Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Peds Exam 2 > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

Fontanelle Characteristics

A
  • Fontanelles present in infants
  • allows for growth of brain and skull
  • anterior closes 7-19 mths
  • posterior closes 7-19 mths
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Epiphysis

A

ends of long bones

  • remain cartilaginous until 20 years old when skeletal maturation is complete
  • long bones are porous and less dense
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Peds Spine

A

convex in cervical and lumbar regions in babies

-cervical becomes concave with holding up of head and lumbar with walking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Growing pains

A

muscles are pulled when bones grow quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Bones of children

A

porous and less dense than adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Injury to epiphyseal plate

A

can impact future growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

bones can bend, buckle, and break…

A

even with a simple fall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rapid growth of bones..

A

allows for rapid healing with a fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is needed for new bone growth?

A

calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MS system at birth…

A

almost completely formed at birth

  • muscles increase in length and circumference but not in number
  • ligamens and tendons are stronger than bones until puberty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ligaments

A

connect bones, sprain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tendons

A

connects bones to muscles

grow in length and fibrous tissue as mechanical pressure is placed on them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

intoeing

A

when a child walks or runs, the feet turn inward instead of pointing straight ahead. It is commonly referred to as being “pigeon-toed.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Metatarsus adductus

A

when a child’s feet bend inward from the middle part of the foot to the toes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clubfoot

A

congenital anomaly

-foot is twisted and involves muscles, bones and tendons

aka talipes equinovarus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Etiology/Pathophys of Clubfoot

A
  • exact cause unknown
  • occurs in boys more than girls
  • bilateral in half of cases
  • most common in polynesian groups of pacific
  • lowest among asian
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Clinical Management of CLubfoot

A
  • cannot be corrected by exercise
  • early tx essential to prevent complications
  • serial casting tx of choice
  • casting should start ASAP after birth, bones of feet begin to ossify
  • foot is manipulated into position
  • long leg cast changed q 1-2 wks
  • manipulation and casting for 8-12 wks
  • then brace and corrective shoes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

if clubfoot not corrected with casting…

A

surgical correction 3-12 mths of age

casting continues for 6-12 weeks after sx, then brace or corrective shoes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Slipped Capital Femoral Epiphysis

A
  • spontaneous displacement of the proximal femoral epiphysis
  • between age of 10-16 before or during accelerated
  • multifactorial: obesity, pubertal hormone changes, more freq in male
  • can also be associated with endocrine disorders, growth hormone therapy, renal osteodystropthy and radiation therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Clinical Manifestations fo Slipped Capital Femoral Epiphysis

A
  • limp on affected side
  • pain in hip, can also be referred to groin, thigh or knee
  • shortening of lower extremity
  • restricted internal rotation with on adduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Management of Slipped Capital Femoral Epiphysis

A
  • bed rest to prevent further slippage
  • surgical pinning-percutanous screw fixation
  • preop BR or traction
  • postop pain management, neuro status, cast care, and skin care
22
Q

Developmental Dysplasia of the Hip (DDH)

A

formerly congenital hip dysplasia

  • femoral head and acetabulum impropertly aligned
  • may include hip instability, dislocation, subluxation, or dysplasia
  • occurs in girls more than boys…unilateral 80p of cases
23
Q

Causes of DDH

A
  • positive fam hx
  • breeched
  • female infant’s hormones
  • traditional swaddling
24
Q

Three degrees of DDH

A
  1. Dysplasia
  2. Subluxation
  3. Dislocation
25
Q

Dysplasia

A

mildest form
abnormal structural development of acetabular roof
femoral head remains in the acetabulum

26
Q

Subluxation

A

partial dislocation of hip

27
Q

Dislocation

A

femoral head loses contact with acetabulum and is displaced posteriorly and superiorly

ligaments elongated and taut

28
Q

Clinical Manifestations of DDH (infant)

A
  • shortened limb on affected side
  • restricted abduction of hip on affected side
  • asymmetry of the gluteal and thigh fat folds…unequal gluteal folds when infant prone
  • positive barlow test
  • positive ortolani test
29
Q

Clinical Therapy for DDH

A
  • importance of early intervention
  • screening done each well baby visit until walking
  • if clinical signs are present, hip US done to confirm
  • NB to 3 mths–Pavlik harness for abduction of hip

-over 6 mths–closed reduction sx and spica cast

older child over 18 mths–open or closed operative reduction, casting, and bracing (some may need preop Bryant’s traction

