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PEDs > Muskuloskeletal Disorders > Flashcards

Muskuloskeletal Disorders Flashcards

1
Q

-what is Developmental Dysplasia of Hip
- s/s in newborn vs older childres

A
  • hip instability after birth; usually associated with breech delivery
  • assymetry and unequal number of skin fold on posterior thighs/glutes
  • older child: limp, leg discrepancy
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2
Q

diagnostic evaluation for DDH

A

Ortolani and Barlow Test
ortolani- outward (abduction)
barlow- inward (adduction)

Ultrasound prior to 4 months of age
X ray after 4-6 months

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3
Q

populations at risk for Developmental Hip Dysplasia

A

female, history of DDH, oligohydramnios, high birth weight, firstborn

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4
Q

Pavlic Karness vs. casting for Dysplasia of hip

A

pavlic: prevents hip flextion and adduction
- skin care is important
- cothing and diaper should be under the straps

cast: for 12 weeks

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5
Q

what is the treatment for developmental dysplacia of hip in infants under 6 months

A

Pavlic Harness
- >6 months need surgery

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6
Q

how is Osteogenesis Imperfecta inherited

A

Autosomal dominant inherited disorder

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7
Q

what does osteogenesis imperfecta cause in the body
and what are s/s

A

extremely brittle bones, fractures, and bone deformities
s/s: BLUE sclerae, hearing loss, discolored teeth

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8
Q

how is osteogenesis imperfecta diagnosed and how is it treated

A

bone biopsy
-biphosphates, physical therapy, braces and splints,

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9
Q

what is congenital club foot

A

deformity of ankle and foot, involves bone and soft tissue contracture

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10
Q

how is congenital clubfoot diagnosed

A

diagnosed prenatally

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11
Q

symptoms of congenital clubfoot

A

affected foot is smaller,limb shorter, calf atrophy

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12
Q

what other disease can co-occur with congenital clubfoot

A

cerebral palsy, spina bifida, chromosomal defects

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13
Q

what populations is more likely to get congenital clubfoot

A

boys are affected 2x as often

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14
Q

how is congenital club foot diagnosed and treated

A

-physical exam
- serial casting until corrected
- if does not help by 3 months then surgery between 6-12 months of age
-abduction bracing at night for 3-5 years

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15
Q

an infant born with unilateral congenital clubfoot is at higher risk of having…..

A

chromosomal defects

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16
Q

scoliosis screening

A

Adam’s bend test: asymmetry of should height, scapular, or flank shape, or hip height
Standing radiographs to determine degree of curvature

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17
Q

therapeutic management for scoliosis

A

exercise, bracing, surgical intervention for severe curvature

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18
Q

what percent does a scoliosis curvature need to be to be considered severe and need surgical intervent.

A

over 25 degrees

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19
Q

what is Legg-Calve-Perthes

A

avascular necrosis of femoral head

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20
Q

clinical manifestations of Legg-Calve

A

delayed bone age, painless limp, stiffness of hip, decreased ROM, hip/thigh/knee pain, shortening ofleg affected

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21
Q

how do you test bone age

A

left wrist x-ray starting at age 3

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22
Q

diagnostic measure for Legg-Calve

A

XRAY, MRI

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23
Q

Treatment for Legg-Calve

A

initially-rest, limited weight bearing to reduce inflammation, traction to stretch the tight adductor muscles
meds- NSAIDS, PT, ROM exercises

24
Q

what population ismorelikely to be affected by Legg-Calve

A

boys age 4-8

25
Q

what is Slipped Capital Femoral Epiphysis

A

spontaneous displacement of the proximal femoral epiphysis in a posterior and inferior direction

ball of thight bone (femoral head) slips off the neck of thigh bonebecuase growth plate is damaged

26
Q

clinical manifestations of Slipped Capital Femoral Epiphysis

A

limp, pain, episode of trauma with acute displacement, gradual displacement without definite injury

