MSK Peds Flashcards
In what position do you examine an infant for MSK?
Full undressed and lying on back.
What is the bone most frequently fractured during birth?
Clavicle
What is the normal curve of a newborn’s spine?
C-curve
How do you observe ROM in an infant?
Through spontaneous movement.
_____ is common throughout childhood -> marked with muscular dystrophy and rickets.
Lordosis
Shoulders should be level within _____ cm.
1 cm
How long is genu varum (bowlegged) normal?
For 1 year after child begins walking.
When do knock knees (genu valgum) usually occur?
Between 2 and 3.5 years. No treatment indicated.
T/F Flatfoot (pes planus) is common in infants and toddlers.
True. Flatfoot (pes planus): pronation, or turning in, of medial side of foot because normal longitudinal arch concealed by fat pad until age 3 years.
What causes pigeon toes and how is it treated?
Pigeon toes demonstrated when child tends to walk on lateral side of foot, and longitudinal arch looks higher than normal. Often starts as forefoot adduction, and usually corrects spontaneously by age 3 years.
How do you screen progressive subluxation of hip?
Check Trendelenburg’s sign to screen progressive subluxation of hip -> pelvis sags on the side opposite the affected side during single leg stance on the affected side.
When is subluxation of elbow (head of radius) most likely to occur and why?
Occurs most often between 2 and 4 years of age as a result of forceful removal of clothing or dangling while adults suspend child by hands.
Why is kyphosis (outward curvature of spine causing hunching) common during adolescence?
Chronic poor posture
How do you measure bone age?
Measured by radiographs of the left hand and wrist.
Why would you measure bone age?
Can be used to quantitatively determine somatic maturation and serves as a mirror that reflects the tempo of growth.
When do skeletal growth spurts begin, peak, and end?
Begin: Tanner 2 in girls and Tanner 3 in boys.
Peak: Tanner 4
End: Tanner 5
Do boys or girls have longer growth spurts?
Boys
When does the pelvis widen in girls?
Early in pubescent girls.
Do the legs lengthen or thighs broaden first in growth spurts? What happens after that?
In both sexes the legs usually lengthen before the thighs broaden.
Next the shoulders widen, and the trunk completes its linear growth.
When does bone growth end?
When the epiphyses close.
What separates the epiphysis from the diaphysis?
Growth plate (physis)
Why is the growth plate weaker than the remaining bone?
Less calcified.
These cells live in the growth plate and produce cartilage cells. After they die, they are absorbed and the calcified matrix is converted to bone.
Chondrocytes
What can jeopardize the survival of chondrocytes? What happens if they die?
Because the blood supply to the growth plate comes primarily through the epiphysis, damage to epiphyseal circulation can jeopardize the survival of the chondrocytes. If chondrocytes stop producing, growth of the bone in that area stops.
Where does longitudinal bone growth occur?
Ossification centers
How do changes in bone length, width and strength occur?
Via intramembranous ossification: Length of long bones comes from growth at the epiphyseal plates. Diameter increases as a result of deposition of new bone on the periosteal surface and resorption on the surface of the medullary cavity.
T/F Development of muscles and bones is influenced by use.
True
Which are key nutritional elements for bone growth and development?
Protein, Ca, Vit D
