skeletal modelling (1)

Question 1

neurological disorders may show clinically as:

Answer 1

delays in milestones
head size abnormalities (too big/too small)
activities, reflexes or movement abnormalities
lack of co-ordination (DSD: developmental co-ordination disorder/dyspraxia)
changes in level of consciousness or mood
mm changes: spasms, hypotonicity,
headaches, vision changes

Question 2

name some examples of gross motor testing examples

Answer 2

• hopping/ jumping on one foot
• pushing against hands
• eyes closed: touch nose
• plantar
  patella/AJ reflexes

Question 3

name some examples of fine motor tests

Answer 3

pincher grasp
writing ability
picking up objects?
transfer from one hand to another
shoe laces
clapping

Question 4

name some common neurological syndromes

Answer 4

muscular dystrophy
myasthenia gravis
cerebral palsy
huntington's chorea 
MS

Question 5

when does osteogenesis occur?

Answer 5

begins at week 5 until about 25 y/o

Question 6

what makes up the ‘blue print’ for mature skeleton?

Answer 6

prenatal cartilage

–> x rays show the bone ‘chasing’ the cartilage

Question 7

what % water is hyaline cartilage?

Answer 7

78%

Question 8

outline Wolff’s law

Answer 8

form follows function:
skeletal architecture adapts to its history of mechanical usage
must be dynamic stress

Question 9

identify some ‘evidence’ or examples of wolff’s law

Answer 9

long bones are thickest mid shaft
curved bones are thickest where they are most likely to buckle
there are large bony nodules where active mm attach

Question 10

what are some hormonal forces in bone remodelling?

Answer 10

PTH increases renal retention of calcium

calcitonin (from thyroid) increases osteoblast activity

Question 11

what is the epiphysis?

Answer 11

growth plate

Question 12

what is the metaphysis?

Answer 12

the bit in between the growth plate and the rest of the bone

Question 13

what is an apophysis?

Answer 13

insertion to bone via the tendon unit

Question 14

what is cantilever force?

Answer 14

force applied to the end of an already curved object –> further curving. e.g. WB on already bowed and highly cartilaginous femur/tibia

Question 15

what flexure?

Answer 15

requires 3 points of pressure. think of bending uncooked spaghetti

Question 16

what is sheer-torsion force?

Answer 16

when the forces are applied in opposite directions (think of wringing out a wet towel)

Question 17

which # is the most common in the salter harris scale?

Answer 17

type 2: metaphysis and physis fracture

Question 18

type 1 salter harris fracture

Answer 18

physis fracture (straight across the neck type area)

Question 19

type 2 salter harris

Answer 19

metaphysis and physis fracture. goes across then proximally

Question 20

type 3 salter harris

Answer 20

epiphysis and physis fracture, kind of takes off the corner of the bone

Question 21

type 4 salter harris fracture

Answer 21

epiphysis to metaphysis fracture is when it makes a thin slice down one side

Question 22

type 5 salter harris

Answer 22

crush fracture

Question 23

what influences the configuration and size of skeletal muscles?

Answer 23

nutrition, hormones, electrical activity and mechanical forces

Question 24

do patients under 4 years have R1?

Answer 24

no they don’t have an R1 (in the stress strain curve) because they have such flexible bones

Question 25

why do mm imbalances occur?

Answer 25

• disturbances in mm recruitment due to CNS dysfunction
• pathological resting postures
• inappropriate or excessive distances between load bearing joints and vertical body weight load lines
• inappropriate distribution of COM over the feet (i.e. leaning forward, to the side etc.)