Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine II: Orthopedics > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Intrauterine crowding and positioning may contribute to:

A

Torticollis, Club Feet, Intoeing and Developmental Dysplasia of Hip (DDH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Developmental Dysplasia of Hip (DDH)

A

A spectrum of disorders describing abnormal development resulting in dysplasia and possible subluxation of dislocation of the hip. The femoral head is pulled up and makes it’s own pseudo-joint.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Barlow Maneuver:

A

apply posterior pressure onto hip while holding at knee (so you are pushing from the front), bring leg into adduction, hip subluxes out of acetabulum with posterior pressure and adduction (clunk): “out to the bar- barlow pushes it out”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ortolani Maneuver:

A

apply pressure to the posterior acetabulum (you are pushing from the back), hip is reduced back into acetabulum over neolimbus during abduction (clunk): “order in- ortalani pushes it in”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Galeazzi Test:

A

supine, hips flexed, knees bent, affected leg’s knee appears lower

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment for Developmental Dysplasia of Hip (DDH)

A

1st line tx: Pavlik harness: pushes hip back in socket. Operative if too severe of harness fails to help.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Risk Factors for Developmental Dysplasia of Hip (DDH)

A

First-born Females (4-5X MC), breech delivery (Funky), Firstborn infants, oligohydraminos, FHx DDH, limited Fetal mobility (limited hip abduction). THE FIVE F’s!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Special Tests for Developmental Dysplasia of Hip (DDH)

A

Barlow Maneuver, Ortolani Maneuver, and the Galeazzi Test.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Imaging for Extra for Developmental Dysplasia of Hip (DDH)

A

Radiographs are not generally useful prior to the ossification of the femoral head (between 4-6 mo). US can be helpful!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Congenital Torticollis

A

unilateral SCM contraction that causes ipsilateral head tilt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Risk Factors for Congenital Torticollis

A

Primiparous mother, heavy male baby in breech position, multiple birth, maternal uterine abnormalities, male gender

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment for Congenital Torticollis

A

PT (stretch the muscle- can take as long as 6-8mo), surgery or botox inj into SCM to relax it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Congenital Torticollis associated disorders

A

DDH, Metarsus Adductus, Traumatic Delivery, Plagiocephally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Acquired Scoliosis

A

spinal curvature, cobb angle > 10 degrees, not only C shaped curve, also has twisting.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Risk Factors for `Scoliosis

A

Adolescents, F>M, rapidly progresses during rapid growth, ask girls if they have gotten their period- chance of progression during growth period before period (can help before).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment of Scoliosis

A

Observation, Bracing (16-23hrs) for those with growth potential and curve magnitude 20-45 degrees. Spinal fusion if curve >45 degrees. Curvature remains fairly stable after skeletal maturity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Diagnosing Scoliosis

A

Testing: diff height shoulders, protruding shoulder blade, diff length arm, protruding side of back when bending over. Measure COBB angle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

COBB angle:

A

Identify upper and lower end vertebrae, draw lines extending along vertebral borders, measure cobb Angle directly or geometrically.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which type of curve is most common for Scoliosis?

A

Rightward thoracic curves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Genu Varum

A

Physiologic Bowing, bowing for first two years it is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Risks for Genu Varum

A

Early walkers, overweight children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Diagnosing Genu Varum

A

Differentiate btwn Blount’s dz (proximal tibia physis abnormality, stops growing on medial side), ricketts, skeletal dysplasias.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Genu Varum in adolescents over 10

A

Less severe, unilateral, usually due to obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Genu Valgum

A

(knock-knees); 5-7 degrees of valgus is normal in adults & children older than 6-7yrs age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Complication of Genu Valgum

A

May result in “miserable malalignment syndrome”: contributing to patellofemoral dysfunction.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment of Genu Valgum

A

Typically improves with growth, lateral aspect has most pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Goal for Genu Valgum

A

Goal is to differentiate between what it “normal” and what is pathological (Ricketts, tumors, skeletal dysplasia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Intoeing

A

The feet turn inward instead of pointing straight ahead. It is commonly referred to as being “pigeon-toed.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Causes of Intoe:

A
  1. Feet are turning in: metatarsus adductus (flat feet),
  2. Lower legs are turning in: tibial torsion,
  3. Hips/Thighs are turning in: femoral anteversion.
30
Q

Physical Exam for Intoeing

A

Examine by putting in prone position and bending at knee, the foot will twist in medially.

31
Q

Femoral anteversion

A

(hips/thighs turn in)- increased twist of prox femur (Results in “turning in” of femur, knee, and feet). Sit in a “w” position

32
Q

Treatment of Femoral anteversion

A

Typically improves with growth, best to examine extremities when young. No indication for special shoes, bracing, or PT

33
Q

Tibial Torsion

A

(lower legs turn in)- twisting in of tibia. Examine by putting in prone position and bending at knee, the foot will twist in medially.

34
Q

Treatment of Tibial Torsion

A

Typically improves with growth. No need for special shoes, bracing, or PT

35
Q

Foot Disorders

A

Metatarsus Adductus (flatfeet)- “C- Shaped foot” and Talipes equinovarus (Clubfoot)

36
Q

Metatarsus Adductus

A

(flatfeet)- “C- Shaped foot”. Medial deviation (adduction contractures of TMT joints, metatarsals are oriented medially).

37
Q

Treatment of Metatarsus Adductus

A

Flexible, mild metatarsus adductus, typically improves with growth. Rigid, severe metatarsus adductus may require casting.

