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Peds - Spring 2016 > Musculoseketal Dysfunction - Part 2 - Unit 4 > Flashcards

Musculoseketal Dysfunction - Part 2 - Unit 4 Flashcards

1
Q

What are the forms of congenital clubfoot?

A

Talipes varus, talipes valgus, talipes equinus, talipes calcaneus

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2
Q

What is talipes varus?

A

inversion or bending inward of feet.

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3
Q

What is talipes valgus?

A

Eversion or bending out of feet.

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4
Q

What is talipes equinus?

A

Plantar flexion with toes lower than the heel.

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5
Q

What is talipes calcaneus?

A

Dorsiflexion with toes higher than the heel.

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6
Q

What are the 3 classifications of congenital clubfoot?

A

Positional, syndromic, congenital

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7
Q

What is positional clubfoot?

A

Mild/postural - may correct spontaneously or require passive exercise or serial casting.

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8
Q

What is syndromic clubfoot?

A

Tetralogic - associated with other congenital anomalies. Usually require surgical correction with high incidence of recurrence.

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9
Q

What is congenital clubfoot?

A

Idiopathic - bony abnormality almost always requiring surgical intervention.

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10
Q

What is legg-calve perthes disease?

A

Affects children between 2-12 and especially boys between 4-8. Avascular necrosis of femoral head. There’s a disturbance in circulation that causes ischemia to femoral epiphysis producing hip deformities due to restricted bone growth.

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11
Q

100% of cases of legg-calve perthes disease have bilateral hip involvement. T?F?

A

FALSE - 10%

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12
Q

What are some clinical manifestations of legg-calve perthes disease? How is it diagnosed?

A

History of limp, soreness/stiffness, limited ROM, vague history of trauma, pain and limp most evident on arising and at end of activity…diagnosed by XRay.

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13
Q

If a deformity is going to occur in a child diagnosed with legg calve perthes disease, at what point in the disease process will it occur?

A

EARLY

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14
Q

How do we treat legg calve perthes disease?

A

Keep head of femur in acetabulum, containment with various appliances and devices, rest, no weight bearing initially, surgery in some cases, home traction in some cases.

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15
Q

What is the most common type of spinal deformity?

A

Scoliosis

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16
Q

What is scoliosis?

A

Complex spinal deformity involving curvature and spinal rotation. Classified according to age of onsert.

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17
Q

When is scoliosis more common?

A

Early adolescence.

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18
Q

When do we screen for scoliosis (age?)

A

Girls - 10 & 12

Boys - 13 & 14

19
Q

When top removed for scoliosis screening, what do we do?

A

Observe FRONT and BACK and use a scoliometer to measure degree of curvature (referral needed for >7 degrees).

20
Q

How do we treat scoliosis?

A

Bracing and exercises (20-40 degrees - must be worn 23 hours a day), surgery for >40 degrees, and posture/pain/respiratory compromise are possible long term complications.

21
Q

What are some nursing caring things for scoliosis?

A

Assessment and screening, education and support, preoperative care (autologous blood transfusion), postoperative in PICU, chest tube, PCA, assess for hemorrhage, neurovascular assessment, prevention of respiratory complications (positioning and ambulation), prevention, UTI, prevention of constipation)

22
Q

What is osteomyelitis?

A

Infectious process in the bone.

23
Q

Osteomyelitis - signs/symptoms begin abruptly and resemble what?

A

Arthritis/leukemia.

24
Q

Osteomyelitis - marked leukocystosis. T/F?

A

TRUE

25
Q

Osteomyelitis - bone cultures obtained from biopsy or aspirate. T/F?

Osteomyelitis - early x-ray films may appear normal. T/F?

A

TRUE

TRUE

26
Q

What is the most common organism responsible for osteomyelitis?

A

Staph aureus

27
Q

What are the two types of osteomyelitis?

A

Acute hematogenous (from a blood borne bacteria like tonsils, abscessed teeth, etc.) and exogenous (fracture or puncture wound to the bone)

28
Q

How do we manage osteomyelitis?

A

May have subacute presentation with walled-off abscess rather than spreading infection, prompt/vigorous IV antibiotics for extended period (3-4 weeks), monitor blood, immobilize limb, pain management, psychosocial needs.

29
Q

What is achondroplasia?

A

Genetic condition that results in an adult height of 58 inches or less. Short arms and legs with normal sized head and torso…LARGE, prominent forehead. Just support them!

30
Q

What is marfan’s?

A

Inherited, autosomal dominant disorder of connective tissue. Causing mitral valve prolapse/aortic regurgitation, pectus excavatum/long arms and fingers, sociolosis, eye issues, pneumothorax, etc.

31
Q

What is osteogenesis imperfecta?

A

A group of heterogeneous inherited disorders of connective tissues characterized by excessively fragile and defected bones.

32
Q

What is type 1 O1? Type 2?

A

type 1 = most common, widely variable.

type 2 = most severe, usually stillborn.

33
Q

OI - defective periosteal bone formation and reduced cortical thickness of bones and hyperextensibility of ligaments. T/F?

A

TRUE

34
Q

How do we manage OI?

A

Primarily supportive care, drugs don’t really do much, caution with handling to prevent fractures, family education, occupational planning and genetic counseling.

35
Q

What is the largest single group of muscle disease in childhood?

A

Muscular dystrophy

36
Q

What is duchenne muscular dystrophy?

A

Inherited non-inflammatory progressive muscle disorder. Muscular atrophy caused by fatty infiltration of muscles. Disorder of the gene that encodes dystrophin, most common and most severe MD, males can have it more, too!

37
Q

Muscular dystrophy causes abnormalities of the muscles and peripheral nerves - T/F?

A

FALSE - there is no central or peripheral nerve abnormality.

38
Q

What replaces muscle protein and fibers when degeneration occurs?

A

Connective tissue.

39
Q

What order does muscle fiber degeneration occur?

A

From proximal to distal.

40
Q

At what age does muscle weakness become apartment in the child with MD?

A

3-5 years.

41
Q

At what age does independent ambulation cease for a kid with MD?

A

9-12 :(

42
Q

What are some manifestations of MD?

A

Contractures and scoliosis, disease progresses to involve diaphragm and cardiac muscles, waddling gait, gower’s sign (children assume a standing position by “walking up their legs”)

43
Q

Why would the muscles of a child with MD appear to have become enlarged?

A

They are enlarged due to fatty infiltration, which is referred to as pseudohypertrophy. It especially affects the muscles in the calves, thighs, and upper arms.

44
Q

Swimming and soccer - bad for a kid with MD. T/F?

A

FALSE

Peds - Spring 2016 (29 decks)

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