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Phty3130 Final > Short answer > Flashcards

Short answer Flashcards

1
Q

**Name 3 things musculoskeletal development is affected by

A
  • Genetics
  • Nutrition
  • Drugs
  • Hormones
  • Mechanical forces
  • Injury/trauma
  • intervention (surgery, splinting, casting, restraints)
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2
Q

**Name specific items you would look for in a child’s medical chart relating to orthopaedic growth ol development

A
  • height
  • weight
  • head circumference and/or other cranial measures
  • In-utero measures
  • Signs of skeletal maturity
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3
Q

**4 levels of DDH

A
  • Subluxable: femoral head can easily be partially displaced to the rim of the acetabulum
  • Dislocatable: femoral head is in the socket but it it can be displaced completely outside the acetabulum wiht manual therapy
  • Dislocated: femoral head lies completely outside hip socket but can be reduced with manual therapy
  • Teratologic: femoral head lies completely outside the hip socket & cannot be reduced with manual pressure
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4
Q

**When is ossification of the hind foot first observable?

A
  • Calcaneous: 23 wks of gestation

- Talus: 28 wks

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5
Q

**Describe the anatomy of the CTEV deformity

A
  • Equinas (plantarflexion) at the talocrural joint
  • Adduction & inversion at the subtalar & mid tarsal joints. Navicular tuberosity is close to the medial malleolus
  • Metatarsal adductored
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6
Q

What condition may be associated with postural TEV?

A
  • facial deformity, mandibular asymmetry
  • plagiocephaly
  • toricollis
  • hip dislocation
  • metatarsus adductus
  • Postural TEV
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7
Q

Describe the management of Postural TEV

A
  • AROM: encourage DF & eversion
  • PROM: gentle passive stretches
  • Taping: may include maintaining the corrected alignment of the foot & ankle with adhesive taping
  • Follow up: once correction is attained there is no potential for relapse, so you can discharge the child, with parent able to return if concerned
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8
Q

**6 clinical signs of contracture according to the Pirani & Outerbridge Evaluation of CTEV

A

Postural contracture (hind foot contracture)

  • Posterior crease
  • Empty heel
  • Rigid Equinas

Medial Contrature

  • Curvature of lateral border of the foot
  • Medial crease
  • Lateral part of the head of the talus
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9
Q

Physio management technique for Structural TEV

A
  • Serial casting

- Ponseti method

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10
Q

What is the steps of ponseti correction technique?

A
  1. Correct the cavus
    o 1st MT is in more fl than other MT (causing cavus)  corrected by ext the 1st MT + holding forefoot in supination to align w/ midfoot and calc
    o Heel is not touched
  2. Re-align the fore-foot, mid foot and hindfoot= swing foot outwards
    o Gradually abduct supinated foot under talus w/ counter-pressure on head of talus to stabilize bone
    o Medial tarsal lig are stretched allowing calc to abduct w/ foot + ant tuberosity of calc is disengaged from its position under head of talus
  3. Correct into DF
    o Don’t do this early or else mid foot will break – must do above 2 steps first
    o Corrected when dots on head of talus and on nav coincide + ant tub of calc is disengaged from its position under headl of talus
  4. Overcorrection – getting to neutral is not enough
    Requires full abd of midfoot and forefoot – stretches tight medial tarsal ligs through full ROM
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11
Q

What is treatment for congenital vertical talus

A

-Refer: surgical correction required to re-align this congential anomaly

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12
Q

S & S of Benign Joint Hypermobility Syndrome

A

Primary characteristics

  • generalised joint hyper mobility
  • chronic joint pain
  • Other MSK signs related to defect in collagen

Females> Males
Family history
Often posture and motor control diff similar to DCD

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13
Q

Name the items on the Beighton Score test

A 
elbow 
knee 
pinky
thumb
touch floor
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14
Q

Treatment for BJHS

A
  • Joint stability
  • Low-impact exercise
  • Lifestyle modifications
  • Pain management
  • Proprioception
  • Joint range
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15
Q

MSK issued associated with Ehler’s Danlo Syndrome

A
  • Hyper-flexible joints (unstable, finger deformities)
  • Joint & tissue degeneration (early onset OA, tearing muscles and tendons)
  • Deformities of the spine (scoliosis, kyphosis, tethered spinal cord syndrome, occipitoatlantoaxial hyper mobility)
  • Pain (Myalgia, arthralgia, Osgood-schlatter disease)
  • Trendelenburg
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16
Q

Mx Type 1 Osteogenesis imperfecta

A

Collagen normal quality but insufficient quantities
MSK features: short stature, bone fracture easily, slight spinal curvature, loose joint, poor muscle tone

