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CPNP > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

What diagnoses SCFE?

A

Radiographs

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2
Q

What salter has fractures require open reduction with internal fixation?

A

Salter 3 and 4

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3
Q

What is gower’s maneuver? Why does it occur?

A

Due to the loss of tone in the core muscles the child walks hands up legs to attain a standing position one getting up. Also suggest pelvic girdle weakness

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4
Q

What is the term for bowleg?

A

Genu Varum

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5
Q

Describe a grade one ankle sprain.

A

Local tenderness, minimal edema, full range of motion present but maybe uncomfortable, patient can wear weight

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6
Q

What arm injury is often associated with a straight, outstretched arm fall?

A

Elbow fracture

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7
Q

When does genu valgum typically resolve?

A

7 years of age

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8
Q

Describe a typical person who has suffered from slipped capital femoral epiphysis?

A

Obese, sedentary, adolescent

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9
Q

What is a lateral curvature of the spine?

A

Scoliosis

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10
Q

How are salter Harrison fractures classified?

A

There are five classifications. They go slipped, above, lower, through, crushed

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11
Q

When is referral needed for Genu Varum?

A

Continues after age 2, unilateral, becomes worse after walking

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12
Q

Until what age is tibial torsion normal?

A

Self resolves by age 4

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13
Q

You see a child with an insidious onset of a limp with knee pain that has migrated to the groin or lateral hip. They are afebrile. What is this disease?

A

A vascular necrosis of the femoral head

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14
Q

What is the classic sign or symptom of Osgood-Schlatter disease?

A

Pain and tenderness at the tibial tubercle

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15
Q

What is the hallmark laboratory change in muscular dystrophy?

A

Markedly elevated creatinine kinase levels

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16
Q

What type of injury occurs in the growth plate of long bones during development as a traumatic injury?

A

Salter Harris fractures

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17
Q

When does a child with Legg-Calve-Perthes Disease need to be referred to orthopedics?

A

When more than one half of the femoral head is involved and in children older than 6 years of age

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18
Q

What is the management of Osgood-Schlatter disease?

A

Limit the activity to control pain and use knee immobilizers if helpful

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19
Q

What is the most common inherited neuromuscular disease in children?

A

Duchesne’s muscular dystrophy

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20
Q

What sign or symptom distinguishes slipped capital femoral epiphysis from avascular necrosis of the hip?

A

There is an acute onset in severe pain causing the inability to emulate or move the hip

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21
Q

When is it appropriate to observe Legg-Calve-Perthes Disease?

A

If the child has full range of motion, is less than 6 years of age and involvement is less than 1/2 of the femoral head

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22
Q

By what age is a child with muscular dystrophy wheelchair dependent?

A

12 years of age

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23
Q

What physical exam finding is found with a vascular necrosis of the femoral head?

A

Limited passive internal rotation and abduction of the hip joint

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24
Q

On assessment a painful limp is seen that is unilateral it was insidious in onset. Also internal rotation of the hip caused a spasm and there were no obvious signs infection on inspection or palpitation. What is this?

A

Toxic synovitis

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25
Q

what is an inflammation of the tibial tubercle as a result of repetitive stressors in patients with immature skeletal development?

A

Osgood-Schlatter disease

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26
Q

what is the spontaneous dislocation of the femoral head both downward and backward relative to the femoral head and secondary to disruption of the epithelial plate?

A

Slipped capital femoral epiphysis

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27
Q

How are salter Harris fractures diagnosed?

A

X-ray

28
Q

What salter hairs fractures can be casted or splinted with closed reduction?

A

Salter one and two

29
Q

Describe a grade three ankle sprain.

A

Complete ligament tearing causing severe pain significant edema and bruising, in the patient is unable to bare weight or rotate the ankle

30
Q

What is Legg- Calve- Perthes disease?

A

A vascular necrosis of the femoral head

31
Q

Until what age is femoral anterversion normal?

