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Nursing 202 > Musculoskeletal PEDS > Flashcards

Musculoskeletal PEDS Flashcards

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1
Q

What is the epiphyses and why is knowledge of this important in the understanding of growing children?

A
  • Growth plates

- it is important because children are at risk for bone deformity if there is trauma or infection at those locations

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2
Q

Describe the ortolani maneuver for checking an infant’s hips. How should it feel?

A
  • With the infant supine, flex the knees holding your thumb on the inner mid thighs and the rest of your fingers outside on the hips touching the greater trochanters. Adduct the legs until your thumbs touch. Then gently lift and abduct, moving the knees apart and down so their lateral aspects touch the table.
  • It should feel smooth with no sounds
  • gluteal folds should be even
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3
Q

Describe how to screen an adolescent for scoliosis. What should you expect?

A
  • Seat yourself behind the standing child and ask him or her to stand with their feet shoulder-width apart and bend forward at the waist slowly to touch their toes.
  • Expect a straight vertical spine while standing and also while bending forward.
  • The posterior ribs should be symmetric with equal elevation of shoulders, scapulae, and iliac crests
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4
Q

What would you tell a parent who tells you her 2-year-old is “flatfooted”?

A

-The child may look flatfooted because the normal longitudinal arch is concealed by a fat pad until the age of 3. When standing begins, the child takes a broad-based stance which causes pronation. Thus pronation is common between 12 and 30 months.

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5
Q

What would you tell a parent who tells you his 18-month-old, who started walking at 11 months, is “bowlegged”?

A
  • It is normal for 1 year after the child begins walking. The child may walk with a waddling gait.
  • This resolves with growth and requires no treatment.
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6
Q

List 6 health risks for children exposed to environmental tobacco smoke.

A
  • Pneumonia
  • Bronchitis
  • Coughing, sneezing, and shortness of breath
  • A greater risk for sudden infant death syndrome (SIDS)
  • Acute and chronic otitis media
  • Asthma
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7
Q

Describe expected inspection finding of a newborn that differ from the adult.

A
  • The chest circumference is 30-36 cm and is 2 cm smaller than the circumference of the head and will remain this way until age 2.
  • The chest wall is thin with little muscle.
  • The ribs and xiphoid process of the sternum are prominent
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8
Q

Describe expected inspection finding of an infant that differ from the adult.

A

-The infant’s thorax is rounded with and equal AP to transverse chest diameter.

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9
Q

Describe expected inspection finding of a child that differ from the adult.

A
  • Harrison groove
  • a horizontal groove in the ribcage at the level of insertion of the diaphragm, occurs normally
  • It extends from the sternum to the midaxillary line.
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10
Q

Why is percussion of the chest not very useful in the premature infant?

A
  • adults’ hands are too big

- infants are belly breathers

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11
Q

What is normal for an infants respiratory rate? When can they increase?

A
  • 30-40 breaths a minute
  • little excitation
  • irregular when extremes in temperature, feeding, crying, or sleeping
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12
Q

What has formed by 3 months gestation?

A

-a scale model of the skeleton made out of cartilage

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13
Q

What is growth like in infancy and adolescence compared to child?

A
  • very rapid

- steady in childhood

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14
Q

Where does bone lengthening occur?

A

-at the epiphyses

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15
Q

What can happen if there is trauma or infection at an epiphyses?

A

-bone deformity

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16
Q

When does longitudinal bone growth close?

A

-around 20 years old

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17
Q

What shape is the spine at birth?

A

-a single c shaped curve

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18
Q

At 3-4 months, what curve of the spine is developed? How does it develop?

A
  • the anterior curve in the cervical neck

- holding up their head and tummy time

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19
Q

What curve of the spine is developed at 12-18 months? How does it develop?

A
  • the anterior curve in the lumbar area

- from the child standing erect

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20
Q

Why, besides death, do babies need to be resuscitated quickly after delivery?

