peds47

Question 1

management of nursemaid’s elbow

Answer 1

reduce it by simultaneously flexing the elbow and supinating the hand

Question 2

prognosis of nursemaid’s elbow

Answer 2

excellent; reduction is grat; subluxation may recur

Question 3

anterior shoulder dislocation

Answer 3

most common type of shoulder dislocation; treatment by immobilization; recurrance rate is 90%, so some docs recommend surgery

Question 4

torticollis

Answer 4

tilting of the head to one side

Question 5

congenital torticollis

Answer 5

very common; usually the result of uterine constraint or birth trauma; can rarely be caused by cervical spine abnormalities (Klippel-Feil syndrome)

Question 6

congenital torticollis- contracture of what msucle?

Answer 6

sternocleidomastoid

Question 7

clinical features of congen torticollis

Answer 7

head tilited TOWARD affected side with; bleeding into the muscle can sometimes be palpated

Question 8

management of torticollis

Answer 8

stretching exercises to relieve the musscle contracture; helmet therapy if needed

Question 9

acquired torticollis

Answer 9

rare compared to congenital; multiple causes

Question 10

atlantoaxial instability

Answer 10

unstable joint between occiput and the first cervical verebrai or between first and second cervical vertebrae;

Question 11

clinical features of atlantoaxial instability

Answer 11

asymptomatic and normal phys exam; spinal cord injury may occur if patient with instability sustains injury;

Question 12

management of atlantoaxial instability

Answer 12

fusion of C1 and C2 if instability is severe

Question 13

klippel-feil syndrome

Answer 13

failure of normal vertebral segmentation that results in fusion of vertebrae; usually cervical spine; assoc with Sprengel’s deformity

Question 14

Sprengel’s defomity

Answer 14

congenital abnormality of the scapula in which the scapular is rotated laterally leading to shoulder asymm and diminsed shoulder motion

Question 15

scoliosis

Answer 15

lateral curvature of the spine

Question 16

cobb angle

Answer 16

using radiograph to determine the degree of scoliosis

Question 17

management of scoliosis

Answer 17

observation, bracing, surgery

Question 18

progression of scoliosis

Answer 18

only occurs during growth or if spinal curvature is greater than 50 deg; almost all growth in females ceases within 6 mos of menarche

Question 19

management of scoliois before and during growth spurt

Answer 19

for 10-20 deg of scoliosis, a follow-up scoliosis film is obtained 4-6 mos later to assess for progression; five degrees of prog requires ortho consult; for 20-40 deg, bracing; for greater than 40 deg, surgery

Question 20

management of scolioisis after growth has concluded

Answer 20

surgery is considered if scoliosis greater than 50 deg

Question 21

complications of scoliosis

Answer 21

such as resp or CV compromise, may occur if scoliosis greater than 60 deg

Question 22

kyphosis

Answer 22

ant-post curvature of the thoracic spine

Question 23

flexible kyphosis

Answer 23

most kids with kyphosis have flexible kyphosis, in which they can voluntarily fix the kyphosis

Question 24

Schuermann’s kyphosis

Answer 24

stiff idiopathic kyphosis in which three consec vertebrae are wedged