Musculoskeletal and Neuromuscular Dysfunction Flashcards
Osteogenesis imperfecta
Brittle bone disease - group of 4 heterozygous inherited disorders characterized by connective tissue and bone defects - biochemical defect causes a reduction in the synthesis of collagen
Osteogenesis imperfecta signs
Frequent fractures, thin skin, hyperextensible ligaments, epistaxis, blue sclera, easy bruising, excess diaphoresis, mild hyperpyrexia, deafness, x-ray shows multiple normal callous formations at new fracture sites
Osteogenesis imperfecta treatment
Bisphosphonates - increase bone density
IV pamidronate - pain relief in severe cases
Handle child carefully
Prevent obesity - low calorie, high fiber diet
Vit C and D supplementation
Maintain good oral hygiene so teeth do not break
Developmental dysplasia of the hip
Group of congenital abnormalities of the hip joints which includes subluxation, dislocation, instability, and teratologic dislocation
Hip subluxation
Incomplete contact between the articular surface of the acetabulum and the femoral head
Hip dislocation
Full loss of contact between the articular surface of the acetabulum and the femoral head
Hip instability
Passive manipulation allows for the subluxation or dislocation of the hip
Hip teratologic dislocation
Antenatal dislocation
Developmental dysplasia of the hip signs
Ortolani and Barlow signs, asymmetrical gluteal folds, limited abduction of affected hip, Galeazzi sign (different in knee heights)
Older children - limping, toe walking, Trendelenburg sign (pelvis drops when standing on opposite leg)
Developmental dysplasia of the hip treatment
0-6 months - Pavlik harness, abduction device
6-18 months - traction followed by closed reduction with cast immobilization
Older children - surgical correction
Femur fracture is common in ____
Abuse
Fracture of epiphyseal plate causes potential for ____
Growth deformity
Bend fracture
Bone bends to breaking point, does not straighten without intervention
Buckle fracture
Compression failure of the bone with bone telescoping on itself
Greenstick fracture
Incomplete fracture
Fractures - healing time
Neonates - 2-3 weeks
Early childhood - 4 weeks
Later childhood - 6-8 weeks
Adolescence - 8-12 weeks
Fracture signs
Five Ps - pain, pulse, pallor, paresthesia, paralysis
Deformity, swelling, bruising, muscle spasms, tenderness, impaired sensation, loss of function, crepitus, shock
Fracture treatment
Move injured part as little as possible
Elevate, cold packs
Prevent compartment syndrome, infection (osteomyelitis), renal calculi (fluids), pulmonary embolism
Compartment syndrome
Increased pressure within a closed space compresses circulation to nerves and muscles within the space
Caused by casts, hemorrhage, trauma, burns, surgery
Treated by fasciotomy
Slipped capital femoral epiphysis
Ball of the upper end of femur slips off in a backward direction due to weakness in the growth plate - develops during accelerated growth after onset of puberty
Can be a complication of growth hormone therapy
Considered an emergency - necrosis of femur head can occur without prompt treatment
Slipped capital femoral epiphysis signs
Hip or knee pain, limp, unable to bear weight, affected hip does not have full ROM, hip usually turned outward and may appear shorter
Scoliosis
Spinal deformity involving lateral curvature of the spine, spinal rotation, and thoracic hypokyphosis
Cerebral palsy
Group of disabilities caused by injury or insult to the brain either before or during birth or in early infancy
Spastic cerebral palsy
Most common type
Hypertonicity with poor control of posture, balance, and coordinated movement, and impairment of fine and gross motor skills
Active attempts at motion increase abnormal postures
Hemiparesis = one side affected
Quadriparesis = all four extremities affected
Diplegia = similar body parts affected (eg. both arms)
Dyskinetic/athetoid cerebral palsy
Involves abnormal involuntary movement, dyskinetic movement of mouth, drooling and dysarthria, movements are choreoid, dystonic, ataxic
Duchenne’s muscular dystrophy
Group of disorders that cause progressive degeneration and weakness of skeletal muscles - dystrophin, a protein product in skeletal muscle, is absent
Death occurs in adolescence usually from infection or cardiopulmonary failure
Duchenne’s muscular dystrophy signs
3-5 years of age - weakness in pelvic girdle, delays in motor development, difficulties running/riding bike/climbing stairs, abnormal gait, Gower’s sign
Walking ceases between age 9-12
Cardiac and breathing problems
Duchenne’s muscular dystrophy treatment
Monitor temperature - at risk for malignant hyperthermia
Maintain optimal physical mobility
Compensate for disuse syndrome
