MSK across lifespan

Question 1

when does chondrogenesis take place?

Answer 1

intermittent loading

Question 2

when does osteogenesis take place?

Answer 2

continuous loading

Question 3

what tissues are developed from the mesoderm

Answer 3

bone, cartilage, and muscle

Question 4

bone formation occurs through:

Answer 4

endochondral or intramembranous ossification

Question 5

which bones are not formed by endochondral ossification?

Answer 5

clavicle, mandible, and skull

Question 6

When is cartilage gradually replaced through ossification?

Answer 6

8th fetal weeks

Question 7

Where is the primary ossification center located in bones?

Answer 7

typically in the center of the diaphysis

Question 8

T/F: the epiphyses are ossified at birth

Answer 8

False

they remain cartilaginous

Question 9

what to keep in mind for premature babies in regards to calcification

Answer 9

they have less calcified bones

Question 10

when are most bones fully ossified?

Answer 10

by 20 years old

Question 11

Where do long bones grow in length?

Answer 11

epiphyseal plate

Question 12

what is appositional growth?

Answer 12

accumulation of new bone on the bone surface

Question 13

when are the most rapid periods of bone growth?

Answer 13

prenatal
7 years old
adolescence

Question 14

when is the basic structure of a joint formed

Answer 14

6-8 weeks of gestation

Question 15

when is the final joint shape formed?

Answer 15

throughout early childhood

Question 16

Effects of mechanical forces:

Prenatal

Answer 16

1. early on role is minimal

2. as fetus grows and space is confined, mech force more important

Question 17

process that includes bone formation and resorption to shape bones

Answer 17

modeling

Question 18

wolff’s law

Answer 18

bones develop a particular internal trabecular structure in response to the mechanical forces placed on them

Question 19

Longitudinal loading

Answer 19

1. parallel to direction of growth

2. results in either compression or tension

Question 20

How to stimulate bone growth with longitudinal loading

Answer 20

apply intermittently with appropriate forces

Question 21

Which stimulates more growth:

intermittent compression or tension?

Answer 21

compression

Question 22

T/F: Constant or excessive static loading causes bone material to increase

Answer 22

False

Question 23

Hueter-Volkmann Principle

Answer 23

growth plates produce:

1. increased growth in response to tension
2. decreased growth in response to excessive compression

Question 24

What could happen if malalignment forces unequal forces across the epiphyseal plate?

Answer 24

uneven growth and malalignment

Question 25

stapling epiphyseal plate

Answer 25

slow growth

commonly used with leg length discrepencies in children

Question 26

procedure for limb lengthening

Answer 26

Ilizarod technique

Question 27

Shear forces parallel to epiphyseal plate leads to:

Answer 27

torsion / twisting changes

occurs with normal muscle pull

Question 28

Results of torsion:

Answer 28

1. genu varum, valgum
2. scoliosis
3. assymetrical growth=fracture

Question 29

flexure drift

Answer 29

1. strain on curved bone wall applied by repeated loading moves bone surface in direction of concavity
2. bone resorbed from convex side and laid down on concave side
3. seen in the femur as the child loses the initial genu varum

Question 30

Neonate alignment

Answer 30

1. neonatal contractures (physiological limitations in motion)
2. hip, knee, elbow FLX (hip 30 degrees)
3. Hips shallow and unstable

Question 31

Neonate hip traits

Answer 31

1. acetabulum largely cartilaginous and shallow
2. femoral head flat.
3. large femoral neck shaft angle
4. anteverted
5. excessive ABD (69-76. 60 by 2 y.o.).
6. lateral rotation > medial rotation.
7. coxa valga (135-145)

Question 32

neonate hip ABD decreases with:

Answer 32

development of upright postures

Question 33

neonate hip lateral rotation decreases with:

Answer 33

increased hip extension in first 2 years

Question 34

neonate coxa valga decreased to 125 by adolescence due to:

Answer 34

compression and tension forces that occur with WB and muscle pull

Question 35

antetorsion

Answer 35

head and neck of femur rotated forward in sagittal plane relative to axis through femoral condyles

Question 36

retrotorsion

Answer 36

head and neck of femur are rotated backwards

Question 37

femoral version

Answer 37

position of head of femur in acetabulum relative to posterior pelvis

Question 38

hip anteversion

Answer 38

head of femur anterior in acetabulum.

position of thigh ER

Question 39

hip retroversion

Answer 39

head of femur posterior in acetabulum

position of thigh IR

Question 40

Neonate femoral version

Answer 40

60 degrees of anteversion

Question 41

adulthood femoral version

Answer 41

12 degrees anteversion

Question 42

Why is the femur externally rotated at birth

Answer 42

anteversion > antetorsion

Question 43

neonate knee alignment

Answer 43

1. knee flexion contracture of 20-30 degrees
2. apparent physiological bowing
3. tibiofemoral varus up to 15 deg

Question 44

apparent physiological bowing

Answer 44

tibia appears outwardly bowed in frontal plane

places lateral head of gastroc in more forward position

Question 45

When to treat neonate genu varus

Answer 45

if position of knees not decreasing by 18 months-2 years

especially if > 25 degrees

Question 46

When to treat neonate genu valgus

Answer 46

if it does not reduce to 5-7 degrees

Question 47

neonate tibial torsion

Answer 47

slight external torsion (5 degrees)

Question 48

tibial torsion age 14

Answer 48

18 degrees

Question 49

tibial torsion skeletal maturity

Answer 49

23-25 degrees

Question 50

neonate ankle and foot

Answer 50

1. very flexible
2. may have PF limitation
3. talus and calcaneus inclined medially
4. forefoot inverted in NWB
5. foot should have straight lateral border
6. if lateral border is a C: metatarsus adductus