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PEDIATRIC BRS > ortho > Flashcards

ortho Flashcards

1
Q

this is the most common cause of a painful limp in TODDLERS

A

transient synovitis

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2
Q

this is idiopathic avascular necrosis of the femoral head

A

Legg-Calve- Perthes disease

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3
Q

Legg - Calve - Perthes disease pain occurs on internal or external rotation?

A

Internal

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4
Q

what is the hallmark sign on radiograph of legg calve perches disease?

A

Crescent sign

” AP and frog leg lateral radiograph show an increased density int he affected femoral head or a crescentic subchondral fracture int he femoral head”

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5
Q

what is the management for legg calve parties disease?

A

physical therapy and restriction of excursive

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6
Q

the typical patient for this is an OBESE ADOLESCENT BOY

A

slipped capital femoral epiphysis

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7
Q

endocrine disorder related to SCFE

A

obese adolescent boy

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8
Q

true or false a klein line crosses the epiphysis in a SCFE?

A

false, it does NOT cross the epiphysis at all

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9
Q

name 4 complications of SCFE

A
  1. avascular necrosis of the femoral head
  2. chondrolysis
  3. Limb length discrepancy
  4. Osteoarthritis
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10
Q

this is an infection of the bone

A

osteomyelitis

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11
Q

pathogen for osteomyelitis w/ sickle cell?

A

salmonella

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12
Q

what are the lab studies for osteomyelitis?

A

elevated WBC

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13
Q

MRI/BONE SCAN/ PLAIN RADIOGRAPH to diagnose osteomyelitis?

A

MRI/BONESCAN

  • not plain radiograph because it is not a good initial study
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14
Q

what 2 things may cause chronic osteomyelitis

A

sequestrum and involucrum

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15
Q

metatarsus adductes causes ?

A

intoning of the foot

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16
Q

how can you distinguish clubfoot w/ intoe?

A

clubfoot cannot dorsiflex

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17
Q

what is the management of a intoefoot that can overcorrect?

A

observation

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18
Q

what is the management of intoe foot that cannot over correct but is flexible?

A

stretching excersizes

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19
Q

what is the management of stiff foot that cannot be straightened?

A

refer to pediatric orthopedic specialist

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20
Q

talipes equinovarus AKA?

A

club foot

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21
Q

management of club foot?

A

casting and then surgical correction

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22
Q

this form of intoe is caused by utero position?

A

internal tibial torsion

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23
Q

what is the management for internal tibial torsion?

A

observation only

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24
Q

what is the difference in incidence age of internal tibial torsion and femoral ante version?

A

femoral anteversion >2 years

internal tibial torsion

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25
Q

if a child prefers to sit in a W position vs. a cross legged position what may he have?

A

femoral anteversion

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26
Q

clinical presentation of calcaneovalgus foot

A

foot is excessively dorsiflexed

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27
Q

ghetto walk of african american boys? Lateral thrust with gait?

A

Blount’s disease

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28
Q

etiology of blunts disease?

A

overload injury to the medial tibial growth plate causing inhibited growth only on the medial side

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29
Q

when should blounts disease be considered in a child ?

A

anyone with leg bowing after 2 years old

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30
Q

this is inflammation or micro fracture of the tibial tuberosity caused by overuse injury?

A

osgood shatter disease

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31
Q

true or false, radiographs diagnose osgood shatter disease?

A

FALSE - too small to be seen

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32
Q

lateral position of the patella causing knee pain in girls

A

patellofemoral syndrome ( patellar chondromalacia)

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33
Q

what is the timing of growing pains?

A

bilateral leg pain occurring in LATE AFTERNOON OR EVENING ( DONT INTERFERE W/ PLAY )

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34
Q

open vs closed fracture?

A

closed- skin intact

open - skin broken (need antibiotics)

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35
Q

A. nondisplaced
B. displaced
C. Angulated
D. Overriding

fracture ends that are shifted

A

B. Displaced

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36
Q

A. nondisplaced
B. displaced
C. Angulated
D. Overriding

Fracture ends that are well approximated

A

A. Non displaced

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37
Q

A. nondisplaced
B. displaced
C. Angulated
D. Overriding

fracture ends that override w/out cortical contact

A

D. Override

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38
Q

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

Occur w/ twisting injuries common in child abuse

A

E. Spiral

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39
Q

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

horizontal fracture

A

c. transverse

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40
Q

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

buckle fracture occurring under a compressive force in the metaphysis?

41
Q

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

incomplete fracture where one side side of cortex is fractured and the other side is intact causing angulation. may require fracturing the other side to minimize angulation

A

b. greenstick

42
Q

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

type of fracture w/ many pieces?

A

f. comminuted

43
Q

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

diagonal fracture across a bone

44
Q

the salter harris classification system describes what?

A

fractures involving the growth plate

45
Q

bone growth is affected in all grade ____ -_____ fractures?

A 
grade IV (through and through)
grade V ( Crush )
46
Q

SALTR stands for?

A

SAME, ABOVE, LOW, THROUGH, cRUSH

47
Q

FOOSH fracture?

A

supracondlar

48
Q

why is supracondylar fracture an orthopedic emergency?

