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PT Across the LIFESPAN > Musculoskeletal Changes Across the Lifespan > Flashcards

Musculoskeletal Changes Across the Lifespan Flashcards

1
Q

Cartilage types

A
  • Hylaine/Articular Cartilage
    • fetal skeleton, joints, trachea, larynx
  • Fibrocartilage
    • Meniscus, pubic symphysis, intevertebral discs.
  • Elastic Cartilage:
    • ​Ear & epiglotis
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2
Q

Types of cartilage growth:

A
  • Appositional: New surface
  • Interstitial: Increased internal mass
  • Limited growth/repair after childhood
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3
Q

Cartilage properties:
nutrients from?

A
  • Lack of innervation, vascularization
    • Nutrients from diffusion
    • Compression/Decompression
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4
Q

Cartilage: Over Time

A
  • Thinning
  • Atrophy
  • Decreased water content
  • Decreased number of Chondrocytes
  • Rougher surface → decreased efficiency
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5
Q

Bone is formed by endochondral ossification except:

A

Clavicle, carpals and tarsals, mandible, skull

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6
Q

Diaphysis is ossified at

A

birth

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7
Q

Bony maturity by

A

20 y

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8
Q

Epiphyseal plate forms in

A

early childhood

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9
Q

Interstitial bone growth:

A
  • Growth in lenght (occurs befor growth in diameter)
  • Compression forces (ideally symmetrical, perpendicular)
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10
Q

Appositional bone growth:

A
  • Growth in diameter
  • Most rapid during prenatal period
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11
Q

Joints form at _____ weeks gestation

A

6-8

  • Change in response to loading and movement
  • Acetabulum shows significant changes
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12
Q

Femoral anteversion ________(decreases or increases?) over time

A

decreases

new born is 25 -30 deg

adult 10 -15 deg

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13
Q

knee aligment development

A
  • new born: peak varum
  • 1-2 yr: straight
  • 2-4 yr: peak valgum
  • 16 yr: straight
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14
Q

Bone in infancy and childhood:

A
  • Growth is dynamic at this point
  • Spontaneous resolution
  • Relatively rapid response to ortho intervention
  • Epiphysis vulnerable:
    • Infection or fracture
    • Asymmetrical growth
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15
Q

Growing pains

A
  • 4-12 year olds
  • Late evening or night, resolve by am
  • Muscle grows slower than bone
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16
Q

Growth spurts at what age?

A
  • 12-13 y for girls
  • 14-16 for boys
  • Decreased flexibility
  • Length grows faster than cortical strength
17
Q

The role of hormones testosterone and strogen in bone growth

A
  • Estrogen: Slows bone resorption (inhibits osteclasts activity)
  • Testosterone: Enhances calcium absorption (increases osteoblast activity)
18
Q

Bone: Activity Related Concerns

A
19
Q

Salter-Harris fractures

A

Epiphyseal Injury

20
Q
A

Greenstick Fracture

in children

21
Q

Adolescent Bone Concerns:

A
  • Scoliosis
  • Apophysitis
  • Apophyseal avulsion
  • Stress fracture
22
Q

Cobb angle

A
  • Named for convex side
  • curve in scoliosis measurement
  • Structural vs. Non structural
  • 0-20: Monitor
  • 20-40: Bracing & Exercise
  • 40: Surgical stabilization
23
Q

Risser sign

A
  • Bone Maturity measurement
  • 0 to 5 scale
  • 5 is completely closed
24
Q

Growth plates begin closing in ______ . And are complete by ____.

A
  • childhood
  • Complete by 25 years
  • Vertebra close last
  • Remodeling continues
25
Q

Annulus Fibrosis: Increasingly fibrotic

Peak lost:

A

20-40y

26
Q

Adult Bone Concerns:

A
  • Back pain/Disc changes
  • Nucleus Pulposus: Loss of volume
  • Annulus Fibrosis: Increasingly fibrotic
27
Q

Pre-natal and 1st year: _____(increases or decreases) number of fibers

A

Increased

28
Q

After 1st year: Increased fiber _______

A

size

29
Q

muscle maturation is achieved when

A
  • Relaxation speed improves
  • Adult speeds reached by 10
30
Q

Bone growth is faster or slower than muscle?

A

faster

31
Q

Boys have a longer ___________ and sharper
acceleration in growth

A

“growing period”

32
Q

Strength training can decrease speed of loss but not
______

A

prevent it

33
Q

Sarcopenia:

A
  • Muscle wasting: decline in number and size of muscle fibers
  • Not typical!
  • Reported by 6-15% of older adults
    ∗ Activity level
    ∗ Hormonal level
    ∗ Loss of contractile properties
34
Q

Strength over the Lifespan: adults

A
  • Continued increase into 20s
  • Peaks in the 30s
  • Declines into the 50s
  • Strength training can decrease speed of loss but not prevent
  • Frailty and advanced age are not contraindications for strengh training.
35
Q

cobb angle of 18 deg

A

just monitor

36
Q

cobb angle of 25 deg

A

bracing and exercise

37
Q

cobb angle of of 45 deg

A

surgical stabilization

38
Q

Pt presents with a cobb angle of 22 deg and you decide to:

a. continue to monitor the curve
b. recommend bracing and therapeutic exercises
c. refer to a doctor for surgery

A

bet 20 -40 deg = bracing and exercise

39
Q

a 3 y/o has

a. straigh legs
b. peak valgum
c. varum

A

peak valgum

PT Across the LIFESPAN (13 decks)

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