Musculoskeletal Flashcards
What is epiphysis?
Where osteoblasts replace cartilage, pushing the end of the bone away from the shaft, resulting in growth of new bone
What is serial casting?
Casting in multiple stages until goal achieved
What are nursing care concerns with a casted child?
Skin integrity
growth/development
mobility
What is the treatment of choice for clubfoot?
serial casting
What is DDH?
Developmental dysplasia of hip
Femoral head and acetabulum improperly aligned
What is limited in affected hip of DDH?
abduction
What will you see with gluteal and thigh fat folds in child with DDH?
asymmetry
The affected side of DDH will be ___
shorter
Child with DDH will be ___ for Ortolani sign?
positive (click present)
DDH in newborn - 6 months
pavlik harness. Helps abduct and hold joint together so it’s not popping out.
If pavlik harness is unsuccessful, what is treatment for DDH?
spica cast
If child is 6-18 months, when is dislocation seen?
when child begins to stand and walk
When an older child is diagnosed with DDH, what is treatment?
operative reduction.
Scoliosis is more common in ___
girls
When is scoliosis noticed?
after preadolescent growth spurt
What are abnormal findings in scoliosis?
prominent scapula
one-sided rib hump
curve on spine
asymmetry of shoulder or hip height
What is treatment for scoliosis?
brace
surgery (super painful)
What is Legg-Calve Perthes?
Necrotized femoral head
temporary interruption of blood flow
When are we teaching log rolling for scoliosis spine surgery?
pre-operatively
What will scoliosis surgery patients come back with?
foley cath and chest tube
What are the s/sx of Legg-Calve Perthes?
Limp
Hip soreness/ache
Stiffness
Limited ROM
symptoms worse after activity/end of day
What test is done to diagnose Legg-Calve Perthes?
MRI
What is treatment for Legg-Calve Perthes?
Restoring ROM
Prevent extrusion/subluxation
Abduction brace, sling/harness, cast Rest **Non-weight bearing** Possible traction Surgery in some cases
What bone tumor is more common?
osteosarcoma
Where does cancer occur in the long bone?
metaphysis
What are symptoms of osteosarcoma?
bone pain
swelling
limp
Where does ewing sarcoma occur?
In marrow (shaft of bone)
will see more blood effects where we are producing RBC.
What labs will be elevated with Ewing Sarcoma?
ESR, CRP, and WBC (inflammation and infection markers)
What is muscular dystrophy?
Degeneration of muscle fibers, progressive weakness, wasting of skeletal muscles
What is Duchenne Muscular Dystrophy?
Enlargement of muscles due to infiltration of fatty tissue
What are the 5 p’s?
Pain Paresthesias Pallor Pulselessness Paralysis
What is the developmental pattern for DMD?
Starts in lower extremities, works upward
What are the clinical manifestations of DMD?
waddling gait
frequent falls
lordosis
hypertrophied calves
When does DMD onset?
early childhood
What is the primary goal in treating DMD?
maintain function in unaffected muscles as long as possible.
keep child active
ROM, performance of ADL
What are s/sx of fractures?
generalized swelling
Pain/tenderness
Abnormal position
bruising
What is the treatment for fracture?
closed reduction
ORIF
traditional traction
R I C E
What is the goal of treatment for fracture?
regain alignment
restore function
What’s the most important thing to know about traction?
do not adjust!!