A

when it is DISPLACED or ANGULATED because risk of neuromuscular injury and compartment syndrome

49
Q

how can you detect neuromuscular injury and compartment syndrome in Supracondylar fracture?

A

assess pulse, sensation and movement of fingers + passive extension

50
Q

posterior fat gap sign shows what?

A

supracondylar fraacture

51
Q

what do you never do in a supracondylar fracture?

A

never passively move the arm

52
Q

this is a fracture to the distal radius

A

Colles fracture

53
Q

fracture to the proximal ulna w/ dislocation of the radial head

A

monteggia fracture

54
Q

fracture of the radius w/ distal radioulnar joint dislocation

A

galeazzi fracture

55
Q

this is a ‘ tollders fracture’ which occurs after a very mild or no identified trauma

A

spiral fracture of the tibia

56
Q

upper brachial plexus injury involving c5 and c6 roots

A

erb’s palsy

57
Q

erbs palsy position?

A

waiters tip

extended pronated and flexed fingers

58
Q

involves c7 and c6 nerve roots?

A

klumpke palsys

59
Q

klumpke palsy position?

A

claw hand, decreased ability to extend elbow and flex wrist

60
Q

what may be present in klumpke’s palsy?

A

horners syndrome (ptosis, miosis and anhydrosis)

61
Q

this is a subluxation of the radial head that occurs when pulling the toddler upward?

A

nursemaid’s elbow

62
Q

what is the most common shoulder dislocation?

63
Q

true or false, recurrence is common with anterior shoulder dislocation?

64
Q

defined as tilting of the head to one side?

A

torticollis

65
Q

management of cervical torticollis?

A

stretching excersizes, if not helmet therapy by 4-6 months of age

66
Q

what are complications of torticollis?

A

skull deformity and facial asymmtery (plagiocephaly)

67
Q

altantoaxial instability is seen most w/ what anomaly?

A

down syndrome

68
Q

if there is severe instability in the AA joint what is management?

A

c1 and c2 fusion

69
Q

this is a failure of normal vertebral segmentation that results in relative fusion of the involved vertebrae?

A

klippel feil syndrome

70
Q

klippel fiel syndrome is also related to what?

A

torticollis, genitourinary, hearing loss and sprengels deformity ?

71
Q

what is sprengels deformity?

A

abnormality of the scapula where scapula is rotated laterally leading to shoulder asymmetry and diminished shoulder motion

72
Q

how is the cobb angle measured?

A

line along the most angulated vertebra on either end of the curve

73
Q

when does progression of scoliosis occur?

A

only during growth or if spinal curvature is greater than 50 %

74
Q

so if a woman has had her period for 6 months and has scoliosis does it need to be managed?

A

no because all growth in females ceases between 6 months of menarche

75
Q

this degree of scoliosis only requires observation

A

10-20 degrees

76
Q

this degree of scoliosis requires bracing?

A

20-40 degrees

77
Q

this degree of scoliosis requires surgery if still growing?

78
Q

what degree of scoliosis causes respiratory and CV compromise?

79
Q

backpain, urinary incontinence, and palpable step off in the limbo sacral area are a result of?

A

spondylolithesis

80
Q

how can you distinguish between ankylosing spondylitis and spondylolithesis?

A

spondylolithesis will have a neurologic component

81
Q

this is a infection caused by staph aureus of the intervertebral disk?

82
Q

what is treatment of a herniated disk in an adolescent?

A

bed rest unless abnormal neurologic examination

83
Q

flat acetabulum and breech position cause?

A

developmental dysplasia of the hip

84
Q

this maneuver attempts to dislocate a hip by pushing posterior and laterally?

A

barlow maneuver

85
Q

this maneuver attempts to reduce a hip by pushing upward and medial

A

ortolani maneuver

86
Q

how can you diagnose DDH in older infants?

A

assymmetric buttock folds

87
Q

what is used to diagnose DDH in infants 4-6 months of age?

A

ULTRASOUND

88
Q

if someone greater than 6 months is suspected of DDH, what do you order?

A

AP RADIOGRAPH

89
Q

this holds the head of the femur against the acetabulum to stimulation formation of the normal cup shape of the acetabulum used in ages 2-3 months if dx by 6 months?

A

pavlik harness

90
Q

if diagnosis is made beyond 6 weeks of age what is indicated in DDH?

91
Q

what is most commonly affected in younger children w/ septic arthritis?

92
Q

what is most commonly affected in older children w/ septic arthritis?

93
Q

how is the hip held in septic arthritis?

A

flexion/abduction and external rotation

94
Q

how are lab studies in septic arthritis?

A

elevated white blood cell count, elevated ESR and elevated CRP

95
Q

what is the best imaging used for septic arthritis?

A

ultrasound

96
Q

what should you do before ultrasound for septic arthritis?

A

synovial fluid aspiration

97
Q

what is the management for septic arthritis?

A
  1. surgical decompression

2. empiric antibiotics covering gram positive organisms

98
Q

what usually processed transient synovitis?

A

URI and Diarrhea

99
Q

what is the treatment for transient synovitis?

A

nsaids, bed rest and observation

PEDIATRIC BRS (9 decks)

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