musculoskeletal part 1 (2) Flashcards
what is looked at in a musculoskeletal assessment?
- bones, muscles, joints
- posture and spinal alignemnt
- upper and lower extremities
what are the functions of the musculoskeletal system?
- protects vital organs
- stores minerals
- supplies RBCs
- others (support weight, control motion)
when does the posterior fonatnel close?
2-3 months
when does the anterior fontanel close?
7-19 months
what are epiphyses made of?
cartilage
what causes growing pains?
epiphyses growing at the epiphyseal plate
describe bone density in children
porous
less dense
do muscles increase in numbers as we age?
no
what is stronger than bone, need to consider fracture vs. sprain
ligaments
what is stronger than bone and grows in length and fibrous tissue?
tendons
by what age is the skull fully grown?
16 Y.O.
when is the growth of long bones complete?
20 y.o.
what is needed extra in adolescent to support bone density and growth?
calcium?
what is the function of ligaments?
connect bone to bone
what is the function of tendons?
connect bone to muscle
what is a sprain
tearing of ligMENTS
how is the midfoot positioned in congenital clubfoot?
Directed downwards (equinos)
how is the hindfoot positioned in congenital club foot
turns in (varis)
how is the forefoot positioned in congenital club foot
curls towards the heel, turns up in partial supination
what does the foot and leg looks like in congenital club foot
the foot is small with a short Achilles, the muscles in the lower leg are atrophied but the leg length is normal
what are possible etiologies of congenital club foot?
EXACT IS UNKNOWN
* Neuromuscular or vascular problems
* genetics
* arrested normal fetal development
* abnormal uterine position
is congenital club foot more common in families with a history of it?
yes
What condition is congenital clubfoot mostly associated with
myelomeningocele
which of the following is included in education about clubfoot?
1. It is fine to wait for correction for one to two months
2. Early treatment is essential
3. x-rays will confirm the severity
4. the treatment is serial (ponseti) casting
2,3,4
when should serial casting begin? what goes first?
ASAP, varous first, then equinous
How often does the clubfoot cast need changed and how long will it need to be changed for?
every 1-2 weeks for 8-12 weeks
How long will treatment of clubfoot last? describe?
Shoes with braces worn for 23 hours a day for three months, then worn at night and for naps for three to four years due to reoccurrences
Why do some people with clubfoot need surgery?
It was not corrected with casting
When is clubfoot surgery done?
Between 3 and 12 months
Describe pins and casting after club foot surgery?
Pins hold things in place, they are casted in knee flex position to prevent pin damage and promote weight bearing
describe skin care for club foot?
- Assess circulation
- Avoid lotions oils and powders
- Avoid poking sharp objects down the cast
describe cast care for clubfoot?
- Keep dry and protected
- Raise above heart level to prevent swelling
- allow the cast to fully dry, can take 24 to 48 hours
How long can it take for a cast to dry?
24 to 48 hours
what color should the toes be while in a cast and what should the temperature be?
Toe should be pink, not blue or white. skin should be warm
What occurs when the femoral head and the acetabulum are improperly aligned with an unstable connection. Can include hip and stability, dislocation, subluxation, acetabulum dysplasia (abnormal development leading to instability)
Developmental dysplasia of the hip (DDH)
what gender does developmental dysplasia of the hip DDH occur more in?
girls
Is developmental dysplasia of the hip usually unilateral or bilateral? Which side is greater?
unilateral, Left more than right
Does herende play a factor in developmental dysplasia of the hip?
yes
What are causes of developmental dysplasia of the hip DDH
- intrauterine position
- maternal estrogen
- breech
- Lack of Vitamin D supplement
what cultural factor can prevent DDH
carrying the baby on the hips, separates legs
What diagnostic test for DDH is where one knee is lower than the other
Allis sign
which diagnostic test of DDH is where a click or clunk is felt?
ortolani-barlow
What diagnostic test for DDH is used before four months
ultrasound
Which diagnostic test for DDH is used after four months
radiographs
What kind of demographic is ultrasound in radiograph used to diagnose DDH?
Females breech born or having history of it
when is a pavlik harness worn?
One continuously, not even taken off to change, only to bathe
how often is progress monitored with a pavlik harness
1-2 wks
at what age is a pavlik harness warm?
under 6 mo
What movements does a pavlik harness allow and what movements does it not allow?
allows hip flexion and abduction
does not allow hip extension or adduction
What is the goal of a pavlik harness?
Relocate femoral head into acetabulum, stretch tissue
what is a spica cast used for?
DDH after surgery