27
Q

who is more at risk to get slipped capital femoral epiphysis

A

obesity, puberty hormone changes, bone changes

28
Q

treatment for SCFE

A

goal: keep head of femur in acetabulum
- rest
- no weight bearing
- sometimes surgery

29
Q

What is Juvenile Idiopathic Arthritis

A

chronic childhood arthritis (last for 6 weeks or longer)
chronic synovial inflammation with joint effusion, destruction, and destruction of cartilage

30
Q

when is a child most likely to develop Juvenile Idiopathic Arthritis

A

Before 16 yrs
Peaks- 1 to 3 years and 8 to 10 years

31
Q

clinical manifestation of JIA

A

90% of children have negative rheumatoid factor

stiffness, swelling, warm to touch, loss of mobility in affected joints, growth retardation

32
Q

Meds and treatment for JIA

A

Meds: NSAIDS, antirheumatic drugs, tumor necrosis factor alpha inhibitors

Tx: PT/OT to strengthen muscles, mobilize joints, splinting

33
Q

4 criteria for diagnosis of JIA

A
  1. age of onset is >16 yrs
  2. One or more affected joints
  3. Duration is >6 weeks
  4. Exclusion of others forms of arthritis
34
Q

diagnostit procedure for JIA

A

XRAY- rules out fractures

35
Q

what is an EMG

A

diagnostic measure to assess the health of muscles and the nerve cells that control them (motor neurons)

36
Q

What is a CPK test

A

creatine phosphokinase (CPK)
- most specific test for muscular dystrophy
- elevated CPK levels indicate muscle disease

37
Q

If you have upper motor neuron lesions this is primarily going to be___

A

cerebral palsy

38
Q

what is the most common permanent physical disability in childhood

A

cerebral palsy

39
Q

etiology of Cerebral Palsy

A

any perinantal/ neonatal brain lesions

prenatal infection, hypoxia, asphyxia, preterm birth

40
Q

what is spastic cerebral palsy

A

most common type
presents hypotonia

41
Q

Quadriparesis Cerebral Palsy

A

4 extremities are involved
- speech and swallowing difficulties
- tongue protrusion
- labile (eratic) emotions in some

42
Q

developmental signs of CP

A

-poor head control after age 3 months
- stiff/rigid limbs
- unable to sit without support at age 8 months
- no smiling by age 3 months
- feeding difficulties

43
Q

management of CP

A

mobilizations, meds, seizure control

44
Q

what percent of CP patients have a normal IQ

A

50-60%

45
Q

therapy goals for CP

A
  • establish locomotion, communication, and self-help
  • gain optimum integration of motor function
  • correct defects are early and affectively aspossible
46
Q

meds to treat spasticity in CP

A

diazepam and baclofen -muscle relaxant
valium- pain med
botox

47
Q

signs of CP freqently present:

A

-delayed developmental milestones
- hyper or hypotonicity
- arching (feet, position)
- feeding difficulty

48
Q

muscular dystrophies all have a genetic origin with

A

gradual degeneration of muscle fibers, progressive weakness, and wasting of skeletal muscles

49
Q

genetic inheritance of Duchene Muscualar Dystr

A

x-linked (males are most exclusively affected)

50
Q

cause of Duchene MD

A

dystrophin protein is absent

51
Q

characteristic of Duchene MD

A

delayed motor development esp walking
- muscle weakness begins 3-5 yrs old
-progressive muscle weakness
-calf muscle hypertrophy

52
Q

labs and diagnostic test for Duchene MD

A

Labs:Serum CPK and AST high in first 2 years of life

Test:confirmed by EMG, muscle biopsy,

53
Q

what condition presents with Lordosis

A

Duchene MD
- accentuated lower back curve, belly pushing out

54
Q

management of Duchene MD

A

no curative treatment
- maintain function in unaffected muscles as long as possible
- so do ROM, bracing, perform ADLs
- meds:corticosteroids like prednisone to increase muscle strength

55
Q

in what conditions do children tend to be overweight or obese

A

Duchene MD and Legge-Calve

PEDs (2 decks)

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