Gentle to decrease risk of fracture, pain, fear of moving, pressure

  • Strengthen muscles & improve flex to reduce deformity
  • improve endurance

Developmental therapy

  • hydrotherapy
  • land play-based therapy

Physio

  • Physical aids
  • Monitoring & education
17
Q

S & S Legg-Calve perches disease

A
  • painful limp
  • limitaiton of IR and ABD hip
  • Most commonly seen in 4-8 year old children
  • leg length inequality
18
Q

S & S Slipped capital/upper femoral epiphysis

A

-more common in adolescent males
-can be acute
-chronic
-referred pain to thigh and knee
-may limp
hold leg in hip ER
-leg length inequality

19
Q

S & S Osterosarcoma

A
  • pain a presenting feature: severe joint/bone pain, pain at rest
  • swelling in bones/joints
  • reluctance to weight bear/accept load with limb
20
Q

elements of PT role pre-post surgery for osteosarcoma

A

ASSESS
-Pain, extent of deficiency, AROM, PROM, muscle imbalance, impact motor skills, monitor growth

TREAT
PRE: ROM, strength, mobility

Post: maintain ROM, M strengthening, mobility training, manage pain

21
Q

What is cranial index and what does it measure

A

Anteroposterior measures

  • ration of anterograde-posterir to lateral diameter of the cranium
  • degree of flattening
  • identify brachycephaly >width and scaphocephaly
22
Q

treatment for plagiocephaly

A

ABC
Active baby- play positions
Balanced handling- carrying in diff postions
Correction strategies- encourage baby to turn their head to their non-preferred side

23
Q

Treatment for torticollis

A
  • Parent education
  • Active facilitation: into limited range of movement
  • Positioning: encourage movement into limited range movement
  • Carrying positon: encourage lengthening of contracture
24
Q

Treatment for DMD

A

stretching, positioning, splinting, orthoses, seating, standing =activities, adaptive equipment, assisted technology, strollers/scooters, wheelchairs

25
Q

Congenital scoliosis

A
  • Unique risks of progression
  • Usually accompanied by rib deformities
  • Due to congenital bony issues (brace does not work)
  • Early onset scoliosis
26
Q

Congenital Vertical talus

A 
Hindfoot planterflexed
Talus vertical
Talo-nav joint subluxed
Forefoot abd + DF 
Increased angle between calc and talus
27
Q

CTEV Structural association

A

torticollis, plagiocephaly/facial moulding, spinal asymmetry, hip dysplasia

28
Q

NMD symptoms

A
  • mainly muscle weakness and wasting

- LL then UL

29
Q

Orthopaedic changes in MND

A

MSK

  • hyperlordosis spine –> shortening hip muscles
  • contracture in achilies and hamstrings
  • Pseudohypertrophy= muscle increase in size but not in strength
  • scoliosis

Developmental signs

  • lack of balance, frequent falls
  • usual/awkward gait
  • loss of ability to walk age 12
  • Difficulty getting up from ground

Cardiovascular signs

  • Fatigue, aspiration
  • breathing difficulties
30
Q

Juvenile Idiopathic Arthritis & Hemiaphillia

A

Pain, swelling and tenderness
Joint warmth
Pain with motion

31
Q

Type of deformation of plagiocephaly –> Argenta Classification

Active head righting assessment

Cranial index

cranial vault asymmetry index

A 
Type 1: Posterior flattening
Type 2: Ear shift
Type 3: Forehead deformity
Type 4: Cheek, face and jaw deformity
Type 5: vertical and/or temporal deformity
32
Q

Plagiocephaly Management

A

ABC
Active Baby
Balanced Handling
Corrective strategies

33
Q

Management/Treatment of Brachial plexus palsy

A

Care for UL

  • Aware of poor SENSATION
  • Teach parents to carefully SUPPORT flaccid arm
  • Teach SAFE positioning during sleep and play

Maintain and improve ROM

  • POSITIONING to avoid contracture
  • Passive facilitation
  • PROMOTE active movement as soon as able
  • senstion treatment= warm baths
  • GM stim:
  • posture and balance
  • fine motor tasks
34
Q

Cobb angle

A

Magnitude of spinal deformity >10 deg scoliosis

35
Q

Indication for surgery scoliosis

A
  • > 40 deg in immature spine, >50 in mature
  • Relentless progression
  • Cardiopulmonary compromise
  • Functional improvement
36
Q

Scoliosis outcome measures

A

AIS= Scoliosis research society questionaire
Early onset scoliosis
Back and leg pain=Oswestery disability index, back VAS, leg VAS

37
Q

ORIF

A
  • lateral condylar #
  • supracondylar # elbow
  • SH3 and 4
  • poly trauma
  • end of growth plate= tibial triplantar #
  • Age 10+= femoral start #, displaced midforearm #
38
Q

Why are children more susceptible to brain injury

A

head:body ratio, less myelinated brain, thinner cranial bones, hemorrhagic shock

Phty3130 Final (10 decks)

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