Pediatrics musculoskeletal exam

Question 1

during what months can a baby raise head

Answer 1

2 months

Question 2

during what months can a baby roll from prone to supine

Answer 2

4 months

Question 3

during what months will a baby sit using tripod position

Answer 3

6 months

Question 4

during what months does a child begin creeping

Answer 4

9 months

Question 5

during what months should a child stand without support momentarily

Answer 5

12 months

Question 6

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

Answer 6

neurological problems

Question 7

what is the cutoff for walking?

Answer 7

18months

Question 8

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

Answer 8

that babies hit their milestones in order! no skipping

Question 9

a healthy newborn will exibit some resistance to what position

Answer 9

full extension

Question 10

how do you get a newborns fingers open

Answer 10

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

Question 11

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

Answer 11

scarf test,

looking for normal flexion/ muscle tone.

Question 12

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

Answer 12

arm recoil test, normal flexion tone

Question 13

a single crease extending across the entire palm

Answer 13

simian crease, down syndrome

Question 14

in what position should you inspect the spine of a toddler

Answer 14

standing

Question 15

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

Answer 15

twitching

Question 16

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

Answer 16

Gower sign, muscular dystrophy

Question 17

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

Answer 17

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

Question 18

should the child be undressed during inspection?

Answer 18

yes, unless they are of age then use a gown

Question 19

what are the evaluateions for developmental hip dysplasia

Answer 19

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

Question 20

what are the three grades of developmental hip dysplaisa

Answer 20

1. acetabular displaisa
2. subluxation
3. dislocation

Question 21

is plain film good for an infant under 6 months?

Answer 21

no, ultrasound

Question 22

what is best used to catch subtle signs of hip dislocation

Answer 22

ultrasound

Question 23

who should you check for hip dysplasia

Answer 23

every pediatric under 1 year old, developmental hip dysplasia.

Question 24

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

Answer 24

congenital hip dysplasia

Question 25

when a hip dislocates what length change happens

Answer 25

leg become shorter.

Question 26

what type of abduction is sign of hip dysplasia

Answer 26

decreased hip abduction

Question 27

this test tests for leg length inequality only, not dislocation

Answer 27

allis sign

Question 28

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

Answer 28

decreased hip abduction | after 3 months child becomes so strong you can get false negatives

Question 29

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

Answer 29

clunk. clicks are normal

Question 30

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

Answer 30

Barlows maneuver,

Question 31

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

Answer 31

Barlow's test

Question 32

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,

Answer 32

ortolani maneuver

Question 33

what is the gender bias for developmental hip dysplasia

Answer 33

females

Question 34

name of the brace used to help developmental dysplasia

Answer 34

pavlik harness, greater success less than 6 months old

Question 35

how do you test for muscle strength in an infant

Answer 35

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

Question 36

Erb's Palsy effects what nerve roots

Answer 36

C5 C6

Question 37

what is the most common brachial plexus injury

Answer 37

Erb's Palsy

Question 38

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

Answer 38

grasp reflex

Question 39

how far apart should the shoulder scapulae be

Answer 39

3-5 inches

Question 40

c shape of a babies foot

Answer 40

metatarsus adductus

Question 41

longitudinal arch is o scured by a fat pad until when

Answer 41

about 3 years

Question 42

forefoot adduction

Answer 42

metatarsus adductus

Question 43

what is the most common congenital foot deformity

Answer 43

metatarsus adductus

Question 44

a line through the midline of the foot may bisect what

Answer 44

the 3rd and 4th toes

Question 45

when does tibial torsion tend to resolve

Answer 45

months to years of weight bearing

Question 46

how do you access for tibial torsion

Answer 46

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

Question 47

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

Answer 47

tibial torsion

Question 48

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

Answer 48

reverse tailor position

Question 49

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

Answer 49

femoral anteversion

Question 50

what is the gender bias for femoral anteversion

Answer 50

females

Question 51

femoral anteversion is associated with what type of sitting

Answer 51

reverse tailor sitting

Question 52

what is the grading for genu varum?

Answer 52

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

Question 53

what is genu varum normal

Answer 53

until 18 months of age.

Question 54

how to tell from genu valgum

Answer 54

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

Question 55

when is genu valgum normal

Answer 55

2-4 yoa

Question 56

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

Answer 56

talipes Equinovarus

Question 57

what is the gender bias for talipes equinovarus

Answer 57

males 2/1 females

Question 58

is there a congenital risk with talipes equinovarus?

Answer 58

`yes 10%

Question 59

bilateral involvement of what percentage of cases of talipes equinovarus

Answer 59

30-50%

Question 60

what is the name of the treatment of talipes equinovarus

Answer 60

ponseti method

Question 61

what is the ponseti method

Answer 61

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

Question 62

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

Answer 62

talipes calcaneovalgus

Question 63

does talipes calcaneovalgus require surgery

Answer 63

no

Question 64

what happens with most talipes calcaneovalgus's

Answer 64

they resolve on their own

Question 65

what usually causes talipes calcaneovalgus

Answer 65

uterine position

Question 66

avascular necrosis of the femoral head

Answer 66

legg-calve-perthes

Question 67

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

Answer 67

boys 2-10

Question 68

capital femoral epiphysis slips over the neck of the femur

Answer 68

SCFE

Question 69

what is the gender bias and age range for a SCFE

Answer 69

girls 8-16

Question 70

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

Answer 70

SCFE

Question 71

where does knee pain come from with SCFE,

Answer 71

referred from hip

Question 72

traction apophysitis | develops in assocation with inflammationof the anterior patellar tendon self limiting

Answer 72

osgood-Schlatter

Question 73

what is the gender bias and age range for osgood schlatter

Answer 73

MC in boys 9-15 yoa