Musculoskeletal

Question 1

What is epiphysis?

Answer 1

Where osteoblasts replace cartilage, pushing the end of the bone away from the shaft, resulting in growth of new bone

Question 2

What is serial casting?

Answer 2

Casting in multiple stages until goal achieved

Question 3

What are nursing care concerns with a casted child?

Answer 3

Skin integrity
growth/development
mobility

Question 4

What is the treatment of choice for clubfoot?

Answer 4

serial casting

Question 5

What is DDH?

Answer 5

Developmental dysplasia of hip

Femoral head and acetabulum improperly aligned

Question 6

What is limited in affected hip of DDH?

Answer 6

abduction

Question 7

What will you see with gluteal and thigh fat folds in child with DDH?

Answer 7

asymmetry

Question 8

The affected side of DDH will be ___

Answer 8

shorter

Question 9

Child with DDH will be ___ for Ortolani sign?

Answer 9

positive (click present)

Question 10

DDH in newborn - 6 months

Answer 10

pavlik harness. Helps abduct and hold joint together so it’s not popping out.

Question 11

If pavlik harness is unsuccessful, what is treatment for DDH?

Answer 11

spica cast

Question 12

If child is 6-18 months, when is dislocation seen?

Answer 12

when child begins to stand and walk

Question 13

When an older child is diagnosed with DDH, what is treatment?

Answer 13

operative reduction.

Question 14

Scoliosis is more common in ___

Answer 14

girls

Question 15

When is scoliosis noticed?

Answer 15

after preadolescent growth spurt

Question 16

What are abnormal findings in scoliosis?

Answer 16

prominent scapula

one-sided rib hump

curve on spine

asymmetry of shoulder or hip height

Question 17

What is treatment for scoliosis?

Answer 17

brace

surgery (super painful)

Question 18

What is Legg-Calve Perthes?

Answer 18

Necrotized femoral head

temporary interruption of blood flow

Question 19

When are we teaching log rolling for scoliosis spine surgery?

Answer 19

pre-operatively

Question 20

What will scoliosis surgery patients come back with?

Answer 20

foley cath and chest tube

Question 21

What are the s/sx of Legg-Calve Perthes?

Answer 21

Limp
Hip soreness/ache
Stiffness
Limited ROM

symptoms worse after activity/end of day

Question 22

What test is done to diagnose Legg-Calve Perthes?

Answer 22

MRI

Question 23

What is treatment for Legg-Calve Perthes?

Answer 23

Restoring ROM

Prevent extrusion/subluxation

Abduction brace, sling/harness, cast
Rest
**Non-weight bearing**
Possible traction
Surgery in some cases

Question 24

What bone tumor is more common?

Answer 24

osteosarcoma

Question 25

Where does cancer occur in the long bone?

Answer 25

metaphysis

Question 26

What are symptoms of osteosarcoma?

Answer 26

bone pain
swelling
limp

Question 27

Where does ewing sarcoma occur?

Answer 27

In marrow (shaft of bone)

will see more blood effects where we are producing RBC.

Question 28

What labs will be elevated with Ewing Sarcoma?

Answer 28

ESR, CRP, and WBC (inflammation and infection markers)

Question 29

What is muscular dystrophy?

Answer 29

Degeneration of muscle fibers, progressive weakness, wasting of skeletal muscles

Question 30

What is Duchenne Muscular Dystrophy?

Answer 30

Enlargement of muscles due to infiltration of fatty tissue

Question 31

What are the 5 p’s?

Answer 31

Pain
Paresthesias
Pallor
Pulselessness
Paralysis

Question 32

What is the developmental pattern for DMD?

Answer 32

Starts in lower extremities, works upward

Question 33

What are the clinical manifestations of DMD?

Answer 33

waddling gait
frequent falls
lordosis
hypertrophied calves

Question 34

When does DMD onset?

Answer 34

early childhood

Question 35

What is the primary goal in treating DMD?

Answer 35

maintain function in unaffected muscles as long as possible.

keep child active

ROM, performance of ADL

Question 36

What are s/sx of fractures?

Answer 36

generalized swelling
Pain/tenderness
Abnormal position
bruising

Question 37

What is the treatment for fracture?

Answer 37

closed reduction

ORIF

traditional traction

R I C E

Question 38

What is the goal of treatment for fracture?

Answer 38

regain alignment

restore function

Question 39

What’s the most important thing to know about traction?

Answer 39

do not adjust!!