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Pediatrics > Orthopedics > Flashcards

Orthopedics Flashcards

1
Q

Scoliosis is a spinal deformity in which there is a lateral curvature and rotation of the verebrae in the spine greater than (?) degrees?

A

7

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2
Q

What is the most common type of scoliosis?

A

Adolescent idiopathic

onset is 10 years and older

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3
Q

When does congenital scoliosis begin?

A

During fetal development

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4
Q

When does infantile scoliosis begin?

A

Before the age of 3

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5
Q

What are important facts regarding adolescent idiopathic scoliosis?

(3)

A
  1. Possible genetic link
  2. More common in girls
  3. Most common type of scoliosis
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6
Q

Which curve progresses more single or double?

scoliosis

A

double

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7
Q

Which gender is more at risk for further curve progression?

scoliosis

A

Females

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8
Q

What are the common symptoms (6) associated with scoliosis?

A
  1. Head not centered over body
  2. One shoulder higher
  3. One shoulder-blade higher and possibly more prominent
  4. Spine obviously curved
  5. Unequal gaps between the arms and the trunk
  6. One hip more prominent (may cause one leg to appear longer)
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9
Q

When are females screened for scoliosis?
how about males?

A
  • Females 10 and 12
  • Males 13 or 14

Females get screened TWICE.

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10
Q

During which events in Tanner stages are adolescents most at risk for curve progression?

A

Peak heigh velocity
(Stage 2 to 3 for females; 3 to 5 for males)

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11
Q

What are the two screening tools for scoliosis

Not-Diagnostic

A
  1. Adams bend forward test
  2. Scoliometer
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12
Q

How is Adams bend forward test conducted?

A
  • Bend forward at waist until spine becomes parallel to the floor
  • hold palms together with arms extended.
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13
Q

What does the Cobb angle determine?

A

The magnitude of the curve

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14
Q

Which brace is no longer used due to it not preventing curve progression

A

Spine-Core

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15
Q

What are the benefits of the RSC brace?

A
  1. Helps with lateral AND rotation associated w/ scoliosis.
  2. Decreases curve progression w/ chroth method (physical therapy).
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16
Q

Where does the Cobb angle measure from?

A

An angle is formed from the superior and inferior vertebrae.

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17
Q

What does the Risser scale evaluate?

A

Evaluates skeletal maturity on radiographs between 0 to 5.

0 is youngest, lots of room for growth.

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18
Q

When is bracing indicated?
When is surgery indicated?

Scoliosis

A
  • Bracing > 30° or curve which increased from 10° → 25°
  • Surgery > 45°
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19
Q

What is the goal of bracing?

Scoliosis

A

prevent curve progression or until curve progression can’t be controlled

allows skeletal growth and maturity

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20
Q

What is the goal (4) of surgery?

Scoliosis

A
  1. Arresting progression
  2. Permanent correction
  3. Improve appearance
  4. Reduce short & long term complications
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21
Q

What is the length of treatment for bracing?

Scoliosis

A

Until growth has stopped

(skeletal maturity achieved)

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22
Q

What is the most common type of clubfoot?

A

congenital (idiopathic) clubfoot

Talipes Equinovarus

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23
Q

Which gender is more likely to develop clubfoot?

A

Boys are twice as likely

24
Q

Clubfoots involves (?) deformities and malposition with (?) contractures

A
  • Bone
  • soft tissue
25
Q

Which is the most severe form of clubfoot?

A

Syndromic clubfoot

26
Q

Which type of clubfoot occurs primarily due to intrauterine crowding?

A

positional clubfoot

27
Q

Which type of clubfoot does not have an exact cause for it?

A

congenital (idiopathic) clubfoot

Talipes equinovarus (TEV)

28
Q

How often does bilateral clubfoot occur?

How often are both feet affected?

A

50%

29
Q

What is the ponseti method?

A

The use of cast and braces to treat clubfoot.

Talipes equinovarus (TEV)

30
Q

Which type of clubfoot is associated with congenital abnormalities?

