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NPTE MS > Pediatric orthopedic conditions > Flashcards

Pediatric orthopedic conditions Flashcards

1
Q

Torsional conditions - toeing in/out - foot progression angle is the angle made by the foot with respect to

A

a straight line plotted in the direction the child is walking

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2
Q

Torsional conditions - toeing in/out - foot progression angle can be normal in children with combined torsional deformity - (+) sign denotes? (-) sign denotes

A

+ sign denotes out toeing angle

- sign denotes in toeing angle

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3
Q

Torsional conditions - toeing in/out - thigh foot angle is the angle between

A

axis of foot and axis of thigh measured with child prone and knees at 90
The angle describes the degrees of tibial torsion

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4
Q

Torsional conditions - toeing in/out - toeing in (pigeon toed) is common in

A

W sitting and is caused by three types of deformities

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5
Q

Torsional conditions - toeing in/out - toeing in is caused by what 3 types of defomities

A

metatarsus adductus
internal tibial torsion
increased femoral anteversion

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6
Q

Torsional conditions - toeing in/out - most common congenital foot deformity

A

metatarsus adductus

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7
Q

Torsional conditions - toeing in/out - matatarsus adductus greater occurance in

A

females on left side

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8
Q

Torsional conditions - toeing in/out - most common cause for metatarsus adductus

A

intrauterine packing

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9
Q

Torsional conditions - toeing in/out - metatarsus adductus - types

A

Rigid

Flexible

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10
Q

Torsional conditions - toeing in/out - metatarsus adductus - Rigid form results in

A

medial subluxation of tarsometatarsal joints

Hindfoot slightly in valgus with navicular lateral to head of talus

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11
Q

Torsional conditions - toeing in/out - matatarsus adductus - flexible form is observed as

A

adduction of all five metatarsals at the tarsometatarsal joints

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12
Q

Torsional conditions - toeing in/out - metatarsus adductus - flexible form treatment

A

85-90% identified at birth will resolve without treatment in 1 year

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13
Q

Torsional conditions - toeing in/out - most common cause of toeing in

A

internal tibial torsion

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14
Q

Torsional conditions - toeing in/out - increased femoral anteversion

A

Normal is 10-15 degrees

Considered excessive if angle is greater than 25-30 degrees

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15
Q

Torsional conditions - toeing in/out - toeing out is how common? can be caused by what?

A

less common

can be caused by femoral retroversion, external tibial torsion, flat feet

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16
Q

Torsional conditions - toeing in/out - toeing out - retroversion defined as

A

less than 10 degrees

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17
Q

Talipes equinovarus (clubfoot) - etiology

A

postural from intrauterine malposition

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18
Q

Talipes equinovarus (clubfoot) - observation

A

PF, adducted, and inverted foot

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19
Q

Talipes equinovarus is defined as

A

PF at talocrural joint
Inversion at subtalar, talocalcaneal, talonavicular, and calcaneocuboid joints
Supination at midtarsal joints

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20
Q

Angular conditions - genu valgum

A

excessive lateral tibial torsion, referred to as knock knees
Excessive lateral patellar positioning

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21
Q

Angular conditions - genu varum

A

excessive medial tibial torsion

referred to as bowlegs

22
Q

Genu varum is normal in

A

newborns and infants

23
Q

Maximal varum occurs at what age

A

6 to 12 months

24
Q

Lower limbs straighten with a zero tibiofemoral angle by what age

A

18 to 24 months

25
Q

Knees gradually drift into valgus and is max at what age

A

3 to 4 years with avg lateral tibiofemoral angle of 12

26
Q

Genu valgum corrects by age

A

7 to adult alignment

8 in females and 7 in males

27
Q

Hip dysplagia - who is at higher risk

A 
females
breeched position
family hx 
low levels of amniotic fluid 
swaddling infant too tightly
28
Q

Hip dysplagia - gold standard tx

A

Pavlik harness - 95% success in those under 6 months

29
Q

Transient synovitis in children - etiology

A

acute onset of sudden hip pain in children ages 3 to 10

Transient inflammation of synovium of the hip

30
Q

Transient synovitis in children - s/s

A 
unilateral hip or groin pain
less common medial thigh or knee pain
crying at night
antalgic limp
pain not common
recent hx of upper resp. infection
31
Q

Leg Calve Perthes disease - etiology

A

blood supply interrupted to femoral head
onset age 2 to 13 years
4x greater incidence in boys

32
Q

Leg Calve Perthes disease - clinical s/s

A

Psoatic lump from weakness of psoas mm - moves in ER, flex, add
gradual onset of aching pain at hip, thigh, and knee
AROm limited in abd and ext

33
Q

Slipped capital femoral epiphysis - etiology

A

most common hip disorder observed in adolescents of unknown etiology

34
Q

Slipped capital femoral epiphysis - what is it

A

femoral head is displaced post and inf in relation to femoral neck and within confines of acetabulum

35
Q

Slipped capital femoral epiphysis - onset in males is? females?

A

Males 10-17 yrs with avg being 13
Females 8-15 yrs with avg 11
2x greater incidence in males

36
Q

Slipped capital femoral epiphysis - dx based on clinical exam

A

AROM restricted in abd, flex, IR
Pt describes pain as vague at knee, thigh, hip
Chronic - might see trendelenburg gait

37
Q

Tendon lengthening conditions - osgood schlatter disease - etiology

A

mechanical dysfunction resulting in traction apophysitis of tibial tubercle ate the patellar tendon insertion

38
Q

Tendon lengthening conditions - Sever’s disease (calcaneal apophysis) - etiology

A

most common cause of heel pain in growing children - occurs before or during peak growth spurt
Caused by repetitive microtrauma due to inc traction by achilles tendon at insertion

39
Q

Tendon lengthening conditions - sinding larsen johannsons disease - etiology

A

traction apophysitis at patella-patellar tendon junction, overuse from repeated stresses, can occur after significant growth spurt and/or increase in activity

40
Q

Growing pains - etiology

A

unknown but could be due to muscular fatigue, poor posture, stress

41
Q

Growing pains - effects what ages

A

most likley between 3 to 5 and 8 to 11

42
Q

Osteochondritis dissecans - etiology

A

adolescents between ages of 12 and 15 yrs
Most common cause is a separation of articular cartilage from underlying bone
Osteochondral bone fragment becomes detached and forms loose body in joint

43
Q

Panners disease - etiology

A

localized avascular necrosis of capitelum leading to loss of subchondral bone with fissuring and softening of articular surfaces of radiocapitellar joint
Unknown etiology - usually ages 10 or younger

44
Q

Scoliosis - treatment

A

conservative if less than 25 degrees
bracing if between 25 and 45
surgery if over 45 degrees

45
Q

Ped planus (flat foot) - normal in who

A

infant and toddler feet and develop around 2 to 3 years

46
Q

Congenital muscular torticollis - observation

A

side bending toward and rotation away from affected SCM

47
Q

Spasmodic torticollis - is what

A

movement disorder with CNS pathology

48
Q

Plagiocephaly (flat head syndrome) - etiology

A

flat spot on back or side of head as skull is soft and malleable
No lasting harmful effects on infant

49
Q

Arthrogryposis multiplex congenita - etiology

A

congenital deformity of skeleton and soft tissues characterized by limitation in joint motion and sausage like appearance of limbs
Nonpregressive contractures
Intelligence develops normally

50
Q

Osetogenesis imperfecta - etiology

A

inherited transmitted by autosomal dominant gene
Characterized by abnormal collagen synthesis leading to imbalance between boen deposition and reabsoroprtion
Leads to fractures and deformity of WB bones

51
Q

Spondylolistheiss - etiology

A

congenitally defective pars interartciularis
lysis - fracture
listhesis - anterior slippage

52
Q

Spondylolisthesis - grades

A

graded from grade 1 (25% slippage) to a grade 4 (100% slippage)

NPTE MS (29 decks)

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