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Peds > Lecture 7: Musculoskeletal Development Across the Lifespan > Flashcards

Lecture 7: Musculoskeletal Development Across the Lifespan Flashcards

1
Q

Skeletal , muscle tissue, limb buds = what week

A

5

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2
Q

Limb movements = what week

A

8th

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3
Q

Kick legs, turning feet, bending wrist, turn heading head, opening mouth, and swallowing = what month

A

3rd month

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4
Q

Thumb sucking = what month

A

4th

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5
Q

Infancy has what type fibers primarily

A

Type 1 (slow twitch)

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6
Q

What is sarcopenia?

A

Decresed muscle mass

note infants have this

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7
Q

How much does muscle mass decrease after age 30

A

3-8%

note this number increases after 60

Neurmuscular alternations include a decrease in the nervous firing rate to muscle, the number of motor neurons, and the regenerative abilities of the nervous tissue

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8
Q

Connective tissue = dense ordinary connective tissue: regular or irregular

Do tendons have a regular or iregular arrangement?

Connective tissue that surrounds bones, muscles, heart is regular or iregular?

A

1 = regular
2 = irregular

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9
Q

Where is cartilage primarily found?

A

Articulating joints

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10
Q

Clavicle, manduble, and facial, cranial flat bones (irregular bones primarily) ossify how?

A

Intramembranous ossification

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11
Q

Deposition of bone on a cartilaginous model, limb bud, or outgrowth

A

Endochondral ossification

more long bone

Primarily ossification center that grows outward in the middle

Secondary in the ends of the bones that grow inward
* dont fully meet till ~18

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12
Q

Epiphyseal plates: allow the bone to grow until adult stature is attained

A
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13
Q

When is almost all bone growht done by?

A

18 (boys earlier than girls)

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14
Q

where would you guess you see bone fractions more older or younger?

A

Older: osteoblast activity decrease and osteoclast activity increases

Children have more cartilage so can absorb force/wt more

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15
Q

Result of joint mobility and the extensibility of soft tissues that cross the joint

A

Flexibility

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16
Q

What is physiologic flexion?

A

Wanting to be in flexion more as a baby
* becuse they were crunched up in utero

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17
Q

When do you see physiological flexion?

A

In both infants and older adults

old adults because age related changes at the cellular level compromise repair/function

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18
Q

KNOW: Babies typically have more ROM because they don’t have as much ossification (all the bones havent fully come together yet) and they’re already in ltos of physiological flexion

A
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19
Q

KNOW: Pre mature babies are bronw w/o physiological flexion (dont have to fit)

A
20
Q

Breech

A

coming out feet first
* not optimal for dilvery

21
Q

No children have much more DF than adults

A
22
Q

Infants have how many bones

adults

A

~300 (hard to tell because some havent fully ossified and others have at different times)

206

23
Q

Head bigger in babies torso smaller
* eyes don’t really change in size

A
24
Q

KNOW: Fontanelles are there so the skull can fit through the birth canal

A
25
Q

Heart takes up much more of thoracic cavity in children

A
26
Q

KNOW: Posture starts at physicalgical flexion and end with it

starts curving around the time they start sitting ~6 months

A
27
Q
A
28
Q

KNOW: variability is a crucial element of motor development
* Allowing adaptability to the demands of a task and contextual aspects of the environment

Essentially everyone develops differently so we need have variability in what we do and how poeple do specific movements because not everyone is the same
* we all stand up and sit down a zillion different times and our body picks the patterns that are best for us

also doing tasks in varying environments

A
29
Q

What is Sarcopena?
* causes what in older adults?

A

Decreased muscle mass that leads to decerased strength
* Slowing of contractile properties
* muscle loss can be accelerated by disease/medications
* Major cause of disability and frailty in older adults

30
Q

KNOW: ligaments and tendons affected by surronding sturcutres
* Can be come stiff, lose elasticity, and decreased tensile strength

Tensile strength: Tension
* The maximum amount of stress a materal can withstand before breaking when it is pulled/stretched

A
31
Q

What muscle fibers are mo affected in muscle loss type 1 or 2

A

type 2

KNOW: muscle fibers are replaced by fat
* Not due to being obese or sedentary lifestyle
* Muscle loss is going to happen no matter what and the body needs to fill its gaps and uses adipose tissue

32
Q

Metabolic changes that contribute to sarcopnia: (5)

A

1) Increased insulin resistance (decerases the amount of GH in body)
2) decreased GH and insulin like GH (when osteoblasts are not being stimulated)
3) Decrease estorgen/testosterone (aids in production of GH)
4) Vitamin D deficiency
5) Increased parathyroid hormone (Increases Ca2+ which increases osteoclastic activity)

33
Q

How can sarcopenia be reversed?

