Musculoskeletal Flashcards
leading cause of death in children older than one year
trauma
assessing LOC using AVPU method
A- child is alert
V- child responds to verbal stimulus
P- child responds to painful stimuli
U- child is unresponsive
manual traction
applied to the body part by a hand
skin traction
pulling mechanism is attached to skin, indirectly applying pressure to skeletal structure
skeletal traction
applied directly to a bone by a pin, wire, or tongs
nursing care with traction
never released by nurse carefull assessment pin site care pain management educate for discharge
amputation post op care
elevate stump for 24 hours, then natural position
child should be turned side to side and front to back
child should lay prone for at least a few hours a day
complete v incomplete fracture
complete: fracture fragments are separated
incomplete: fracture fragments are still attached
simple v compound fracture fracture
simple: no break in skin
compound: break in skin; bone sticks out of skin
complicated v comminuted fracture
complicated: fragments that cause damage to surrounding organs / tissues
comminuted: fragments remain in surrounding tissue
transverse, oblique, spiral fracture
T: crosswise, right angle to long axis of bone
O: slanting but straight
S: slanting / circular
buckle fracture
produced by compression of the bone
greenstick fracture
bone is angulated beyond limits of bending
looks like a broken stick
plastic deformation
when bone is bent but not borken
epiphyseal injury
injury involving the growth plate
its the weakest point of long bones
salter-harris classification
S- separated growth plate A- above growth plate L- below growth plate T- through growth plate ER- eraser of growth plate (its squished between two bones)
symptoms of epiphyseal injuries
generalize swelling
pain / tender
diminished functional use
bruising, severe muscle rigidity, crepitus
assessing the 5 P’s
Pain Pallor Pulse Parasthesia Paralysis
contusion
damage to soft tissue
escape of blood into tissues
ecchymosis, swelling, pain, disability, crush injuries
dislocation
force of stress disrupts normal position of bone / socket
pain inc. with passive / active ROM
nursemaids elbow = most common (pulling on arm to catch / lift a child)
sprain
causes ligament to be stretched; partially or completely torn
- occurs suddenly
joint laxaty= indicator of severity
onset of swelling w/ disability
strain
microscopic tear
common to sprain
no joint laxity
over time rather than suddenly
stress fracture
repeated muscle contraction in repetitive weight bearing sports
tibial = most common
sharp, persistent, progressive pain
Treatment = rest, alteration of activity, PT, NSAIDS
heat cramps
cause = sodium depletion
occurs in legs, child sweats profusely
treatment = replace electrolytes
heat exhaustion
cause = excessive loss of fluids
gradual onset
head, fatigue, dizzy, anxiety, maybe disoriented,
Treatment = move to cool environment, provide rest / fluids
heat stroke
failure of normal thermoregulatory mechanism
onset = rapid headache, weakness, disoriented then = confusion, agitation, lethargy, temp > 104
treatment = cool child with wet towels and pants, transport to hospital
skeletal limb deficiency
congenital: genetical / environment causes / meds in utero
treatment t- prosthetic devices
developmental dysplasia of hip
ortolani / Barlow tests: most reliable until 4 weeks of age;
galeazzi sign: shorter thigh on affected side
trendelenberg sign: child stands on one leg on affected side, normal side tilts down
newborn -6 months = pavlik harness
6+ monts = surgery
lego-calve perches disease
femoral head changes shape and no longer fits into acetabulum
cause unknown; involves disturbed circulation to femoral head
T= therapy, rest, activity restriction, NSAIDs
slipped capital femoral epiphysis (SCFE)
spontaneous displacement of proximal femoral epiphysis in posterior / inferior direction
separation at growth plate before or during puberty (accelerated growth)
Tx= keep head of femur in acetabellum, rest, surgery
club foot
congenital deformity caused by shortened achilles, causes feet to turn in and under
could be caused by abnormal position in utero
t= serial casting to correct for 5-8 weeks
night time bracing 3-5 years
osteomyelitis
causes
- exogenous: infectious agent invades bone (penetrating wound, open fracture, contamination during surgery, or burn
- hematogenous: preexisting infection spreads to bone
S/S- abrupt fever, severe pain, irritable, tender, leukocytosis, bone cultures
T= antibiotics, bed rest, immobility of limb, pain meds
osteogenesis imperfecta
most common osteoporosis in kids
excessive fractures / bone deformity
autosomal dominant
blue sclerae, heading loss, dentinogenesis
T= biphosphonate therapy; bracing / splints / prevent fractures
juvenile idiopathic arthritis
negative rheumatoid factor chronic inflammation of synovium, destruction of cartilage
T= relieve symptoms, OT,PT, splinting devices, NSAIDS corticosteroids, DMARDS
systemic lupus erythmatosus
autoimmune disease of connective tissues / blood vessels
diagnostic criteria (need at least 4): butterfly rash, discoid rash, photosensitivity, arthritis, serositis, proteinuria
T= meds, anti-inflammatory, corticosteroids, immunosuppressive agents, avoid sun
