PEDS Musculoskeletal Panopto

Question 1

Why do fractures heal faster with kids than in adults?

Answer 1

They’ve got a better blood supply & perfusion + A thicker lining and coating to their bones

Question 2

What are the risk factors for a fracture in kids?

Answer 2

Obesity + Poor Nutrition (Lack of Calcium or Vitamin D) + Ordinary Play Activities + Falls + Sports Injury

Question 3

What are the expected findings for fractures in kids?

Answer 3

Pain + Crepitus + Deformity + Edema + Ecchymosis (Bruising) + Less Use of Affected Limb

Question 4

What is Crepitus?

Answer 4

A Popping / Cracking Sound from an affected extremity

Question 5

What are the common fractures that you’d see in a pediatric setting?

Answer 5

Plastic / Bowing Fracture + Buckle + Greenstick + Transverse + Oblique + Spiral + Physeal + Complete + Open / Compound

Question 6

What’s a Plastic / Bowing Fracture?

Answer 6

It is when the affected bone is bent under 45 degrees without breakage

Question 7

Why does a Plastic / Bowing Fracture occur often with kids?

Answer 7

Their bones are more pliable than adults

Question 8

What’s a Buckle Fracture?

Answer 8

A compression of a bone that results in a bulge at the fracture site without breakage (Happens often with the Wrists)

Question 9

What’s a Greenstick Fracture?

Answer 9

A breakage of the bone that doesn’t go all the way across (An Incomplete Fracture)

Question 10

What’s a Transverse Fracture?

Answer 10

A complete break that goes straight across the bone

Question 11

What is an Oblique Fracture?

Answer 11

A complete break that goes across the bone diagonally

Question 12

What is a Spiral Fracture?

Answer 12

It’s a type of fracture that spirals along the bone

Question 13

What fracture is a sign of abuse?

Answer 13

Spiral Fractures

Question 14

What’s a Physeal Fracture also called?

Answer 14

A Growthplate Fracture

Question 15

What is a growth plate?

Answer 15

It produces cells that help with growth

Question 16

What is an indicator of a Physeal Fracture?

Answer 16

Uneven or Restricted Growth in a Limb

Question 17

When dealing with a Physeal Fracture, what may occur if the bone casting isn’t set properly?

Answer 17

The bone may not heal back into alignment, leaving a permanent injury

Question 18

What’s a Complete Fracture?

Answer 18

A fracture where the bone fragments are completely separated

Question 19

What’s an Open / Compound Fracture?

Answer 19

A fracture where a part of the bone is sticking out of the skin

Question 20

What is the major concern with a Compound Fracture?

Answer 20

Infection

Question 21

What’s important to do with pediatric pt’s who’re having an x ray?

Answer 21

Keep them staying still

Question 22

If applying ice to a fracture, how long should the ice be applied to the extremity?

What else should be done while applying the ice? Why?

Answer 22

Under 20 Minutes

Keep something in between the skin and the ice (Towel, Pillow Case, etc.), to avoid damaged skin integrity

Question 23

You have a pediatric patient with a suspected pelvic fracture, what needs to be done for them? Why?

Answer 23

Monitor for the development of Hypovolemic Shock (Assess the blood labs)

This is done because with a Pelvic Fracture, a fragment of bone may nick the bladder and cause rapid blood loss

Question 24

What kind of fracture would a child need to be up to date on with their Tetanus Shot?

What else needs administered?

Answer 24

Open Fractures

Administer Antibiotics

Question 25

What is one important neurovascular observation to make in terms of movement after a fracture occurs?

Answer 25

Pt should be able to move bones distal to the fracture (If ulna is broken fingers should still be able to move, if tibia is broken toes should still be able to move, etc.)

Question 26

What complications are there to look out for with pediatric fracture patients?

Answer 26

Compartment Syndrome + Renal Calculi + Embolism + Osteomyelitis

Question 27

What are the causes of compartment syndrome?

Answer 27

Burns + Surgery + Tight Dressings or Casting + Skin Traction + Hemorrhage + Trauma + Severe IV Infiltration

Question 28

What’s the definition of Compartment Syndrome?

Answer 28

Compression of the Nerves, Muscles, and Blood Vessels in a confined space that leads to Ischemia

Question 29

In what Fractures does Compartment Syndrome most often occur?

Answer 29

Leg Fractures (Tibial Fractures, etc.)

Question 30

If untreated, what can Compartment Syndrome lead to aside from Ischemia?

Answer 30

Infection + Deformity + Amputation + Paralysis Volkmann Contracture

Question 31

What’s a Volkmann Contracture?

Answer 31

A permanent contracture of the forearm and hand (Causes the hand to draw up into a claw-like position, leaving the pt unable to use it anymore)

Question 32

What is an early finding of Compartment Syndrome?

Answer 32

Paresthesia (Numbness / Tingling in the affected Extremity)

Question 33

Five P’s?

Answer 33

Pulse, Pallor, Paresthesia, Paralysis, Pain

Question 34

What is a late finding of Compartment Syndrome?

Answer 34

Pulselessness

Question 35

If Compartment Syndrome is ever suspected in a pediatric pt, what surgery do they need to be prepared for?

Answer 35

A Fasciotomy

Question 36

What is a Fasciotomy?

Answer 36

Cutting the Fascia (Connective Tissue) around a muscle compartment to relieve pressure + return blood flow

Question 37

What is the other name for Renal Calculi?

Answer 37

Kidney Stones

Question 38

What types of fractures cause Renal Calculi? What should be done to prevent them from occurring?

Answer 38

Any Non-Weight Bearing Injuries Maintain proper nutrition + Monitor urine output + Drink lots of water to maintain hydration

Question 39

What is an Embolism?

Answer 39

Basically a Pulmonary Embolism but instead of a blood clot blocking the arteries it is fat

Question 40

Infection within the bone =

Answer 40

Osteomyelitis

Question 41

How is Osteomyelitis treated?

Answer 41

The same as you’d treat a Open Fracture (Antibiotics)

Question 42

Symptoms of Osteomyelitis?

Answer 42

Tachycardia + Edema + Fever + Irritability + Not using the affected extremity + Constant Pain (Increases with Movement) + Warm to touch skin of extremity

Question 43

What always needs to be done for a pt with Osteomyelitis prior to giving antibiotics? Why?

Answer 43

Do a lab culture to figure out what kind of bacteria is in the bone (Assist with a Joint or Bone Biopsy). If you administer antibiotics prior to a lab culture, it could skew the results and make the problematic bacteria unidentifiable.

Question 44

What complication can result from long term antibiotic use?

Answer 44

C. diff

Question 45

For how long is antibiotic therapy utilized for Osteomyelitis?

Answer 45

6-8 Weeks

Question 46

Certain antibiotics, such as Gentamicin, can result in what complication?

Answer 46

Ototoxicity (Hearing Loss)