30
Q

Pavlik Harness

A
  • allows movement
  • ensure hip flexion and abduction
  • does not allow hip extention and adduction
  • teach parents proper application of the harness
  • teach daily care
  • feed in upright position, how to change diaper without removing the harness
  • harness is worn 23 hours per day, observe for reddened or irritated areas
  • check toes for circulation–undershirt and socks worn to prevent rubbing of the skin
31
Q

Nursing Management of DDH

A
  • ARNP/MD: assessment of hip at birth and continues a well child visits
  • RN: nursing care depends on the tx, provide cast care, educate regarding Pavlik harness, spica cast, prevent complication from immobility, maintain traction
32
Q

Scoliosis

A

Lateral S or C shaped curvature of the thoracic or thoraco-lumbar spine

  • more than 10 deg is abnormal
  • most common spinal deformity
  • most often in girls during growth spurt age 10-13 years
33
Q

Types of Scoliosis

A
  1. structural

2. functional

34
Q

Structural scoliosis

A

spine curves laterally with vertebral rotation

may be congenital, idiopathic or acquired

more serious, progressive

35
Q

Functional scoliosis

A

no rotation, no progression

36
Q

Clinical Manifestations for Scoliosis

A
  • generally becomes noticeable after preadolescent growth spurt
  • truncal asymmetry, uneven shoulders and hips, a one-sided hip rib hump and prominent scapula
  • may have complaints of ill fitting clothes
37
Q

Clinical Tx of Scoliosis

A
  • goal: limit or stop progression of curvature
  • tx depends on degree of curvature
  • mild: exercises to improve posture
  • mod: bracing 23 hrs per day and goal is to avoid increase of curvature
  • severe: surgery to fuse spine
38
Q

Mild Scoliosis degrees

A

10-20

39
Q

Moderate Scoliosis degrees

A

20-40

40
Q

Severe Scoliosis degrees

A

40 or more

41
Q

Postop care for Scoliosis

A
  • pain control, PCA
  • IS
  • cough and deep breathe
  • reposition q 2hrs
  • ROM exercises
  • ambulation as per MD order
42
Q

Osteromyelitis

A

most frequently seen in children 10 years or younger

staph aureus is the most common causative organism

caused by direct inoculation of bone during trauma, puncture or sx

can also be caused by pre-existing infection such as tonsilitis or impetigo or from an adjacent infected bone or joint

usually involves femur or tibia

43
Q

Clinical Manifestations of osteomyelitits

A

General:

  • hx of trauma
  • child is ill appearing
  • irritability, restlessness
  • fever
  • tachycardia
  • dehydration

Local:

  • tenderness
  • warmth
  • diffuse swelling over the bone
  • very painful extremity
  • involved extremity involved in semi-flexion
  • surrounding muscles tense and resist movement
44
Q

Osteomyelitis Management

A
  • long term IV AB at least 6 wks
  • sx intervention if AB do not work or the infection spreads to the joint
  • nursing: comfort, pain management, positioning, wound care as applicable, family support and education child will be discharged with IV line and AB
45
Q

Muscular Dystrophies

A

group of inherited diseases- Duchenne most common

  • largest group of muscular diseases in children
  • all have genetic origin with gradual degeneration of muscle fibers, progressive weakness, and wasting of skeletal muscles
  • all have increasing disability and deformity with loss of strength
  • all are terminal…from few to many years
46
Q

Duchenne Muscular Dystrophy

A

DMD

  • also called pseudohypertropic muscular dystrophy–enlarged calves due to infiltration of fatty tissue
  • most severe and most common of muscular dystrophies in childhood
  • x-linked inheritance pattern; one third are fresh mutations
  • incidence 1 in 3500 male births
47
Q

Characterisitics of DMD

A
  • onset between first 3-4 years of life
  • progressive muscle weakness, wasting and contractures
  • calf muscles hypertrophy (muscle replaced with fat)
  • progressive generalized weakness in adolescence
  • death from resp or cardiac failure
48
Q

Clinical Manifestations of DMD

A
  • delayed walking, waddling gait, frequent falls, gower maneuver (use arms to raise themselves to standing position)
  • lordosis
  • profound muscular atrophy in later stages
  • mental deficiency common
  • gower maneuver
49
Q

Toddlers with DMD

A
  • late walkers

- enlarged calf muscles

50
Q

Preschoolers with DMD

A

-

Peds Exam 2 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions