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Pediatric PT Exam 1 > Pediatric Orthopedics Part 2 > Flashcards

Pediatric Orthopedics Part 2 Flashcards

1
Q

Scoliosis: What are the three types?

A

Infantile
Juvenile
Adolescent

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2
Q

Scoliosis: Infantile: Is what ages?

What curve is most common?

Common in what gender?

_____% resolve spontaneously

A

Less than 3 years old

Left thoracic

M>F

80-90%

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3
Q

Scoliosis: Juvenile: What are the ages?

What curve is most common?

Common in what gender?

A

3 years-puberty

R thoracic

M=F

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4
Q

Scoliosis: Adolescent: When does this occur?

Common in what gender, what is the ratio?

Greater than _____ degrees, had what ratio?

What gender progresses more?

A

AT or AROUND puberty

F:M, 3.6 : 1

20 degrees, 6.4 : 1

Females progress more

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5
Q

Scoliosis: A progressive curve have an increase of ___ degrees or more on ___ exams

A

5 degrees

2 exams

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6
Q

Scoliosis: When looking at progressive curves, what else is important?

A

Age - Younger

Double curves

Before menarche

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7
Q

What are the 8 things that are looked at in scoliosis screening?

A
  1. Unequal shoulder level
  2. Scapular prominence
  3. Universe waist lines/hip prominence
  4. Pelvic asymmetry
  5. Unequal distance btw arms and body
  6. Unequal knee level
  7. Forward bend test — rib hump
  8. Sideways- lordosis or kyphosis
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8
Q

Scoliosis: Management:

At what degrees is bracing required?

A

Greater than 25 degrees

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9
Q

Scoliosis: Management: At what degrees in surgery required?

A

Greater than 40 degrees

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10
Q

Scoliosis: Management: What are three parts of exercise that need to be worked on?

A

Strength
Flexibility
Respiratory

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11
Q

Scoliosis: Management: What needs to be strengthened?

A

Trunk and hip extensors

Abdominal

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12
Q

Scoliosis: Management: What needs flexibility?

A

Lateral flexion, trunk shifts

Shoulder retraction (pecs)

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13
Q

Scoliosis: A curve that is greater than 40 degrees is also called ________

A

Malignant

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14
Q

Scoliosis: TLSO: Compresses the ____ ____

A

Rib cage

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15
Q

Scoliosis: There is a compliance issue with ______ and ______

A

Bracing

Exercises

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16
Q

Hemophilia: What kind of disorder is this?

A

Bleeding/clotting

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17
Q

Hemophilia: What are the impairments that are present?

A

PAIN

Decreased range and strength secondary to joint and intramuscular bleeding

Peripheral nerve lesions

Gait changes

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18
Q

Hemophilia: _______ joints most common

A

Hinge

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19
Q

Hemophilia: ________ arthritis

A

Chronic

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20
Q

Hemophilia: If you exercise, you will probably get a ________

A

Microtear

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21
Q

Hemophilia: What two joints are most common to get bleeds?

A

Elbow and knee

No bulk, so you will bleed

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22
Q

Management for Hemophilia: What 4 things can you do?

A

Range/mobilization
Splinting
Strengthening
Gait training

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23
Q

Management for Hemophilia: What are 3 types of splinting?

A

Dynamic: slowly progress

Serial casting

Protective - D/C when strength is in good range

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24
Q

Management for Hemophilia: For strengthening, what should you avoid?

A

Slow speed isokinetics

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25
Q

Management for Hemophilia: Less than ___% need WCs

A

10%

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26
Q

Management for Hemophilia: If a patient is not motivated to walk, you should make them ___ independent

A

W/C

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27
Q

Management for Hemophilia: Need to have taken their __________

A

FACTOR

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28
Q

Management for Hemophilia: For serial casting, what is the process?

A

Cast, pull off, cast w/ new range

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29
Q

Management for Hemophilia: Must teach them to use ______ instead of joint

A

Muscles

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30
Q

JRA/JIA: What does this stand for?

A

Juvenile idiopathic arthritis

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31
Q

JRA/JIA: The more joints that are affected, the ______

A

Worse

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32
Q

JRA/JIA: How do you diagnose?
Before age _____ and persists greater than ___ weeks
Must ____ _____ other causes

A

16, 6 weeks

RULE OUT

33
Q

JRA/JIA: Look for pain in this joint to rule it out…

A

HIP

34
Q

JRA/JIA: What are the 4 impairments you would see?

A

Pain

Joint deformity/destruction

Weakness secondary to pain and immobility

Gait changes (shuts off muscles around joint)

35
Q

JRA/JIA: What are the functional limitations?

A

Gait/mobility

ADLs: MCPs will ulnar drift

36
Q

JRA/JIA Management: If joint is hot, no ______

A

PROM

37
Q

JRA/JIA Management: What should be done?

A

Range
Strengthening
Protection joint alignment

Theraband
Hydrotherapy
Bike riding

38
Q

JRA/JIA Management: With range, no long _____ ____, risk for _______ subluxation

A

Lever arms
AA

can have slippage of C1 on C2

39
Q

What is osteogenesis imperfecta (OI)?

