MSK Flashcards
when does bone formation starts
6 weeks of embryo development
this is the menencymal skeleton
what is intramembranous ossification
within the membrane
what is endochondral ossification
within the cartilage
menencymal –> cart –> bone
what is calcification
tissue hardening
what is formed by intramembranous ossification
flat bones of the skull
most facial bones
mandible
medial part of the clavicle
what are between the bones of the skull
fonntanels - soft spots
what is ossification
the process in which bone form
4 steps:
initial formation
growth
remodeling
repair of bone
Compression and tension on bones is what
Weightbearing and muscle pull
Compression and tension: Appropriate intermediate force
long and appositional bone growth
Compression and tension: Decrease muscle pull
less bone growth and shorter limb length
Compression and tension: Excessive or constant loads
slowed bone growth or reabsorption of bone
Uneven forces across the growth plate lead to what
asy growth, angulation of bone (cave and vex)
what is the force of Torque on the bone
twisting or shearing of the long axis
what does torque do to the bone
Alter the rot shape of the bone
When do most epiphyseal plates close - female
14-16 AFAB
When do most epiphyseal plates close - male
17-18 AMAB
what is risser’s sign
this is a classification of skeletal maturity
what is a grade 1 risser sign
immature
what is a grade 5 risser signn
mature
around what age do most bone fuse
early teen to young adult
what is epihystis
this is the inflammation of the epiphyseal plate (growth plate) of the cart joining the epi to the plate
why is the growth plate a vulnerable place
this is a location of excessive stress and the plate can lead to pain and even bone remodeling
there is not much we can do about this type of pain
what is valgus extension overload
due to overhead throwing activities - young baseball players
rep to tissue that are still developing
causes pain and swelling over the medial epicondyle of the humerous at the elbow joint
what is osgood schaltters
inflammation of just below the knee where the patellar tendon attaches
effect the bottom part of the patella tendon
what is sever disease
inflammation of the growth plate in the calcaneus
what is sinding larsens john syndrome
inflammation of just below the knee
proximal part of the patellar tendon
normal alignment at infant 0-18
varus
forces are falling on the medial side of the knee
normal alignment at baby 18-24
varus is gone normal aligment
normal alignment at child-1 3-4
valgus
normal alignment at child-2 8-10 years old
neutral
What contributes to early intoeing
Femoral anteversion,
internal tibial torsion,
metatarsal adductus
what is femoral anteversion
change is the orentaion of the femoral neck in the transverse plane
anterversion larger
femoral anteversion at birth
30 -40
femoral anteversion with skeletal maturity
15 by skeletal adult marturity
min changes occur after the age of 8
if you have excessive femoral anteversion do you have toe in or out
toe in
how long does it take of tibial torsion to plateau
10-15 yo
knock knees often seen in what population
neuro
cerebral plasy
what is metatarsal adductus
elongated lateral side of the foot and the medial side is shorten
often paired with tibial torsion
the foot is more rigid
expect indivduals to grow out of this - no intervention
what is club foot
also known as TEV
foot is suck in PF and inverted (varus)
what is the score used to estimate club foot
pirani score
what age do we normally see metatarsal adductus
0 - 6
gait: in toeing
what age do we normally see internal tibial torsion
12- 18 months
gait: in toeing
what age do we normally see increased femoral anteversion
3 -10 years
gait: in toeing
hip rot at birth
because of anteversion this is a lot of anteversion at birth
how long do we see chnages in hip rot
10 -15
hip ER vs IR
kids have and lose a lot of ER
not much IR to begin with so we do not lose that much
what is Ortolani
examination for developmental dysplasia of the hip
clunk = positive
Barlow
instablity of the hip
posterior subluxation
looking for the hip to pop out of the socket
what are the mech reason for hip dys
small intrauterine space
breech position
fetal head against the mothers sacrum
physiological factors for hip dys
materal hormones > ligamentus laxity
environmental factors that lead to hip dys
strapping children LE in add and ext
what is non-conservative treatment for hip dys
peri acetablular osteotomy
femoral osteotomy
what is SCFE
growth plate is damaged and the femoral head moves (“slips”) with respect to the rest of the femur
SCFE - acute
sig trauma that causes pain and blocks hip ABD and IR
SCFE - acute, chronic
the child has already experience pain in this region and then experience a trauma to this area and the epip slips father
SCFE - chronic
most common
child has hx of limp or pain for weeks or months, and loss of hip ROM (abd and IR)
what is Legg-clave
ischemic necrosis at the center of ossification of the femoral head, medial femoral circumflex
what are the sym for Legg-clave
pain at the knee or the hip during activity, antalgic gait during stance time on effect limb, limited ROM abd and IR
conservative treatment of legg clave
mim WB
max hip ROM
bracing
non conservative treatment of legg clave
varus osteoomy - redirect the head of the femur towards the acetabulm
what are the most common prediaric fractures
elbow
finger
forearm - lower arm
shoulder
wrist
PT and fracture
PT is not often prescribe following fracture
