Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BRS Year 2 > orthopaediatrics > Flashcards

orthopaediatrics Flashcards

1
Q

child vs adult bones

A 
Child's has 270 bones - in continuous change
Physis (growth plates)
Elasticity greater
Speed of healing faster
Remodelling always
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

development of flat bones

A

intramembranous ossification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

development of long bones

A

endochondral ossification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

intramembranous ossification

A

formation of ossification centre - condensation of mesenchymal cells to osteoblasts
secreted osteoid traps osteoblasts – osteocytes
trabecular matrix and periosteum form
compact bone develops superficially, crowded blood vessels become red bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ossificaiton centres

A

primary ossification centres - pre-natal bone growth through endochondral oss from central part of bone
secondary ossification centres - post-natal after primary ossification centres, forms the physis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what ossification centre is there pre-natally

A

primary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

endochondral primary ossification

A

mesenchymal differentiation creates a cartilage model in diaphysis
angiogenesis penetrates, primary centre forms and spongy bone
continues up the shaft, cartilage and chondrocytes form bone ends.
secondary ossification centres form at bone ends now

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

endochondral secondary ossification

A

centre calcifies and dies to immature spongy bone
epiphyseal side contains active hyaline cartilage which continues dividing to form hyaline cartilage matrix (epiphyseal growth plate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What happens if the physis are faulty

A

Any congenital malfunction or acquired insult – traumatic/infective or otherwise will have impact on growth of the child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

why are childrens bones more elastic

A

increased density of haversian canals (need blood supply for growing tissue)
dissipation of energy means it can bend more before breaking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

importance of childrens bone elasticity

A

plastic deformations - bends before breaking
buckle fractures - pushes outwards like roman column
greenstick fractures - one cortex fractures but other side doesnt break

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when does bone growth stop

A

when physis closes - puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is physis closure dependent on

A

parental height
menarche
puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when are boys and girls’ physis closed

A

boys - 18/19

girls - 15/16

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is a physeal injury

A

salter harris

may lead to growth arrest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

remodelling potential of children

A

greater the younger they are

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

common congenital ortho conditions

A

developmental dysplasia of the hip
club foot
achondroplasia
osteogenesis imperfecta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is developmental dysplasia of the hip

A

head of femur unstable or incongruous with acetabulum

may result in subluxation - hip popping in and out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

risk factors for developmental dysplasia of hip

A

female
first born
breech
family history

20
Q

examination for DDH

A

baby check - hip RoM

21
Q

investigation for DDH

A

ultrasound - measure acetabular dysplasia and hip position

22
Q

treatment of DDH

A

if reducible - pavlik harness

if failed/irreducible - MUA+closed reduction and spica

23
Q

what is club foot

A

congenital deformity of foot
CAVE - cavus, adductus foot, varus, equinous
familial disorder

24
Q

what does CAVE mean in relation to club foot

A

Cavus - high foot arch
Adductus of foot - tight tib post and ant
Varus - tight tendoachilles, tib post tib ant
Equinous - tight tendoachilles

25
Q

treatment of club foot

A

ponseti method - casts, operation (soft tissue release), brace, may need additional operations

26
Q

what is achondroplasia

A

skeletal dysplasia - normal trunk, femur smaller than tibia and humerus smaller than forearm
G380 mutation of FGFR3

27
Q

pathophysiology of achondroplasia

A

inhibition of chrondrocyte proliferation in proliferative zone of physis
results in defect in endochondral bone formation

28
Q

what is osteogenesis imperfecta

A

hereditary autosomal D/R
decreased type I collagen - decreased secretion and production of abnormal
leads to insufficient osteoid production

29
Q

problems caused by osteogenesis imperfecta

A 
fragility fractures
short stature
scoliosis
blue sclera
brown, soft teeth
30
Q

classification of salter harris fractures

A 
SALT
Separation
through then up Above physis
through then goes Lower physis
Through epiphysis (vertically)
crush injury
31
Q

what type of salter harris fracture has greatest risk of growth arrest

A

type 5 - crush injury

32
Q

how is growth arrest affected by the fracture

A

whole physis - complete arrest

partial physis - angulation

33
Q

principles of treatment of salter harris fractures

A

correct deformity - minimise angular deformity and limb length difference

34
Q

limb length corretcing

A

shorten long side

lengthen short side - plates

35
Q

angular deformity correction

A

stop growth of affected side

reform bone - osteotomy

36
Q

closed reduction for paediatric fracture

A

gallows traction for long bones

correction for deformity

37
Q

4 rs of paediatric fractures

A

resuscitate
reduce
restrict
rehabilitate

38
Q

restriction for paediatric fractures

A

plasters and splints most common

operative internal avoided but titanium nails more elastic so best for growing bones

39
Q

rehabilitation techniques for children

A

play

use it move it strengthen it

40
Q

differential Dx for limping child

A

septic arthritis
transient synovitis
perthes
slipped upper femoral epiphysis

41
Q

septic arthritis in children kochers classification

A

non-weight bearing
ESR over 40
WBC over 12,000
temp over 38

42
Q

when can transient synovitis be diagnosed in children

A

after exclusion of septic arthritis

43
Q

perthes disease

A

idiopathic necrosis of proximal femoral epiphysis

boys 4-8 more likely

44
Q

SUFE usual presentation

A

obese adolescent males
12-13 yo
associated with hypothyroid/pituitarism

45
Q

treatment for SUFE

A

operative fixation with screw to prevent further slip and minimise long term growth problems

46
Q

what is transient synovitis

A

inflamed joint in repsonse to a systemic illness

treated by antibiotics

BRS Year 2 (67 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions