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MSK Unit 2 > Pediatrics - Week 7 > Flashcards

Pediatrics - Week 7 Flashcards

1
Q

Developmental considerations

A
  • Structural and developments
  • Emotional/psychological
  • Cognitive
  • Communication
  • Motivation
  • Parent/care givers
  • Constantly changing
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2
Q

Adolescent growth spurt

A
  • Large changes in skeletal and muscle mass
  • Trunk > extremities
  • Muscles’ spurt 3 months after bone
  • Bone demineralization prior to spurt
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3
Q

Endochondrial ossification

A

How bone develops - where cartilage is being replaced by ossified bone tissue

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4
Q

Physis, epiphyseal plate cartilage

A

Growth plate

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5
Q

Diaphysis

A

Shaft, primary ossification center

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6
Q

Epiphysis

A

The ends, secondary ossification center

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7
Q

Metaphysis

A

In between the epi- and dia - physes, part of growth plate (more central side)

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8
Q

Apophysis

A

Secondary ossification center
Growth plate attachment of a muscle

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9
Q

Why are adolescence at an inherent risk for overuse injuries?

A

Because of the point they’re at with skeletal maturity

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10
Q

What factors interact with each other to produce an overuse injury?

A

Adolescent growth spurt
Growth related disorders
Repeated microtrauma

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11
Q

Overuse injury

A
  • Repetitive submaximal loading of the MS system; stress injuries
  • Rest is not adequate to follow for structural adaptation to take place
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12
Q

Overuse injury sites

A
  • Muscle-tendon junction
  • Bone
  • Articular cartilage
  • Physis stress injury
  • Bursa
  • Neurovascular structures
  • Diminished metaphysical perfusion - less perfusion —> less bone growth —> injury to those tissues
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13
Q

Characteristics of growth cartilage in adolescent (physes, apophyses, articular surfaces)

A
  • Less resistant to tensile, shear and compressive forces
  • Most vulnerable stage
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14
Q

Characteristics of adolescent bone

A
  • Decrease in bone mineral density and strength
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15
Q

Characteristics of rapid changes in limb length and body mass in an adolescent

A
  • Imbalances between growth and strength
  • Changes in moments of inertia that demand greater force generation
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16
Q

Characteristics of longitudinal growth of extremities in an adolescent

A
  • Change in length, mass and stress forces on bone-tendon and muscle-tendon junctions, growth cartilage and ligaments
17
Q

Other risk factors for overuse injury

A
  • Previous injury
  • History of amenorrhea
  • High training volume
18
Q

Prevention - moderate evidence

A
  • Limits on participation and scheduled rest
  • Monitor training closely
  • Pre-season conditioning
  • Pre-practice neuromuscular training
19
Q

Prevention - low level evidence

A
  • Training modifications made on individual basis
  • Proper fitting of equipment
20
Q

Considerations for manual therapy

A
  • Physical, psychological and emotional response more variable than with adults
  • Structures —> less rigid/more flexible, susceptible to microtrauma
  • joint mobility changes with age and conditions
  • Ability to gauge response
  • Parental facilitators
  • Neuro impairments can be more involved than orthopedic impairments
21
Q

Indications for manual therapy

A
  • Improve joint mobility
  • Improve neurophysiology to gain better response to exercise
  • Address pain and stiffness
  • Some conditions improve mobility vs cure disorder
22
Q

Precautions to manual therapy

A
  • Skeletal maturity of patient
  • Muscular and ligamentous support
  • Patient size
  • Systemic problems
  • May be exaggerated risk of stroke in young children w/ cervical manipulation/manual therapy
23
Q

Symptoms of stroke in infants

A

Seizures

24
Q

Symptoms of stroke in kids

A
  • Headaches
  • Trouble moving
  • Paralysis on one side
  • Slurred speech
  • Loss of vision
  • Confusion
25
Q

Absolute contraindications to manual therapy

A
  • Malignancy
  • TB
  • Osteomyelitis
  • OA
  • Fracture
  • Ligament rupture
  • Disc prolapse w/ nerve root compression
  • Influenza
26
Q

Regional contraindications for manual therapy

A
  • Vertebral artery syndrome
  • C1 ligament trauma
  • Cauda equina syndrome
  • Suspect spinal aneurism
  • Post op - depending on phase
  • Cervical RA
  • Hemarthorosis
  • Long term corticosteroid use
  • Clotting disorder
27
Q

Common uses for manual therapy

A
  • Post sports injury - regain motion and function
  • Scoliosis or hyperkyphoisis
  • Juvenile RA
  • Hip dysplasia
  • LBP
  • Brachial plexus injury, torticollis

MSK Unit 2 (12 decks)

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