4
Q

What do growth charts track?

A
  • Height
  • Weight
  • Head circumference
  • Ranked by percentiles (should generally remain on same percentile)
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5
Q

What are some of the reasons head circumference may be below the percentile line?

A
  • Microcephaly (abnormal smallness of head usually associated with ID)
  • Cranial stenosis (premature closure of cranial sutures)
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6
Q

What is one of the reasons why head circumference may be above the percentile line?

A

Hydrocephalus (increase CSF causing dilation of ventricles & raised ICP

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7
Q

What are the important features of musculoskeletal growth?

A
  • Rapid growth from birth-2yrs
  • At 2 years approx half adult height
  • In childhood & adolescence occurs distal to proximal
  • Hands/feet have accelerated growth spurt followed by limbs then trunk
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8
Q

When does peak height velocity (most rapid rate of growth) occur?

A
  • Females: Starts 8-10yrs, peaks 11-12 yrs

- Males: Starts 10-12yrs, peaks 13-14yrs

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9
Q

What are the types of growth plates?

A
  • Long bone epiphysis
  • Ring epiphysis (e.g. carpals)
  • Apophysis (iliac crest)
  • Traction apophysis (muscle action on bone)
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10
Q

What are the approximate contributions of bone growth proximal/distal?

A

Proximal/distal

  • Humerus: 80/20%
  • Radius: 25/75%
  • Ulna: 20/80%
  • Femur: 30/70%
  • Tibia: 55/45%
  • Fibular: 60/40%
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11
Q

How is skeletal age determined?

A
  • Using X-ray of hand & wrist

- Comparison of amount of cartilage to bone development of carpals relative to reference data for healthy children

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12
Q

What is a Risser sign?

A
  • Measure of extent of ossification of iliac apophysis
  • Commonly used to assess skeletal maturity in scoliosis
  • Scale of 5
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13
Q

What are some of the implications of bone growth?

A
  • Coordination difficulties
  • Muscle contractures as muscles grow in response to bone growth
  • Timing of orthopaedic surgery for children with CP
  • Fractures through growth plates
  • Bone remodelling in young children is possible for a maligned fracture
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14
Q

What is Osgood Schlatter’s disease?

A
  • Inflammation of growth centre (apophysis) that forms the tibial tubercle
  • Occurs during peak height velocity
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15
Q

How are growth plate fractures classified?

A

Salter-Harris Classification of Growth Plate Injuries (1-5)

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16
Q

What are the characteristics of an S-H1 fracture?

A
  • Avulsion/shearing fracture of resting cartilage cells

- Good prognosis as growing cells are undisturbed

17
Q

What are the characteristics of an S-H2 fracture?

A
  • Fracture line passes through metaphysics into epiphyseal plate
  • No fracture observed into epiphysis
  • Produce minimal shortening, rarely result in functional limitations except at knee & ankle
18
Q

What are the characteristics of an S-H3 fracture?

A
  • Passes through epiphysis into articular surface
  • Physis widened at lateral aspect, medial aspect is closed
  • Prone to chronic disability as it typically involves the articular surface of the joint
  • Deformities are rare
19
Q

What are the characteristics of an S-H4 fracture?

A
  • Two bone fragments at medial aspect of distal tibia
  • Fracture through epiphysis, physics & metaphysis
  • Can result in chronic disability
  • Can produce joint deformity with angulation more likely at knee/ankle
20
Q

What are the characteristics of an S-H5 fracture?

A
  • Compression/crush injury of epiphyseal plate with no associated epiphyseal or metaphyseal fracture
  • Poor prognosis as angulation & shortening 100%
21
Q

How are ACL injuries in children managed?

A

Surgery delayed until growth plates have closed as surgical hardware needs to pass through growth plate

22
Q

How is epiphyseodesis (fusion of growth plate) managed in children?

A

Growth plate is closed off either fully (in leg length discrepancies) or on one side of the bone (semi-epiphyseodesis) to correct angulation after an injury

Paediatric Interventions (27 decks)

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