Week 3 Flashcards
What if a “Fracture Blister”?
When the dermis and epidermis separate following a fracture. This is a dermatological emergency!
What is a “Greenstick Fracture”?
A fracture which goes through one of the cortex. Just like when you bend a piece of living wood.
A Torus fracture involves?
A buckling of the cortex.
Where does growth of the bone occur?
What is the weakest part of the growing bone?
The hypertrophic zone.
The hypertrophic zone.
What is the Hueter-Volkmann Principle?
Posits that the growth rate of the epiphyseal plate is inhibited by increased pressure, and accelerated with decreased pressure.
What is Wolff’s Law?
Posits that bones will remodel to strengthen under stress.
A Salter-Harris Class 5 Epiphyseal Fracture involves?
Compression of the growth plate which may cause growth arrest of the bone.
Where does the epiphysis typically move in Slipped Capital Femoral Epiphysis? What is the major complication of SCFE? How is it treated?
- Posterior and Inferior
- Avascular Necrosis
- Managed surgically
What is more-or-less the younger kid version of SCFE?
Legg-Calve-Perthes Disease
{AKA Perthes Disease}
When should you order an X-Ray for an infant.
When they are old enough to have calcified bones! U/S for the little ones, their bones won’t show up well on X-Ray!
How do you treat clubbed feet?
Ponseti Casts!
How do you treat calcaneovalgus feet?
Get the parents to regularly stretch their kids feet. It will usually correct on its own without any more intervention.
What line is used to determine if a kid has SCFE?
Kline’s Line. Drawn parallel the femoral neck it should cross over the border of the epiphysis.
Scoliosis is secondary to another condition. Name a few.
Cerebral Palsy, Spina Bifida, and Spine Fractures.
If scoliosis has a curve of _______ degrees you need to take an X-Ray every _______ months during growth spurts.
> 20 degrees; 6 months
When should you order an MRI for a kid with scoliosis?
- Severe Pain
- Growing Boys Curves > 20
- Headaches, Abnormal Reflexes
- Loss of Bladder Control
- Children < 10 with Curve > 30
Roughly outline treatment of scoliosis in regards to the COBB angle.
- 30° - 45° = Brace {Kids}
- 45° - 50° = Surgery {Kids}
- > 60° = Surgery {Kids + Adults}
Describe characteristics of white muscle fibres.
- Fast twitch.
- Produce lots of force.
- Tire quickly.
- Little myoglobin.
- Use glycogen.
Describe characteristics of red muscle fibres.
- Slow twitch.
- Produce less force.
- High endurance.
- Lots of myoglobin.
- Energy via Krebs Cycle.
What happens in Myasthenia Gravis?
The immune system attacks acetylcholine receptors causing muscle weakness. The external ocular muscles are initially affected in 50% of cases, followed by other cranial nerves, then proximal, followed by distal, muscles. Spontaneous remissions may occur.
What goes wrong in Duschene Muscular Dystrophy?
Genetic defect located on the X chromosome in which the protein dystrophin is incorrectly made. Muscle weakness starting in the legs. Wheelchair by 12, death in their 30’s.
Children affected by arthritis may have bones which grow _______ on the side which is affected.
Longer. Leg length discrepancies in children with arthritis of the knee or hip are due to the affected leg growing longer than the unaffected due to increased vascularization and blood flow.
What often presents with juvenile idiopathic arthritis and Enthesitis-Related Arthritis?
Uveitis
What are the two types of developmental dysplasia of the hip?
Teratologic {Syndromes and Stiff} and Typical {Ligamentous Laxity, Breech, 1st Born Female, Torticollis}.
What are the lab results for transient synovitis like?
Joint Aspirate Cell Count 5 000 - 15 000 25% PMN. ESR, CRP, and WBC counts normal. Effusion on U/S. May look like septic arthritis.
What is the most common pathogen to cause osteomyelitis?
What is usually the first radiological sign?
S. Aureus
Evidence of deep localized soft tissue swelling.
Kids legs start out _____, then go _____ around 2, and should become normal between 4 - 6.
Varus, Valgus
