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Pediatric Orthopedics > History And Development Of The Peds Pt > Flashcards

History And Development Of The Peds Pt Flashcards

1
Q

Your initial diagnosis can be made ____% of the time just based on history

A

75

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2
Q

What happens during the first week of pregnancy

A

Zygote/blastocyst implants into uterine wall

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3
Q

What happens during 2nd week of pregnancy

A

Trilaminar sic (neural tube, myotome, sclerotome, dermotome) is formed
- amniotic cavity is formed

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4
Q

What Happens during 3rd week of pregnancy

A

First week of organogenesis closure of the neural tube occurs

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5
Q

What happens during the 4th week of pregnancy

A

Limb bunds become recognizable
- dermatome becomes skin, myotome becomes muscle, sclerotome becomes bone

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6
Q

What happens during 5th week of pregnancy

A

Hand plate forms

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7
Q

What happens during 7th week of pregnancy

A

Notches in rays occurs from cell death
Failure - syndactylism
Limb rotation: upper lateral and lower medial

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8
Q

What happens during 8th week of pregnancy

A

Embryo assumes human appearance
Basic organ systems complete

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9
Q

What happens during the 9th - 12th weeks of pregnancy

A

First bone develops
Skelton develops cranial to causal
Upper limbs become proportionate but lower limbs do not

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10
Q

What happens during the 13the to 20th week of pregnancy

A

Rapid growth
Lower limbs catch up
Bones begin ossifying

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11
Q

What happens during the 20th to 40th week of pregnancy

A

Growth continues and body become more proportionate and infant-like

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12
Q

What is the first bone to develop

A

The clavicle

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13
Q

What is the embryonic period of the pregnancy

A

Up to week 10
- systems and organs being developed
- minor insults can be catastrophic

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14
Q

What is the fetal period

A
  • growth and maturation
  • less likely to be damages by environmental factors
  • size is a factor due to compression forces
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15
Q

What does the teratogen, phenobarbitine and phenytoin cause

A
  • TEV
  • Polydactyly
  • Met adductus/varus
  • hypoplasia of distal phalanges
  • mental disorders
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16
Q

What does the teratogen sodium valproate and carbamazepine cause

A

Neutral tube defects

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17
Q

What does the teratogen alcohol cause

A
  • spontaneous abortion to intra uterine growth retardation to full fetal alcohol syndrome
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18
Q

What does the teratogen cocaine cause

A

Vasoconstriction,
Intrauterine growth retardation
CNS defects

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19
Q

What does the teratogen Cannabis cause

A
  • intrauterine growth retardation
    = Congentital anomalies like TEV, syndactyly, neurological behavior tics, startle reflex and tremors
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20
Q

What does the teratogen vitamin A cause

A
  • increased intake increases risk of malformation
  • avoid synthetic retinoids
21
Q

What does the teratogen tobacco use cause

A
  • retarded fetal growth
  • premature birth in heavy smokers 2x as frequent
  • nicotine decreases uterine blood flow lowering oxygen supply, impairs cell growth and has adverse effects on mental development
22
Q

What are some infectious viruses during pregnancy/birth

A
  • cytomegalovirus
  • Rubella
  • Toxoplasmosis
  • Herpes simplex II
  • HIV
23
Q

What are some other deforming forces during pregnancy

A
  • Rapid bone growth
  • abnormal growth/excessive load
  • oligohydramnios —> Potter syndrome
  • position of feet and legs
  • malformations
  • multiple pregnancies
  • prima gravies
24
Q

What are some neonatal injuries

A
  • dislocation of hip
  • palsy of arms and legs
  • edema of skull
  • hematoma
  • intraventricular hemorrhage
  • subarachnoid hemorrhage
  • compressional head injury with serious implications
  • if brain is damaged the legs are held in marked extension
  • asyphxia
25
Q

What are the 4 ways a newborn is thought to start breathing

A
  • the temperature change stimulates peripheral thermoreceptors which signal the hypothalamus
  • the passage through the canal
  • cord clamping - increases BP, decreases PO2, increases PCO2, hence the chemoreceptor respond and restore homeostasis
  • Cathether Insertion - noxious stimulation `
26
Q

What are the points on the APGAR scoring system

A

Color
Heart rate
Respiration
Muscle
Reflex irritability

27
Q

What are the points for color on APGAR scoring system

A

Completely pink - 2
Pink with blue extremities - 1
Blue or white - 0

28
Q

What are the points for Heart rate on APGAR scoring system

A

> 100 bpm - 2 points
< 100 bpm - 1
Absent - 0 points

29
Q

What are the points for respiration on the APGAR scoring system

A

Crying lustily - 2
Shallow and irregular - 1
Absent - 0

30
Q

What are the points for muscle on APGAR scoring system

A

active movement - 2
Some flexion of extremities - 1
Flaccid - 0

31
Q

What are the points for reflex inability on APGAR scoring system

A

Cough - 2
Grimace - 1
Nil - 0

32
Q

What is a 0-3 points on APGAR scoring system

A

Vigorous resuscitation

33
Q

What is a 4-6 points on APGAR scoring system

A

Some assistance needed

34
Q

What is 7-10 points on APGAR scoring system

A

No intervention

35
Q

What are some postnatal influences on Peds development

A
  • bones unwind and derotate
  • positions of comfort - knee to chest, Reversed Tailors/W position
  • Sleeping positions
  • keep those feet out
36
Q

What is the disadvantage of knee to chest when laying prone

A

Can lead to low tibial position

37
Q

How does sleeping positions affect development

A

In toeing can be due to internal tibia torsion, ankle equinus, and an adducted forefoot when a child sleeps prone with hips in extension and feet INTERNALLY rotated

38
Q

What is the effect of reversed tailors/W position

A

Prevents the unwinding of the femoral torsion and excessive force directed to the distal tibial epiphysis

39
Q

What are some developmental landmarks at 3 months

A
  • baby produces vigorous movements
  • head bobs when baby held upright
  • head help up when baby lies prone
  • baby is able to hold toy
  • baby smiles, follows and object
40
Q

What are some developmental landmarks at 6 months

A
  • baby is able to lift head up when lying supine
  • baby can roll from supine to prone
  • baby is able to support weight when in a standing position
  • baby can transfer a toy from hand to hand
41
Q

Developmental landmark at 9-10 months

A

Baby can pull self into an upright position

42
Q

Developmental landmark at 12 months

A
  • todder can stand unassisted
  • toddler can walk when led
43
Q

Developmental landmark at 15months

A

Toddler can walk with a broad base of gait

44
Q

Developmental landmark at 18 months

A
  • toddler can run with only occasional falls
45
Q

Developmental landmark at 24 months

A
  • toddler can run without falling, can walk up and down stairs, can rise from a squatting position
  • toddler can walks on heels to test ankle dorsiflexers, can walk on toes to test Gastroc
  • balance may be assessed with toddler’s feet together/cerebellar function may be assessed with toddlers eyes open
  • join position asses with toddler;s eyes closed (Romberg)
46
Q

Developmental landmark at 3 years

A

Balance on one foot

47
Q

Developmental landmark at 4 years

A

Run and jump

48
Q

Developmental landmark at 5 years old

A
  • skin
  • balance momentarily on one foot with eyes closed

Pediatric Orthopedics (18 decks)

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