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MSKJaz > Paed - pathology > Flashcards

Paed - pathology Flashcards

1
Q

talipes =

A

foot twisted

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2
Q

talipes equinus =

A

foot twisted in plantar flexion

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3
Q

talipes calcaneus =

A

foot twisted in dorsiflexion

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4
Q

foot twisted towards midline =

A

talipes varus

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5
Q

foot twisted away from midline

A

talipes valgus

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6
Q

physiological talipes aka

it is fully __

A

positional talipes

correctable

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7
Q

equinovarus =

A

clubfoot

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8
Q

Rx of equinovarus

A

ponseti cast (divide Achilles tendon) for 3 months boots and bar > boot at night for yrs

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9
Q

calcaneovalgus =

if uncorrectable may be due to

A

rockerbottom foot

congenital vertical talus

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10
Q

irreducible hip at birth is ___ not ___

A

teratogenic (not DDH)

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11
Q

irreducible hip at birth can be due to __/__

A

arthrogryposis (fixed contractures of joints ass with neuro deficit)
spina bifida

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12
Q

meningocele contains

A

CSF

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13
Q

form of spina bifida that is found in 10% of normal pop and of no clinical relevance

A

occulta

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14
Q

myelomeningocele contains

A

CSF and nerve roots

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15
Q

if myelomeningocele in spina bifida is above L1/2 =

A

in a wheelchair

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16
Q

if myelomeningocele in spina bifida is T12 and above =

A

numb from waist down , no hip movement

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17
Q

if myelomeningocele in spina bifida is L1 =

A

numb below waist and limited hip movement

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18
Q

if myelomeningocele in spina bifida is L2-3

A

numb from lower hip and weak hip muscles

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19
Q

if myelomeningocele in spina bifida is L4

A

numb below knee and weak leg muscles

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20
Q

if myelomeningocele in spina bifida is L5-S1

A

numb in buttock and feet

abnormal feet position

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21
Q

if myelomeningocele in spina bifida is S2-4

A

can walk without aids, need shoe inserts
numb buttocks
skin sensation may be affected

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22
Q

painful limb aka

minimise __ phase

A

antalgic gait

stance

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23
Q

lurch to one side to get foot clearance as abductors don’t lift pelvis =

A

trendelenberg gait

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24
Q

causes of trendelenberg gait

A 
weak abductors (polio, muscular dystrophies, Hip Sx, motor neuron)
defective fulcrum (congenital/pathological dislocation of hip)
defective lever (Perthes, coxa vara)
25
Q

assess a tight Achilles with ___ test =

A

Silverskold test

flex knee and relax gastroc = can get more dorsiflexion in this position

26
Q

neurological gait (spasticity) can be caused by

A

spina bifida, cerebral palsy, spinal cord/CNS pathology

muscular dystrophy

27
Q

loss of motor development, maintenance of primitive reflexes, selective motor control loss, weakness, balance mechanism injury and abnormal tone are all primary features of ___
may => ++_

A

Cerebral palsy

deformity, contractures and dislocations

28
Q

prenatal causes of Cerebral palsy

A

prem + low birth wt due to congenital brain malformation

intrauterine infection - TXMS, CMV

29
Q

perinatal causes of cerebra palsy

A

birth trauma/asphyxia

kernicterus - choreoathetosis

30
Q

postnatal causes of cerebral palsy

A

meningitis
NAI
cerebral haemorrhage

31
Q

CP with a flexed knee and upper limb + tip toe walk =

A

hemiplegia/unilateral

32
Q

CP with predom lower limb, femoral anteversion => intoe. Often hip and knee flexion contracture =

A

diplegia

33
Q

5 different neurological classes of CP

A 
spastic
athetoid
dystonic
rigid
mixed
34
Q

scale used to assess severity of CP

A

GMFCS levels 1-5

35
Q

orthopaedic problems seen in non-walking cerebral palsy ptnts

A

hip dislocation
pelvic obliquity
spinal deformity
perineal hygiene issues

36
Q

if in Thomas test lumbar lordosis is not obliterated =

A

hip flexion contracture

37
Q

orthopaedic problems seen in CP

A 
psoas and adductors (contractures)
hamstrings
gastrocsoleus
hip dislocation
pelvic obliquity
spinal deformity
38
Q

management of CP =

A

Sx for contractures
benzodiazepines and baclofen
selective dorsal rhizotomy
botox IM

39
Q

Hip problem common in pre/peri walker (0-18m)

A

Congenital dislocation of the hip

40
Q

hip problem common in 2-5yo

A

transient synovitis

41
Q

hip problem common in 5-10yo

A

Perthes

42
Q

hip problem common in 11-15yo

A

SUFE

43
Q

DDH aka

risks =

A

developmental dysplasia of the hip
breech birth
FH
more likely in F and 1st born

44
Q

instability tests for DDH =

unreliable after ___ old

A

Barlow
Ortolani
Gariatri
6wks

45
Q

instability test for DDH where you can dislocate/sublux the hip by flexion adduction

A

Barlow

46
Q

instability test for DDH where if you try to relocate dislocated hip by abduction you can feel a clunk at ring finger on the trochanter

A

Ortolani

47
Q

instability test for DDH where if you lie them on their back with hip 90 degrees flexed there is asymmetry

A

Gariatri

48
Q

imaging for DDH
indication =
time to do it =

A

> 3-6m = xray
<3m = US - lateral (spoon and teacup)
if FH/breech
in first4-6wk preferably

49
Q

treatment of DDH diagnosed early

A

relocate, splint in Pavlik harness (95% success) and monitor acetabular development

50
Q

Rx for DDH
>3m
>9m
>2yo

A 
3 = closed reduction
9 = open reduction
2 = femoral / pelvic osteotomy, preop gallows traction > plaster spica for 3 months - never get a normal hip
51
Q

idiopathic AVN of capital epiphysis of femur

A

Perthes

52
Q

Perthes:
age:
M:F usually __+__
present with __/__

A

4-8yo
M4:1F - small active
limp/pain

53
Q

Rx Perthes :

A

contain femur in acetabulum

rest brace and Sx to maintain hip abduction

54
Q 
SUFE aka
age
M:F
black:white
25-60% are \_\_\_
10-15% complain of only \_\_\_
A 
slipped upper femoral epiphysis
10-16yo
M2:1F
black 2 : 1 white
bilateral
knee/distal thigh pain
55
Q

Ix for SUFE

A

xray - AP (trethowans sign - line from femoral neck doesnt go through epiphysis) and lateral (imperative)
whole leg sticks out

56
Q

less than __ duration makes SUFE acute (any longer = chronic)

A

<3months

57
Q

3 characteristics used to classify SUFE

A

acute/chronic
magnitude of slip - mild, mod, severe
stability of slip - wt bear w/wo aids?

58
Q

adolescent with hip/groin, thigh or knee pain = __ until disproven = immediate ___

A

SUFE

xray

MSKJaz (28 decks)

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