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MSK III & IV > Peds Mini Series > Flashcards

Peds Mini Series Flashcards

1
Q

injury to the upper and lower brachial plexus during difficult vaginal delivery

A

obstetric brachial plexus injury

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2
Q

How does obstetric brachial plexus injury occur?

A

forceful traction or rotation of the head and shoulders (breech delivery)
fracture to the clavicle or humerus

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3
Q

how will a baby present with a diagnosis obstetric brachial plexus injuries?

A

made at birth
arm appears flaccid or moves only slightly

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4
Q

What is the condition called if obstetric brachial plexus injury does not improve?

A

erb’s palsy

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5
Q

A baby with erbs palsy (injury to c5-c6) how will they present with a resting posture?

A

rhomboids, levator, serratus, subscap, supraspinatus, infraspinatus
biceps, supinator affected

baby sits in internal rotation and adduction flaccid shoulder

baby will sit with a “waiters tip” position

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6
Q

If a baby sits with an arm in a waiters tip position what injury would you think?

A

obstetric brachial plexus injury
erbs palsy (C5-C6)

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7
Q

With Obstetric brachial plexus injury would a stretch or a rupture heal faster?

A

stretch

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8
Q

what percentage of OBPI babies recover in 3 months?

A

80-90%

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9
Q

what is a cookie test?

A

if a baby can bring their hand to their mouth

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10
Q

If a baby is unable to bring their hand to their mouth at_____ months they have a poor recovery for OBI

A

> 6 months

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11
Q

A pt should focus on ___ and _____ activities to promote recovery in OBPI?

A

developmental and functional

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12
Q

Current evidence suggest conservative treatment is an _______ intervention for most BPI at this time

A

effective

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13
Q

nonprogressive, congenital neuromuscular syndrome

Clinical picture:
severe joint contracture
muscle weakness
muscle fibrosis
absence of muscles

A

Arthrogryposis Multiplex Congenita

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14
Q

What causes arthrogyposis multiplex congenita

A

etiology unknown

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15
Q

What are the primary impairments of arthrogyposis multiplex congenita

A

severe joint contracture
muscle weakness

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16
Q

Do children with arthrogyposis multiplex congenita have impaired congnition?

A

no normal cognition and speech

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17
Q

Can arthrogyposis multiplex congenita be diagnosed in utero?

A

no definitive test but ultrasound may be suggestive

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18
Q

What are some interventions for decreased ROM for AMC?

A

stretching
positioning
splinting/bracing
casting

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19
Q

By 5 years old what percentage of those with AMC are independent with ADLs and mobility?

A

85%

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20
Q

Will indvidiuals with AMC have pain with aging, increased muscle weakness

A

yes

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21
Q

will individuals with AMC have a compromised lifespan?

A

no but increased secondary impairments

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22
Q

Brittle bone disease; sneezing could cause bones to break
defect in structure of synthesis of type 1 collagen

A

osteogenesis imperfecta

23
Q

Which type of OI is most severe and most rare; frequently fatal in infancy?

A

type 2

24
Q

Do mild or moderate forms of OI affect life expectancy?

A

No

25
Q

Signs and symptoms of OI

A

brittle bones
short small bones
loose joints
curved spine
blue sclera of the eye
brittle teeth
hearing loss

26
Q

What are 3 good interventions for an individual with OI

A
  1. early intervention/positioning handling
  2. strengthening/ aerobic conditioning/ aquatic therapy
  3. protected ambulation
27
Q

are there any congitive declines with OI?

A

no most are ambitious productive 1/2 adults choose to marry

28
Q

Do most individuals with OI use for community mobility?

A

wheel chair

29
Q

is calcaneiovalgus the same as club foot?

A

no its a condition that more than 30% of babies have excessive dorsiflexion that corrects spontaneously

30
Q

what is the presentation of clubfoot- talipes equinovarus

A

forefoot curved medially
small calcaneus, hindfoot varus
ankle plantarflexion

31
Q

Is there good outcomes with conservative treatment of talipes equinovarus (clubfoot)

A

yes

32
Q

What condition do you use ponseti casting method?

A

talipes equinovarus Club foot

33
Q

Do pt need to be trained in the ponseti method?

A

yes

34
Q

What are 3 risk factors for development dysplasia of the hip?

A
  1. female
  2. twins
  3. breached
35
Q

What are 4 conditions from tight packaging?

A
  1. CMT
  2. plagiocephaly
  3. metatarsus adductus
  4. calcaneovalgus
36
Q

What is the barlow test?

A

hip is flexed and abducted gradually adducted with pressure posterior

37
Q

what does a positive Barlow test determine

A

unstable hip

38
Q

What is an ortolani test?

A

in the positive hip the hip is dislocated gentle flexion and abduction and slight anterior traction reduces the hip

39
Q

At what age can you stop using barlow ortolani test

A

3 months

40
Q

Who uses a pavlik harness

A

newborns

41
Q

who uses a hip spica

A

8 months old

42
Q

a disease of the growth or ossification centers in children which begins as a degeneration or necrosis followed by regeneration or recalcification

A

Osteochondrosis

43
Q

self limiting disease of hip produced by ischemia varying degrees of avascular necrosis of femoral head and spontaneous regeneration

A

legg calve perthes disease

44
Q

Legg calve perthes disease is most common in boys or girls

A

boys

45
Q

what are the impairments associated with legg calve perthes disease?

A

pain often in knee, groin or hip
limited ROM: abduction, internal rotation

46
Q

Herring lateral pillar classification is a measure of what in legg calve perthes disease

A

amount of collapsed area

47
Q

approximately 50% of individuals with legg calve perthes will have _____by the 5th decade?

A

degenerative hip disease

48
Q

Displacement of femoral head on femoral neck: head inferior and posterior in relation to the femoral neck

A

slipped capital femoral epiphysis (SCFE)

49
Q

true/false tend to be obese skeletally immature males around time of puberty/growth spurts

A

true

50
Q

What are the 5 common impairments associated with SCFE

A
  1. ROM limited hip flexion and lateral rotation
  2. rest in hip lateral rotation
  3. limp
  4. pain
  5. shortening of affected limb
51
Q

true/false surgical intervention for unstable acute SCFE most return to normal function within 3-6 months

A

true

52
Q

What are the 3 main questions for clinical decision making children with a limp

A
  1. history of trauma
  2. normal neurological examination
  3. fever
53
Q

surgical shortening of long leg

A

epiphysiodesis

54
Q

surgical limb lengthening on affected short leg

A

wagner or illizarov

MSK III & IV (10 decks)

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