A

-to prevent hypotonia aka floppy baby syndrome

21
Q

What can traumatic birth increase the risk for?

A

-clavicular fractures

22
Q

For history for an infant or child, what are some questions that need to be asked?

A
  • trauma during childbirth
  • broken bones
  • deformities
  • milestones and ages
23
Q

For history of adolescents, what needs to be asked about sports?

A

-how often
-safety equipment
-training
-warm ups
-adult supervision
-do they stop when they get hurt
(for all physical activities)

24
Q

How do you examine an infant?

A
  • fully undressed
  • supine
  • maintain body temp with a warming table
25
Q

What does varus mean?

A

-apart

26
Q

What does valgus mean?

A

-together

27
Q

What is metatarsus adduction?

A
  • hindfoot is aligned with lower leg and just the forefoot angles inward
  • common and usually present at birth; resolves by age 3
28
Q

What is tibial torsion? What causes it?

A
  • twisting of the tibia

- may be from intrauterine positioning and then get worse from “TV” squat

29
Q

What is Ortolani’s maneuver used to check for?

A

-classic sign for congenital hip dislocation

30
Q

When is Ortolani’s performed and what does a positive sign indicate?

A
  • every visit until 1 year

- hip instability and needs to be referred

31
Q

What is Allis test?

A
  • used to check for hip dislocation

- compares leg lengths by having both feet flat and looking at location of the knees

32
Q

What is polydactyly?

A

-extra fingers or toes

33
Q

What is syndactyly?

A

-webbed fingers or toes

34
Q

What is Simian crease?

A

-a single palmar crease that goes down the middle and notes for down syndrome

35
Q

What should happen during a Moro’s (startle) reflex?

A

-should pull up both arms

36
Q

What are some signs of spina bifida?

A
  • tuft of hair on spine
  • dimple in the midline of spine
  • cyst on spine
  • mass on spine
37
Q

How do you test muscle strength of the shoulders?

A
  • by lifting with your hands under the axillae

- normal strength: wedges securely between your hands

38
Q

What does it mean if the infant starts to slip between your hands when testing for shoulder strength?

A

-shoulder muscle weakness

39
Q

What should you see in a preschool age child’s spine?

A
  • line from back of head to sacrum
  • shoulders level within 1 cm
  • scapulae are symmetric
40
Q

When is Lordosis common?

A
  • throughout childhood (protuberant abdomen)
  • Ricketts
  • Muscular Dystrophy
41
Q

What does Genu varum mean? When is is normal and when is it common?

A
  • bowlegged
  • normal for kids for about a year after beginning to walk
  • resolves with development
  • common in Ricketts
42
Q

What does Genu valgum mean? Is there treatment?

A
  • knock kneed

- does not need treatment because it almost always resolves on its own

43
Q

What does Pes planus mean? When is it abnormal?

A
  • flat footed
  • pronation of medial side of the foot
  • abnormal after 30 months
44
Q

What does Pigeon toes mean? When does it correct by?

A
  • child tends to walk on lateral side of feet and longitudinal arch looks higher than normal
  • usually corrects by age of 3
45
Q

Where are the babies hands placed when walking during 1-2 and 3+ years?

A
  • 1-2 years: arms are out and weight on inside of the feet

- 3+ years: adduct arms when walking and gait should narrow

46
Q

What is Trendelenburg’s sign?

A
  • screen progressive subluxation of the hip

- abnormal finding: when they stand of the affected leg, the pelvis drops to good side

47
Q

What should the hips look like when testing for Trendelenburg’s sign?

A

-watch from behind and iliac crests should stay level when weight switches from foot to foot

48
Q

How does subluxation of the elbow commonly occur?

A

-between ages of 2-4 from forceful removal of clothes or swinging child from arms

49
Q

What is kyphosis?

A
  • hunchback position due to poor posture

- technology makes this worse

Nursing 202 (4 decks)

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