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Peds - Spring 2016 > Musculoskeletal Dysfunction - Part 1 - Unit 4 > Flashcards

Musculoskeletal Dysfunction - Part 1 - Unit 4 Flashcards

1
Q

Fibers that bind the ends of bones together are called what?

A

Ligaments

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2
Q

FIbers that connect the bones to muscles are called what?

A

Tendons

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3
Q

A sprain is a tearing of what?

A

Ligaments

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4
Q

Primary ossification is nearly complete at birth. T?F?

A

True

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5
Q

Secondary ossification occurs when?

A

During childbirth.

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6
Q

Ends of long bones remain cartilaginous until 20 when skeletal growth is complete. T?F?

Osteoblasts push the end of the bone away from the shaft and lead to calcium deposition in the new bone. T/F?

A

True, True

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7
Q

Fibrous membranes that exist between the cranial bones are called what?

A

Fontanels

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8
Q

What is the purpose of fontanels?

A

Allows growth of the brain and skull.

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9
Q

What are children at risk for fractures?

A

Long bones are porous and less dense.

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10
Q

Muscles increase in # as the child grows. T/F?

A

FALSE, muscles increase in length and diameter.

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11
Q

Muscles reach max diameter in girls at __ years and boys at ___ years.

A

Girls - 10

Boys - 14

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12
Q

Muscle strength continues to increase until __ to ___ years.

A

25-30. So for those over 30, its all down hill!

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13
Q

Growing pains are an old wives tale and have no scientific rationale to explain their existence. T/F?

A

FALSE - they are due to rapid growth where muscles are pulled as the bone grows too quickly.

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14
Q

Leg fractures are the most common. T/F?

A

FALSE - forearm fractures are the most common.

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15
Q

What is a buckle fracture?

A

Common in young kids - bulging area due to compression. Near the epiphyseal plate.

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16
Q

What is a complete fracture?

A

fracture parts are separated - it’s Completely fractured.

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17
Q

What is a greenstick fracture?

A

Due to bone being angled beyond limits.

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18
Q

what is a transverse fracture?

A

at right angle to the bone.

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19
Q

What is an oblique fracture?

A

slanting but straight - perpendicular. Like you’re cutting a piece of meat!

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20
Q

What is a spiral fracture?

A

Twisting.

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21
Q

Where is the weakest point of long bones?

A

Epiphyseal plate (growth plate!)

22
Q

What is a type 1 epiphyseal injury?

A

Common - growth plate undisturbed, growth disturbances rare.

23
Q

What is a type 2 epiphyseal injury?

A

Most common. Growth disturbances rare. Small break in bone.

24
Q

What is a type 3 epiphyseal injury?

A

Less common, serious threat to growth and joint. Looks like the joint is cracked away.

25
Q

What is a type 4 epiphyseal injury?

A

Serious threat to growth. Joint cracked and so is bone.

26
Q

What is a type 5 epiphyseal injury?

A

Rare, crush injury causes cell death in growth plate, arrested growth and limited bone length. If growth plate is partially destroyed, angular deformities may result. CRUSH.

27
Q

What two factors place the child with a femur fracture at risk for shock?

A

Blood loss, pain.

28
Q

What are some clinical manifestations of fractures?

A

Swelling, pain, tenderness, decrease function and use, muscular rigidity, crepitus

29
Q

If a child can walk on his leg, it can’t be fractured. T/F?

A

FALSE

30
Q

What are the 5 P’s of vascular injury assessment?

A

Pain & point of tenderness
Pulse: distal to the fracture site.
Pallor
Paresthesia: sensation distal to the fracture site.
Paralysis: movement distal to the fracture site.

31
Q

How long does bone healing take in…

Neonatal?
Early childhood?
Later childhood?
Adolescence?

A

Neonatal - 2-3 weeks.
Early childhood - 4 weeks
Later childhood? - 6-8 weeks.
Adolescence = 8-12 weeks.

32
Q

When working with a cast, should we remove jewelry before and not use a hot hair dryer to help dry the cast, along with using palms (not fingers!)

A

True

33
Q

Is the cast removal painful?

A

No, but the kid might view it as part of the body along with being afraid that it will hurt, so educate and help them!

34
Q

What is traction?

A

Used to realign bone fragments..can be used pre-post op positioning…defined as forward force produced by attaching weight to distal bone fragment. Adjusted by adding or subtracting weights.

35
Q

How do we provide countertraction?

A

Increase by elevating foot of bed.

36
Q

Frictional force - provided by patient’s contact with the bed. T/F?

A

True

37
Q

What are the types of traction?

A 
Upper extremity (uncommon in children)
Manual traction (force applied with the hand during cast application)
Skin traction (attached with adhesive)
Skeletal traction (attached with pins and wires)
38
Q

Lower extremity traction - what are the 4 types

A

Bryant, Buck, Russel, 90-90

39
Q

What is Bryant traction?

A

under 3 for development hip dysplasia or fractured femur - hips are at 90 degrees with knees extended.

40
Q

Buck traction - what is it?

A

Leg extended without hip flexion - knee immobilization & short term immobilization.

41
Q

Russell traction - what is it?

A

Slightly flexed hip and knees - use of double pulley (one under knee and one to foot) - femur and lower leg fractures benefit from this.

42
Q

What is 90-90 traction?

A

Femur and tibia fractures, skeletal pin to femur and lower extremity in boot cast.

43
Q

What is cervical traction?

A

Halo brace or halo vest can be applied - crutchfield, barton, or gardner-wells tongs used.
Inserted through burr holes in skull with weights attached to the hyperextended head.
As neck muscles fatigue, vertebral bodies gradually separate to the spinal cord is no longer pinched between vertebrae.

44
Q

What is external fixation? When is it used?

A

Can be used for immobilization, limb lengthening, and correction of rotation defects. When it is attached to the outside!

45
Q

50% of children with developmental dysplasia of the hip have something in common. What is it?

A

The same daddy….jk.

They were born breech!

46
Q

What is developmental dysplasia?

A

Previously referred to as congenital hip dysplasia…abnormal development of the hip that may develop at any point.

47
Q

What are some predisposing factors to hip dysplasia?

A

Positioning in utero, breech/multiples at birth, genetics.

48
Q

What are the 3 degrees of hip dysplasia?

A

Acetabular dysplasia (preluxation) - MILDEST FORM, femoral head remains in the acetabulum.

Subluxation - incomplete dislocation of the hip.

Dislocation - femoral head loses contact with acetabulum and is displaced posteriorly and superiorly, ligaments elongated and taut.

49
Q

What are some clinical manifestations of DDH in the infant?

A

Shortened limb on affected side, restricted abduction of hip on affected side, unequal gluteal folds when infant prone, positive ortolani test & positive barlow test.

50
Q

What is the ortolani test? What is the barlow test?

A

Ortolani - hips an dkees flexed. Middle finger over greater trochanter. Click is felt as hips are brought through ROM.

Barlow - palpable dislocation as femoral head slipts out of acetabulum.

51
Q

How does DHH present in the older infant and child?

A

Affected leg shorter than the other, trendelenburg sign (pelvis tilts down on normal side when children stands bearing weight on affected side), greater trochanter is prominent and appears above line from anterior superior iliac spine to tuberosity of ischium, waddling gait

52
Q

How do we manage DHH?

A

Importance of early intervention! 6-18 mo = hard to recognize sometimes, until the child starts walking. Use traction and cast immobilization (spica).
FOr older children, they might need surgery, reduction, tenotomy, osteotomy - very difficult after 4 years of age.

Peds - Spring 2016 (29 decks)

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