A

Syndromic (tetralogic)

31
Q

Which clubfoot is often associated with congential abnormalities

A

Syndromic clubfoot

32
Q

How often is serial casting changed?

Clubfoot

A
  • The cast is changed every few days for the first 1 to 2 weeks.
  • Then once every 1 to 2 weeks until maximum correction is achieved.
33
Q

Define

Sprain

A

severe trauma to a joint causing a ligament to be partially or completely torn.

34
Q

Define

Strain

A

injury to the muscle near the musculotendinous junction, as a result of a forceful contraction of the muscle.

35
Q

Define

Dislocation

A

displacement of bones that form a joint

36
Q

Define

Subluxation

A

partial or incomplete dislocation

37
Q

What location does a separation occur?

A

Epiphysis

end part of long bones

38
Q

What is the most commonly fractured bone in children?

A

clavicle

text says distal femur (radius/ulnar) too

39
Q

Why are toddlers more at risk for fracture compared to infants?

A

increased mobility and immature motor (coordination) and cognitive skills

40
Q

What causes stress fractures?

A

A tiny crack in a bone caused by overuse

41
Q

What are the symptoms of stress fractures?

A

chronic pain that is localized on a bone w/ focal tenderness.

42
Q

What is the recommended daily allownance for calcium in adolescence?

What does it reduce the risk of?

A

1500 mg/daily

Stress fractures

43
Q

What are the five stages of bone healing?

A
  1. Hematoma
  2. Cellular proliferation
  3. Callus formation
  4. Ossification
  5. Consolidation & remodeling
44
Q

What is the difference between closed (simple) and open reduction?

A

Closed reduction is when the bones are moved back into place w/o surgically exposing the bone.

45
Q

What are the five “P’s” of compartment syndrome

signs/symptoms

A
  1. Pain
  2. Pallor
  3. Pulselessness (or weak)
  4. Paresthesia
  5. Paralysis
46
Q

What causes compartment syndrome?

A

swelling caused by trauma and immobilizing device (e.g., casts)

compromises circulation to the muscles and nerves within the space

47
Q

Define

Exogenous osteomyelitis

A

infection of the bone caused by direct inoculation from outside the bone.

due to open wound

48
Q

Define

Hematogenous osteomyelitis

A

Infection of the bone causes by a pre-existing systemic infection

49
Q

What labs are elevated with osteomyelitis?

(3)

A
  1. **leukocytosis **
  2. increased erythrocyte sedimentation rate (Blood test that measures how quickly erythrocytes (RBC) settle at the bottom of a test tube that contains a blood sample.)
  3. Increased C-reactive protein.
50
Q

During which events in Tanner stages are adolescents most at risk for curve progression?

A

Peak height velocity
(Stage 2 to 3 for females; 3 to 5 for males)

51
Q

Which analgesics should be avoided post scoliosis surgery?

A

NSAIDS

can interfere w/ fusion of the rods and vertebrae.

52
Q

Which type of clubfoot is associated with congenital abnormalities?

A

Syndromic (tetralogic)

53
Q

What nutrition is recommended for osteomyelitis?

(3)

A

increase in protein, calcium, and iron

54
Q

What symptom would be atypical of adolescent scoliosis?

A
  • Pain and/or neurological changes (e.g., spinal column pain)
  • Bowel and bladder dysfuntion

(excludes musculoskeletal pain)

55
Q

What would you use to evalaute growth potential in a child with scholiosis?

(3)

A
  1. Tanner stages (peak height velocity)
  2. Risser scale (skeletal maturity)
  3. Sander’s Bone age (hand x-rays)
56
Q

Which type of injury is associated with joint laxity?

joint feels loose, hearing a pop, snap, or tear

A

Sprains

57
Q

What is the difference between acute and subacute hematogenous?

A
  • Acute hematogenous usually within the first few days of an infection (up to two weeks)
  • Subacute hematogenous occurring after 2 weeks of pre-existing infection

Pediatrics (10 decks)

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