Peds Flashcards
Staheli’s Test
- Child placed prone, legs hanging over the table. Examiner extends one limb at a time trying to get limb to neutral.
- If child can’t get to neutral, may be fixed flexion contracture.
Thomas’s Test
- Tests for flexion contracture (illiopspoas)
- Child supine, with knees to chest. Allow one leg to extend.
Ober’s Test
Tests for hip abduction contracture
Ely’s Test
Tests for Rectus Femoris contracture
Ryder’s Test
- Measures femoral antetorsion
- Normal is 10˚ internally rotated
- If femur is ext rotated, there is retrotorsion
- If femur is int rotated, there is antetorsion
APGAR score
Skin Color:
0 - blue
1 - body pink, extrem blue
2 - completely pink
HR:
0 - asystole
1 - 100 bpm
RR:
0 - absent
1 - slow/irregular
2 - good (>60 bpm)
Stimulation Response
0 - no response
1 - facial grimace
2 - sneeze/cough
Muscle Tone
0 - limp/no tone
1 - some flexion of extrems
2 - active motion
What APGAR score indicates extreme distress
1-2 (highest score = 10)
Barlow’s Test
To identify a hip that is fully located (or subluxed), but which can be additionally subluxed or fully dislocated
When to take APGAR score
@ 1 min, 5 min, then q 5 min until normalize
Ortoloni’s Test
To identify a hip that is doslocated but reducible
Palmen’s Sign
A finding of subluxation
Telescoping Sign
To identify a dislocated mobile proximal femur
Galeazzi’s Sign
To identify an apparently short femur in hip dislocation
Allis’ Sign
Tests for shortening in the limb
Trendelenberg’s Test
Tests for weakness of the hip abductors (especially gluteus medius)
Gower’s Sign
Identifies weak hip extensors
Confusion Sign
- Have pt do maneuver unrelated to ankle dorsiflexion, but it will produce reflex ankle
- Seen in children that are neurologically abnormal, with spasticity
Calcaneovarus deformities
ankle = calcaneus FF = supinated (adducted/varus)
Causes of Calcaneovarus
- NM in nature
- tibialis anterior = only muscle really working well (adducted/varus)
- weakness in posterior, lateral, and other anterior muscle groups
Difference b/w calcaneovarus and calcaneus deformity
calcaneus deformity = no forefoot malposition (all anterior muscle groups functioning)
Similarities:
- also NM in nature
- neither are talipes (congenital) deformities
Triad of Talipes Calcaneovalgus
- Ankle Calcaneus
- STJ pronation
- TN subluxation (NOT dislocated – i.e., how to differentiate from vertical talus, in which TNJ is dislocated!)
- note: ankle in calcaneus with PF to neutral only until ~6 mo… after 6mo, ankle in equinus and PF 20 deg (OBLIQUE TALUS AND TALIPES CALCANEOVALGUS = ONE IN THE SAME AFTE 6 MONTHS)
- i.e., ankle equinus, STJ pronated/subluxed, FF abducted
Etiology of Talipes Calcaneovalgus
- congenital (in utero positioning - packaging defect) **most common
- neurological (paralysis below L5)
Tx of Talipes Calcaneovalgus
- serial casting followed by orthotics (UCBL or Type C Heel Stabilizers)
Causes of rigid pediatric flatfoot
- Congenital Convex Pes Valgus (Vertical Talus)
- Tarsal Coalition
- Severe Talipes Calcaneovalgus (more common than CCPV*)