A

With high-intensity progressive resistive EX
* Just make sure dosing is correct (most commonly PT’s underdose older individuals)

34
Q

KNOW: other causes of muscle loss
* Diabetes (insulin resistance)
* Metabolic syndrome (insulin resistance)
* COPD - O2 exchange affected
* Cancer
* CHF - O2 exchange affected
* Arthritits
* Kidney Disease - O2 exchange affected
* Stroke
* Parkinson’s Disease

A
35
Q

With older adults: bone and cartilage are decreased due to

Decreased osteoblastic activity (build)
* Causes decrease in bone mass/density

Decreased tensile strength of bone (more susceptable to fx because of this)
* More susceptible to fractures (women > men due to decreased GH/estogen)

*Long term corticosteriod use
* Impair bone healing

A
36
Q

KNOW: W/ age cartilage dehydrates, becomes stiffer, and thins in weightbearing areas if we dont allow the weight bearing to happen

Decreased collagen production

If you under dose it will not stimulate enough osteoblastic activity, and if you overdose it can blunt osteoblastic activity as well.

A
37
Q

KNOW: These myofibrils empty w/ age, leaving only the structure around them (looks like a honey comb)
* This causes a decrease in structure

You are going to have increased structural protein cross-linkages
* These are those bridges that go from myofibril to myofibril
* However, when you decrease the total # of overall fibers these linkages continue to grow and get longer to connect the reminaing fibers
* These are not as strong or as felxibile as a muscle fiber (its stiffer)
* Same concept as osteoprosis where you’re decrease the density of overall muscle and its weaker

Decreased proteoglyan size

Fragmented collagen

A
38
Q

Age releated changes in connective tissue

Cellular
* decreased proliferation
* Alterd control of apoptosis
* Decreased response to growth factors
* Altered response to loading (dont have the same amount of osteoblastic activity)

A
39
Q

Deeper structures = more normal collagen

Disorganized collagen = more superficial collagen

A
40
Q

Age releated changes in connective tissue

Connective tissue strucutre:
* Increased stiffness
* Decreased h20 content
* Decreased strength
* decreased cross-sectional area and volume

All this stuff also happens to IV discs

A
41
Q

Is osteoprosis a MSK pathology?
* What is it and what is it due to

A

No! its a metabolic disorder due to lack of vitamin D
* Vitamin D needed to synthesize Ca2+

Increased osteoclast and decreased osteoblastic activity

decreased load absorption

Impaired neuromusclar function as well
* Nerves not firing/regenerating as well as they were before which means they might not be innervating the msucles are well as they did before (turns into muscle problem)

Preceeded by osteopenia

42
Q

4 places where fx is common in older adults

A

1) Head of femur

2) Pelvis

3) Distal radius

4) vertebrae

43
Q

Cartilage is how much water?

A

60-80%

44
Q

Cartilage: w/ age

1) decreased proliferation of chondroblasts (decreased strength / volume)
2) Altered apoptosis regulation (programmed cell death)
3) Altered response to loading
4) Increase in collagen fibers increase stiffness (less water in cartilage tissue - remember cartilage is 60-80% H2O)

A
45
Q

W/ age: IV discs

decreased size
* decreased h2O content
* Can cause DDD due to decreased disc height

Nucleus becomes more fibrous (decreased flexibility / elasticity)

Annulus becomes less organized - more fragile to tensile strengths

A
46
Q

Common joint replacements

TKA:
* Most common
* 4.2 adults over 50 have this
* females > males
* ~40% are 50-69 when its done

THA (find percautions)
* Anterior approach
* Lateral approach
* Posterior approach

Total shoulder / reverse
* reverse best for a completely fucked rotator cuff ANDDDD no signs of arthritits (normally more truamatic)

A
47
Q

Frality guidelines

A

Need 3/5 for frality 2/5 for pre

Peds (24 decks)

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