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PHTH 531 > Pediatric MSK conditions > Flashcards

Pediatric MSK conditions Flashcards

1
Q

Brachial plexus injury is usually due to traction on ______ during breech delivery of forceful traction and rotation of _____ during difficult delivery

A

shoulder; head

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2
Q

What is the most common brachial plexus injury?

A

Erb’s palsy

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3
Q

What nerve roots are involved in Erb’s palsy?

A

C5-C6

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4
Q

What position is the arm in Erbs palsy?

A 
Waiter's tip - 
Shoulder - extension, internal rotation, adduction
Elbow - extension
Forearm - pronated
Wrist and fingers - flexed
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5
Q

Grasp is (lost/intact) in Erb’s palsy

A

intact

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6
Q

Is there sensory loss in Erb’s palsy?

A

YES

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7
Q

Klumpke’s palsy = injury to the ____ _____

A

lower plexus (C7-T1)

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8
Q

What are 3 major impairments in Erb’s palsy?

A
  1. paralysis or weakness
  2. muscle imbalances
  3. learned non-use - delay in motor milestones
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9
Q

____ encompasses a spectrum of pathologic hip disorders in which hips are unstable, sublimated or dislocated, and/or have malformed actabla

A

DDH

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10
Q

Normal development of the femoral head and acetabulum are _________

A

co-dependent

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11
Q

The head must be stable in the hip socket for both to form _______ and _______

A

spherically; concentrically

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12
Q

What are 2 large risk factors for developing DDH?

A
  1. breech position

2. + family history

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13
Q

DDH is clinically ______ in infancy/early childhood

A

silent

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14
Q

There is poor prognosis of DDH if unstable and morphologically abnormal by __-__ years of age

A

2-3

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15
Q

What are 4 tests to do in the screening exam for DDH?

A
  1. LLD
  2. asymmetric thigh or gluteal folds
  3. limited or asymmetrical hip abduction
  4. Barlow/Ortolani
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16
Q

In the Ortolani maneuver, a subluxed or dislocated femoral head is reduced into the acetabulum with gentle hip ________ by the examiner

A

abduction

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17
Q

In the Barlow maneuver, a reduced femoral head is gently _______ until it becomes sublimated or dislocated

A

adducted

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18
Q

The _______ maneuver is a test of laxity or instability

A

barlow

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19
Q

What is the most important clinical test for detecting newborn dysplasia ?

A

Ortolani

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20
Q

3 management strategies of DDH?

A
  1. observation
  2. bracing
  3. Sx
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21
Q

6 long term implications of DDH?

A
  1. degenerative arthritis
  2. LLD
  3. limited hip abduction
  4. pain and disability
  5. premature hip replacement
  6. avascular necrosis
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22
Q

_______ ______ = congenital disorder of collagen synthesis

A

osteogenesis imperfecta

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23
Q

OI effects all _______ tissue

A

connective

24
Q

What are 6 effects of OI?

A
  1. OP
  2. excessive fractures
  3. bowling of long bones
  4. spinal deformities
  5. muscle weakness
  6. ligamentous laxity
25
Q

2 management strategies for OI?

A
  1. bisphosphonates

2. orthopaedics

26
Q

PT management of OI?

A

function and participation!!!

27
Q

At what age should you start to worry about toe walking?

A

if it persists past the age of 3

28
Q

What are 2 differential diagnosis’s for ITW?

A
  1. autism spectrum disorder

2. CP

29
Q

Are males or females more likely to be ITW?

A

males

30
Q

There is a ___ association between ITW and language delays, learning impairments and prematurity

A

+++

31
Q

3 symptoms aside from toe walking in ITW?

A
  1. pain in legs
  2. frequent tripping / falling
  3. ankle injuries
32
Q

4 treatments for ITW management?

A
  1. casts/braces
  2. PT
  3. botox-A
  4. surgery
33
Q

PT algorithm for ITW?

A
  1. stretching
  2. strengthening
  3. manual therapy
  4. balance/coordination exercises
  5. gait training
34
Q

_____ disease = avascular necrosis of the femoral head due to loss of blood supply

A

legg calve perthes disease (LCP)

35
Q

What are 5 possible causes of LCP disease ?

A
  1. trauma
  2. transient synovitis
  3. infection
  4. congenital or developmental vascular irregularities
  5. thrombotic vascular insults
36
Q

Most common onset of LCP disease is ____ ages __-__ years

A

boys; 5-7

37
Q

4 stages of LCP disease?

A
  1. condensation
  2. fragmentation
  3. reossification
  4. remodelling
38
Q

______ = femoral head slips or is displaced from normal alignment on femoral neck

A

slipped capital femoral epiphysis (SCFE)

39
Q

SCFE is often associated with onset of ______

A

puberty

40
Q

5 clinical presentations of SCFE?

A
  1. pain in groin, medial thigh or knee
  2. limp
  3. ER of leg
  4. limited hip ROM
  5. inability to WB due to severe pain
41
Q

Management of SCFE?

A
  1. surgery; stabilize growth plate with a pin fixation
  2. bedrest
  3. casting
  4. PT
42
Q

Ogood-Schlatter disease (OSD) = ______ injury

A

overuse

43
Q

OSD = _______ of tibial tubercle

A

apophysitis

44
Q

OSD is common in boys ages __-__ years old and girls ages __-___ years old

A

10-15; 8-13

45
Q

OSD management?

A
  1. ice
  2. rest
  3. stretch
  4. strengthen
46
Q

Osteochondritis dissecans (OCD) = ______ lesion, distal femur most common

A

osteochondral

47
Q

Ages of OCD?

A

13-17

48
Q

Clinical presentation of OCD?

A
  1. generalized pain which increases with activity
  2. increase in pain with rotational movements
  3. swelling
  4. instability
  5. locking
49
Q

_____ disease = localized disorder of bone remodelling

A

pagets

50
Q

__-__ % of Paget’s disease is asymptomatic

A

70-90

51
Q

______ disease normally involves multiple bones, especially axial skeleton

A

pagets

52
Q

There is a very strong _____ link with pagets disease

A

familial

53
Q

_____ = hormonal disorder that develops when your pituitary gland produces too much growth hormone during adulthood

A

acromegaly

54
Q

_____ is characterized by short stature

A

dwarfism

55
Q

Most common type of drawfism?

A

achondroplasia

56
Q

What are the 2 types of dwarfism?

A
  1. disproportionate

2. proportionate

57
Q

5 clinical presentations of LCP’s disease?

A
  1. limp
  2. pain
  3. +ve trendelenberg
  4. decreased ROM
  5. muscle spasm (++ abd and IR, flexion contracture)

PHTH 531 (5 decks)

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