MSK part 1 Flashcards
Clavicular fractures are common in childhood. What 2 things can they cause?
Brachial plexus palsy
Subclavian A. inury
Where on the clavicle do fractures usually occur and why?
Middle 1/3 and the proximal end is superiorly displaced because of the SCM
What is a Greenstick fracture?
Incomplete fracture involving only 1 side of the cortex of the bone
Incomplete fracture that only involves 1 side of the bone
Greenstick fracture
What is a Nursemaid’s elbow?
Radial head subluxation out of the Annular L.
What are the signs of a Nursemaid’s elbow?
Pain, pronation and not moving the arm
How do you reduce a Nursemaid’s elbow?
Hyper-Pronation
Supination with flexion
What is a Torus fracture? Where is it common?
Buckling and compression of the cortex
– Common at the distal radius/ulna with a fall
Where does a Supracondylar Humerus fracture occur?
Just above the elbow
What should you beware of with a Supracondylar Humerus fracture?
Brachial A. entrapment
–> Check the radial pulse
What is Osgood-Schlatter disease?
Overuse apophysitis at the tibial tubercle
What is Apophysitis?
Inflammation where the tendon/muscle attach to the bone
Where does Osgood-Schlatter disease present and what is a symptom?
Tibial tubercle = pain with quadriceps use
What are the treatment options with Osgood-Schlatter?
Decreased activity or a neoprene brace
Where do Salter-Harris fractures occur?
At the growth plate
When will Duchenne Muscular Dystrophy onset?
3-5 years old
How is Duchenne Muscular Dystrophy and Becker Muscular Dystrophy inherited?
X-linked recessive
What causes Duchenne Muscular Dystrophy?
Absent Dystrophin protein
What causes Becker Muscular Dystrophy?
Abnormal Dystrophin protein
– normal levels present
Are distal or proximal muscles more affected with Duchenne Muscular Dystrophy?
Proximal muscles
What are some signs of Duchenne Muscular Dystrophy?
Clumsiness, difficulty walking, ataxic gait
IQ level for Duchenne and Becker Muscular Dystrophy
Duchenne - LOW
Becker - Normal
What maneuver may kids do with Duchenne Muscular Dystrophy?
Gower Maneuver
= Pushing hands off skins, knees, thighs to stand up
What may be present in the calf muscle with Duchenne Muscular Dystrophy?
Pseudohypertrophy
What lab change will be present with Duchenne Muscular Dystrophy?
HIGH CK
What will the EMG show with Duchenne Muscular Dystrohpy?
Polyphasic potentials and recruitment
What is the cause of death for those with Duchenne and Becker Muscular Dystrophy?
High output cardiac failure because of cardiac fibrosis
When will Becker Muscular Dystrophy onset?
Older kids > 5 years
How is Myotonic Muscular Dystrophy inherited?
Autosomal Dominant
What is impaired with Myotonic Muscular Dystrophy?
Impaired muscle relaxation
What genetic mutation is present with Myotonic Muscular Dystrophy?
CTG repeats in the DMPK gene
What are some presenting signs of Myotonic Muscular Dystrophy?
Infantile hypotonia
** prolonged handshake, dysphagia, cardiac conduction anomalies
What are 2 congenital conditions that cause the foot to be turned inward?
Metatarsus Adductus
Clubfoot (Talipes Equinovarus)
Difference between Metatarsus Adductus and Clubfoot?
Clubfoot is NOT flexible and needs surgery and casting
(as opposed to observing with the other)
Spondylolysis
Spondylolisthesis
Spondylolysis = fracture of pars interarticularis
Spondylolisthesis = forward displacement of L5 on S1
In an infant that ingests honey or soil, what can occur?
Botulism
What does Clostridium Botulinum toxin do?
Prevents Ach release
What is the presentation of Botulism?
Symmetric and descending paralysis
Treatment for Botulism?
Botulism Immunoglobulin
What gene is mutated with Spinal Muscular Atrophy?
SMN1
What is degenerating with Spinal Muscular Atrophy?
Anterior horn degernation
What are the signs of Spinal Muscular Atrophy?
Tongue fasciculations and progressive weakness
Tongue fasciculations are present with?
Spinal Muscular Atrophy
Is there a cure for Spinal Muscular Atrophy?
No
