Musculoskeletal (MSK) Flashcards
Pediatric Fracture Considerations
- Children’s bones are more porous and heal faster but are prone to epiphyseal injuries (growth plate fractures).
- Risk of non-accidental fractures: Posterior rib fractures, skull fractures, injuries that don’t match the story
Salter-Harris Fracture Classification
Classifies growth plate fractures into five stages based on severity.
5 P’s of Fracture Presentation
- Pain
- Pulse (distal to fracture)
- Pallor
- Paresthesia (distal to fracture sensation)
- Paralysis (movement distal to fracture)
Fracture Assessment & Care
- Neurovascular assessment (capillary refill, color, warmth, movement, sensation).
Treatment:
- Reduction (realigning bone).
- Immobilization (cast, surgery).
Cast Care Teaching
- Elevate extremity.
- No objects inside the cast.
- Check for circulation (cap refill, warmth).
- Keep edges clean & dry
Scoliosis Definition
Sideways curvature of the spine (>10 degrees)
Scoliosis Screening
During preadolescent growth spurt.
Scoliosis - Sign
Uneven shoulders/hips, rib hump, trunk asymmetry
Scoliosis Managment
- Mild (10-20°): Strength/stretch.
- Moderate (20-40°): Brace.
- Severe (>40°): Surgery
Scoliosis Nursing Consideration
Pain management, body image support
Slipped Capital Femora Epiphysis (SCFE) Cause
The femoral head slips off the growth plate
Slipped Capital Femoral Epiphysis (SCFE) - Common in
Teen boys, overweight children
Slipped Capital Femoral Epiphysis (SCFE) - Symptoms
Hip, thigh, or knee pain, limited internal rotation.
Slipped Capital Femoral Epiphysis (SCFE) - Diagnosis
X-ray (looks like “ice cream slipping off a cone”).
Legg-Calve Perthes - Cause
The femoral head slips off the growth plate
Legg-Calvé-Perthes - Common in
Boys, ages 4-8
Legg-Calvé-Perthes - Symptoms
Hip pain, limp, leg length difference
Legg-Calvé-Perthes - Treatment
Activity restriction, PT, possible bracing
Types of Immunity
Natural Passive Immunity
Natural Active Immunity
Artificial Active Immunity
Artificial Passive Immunity
Natural Passive Immunity
Definition: Antibodies are passed from mother to child.
Achieved Through: Placenta during pregnancy and breast milk.
Example: Maternal antibodies protecting newborns.
Duration: Short-term; wears off after a few months
Natural Active Immunity
Definition: Immunity develops after infection.
Achieved Through:
Exposure to a disease, triggering the body to produce its own antibodies.
Example: Child gets chickenpox, recovers, and gains lifelong immunity
Artificial Active Immunity
Definition: Immunity developed after vaccination.
- Achieved Through: A vaccine stimulates the body to produce antibodies.
- Example: MMR vaccine leading to long-term protection
Artificial Passive Immunity
Definition: Pre-formed antibodies are given for immediate protection
- ## Achieved Through: Injecting immune globulin.
- Example: Rabies immune globulin (RIG) given after an animal bite
5 stages of Salter - Harris
o 1 – through growth plate
o 2 – through growth plate and metaphysis (most common)
o 3 – through growth plate and epiphysis
o 4 – through all elements
o 5 – crush injury of growth plate
Clinical Manifestations of fractures
Swelling
Pain/Tenderness
Diminished Use
Bruising, rigidity, crepitus
Scoliosis Dx Three Key components
o Lateral Curvature – measured by Cobb angle. The bigger the angle the worse the deformity
o Axial rotation – abnormally rotates along the vertical axis – affects ribs and curve rigidity
o Skeletal Maturity – Risser sign (calcificationat the hip bones ridged top as seen on the same xray as Cobbs angle) amount of skeletal maturity remaining is critical to making scoliosis treatment decisions in children and teens
Osteomyelitis
Infection of the bone, most common in children – staph
S/S – tenderness, erythema, warm, edema, limp, fever, chills, refusal to use extremity
Dx – MRI
Tx – IV antibiotics, surgery
Nursing Care - Med Admin, monitor CBC,ESR, Pain Neuro