38
Q

Talipes equinovarus

A

(Clubfoot), Occurs in 1:1000 births with a slight male predilection. Has some genetic component. Malalignment of: Talocalcaneal joint, Talonavicular joint, Calcaneocuboid joint

39
Q

Four components of Talipes aquinovarus:

A

CAVE

  1. Flexion of hind foot and ankle (Equinus deformity)- contracture of the Achilles.
  2. Inward turning of the heel (Varus deformity).
  3. Bean shape deformity of foot with curled outer border (Adductus deformity).
  4. High medial arch of forefoot (Cavus deformity)
40
Q

Treatment of Talipes equinovarus

A

Trt: manipulation: ponseti technique and serial casting, usually requires minor procedure (Achilles lengthening) at end of casting. Denis-browne splinting (at 9-10mo only wear it at night time)

41
Q

Septic Arthritis

A

Orthopaedic Emergency!! Bacterial/fungal infection w/in joint capsule.

42
Q

Most common causes of Septic Arthritis

A

MC bacteria: S. Aureus

Neonates- Group B Strep
1mo-3mo- S. aureus
3-13yrs- All above + H. influenza
Adolescent- S. aureus and N. gonorr.

43
Q

Patient presentation with Septic Arthritis

A

Red swollen joint which can’t bear weight, usually presenting sign (decreased ROM). Elevated WBC, ESR, CRP. Patient often has a Hx of a fever. Kocher Criteria!!!

44
Q

Most common joints affected with Septic Arthritis

A

Knee>Hip>Ankle>small joints

45
Q

Treatment of Septic Arthritis

A

Surgical drainage/irrigation, debridement, metaphyseal decompression + IV Abx until clinical response is observed.

46
Q

T/F: Septic Arthritis of the hip is the most common site of joint infection.

A

False, Second most common after the knee

47
Q

Nursemaid’s Elbow

A

Subluxation of radial head from annular ligament

48
Q

Cause of Nursemaid’s Elbow

A

Common when child’s arm is swung or pulled

49
Q

Patient presentation of Nursemaid’s Elbow

A

Decreased ROM of elbow and use of arm

50
Q

Imaging for Nursemaid’s Elbow

A

Radiographs are negative

51
Q

Treatment of Nursemaid’s Elbow

A

Reduction: Once tension is released, joint pops back into place- apply pressure on radial head and supinate wrist and you bring patient’s elbow into 90 degrees- pt will tell you it’s not as painful anymore

52
Q

Osgood Schlatter Disease

A

Type of juvenile traction osteochondritis: refers to partial avulsion of the tibial tuberosity (anterior surface of apophysis)

53
Q

Prevelence of Osgood Schlatter Disease

A

Usually occurs in late childhood or early adolescence, more common in boys, may represent an over use disease, condition occurs at a time when increasing demands are made on a still immature skeleton

54
Q

Cause of Osgood Schlatter Disease

A

Traction apophysitis at distal attachment of patella on tibial tuberosity

55
Q

Patient Presentation with Osgood Schlatter Disease

A

Anterior knee pain at tibial tuberosity that is worse with activity, typically during rapid growth. Usually tender and swollen.

56
Q

Imaging for Osgood Schlatter Disease

A

X-rays: may see fragmentation on lateral view of tubercle where patellar tendon inserts or irregular ossification of tibial tuberosity.

57
Q

Diagnosis of Osgood Schlatter Disease

A

Clinical

58
Q

Treatment for Osgood Schlatter Disease

A

Rest, Ice, NSAIDS, quadriceps stretching. Usually self-limited, symptoms may improve with conservative measures, or until growth spurt is complete.

59
Q

Legg-Calve-Perthes

A

Idiopathic avascular necrosis of hip, a/w ADHD

60
Q

Common incidences of Legg-Calve-Perthes

A

5-7 yo, M:F 4:1

61
Q

Patient Presentation of Legg-Calve-Perthes

A

Limp of insidious onset, Hip pain referred to anteromedial thigh or knee. Limited internal rotation and abduction of hip. Trendlenberg Gait. Limb length inequality.

62
Q

Imaging for Legg-Calve-Perthes

A

Fragmentation and necrosis of femoral head seen on X-rays

63
Q

Prognosis for Legg-Calve-Perthes

A

Prognosis related to age of onset (younger = better)

64
Q

Treatment for Legg-Calve-Perthes

A

Treatment centers around PT, Surgery sometimes necessary in older kids

65
Q

Indications for a worse prognosis for Legg-Calve-Perthes

A

Prognosis is worse with bone age over 8, loss of ROM, Female sex, Loss of femoral head spericity.

66
Q

SCFE- Slipped Capital Femoral Epiphysis

A

Disorder of the proximal femoral physis that allows for translation of the metaphysis. One of the most common hip disorders of adolescents.

67
Q

Patient Presentation with SCFE- Slipped Capital Femoral Epiphysis

A

Nonradiating, dull, aching pain in hip, groin, thigh, or knee, increased with activity (chronic or intermittent). No hx trauma.

ROM decreased with internal rotation, abduction, flexion. Thigh held in flexion, abduction, external rotation (FABER position). Limp, impaired internal rotation of hip.

68
Q

Risk Factors for SCFE- Slipped Capital Femoral Epiphysis

A

Obesity, renal failure, hypothyroidism, GH deficiency, Down syndrome, male

69
Q

Special Tests for SCFE- Slipped Capital Femoral Epiphysis

A

Klein’s line- draw a line parallel to the femoral neck and tangential to sup cortex of femoral neck, should pass through part of the femoral head.

70
Q

Treatment of SCFE- Slipped Capital Femoral Epiphysis

A

URGENT: refer to ortho, NON-WEIGHT BEARING IMMEDIATELY, Surgical Tx

71
Q

Cause of SCFE- Slipped Capital Femoral Epiphysis

A

Capital femoral epiphysis displaced from femoral neck through physeal plate. Femoral epiphysis slips posteriorly “ice cream falls off ice cream cone”

Medicine II: Orthopedics (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions