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OB/PEDS Unit II > Pediatrics musculoskeletal exam > Flashcards

Pediatrics musculoskeletal exam Flashcards

1
Q

during what months can a baby raise head

A

2 months

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2
Q

during what months can a baby roll from prone to supine

A

4 months

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3
Q

during what months will a baby sit using tripod position

A

6 months

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4
Q

during what months does a child begin creeping

A

9 months

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5
Q

during what months should a child stand without support momentarily

A

12 months

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6
Q

a child in extension prone on the floor that keeps its hands from touching the ground may have

A

neurological problems

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7
Q

what is the cutoff for walking?

A

18months

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8
Q

when talking about sequence of motor development what is the most important

A

that babies hit their milestones in order! no skipping

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9
Q

a healthy newborn will exibit some resistance to what position

A

full extension

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10
Q

how do you get a newborns fingers open

A

stimulate the ulnar aspect of their hand and they will open their hands.

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11
Q

you bring a babies arm across their chest in the front to touch the other shoulder what is it called and why do you use it

A

scarf test,

looking for normal flexion/ muscle tone.

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12
Q

holds arms in flexion, for five seconds, suddenly extend them and release them they will come back in flexion what test is this, what is it testing for

A

arm recoil test, normal flexion tone

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13
Q

a single crease extending across the entire palm

A

simian crease, down syndrome

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14
Q

in what position should you inspect the spine of a toddler

A

standing

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15
Q

posture and movement of a toddler should be symmetric, what shouldn’t you see

A

twitching

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16
Q

child rises from a sitting position by placing hands on the legs and pushing the trunk up. Crawl up their legs

A

Gower sign, muscular dystrophy

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17
Q

why may muscular dystrophy effected children look like they are strong even when they have muscle atrophy?

A

the patient will have fatty infiltrates that make the child appear stronger, pseudohypertrophy due to fatty infiltrates

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18
Q

should the child be undressed during inspection?

A

yes, unless they are of age then use a gown

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19
Q

what are the evaluateions for developmental hip dysplasia

A
  1. asymmetrical thigh and buttocks skin folds or creases
  2. decreased hip abduction > 3 mohts - most reliable sign
  3. allis’ test
  4. ortolani’s
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20
Q

what are the three grades of developmental hip dysplaisa

A
  1. acetabular displaisa
  2. subluxation
  3. dislocation
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21
Q

is plain film good for an infant under 6 months?

A

no, ultrasound

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22
Q

what is best used to catch subtle signs of hip dislocation

A

ultrasound

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23
Q

who should you check for hip dysplasia

A

every pediatric under 1 year old, developmental hip dysplasia.

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24
Q

hip symmetry and no symmetric fat folds or deeper on one side are signs of ?

A

congenital hip dysplasia

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25
Q

when a hip dislocates what length change happens

A

leg become shorter.

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26
Q

what type of abduction is sign of hip dysplasia

A

decreased hip abduction

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27
Q

this test tests for leg length inequality only, not dislocation

A

allis sign

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28
Q

what is the most reliable sign of hip dysplasia in a child under 3 months old and why

A

decreased hip abduction

after 3 months child becomes so strong you can get false negatives

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29
Q

what means a positive test for hip dislocation, click or clunk

A

clunk. clicks are normal

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30
Q

Test one hip at a time, stabilizing the pelvis with the other hand  Infant supine, doctor at infant’s feet  Flex the hips & knees to 90 degrees
 Grasp the leg with your thumb on the inside of the thigh, the base of the thumb on the knee, and your fingers gripping the outer thigh with your fingertips resting on the greater trochanter  Adduct the thigh and gently apply downward pressure on the femur

A

Barlows maneuver,

31
Q

patient supine you bring the knees in and push the femur down and out to test for subluxation/ dislocation

A

Barlow’s test

32
Q

slowly abduct ddthe thigh while maintaining axial pressure
fingertips on the greater trochanter, exert a lever movement in the oppsoite direction
If there is a palpable clunk. femur head slipped into the acetabulum,

A

ortolani maneuver

33
Q

what is the gender bias for developmental hip dysplasia

A

females

34
Q

name of the brace used to help developmental dysplasia

A

pavlik harness, greater success less than 6 months old

35
Q

how do you test for muscle strength in an infant

A

hold them under the axilla, if they maintain position good, if they slip through your hands weak.

36
Q

Erb’s Palsy effects what nerve roots

A

C5 C6

37
Q

what is the most common brachial plexus injury

A

Erb’s Palsy

38
Q

what reflex remains in the effected arm of erb’s palsy

A

grasp reflex

39
Q

how far apart should the shoulder scapulae be

A

3-5 inches

40
Q

c shape of a babies foot

A

metatarsus adductus

41
Q

longitudinal arch is o scured by a fat pad until when

A

about 3 years

42
Q

forefoot adduction

A

metatarsus adductus

43
Q

what is the most common congenital foot deformity

A

metatarsus adductus

44
Q

a line through the midline of the foot may bisect what

A

the 3rd and 4th toes

45
Q

when does tibial torsion tend to resolve

A

months to years of weight bearing

46
Q

how do you access for tibial torsion

A

child prone
flex knees 90 degrees
align the midline of the foot parallel to the femur
using the thumb and index finger, grasp the medial and lateral maleoli
place other thumb and index finger on either side of the kn ee
if your thumbs are not parallel to each other. tibial torsion

47
Q

slight varus curvature of the tibia related to fetal positioning expected to resolve after months or years of weight bearing

A

tibial torsion

48
Q

position that places stress on joints related to in-toeing and femoral anteversion

A

reverse tailor position

49
Q

increased internal rotation of the hip >70 degrees and decreased external hip rotation

A

femoral anteversion

50
Q

what is the gender bias for femoral anteversion

A

females

51
Q

femoral anteversion is associated with what type of sitting

A

reverse tailor sitting

52
Q

what is the grading for genu varum?

A

bring ankles together, if greater than 1 inch gap between the knees then genu varum.

53
Q

what is genu varum normal

A

until 18 months of age.

54
Q

how to tell from genu valgum

A

place knees together and check for greater than 1 inch between feet

55
Q

when is genu valgum normal

A

2-4 yoa

56
Q

congenital defect of the ankle and foot
inversion of the foot
plantar flexion, contracted triceps surae

A

talipes Equinovarus

57
Q

what is the gender bias for talipes equinovarus

A

males 2/1 females

58
Q

is there a congenital risk with talipes equinovarus?

A

`yes 10%

59
Q

bilateral involvement of what percentage of cases of talipes equinovarus

A

30-50%

60
Q

what is the name of the treatment of talipes equinovarus

A

ponseti method

61
Q

what is the ponseti method

A

for treateing talipes equinovarus, usually 4-6 full leg cast and adjustments and surgery

62
Q

exaggerated dorsiflexion allows dorsum of the foot to come into contact with anterior aspect of lower leg

A

talipes calcaneovalgus

63
Q

does talipes calcaneovalgus require surgery

A

no

64
Q

what happens with most talipes calcaneovalgus’s

A

they resolve on their own

65
Q

what usually causes talipes calcaneovalgus

A

uterine position

66
Q

avascular necrosis of the femoral head

A

legg-calve-perthes

67
Q

legg -calve-perthes is MC in what gender and what age

A

boys 2-10

68
Q

capital femoral epiphysis slips over the neck of the femur

A

SCFE

69
Q

what is the gender bias and age range for a SCFE

A

girls 8-16

70
Q

presents with knee pain and a limp
commonly obese, taller than most
leg weakness and reduced internal hip rotation

A

SCFE

71
Q

where does knee pain come from with SCFE,

A

referred from hip

72
Q

traction apophysitis

develops in assocation with inflammationof the anterior patellar tendon self limiting

A

osgood-Schlatter

73
Q

what is the gender bias and age range for osgood schlatter

A

MC in boys 9-15 yoa

OB/PEDS Unit II (8 decks)

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