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Neuromuscular/Musculoskeletal Disorder Flashcards

1
Q

Types of Neuromuscular Disorders

A
  • neurologic insult
  • genetic dysfunction
  • structural abnormality
  • autoimmune in nature
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2
Q

Neurologic Insult

A

trauma or hypoxia to the brain or spinal cord

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3
Q

Anatomic Differences in Child vs Adult

A
  • child’s spinal cord is more mobile
  • myelination is incomplete
  • full ROM present at birth
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4
Q

What would indicate an abnormality?

A

sluggish deep tendon reflexes

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5
Q

What are 2 abnormal findings?

A

hypertonia or hypotonia

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6
Q

What history would we ask about for presence of neuro disorder?

A
  • changes in gait
  • recent trauma
  • poor feeding
  • lethargy
  • fever
  • weakness
  • alteration in muscle tone
  • history of developmental milestones
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7
Q

Inspection and Observation

A

motor function
reflexes
sensory function

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8
Q

Palpation

A

muscle strength and tone

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9
Q

Auscultation

A

lungs for adventitious sounds

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10
Q

What is considered normal to be seen in toddlers?

A

lordosis

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11
Q

When may kyphosis become evident?

A

adolescence

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12
Q

Internal Tibial Torsion/ Genu Varum

A

normal variation in infants lower limbs rotated inward

resolves by 2-3 yrs

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13
Q

When should Genu Valgum/Knock Knees by resolved?

A

7-8 years

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14
Q

Interventions for Preventing Complications of Immobility

A
  • turning/repositioning q 2 hours
  • assessing skin for redness/breakdown
  • performing ROM exercises
  • keep skin clean and dry
  • encourage intake of fluids
  • encourage coughing/deep breathing q 2 hours prn
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15
Q

Cerebral Palsy S/S

A

motor impairments including spasticity, muscle weakness, and ataxia

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16
Q

Complications of Cerebral Palsy

A 
mental impairments
seizures 
growth problems
impaired vision or hearing 
abnormal sensation or perception 
hydrocephalus
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17
Q

Focus of Nursing Care w/ Cerebral Palsy

A

promoting growth and development
promoting mobility
maintaining optimal nutritional intake
providing support and education

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18
Q

What are two acquired disorders for children?

A

Rickets

SCFE

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19
Q

Rickets

A

soft bones from inadequate calcium and vitamin D

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20
Q

SCFE

A
  • femoral head dislocates
  • cause unknown
  • early surgical intervention will decrease risk of long term deformity
  • sudden pain, unable to bear weight
  • ages 9-16, sedentary, overweight, African-American or Polynesian
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21
Q

Teaching Topics for parents of Children w/ Myelomeningocele

A
  • positioning
  • preventing infection
  • feeding
  • promoting urinary elimination through intermittent catheterization
  • preventing latex allergy
  • preventing s/s of complications
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22
Q

Interventions for Neurogenic Bladder

A
  • clean intermittent catheterization
  • meds such as oxybutynin chloride (Ditropan) to improve bladder capacity
  • prompt recognition and treatment of infection
  • surgical interventions
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23
Q

Lab Tests for Myelomeningocele

A

MRI
CT
Ultrasound
Myelography

24
Q

Lab Tests for Spinal Muscular Atrophy

A 
Creatinine kinase: elevated w/ muscular damage 
Genetic Testing
Muscle Biopsy 
Nerve Conduction Velocity test 
Electromyelogram
25
Structural Disorders
Spina bifida occulta Meningocele Myelomeningocele
26
Genetic Neuromuscular Disorders
Various types of muscular atrophy | Spinal muscular atrophy
27
Pectus Excavatum
- a depression in the chest that sinks inward - does NOT resolve as child grows - observation, PT, surgical correction before puberty
28
Polydactyly
extra digit on the hand or foot | -surgical removal
29
Syndactyly
webbing of the fingers and toes | -no treatment required but can be done for cosmetic reasons
30
Metatarsus Adductus
inward deviation of the forefoot w/ the hindfoot remaining normal position - common in utero position - most resolve w/o treatment - may need serial casting before 8 months
31
Congenital Clubfoot
- congenital anomaly - 1 of 1000 births - foot resembles golf clubs - more males - starts as soon after birth as possible
32
What is typically done for Clubfoot?
weekly manipulation and serial casting q 2 weeks shoes and braces surgery
33
Osteogenesis Imperfecta
- genetic bone disorder - low bone mass - increased fragility - connective tissue problems - joint hypermotility - fractures - tooth enamels wear easily and brittle; discoloration - blue/gray sclera
34
Developmental Hip Dysplasia
femoral head has an abnormal relationship to acetabulum - frank dislocation can occur - females - Pavlik harness
35
Torticollis
painless muscular condition in infants and children w/ certain syndromes
36
What may cause congenital torticollis?
From position in utero
37
What can be done for torticollis?
stretching exercises | surgery in preschool years
38
Pectus Excavatum
a depression in the chest that sinks inward | -does not resolve as child grows
39
What can be done for pectus excavatum?
- observations - PT - surgical correction before puberty
40
Muscular Dystrophy
a group of inherited conditions that result in progressive muscle weakness and wasting
41
What may be the causes of muscular dystrophy?
x-linked autosomal dominant recessive
42
What is the most common neuromuscular disorder of childhood?
Duchenne Muscular Dystrophy
43
Duchenne Muscular Dystrophy is usually fatal by what age?
20-25 years old
44
What is the hallmark finding of Duchenne Muscular Dystrophy?
presence of Gowers Sign
45
Nursing Management Goals for a Child w/ Duchenne Muscular dystrophy
- Promoting mobility - maintaining cardiopulmonary function - preventing complications and maximizing quality of life
46
How to promote mobility for DMD?
- administering corticosteroids and calcium supplements | - perform passive stretching and strengthening exercises
47
How to help maintain cardiopulmonary function for DMD?
- teach deep breathing exercises | - performing chest physical therapy
48
How to help prevent complications and maximize quality of life for DMD?
- developing a diversional schedule | - provide emotional support
49
Spinal Muscular Atrophy
genetic motor neuron disease that affects the spinal nerves ability to communicate w/ muscles -autosomal recessive mechanism
50
Death usually occurs at what age for Spinal Muscular Atrophy?
2
51
Legg-Calve Perthes
avascular necrosis of the femoral head - painless limp which may be intermittent for months - mild hip pain or referred knee pain
52
When does Legg-Calve Perthes usually occur?
4-8 years old | More often males
53
Transient Synovitis of Hip
hip pain limping | -self limiting, resolves w/in week but may last 4 weeks
54
When does transient synovitis of hip occur?
3-8 years old
55
Scoliosis
curvature of the spine
56
Signs and Symptoms of Spinal Cord Injury
- inability to move or feel extremities - numbness - tingling - weakness
57
Teaching Topics to Prevent Spinal Cord Injury
- vehicular safety - seat belts/age appropriate seats - sports safety - prevention of falls - violence prevention - water safety

Pediatrics (24 decks)

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