Ortho/neuros

Question 1

When can infant roll prone to supine

Answer 1

4 months

Question 2

When can infant sit using tripod position

Answer 2

6 months

Question 3

When do infants begin creeping

Answer 3

9 months

9 rhymes with mine - creeps be thinking, “you’re mine”

Question 4

When do infants stand without support momentarily

Answer 4

12 months (cut off for when typically pathological 18 months)

Question 5

Polydactyly v. syndactyly

Answer 5

Too many fingers toes

Some of them are fused

Question 6

True or false; newborns under 2 months typically have “twitching” movements - normal variant

Answer 6

false; movements should always be symmetric with no twitching (newborns will naturally have flexed position though)

Question 7

What is the “Gower sign” What is it suggestive of?

Answer 7

Child rises from sitting by placing hands on legs and pushing way up (crawl up their legs)

Muscular dystrophy

Question 8

Early signs of muscular dystrophy

Answer 8

clumsiness
difficulty climbing stairs
frequent falls

Question 9

Muscle atrophy & progressive weakness
pseudohypertrophy from fatty infiltration
Gower sign

Answer 9

muscular dystrophy

Question 10

Barlow’s and Ortolani’s test are both looking for what?

Answer 10

Hip dysplasia (not as reliable >3 months as muscles and ligaments strengthen)

Question 11

3 causes of hip dysplasia

Answer 11

Acetabular dysplasia (delayed ossification of acetabulum)

Subluxation

Dislocation

Question 12

Of the 3 causes of hip dysplasia - which is the only one to cause loss of contact of femoral head with acetabular capsule

Answer 12

dislocation

Question 13

What is Allis sign looking for?

Answer 13

DDx hip dislocation v. shortened femur

A positive would be one knee appearing lower than the other

Question 14

What is the Barlow maneuver? How is it different than Ortolani (considering they’re both looking for same thing)

Answer 14

Barlow you ADduct thigh and press down

Ortolani you ABduct thigh

Both are positive if feel “palpable clunk”

Question 15

True or false; hip dysplasia is MC in females

Answer 15

true - commonly associated with intrauterine constraint (breech)

Question 16

What is MC brachial plexus injury due to birth trauma

Answer 16

Erb’s palsy (C5/C6) - large infant/shoulder dystocia

Causes paralyzed arm “waiter’s tip” sign

Question 17

True or false; an infant with erb’s palsy (C5/C6) will have absent Moro, biceps, radial, and grasp reflexes

Answer 17

false; all are absent EXCEPT grasp

Question 18

What is one of the MC missed findings on infants (hint due to birth trauma)

Answer 18

Fractured clavicle (eventually lump or callus forms)

Question 19

True or false; common for infants to present with pes planus, metatarsus adductus or tibial torsion

Answer 19

true

Question 20

True or false; pes planus (flat feet) is normal until 3 years of age when longitudinal arch should form

Answer 20

true

Question 21

What is the MC congenital foot deformity

Answer 21

Metatarsus adductus (forefoot adduction)

Question 22

True or false; metatarsus adductus can be seen on plain film

Answer 22

true tarsometatarsal joints angled medial

Question 23

What is tibial torsion - what is it caused by

Answer 23

slight varus curvature of the tibia

Related to fetal positioning

Expected to resolved afters months/years of weight bearing

Question 24

How do you asses for tibial torsion

Answer 24

Lay patient prone, flex knee, one thumb on lateral malleolous, other thumb on lateral knee - if thumbs don’t line up = + test

Question 25

What seated position is related to femoral anteversion?

Answer 25

Reverse tailor position

Sitting knees forward feet pointed posterior and lateral to body

Question 26

What gender is MC for femoral anteversion? What is happening to the femur to cause it?

Answer 26

Females

femurs is twisted medially (patella faces inward)

Question 27

True or false; genu varum is common in toddlers up to 18 months

Answer 27

true

should be investigated further if asymmetry between the tibiofemoral angles or space between knees >1.5 inches

Question 28

When is genu valgum common?

Answer 28

2-4 years

investigate further if asymmetry between tibiofemoral angle or space between ankles >2 inches

Question 29

When can infant raise head (prone)

Answer 29

2 months