A

Brittle bone disease

Fracture at a high rate

40
Q

OI: Some patients that have this may be more ______ and others will be ______

Some are ______ because high number of ______

A

Mild

Ambulators

Lethal

Fractures

41
Q

OI: What will you see at the eye?

A

Blue sclera

42
Q

OI: What will you see at the teeth?

A

Dental issues

43
Q

OI: Must do a screening for OI before accusing the parent of _____

A

Abuse

44
Q

OI: Pathology:
Decreased type ___ collagen
Profuse _________/multiple ________
____ joints/weak ________

A

I
Osteoporosis, fractures
Lax, muscles

45
Q

OI: Impairments:
Decreased _______
Skeletal ________
Decreased _______ secondary to _________

A

Range
Deformity
Strength, immobilization

46
Q

OI: What are some functional limitations?

A

Delayed development

Mobility

47
Q

OI: Never do ______, will fracture

A

PROM

48
Q

OI: Make sure that they do not _____, because they will drop, and then _______

A

Fatigue

Fracture

49
Q

X-ray: as they grow, the rods will get ______

A

Longer

50
Q

OI: Rods go across _____ ______ and shut off _____ ______

A

Growth plates

Growth plates

51
Q

OI: As the child hits maturity, things get less severe; it doesn’t go away, but _____ _____ goes down

A

Fracture rate

52
Q

Management for OI:

What 5 things can you do?

A 
Active range only
Strengthening
Orthotics
Parent training
Surgery - intramedullary rods
53
Q

Management for OI: For active range, you should do _______ range only

A

Functional

54
Q

Management for OI: For strengthening, you do it through _______ not resistance

Avoid ______

A

ACTIVITY

Fatigue

55
Q

Management of OI: What kind of orthotic would you use?

A

Clam shell

56
Q

What is arthrogryposis congenita?

A

Joint stiffening

57
Q

Arthrogryposis congenita: In type A
Hip:
Knee:
Feet:

Shoulder:
Elbow:
Wrist:

A

Hip: flexion
Knee: extension
Feet: club feet

Shoulder: IR
Elbow: Flexion
Wrist: Flexion, and ulnar deviation

58
Q

Arthrogryposis congenita: In type B
Hip:
Knee:
Feet:

Shoulder:
Elbow:
Wrist:

A

Hip: Abduction, ER
Knee: Flexion
Feet: Club feet

Shoulder: IR
Elbow: Extension
Wrist: Flexion, ulnar deviation

59
Q

Arthrogyposis congenita: In type A, what will they have a problem with?

A

No lower body hygiene

60
Q

Arthrogryposis congenita: In type B, what problem will they have?

A

Cannot feed

61
Q

Arthrogryposis congenita:
Lack of _____ ______ - in the ___ trimester
Muscle is normal at first, then replaced by _____ and _____ ______

A

Fetal movement

1st

Fibrosis

Fatty tissue

62
Q

Arthrogryposis congenita: What are the impairments? (3)

A

Severe joint contractures

Muscle weakness and fibrosis

Muscle imbalance

63
Q

Arthrogryposis congenita: When you have severe joint contractures, you must _______ them

A

STRETCH

64
Q

Arthrogryposis congenita: Muscle weakness —> will tear in what are?

A

Fibrotic

65
Q

Arthrogryposis congenita: Management: includes what 5 things

A
  1. Stretching
  2. Strengthening
  3. Positioning
  4. Foot orthotics (due to recurring Clubfoot)
  5. Surgery
66
Q

Arthrogryposis congenita: For surgery, it is timed __________

_______ can be performed, in which they break the bone and return it it more appropriate position. Usually done to UE so they can get alignment and more functional

A

Developmentally

Osteotomies

67
Q

PFFD stands for what?

A

Proximal femoral focal deficiency

68
Q

PPFD: 85% are ____, ___% are _____

A

U/L

B/L

69
Q

PFFD: There are ___ classes

A

4

70
Q

PFFD: Class A is defined as what?

A

Short femoral segment

71
Q

PFFD: Class D is defined as what?

A

Short femoral segment plus absent fem. head and acetabulum

72
Q

PFFD: Shorted thigh held in ____, _____, and ____

A

Flexion
Abduction
ER

(Frog leg)

73
Q

PPFD: What two joints have a contracture?

A

Hip and knee

74
Q

PPFD: Severe ____ _____ _________

A

Leg length discrepancy

75
Q

PPFD: What can be done about this condition?

A

Leg lengthening

Amputation

Rotationplasty

76
Q

PPFD: Femur did not form _________

A

Properly

77
Q

PFFD: Should not have pain during your interventions!!! Because you need to gain _____ 1st

A

TRUST

78
Q

PPFD: What is the procedure of a rotationplasty?

What other condition can it be done for?

What muscle becomes the knee extensor, what muscle becomes the knee flexor?

A

Heel of foot becomes front of knee. It is a functional amputation

Knee cancer

Gastroc

Tib ant

79
Q

Signs of discomfort during range (nonverbal children):
Breathing is ________
Negative _________
Changes in _____ expressions (may look ____, _______, ______)
______ in extremities
______/trying to get away

A

Noisy

Vocalizations

Facial (sad, frightened, frowning)

Tension

Fidgeting

Pediatric PT Exam 1 (14 decks)

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