Musculoskeletal Book

Question 1

**know pediatric fracture considerations, what do we care about in kids vs adults

Answer 1

growth may be impacted, healing faster but may outgrow brace or cast, ossification is complete by 20

Question 2

**salter Harris fracture classification, what is the 5 stages

Answer 2

involing the epiphyseal
1. growth plate undisturbed
2. most common, growth disturb rare
3. serious threat to growth and joint
4. serious threat to growth
5. crush, arrested growth
SALTR

Question 3

**what are the 5 P’s of fracture presentation

Answer 3

pain, paraesthesia, pulses, pallor, paralysis

Question 4

** fracture assessment and care along with nursing considerations

Answer 4

neurovascular: pulses, cap refil, sensation, color, warmth
unrelenting pain

Question 5

**what should we be teaching families about cast care

Answer 5

don’t put anything down, plaster takes 2 days to dry so handle with palms, keep dry, if wet try to towel dry and maybe hair dryer on cool, neurovascualr, unrelenting pain, check for any skin irritation or hot spots

Question 6

**what is scoliosis, when do we screen, what things do we look for when screening? how is it managed, what nursing considerations do we worry about?

Answer 6

S or C like curve greater than 10 degrees
becomes notable after preadolescents growth spurt
lateral curve, axial rotation, skeletal maturity
mild: stretch and strengthen
mod: brace
severe: surgery and brace
body image, post op: pain and immobility

Question 7

what is slipped capital femoral epiphysis, what age group is it common in, what are the signs and symptoms

Answer 7

head of femur separates from the epiphysis and slips backwards with partial or complete dislocation
prepubertal growth spurt (B12-15, G 10-13)
s/s acute or chronic hip, thigh, or knee pain, limited internal rotation, obligated external rotation of hip, out toe ing

Question 8

**what is Legg Calves Perthes disease, what age group is it common in, what are the signs and symptoms

Answer 8

paroximal femoral epiphysis has a temporary interruption in blood supply, 4-8 year old
pain in hip, leg length discrepancy, limp, internal rotation, abduction of affected limb

Question 9

what is the most common congenital foot deformity

Answer 9

metatarsus adductus

Question 10

what is metatarsus adducts

Answer 10

inward turning of forefoot at tarsometal joints
intoeing

Question 11

what is club foot

Answer 11

congenital abnormality of which the foot is twisted out of normal position

Question 12

what is involved in club foot

Answer 12

muscles, tendon, and bones

Question 13

treatment for club foot

Answer 13

serial casting

Question 14

what is the most serious complication of a cast

Answer 14

obstruction to normal blood flow and nerve innervation

Question 15

what is developmental dysplasia of the hip

Answer 15

variety of conditions in which the femoral head and acetabulum are inproperly aligned

Question 16

s/s of hip dysplasia

Answer 16

limited abduction
asymmetry of gluteal and thigh folds
Allis sign: one knee lower when flexed
positive ortalani and barlow

Question 17

ortalani and barlow

Answer 17

“hip click”

Barlow: is bring hips together and up to the abdomen
ortalani: flare out the hips

Question 18

if the child is less than 3 mo how do we treat hip dysplasia

Answer 18

pavlik harness

Question 19

how do we treat hip dysplasia greater than 6 mo

Answer 19

surgery with closed reduction

Question 20

what is perthes disease

Answer 20

avascualr necrosis of the femoral head
self limited

Question 21

perthes disease s/s

Answer 21

mild pain in hip or anterior thigh
limp
increase in pain with muscle spasm

Question 22

treatment of perthes

Answer 22

femoral head remain in socket until ossification is complete
- abducted

Question 23

what are some activities good for perthes

Answer 23

horseback - abducted
swimming - mobility
hand crafts - fine motor
computer - stimulate cog development

Question 24

what is slipped cap femoral epiphysis

Answer 24

occurs when the femoral head is displaced from femoral neck

Question 25

s/s of SCFE

Answer 25

limp
knee, thigh, groin, hip pain
loss of hip motion
out toe ing
external rotation with flexion

Question 26

what is scoliosis

Answer 26

lateral S or C shaped curvature
rotational deformity of spine and ribs
>10 degrees

Question 27

s/s of scoliosis

Answer 27

truncal assymtery
uneven shoulder and hip height
one sided rib hump
prominent scapula

Question 28

treatment of mild scolisoss

Answer 28

stretch and strength

Question 29

treatment of mod scoliosis

Answer 29

Boston brace

Question 30

treatment of severe scoliosis

Answer 30

spinal fusion

Question 31

what is osteomyelitis

Answer 31

infection of the bone

Question 32

most common cause of osteomyelitis

Answer 32

S aures

Question 33

s/s of osteomyelitis

Answer 33

pain and tenderness with swelling
decreased mobility
fever
redness
rapid onset

Question 34

treatment of osteomyletis

Answer 34

IV broad spectrum antibiotics
- 3-6 weeks

Question 35

what is a fracture

Answer 35

break in a bone that occurs when more stress is placed on the bone than the bone can withstand

Question 36

s/s of fracture

Answer 36

pain
abnormal positioning
edema
immobility
decrease ROM
ecchymosis
guarding
crepitus

Question 37

treatment for closed

Answer 37

manual reduction

Question 38

treatment for open

Answer 38

surgical reduction

Question 39

what to frequently asses with fracture

Answer 39

neurovasc