A

Normal until adolescence (in-toeing)

32
Q

How is a vascular necrosis of the formal head diagnosed?

A

Radiograph studies

33
Q

What is the most common musculoskeletal injury?

A

Ankle sprain

34
Q

What is the most common age and race of a vascular necrosis femoral head?

A

Caucasian, 4-9 years old

35
Q

In the following years what will need to be watched after the repair of an SCFE?

A

Recurrence in the opposite hip

36
Q

What injury of the arm results in a young child being swung or pulled causing radial subluxation?

A

Nursemaids elbow

37
Q

What is the most common age range for toxic synovitis?

A

2 to 6 years old

38
Q

Describe a grade two ankle sprain.

A

Partial tearing of the ligament causing pain some edema and bruising and pain with weight bearing, decreased range of motion

39
Q

When are radiographs of genu valgum necessary?

A

Over the age of seven or if unilateral involvement

40
Q

What is seen on the radiograph of toxic synovitis?

A

They are normal

41
Q

What is an abnormal distance between the medial malleolus in genu valgum?

A

More than 3 inches

42
Q

What is the fat pad sign?

A

when no fracture is visible on x-ray the lateral view demonstrates elevation of the anterior and posterior fat pads suggesting presence of a fracture

43
Q

What is a self-limiting inflammation of the hip, most likely due to a viral or immune cause?

A

Toxic synovitis

44
Q

what is a progressive genetic disorder beginning the lower extremities and progressing to the upper extremities and torso?

A

Duchesne’s muscular dystrophy

45
Q

Is scolio more common in males or females?

A

Fem

46
Q

When does scoliosis need to be referred to an orthopedist?

A

If the curvature causes pain, or if the curvature is greater than 25°

47
Q

What physical findings are seen with slipped capital femoral epiphysis?

A

Limb may be shorter from proximal displacement of metaphysis and the child will likely be unable to properly flex the hip as the femur abducts externally

48
Q

What is the correct term for knock knee?

A

Genu Valgum

49
Q

What is the Ottawa ankle rule?

A

Recommendations for x-rays in ankle injuries. there is pain near the malleoli and bone test tenderness is present at the posterior edge, distal 6 cm from the tip of either malleolus or the patient is unable to bear weight for at least 4 steps at the time of injury and evaluation

50
Q

What are the peak ages of Osgood-Schlatter disease?

A

11 to 14 years associated with their rapid growth spurt

51
Q

What is a normal variant up until the age of two?

A

Genu Varum

52
Q

What is the most common soldier Harris fracture?

A

Salter 2 above

53
Q

What will a muscle biopsy show in muscular dystrophy?

A

Necrotic degenerating fibers

54
Q

What are radiographs used for in scoliosis?

A

Quantification of the degree of scoliosis

55
Q

What is the classic sign of a nursemaid elbow?

A

Holding arm across the bunny with the thumb up

56
Q

What is the management of SCFE?

A

Surgery with an orthopedist

57
Q

What is the management for an ankle sprain?

A

RICE and NSAIDS

58
Q

What is the general classification for JIA?

A

Arthritis for more than 6 weeks and yard and 16 years old

59
Q

Is systemic JIA autoimmune or uncontrolled activity of phagocytes?

A

Phagocytes

60
Q

What are the exam findings of JIA?

A

Fever, salmon colored rashes, leukocytosis, lymphadenopathy, joint swelling, joint pain, heat and inflammation, loss of range of motion

61
Q

What signifies risk for uvitis in JIA?

A

Positive ANA

62
Q

Foit promocologic management options for JlA?

A

NSAIDS, steroids, MTX and biologics

63
Q

What is the age and gender range for SLE?

A

11 to 12 years and female

64
Q

What are some classic symptoms of SLE?

A

Joint pain, butterfly rash, mouth ulcers

65
Q

What is the positive lab finding in 97% of children with SLE?

A

A n a

66
Q

When are steroids most often used in SLE management?

A

If Reno, cardiac, or CNS involvement

CPNP (15 decks)

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