Musculoskeletal Alterations

  1. Closure of the anterior fontanel
    12-18 months
  2. Posterior fontanel closes in
    2-3 months
  3. Long bone growth completed by
    20 years old
  4. Calcium intake is essential to prevent what?
    Osteoporosis and osteopenia
  5. Types of musculoskeletal conditions
    • Conjenital
    • Anomaly
    • Developmental variations
    • Trauma
  6. grating, crackling or popping sounds and sensations experienced under the skin and joints
  7. A break or disruption in the structure of the bone when more stress is placed on the bone than it can absorb.
  8. Asymmetric startle reflex is seen in the
    asymmmetrical moro reflex
  9. hypotonia
    floppy tone
  10. Scoliosis, Kyphosis, Lordosis
    Spinal column defects
  11. Clubfoot aka talipes equinovarus
    dysplasia of the foot
    Foot and hand deformitites
  12. Ortolani-Barlow Maneuer
    Hip click heard during gentle abduction and external rotation. Used to diagnose developmental dysplasia of the hip
  13. When an injury was unlikely to occur due to the developmental age
    possible physical abuse
  14. Franctures in different stages of healing
    possible physical abuse
  15. Femur fractures in children less than 1 year of age
    possible physical abuse
  16. Sternal fracture
    possible physical abuse
  17. Rib fracture
    possible physical abuse
  18. Inconsistant explanation of how injury occured
    possible physical abuse
  19. Skull, nose of facial fractures
    possible physical abuse
  20. Spiral fractures
    possible physical abuse
  21. Used to see soft tissue masses or bone tumors. May need to use sedation
    CT (Computerized tomography scan)
  22. Test to find spinal or joint structural defects, bonde deformaties. The machine is noisy, and the client must remain immobility
    Magnetic resource imaging
  23. Direct visualization of joints, joint liagament damage and synovial disease
  24. Used to diangose bone pain, osteomyelitus, metastatic bone disease. Use of injected radioactive isotopes. Client must void prior to procedure.
    Bone scan
  25. Inability to return foot and ankle to alignment.
  26. Higher incidence of clubfoot
    Mexican and south african groups
  27. clubfoot is MMOST COMMONLY found in
    Hawaiian polynesians
  28. Diagnostic for talipes equinovarius
    Visual, Xray, MRI
  29. Serial casting is tx for
    talapis equinovarus
  30. Change weekly for manual manipulation
    Serial casting
  31. Braces used to maintain after casting
    Talipes equinovarius
  32. Surgery, tendonotomy if the condition is severe...tx for
    Talipes equinovarus
  33. Genu Varum
  34. (Genu Varum) Bowlegs are normal until
    2-3 years old
  35. Normal assessment of of bolegs
    Norm <5cm (2 in) space
  36. Genu Valgus
    Knock knees
  37. Genu Valgus (knock knees) normal at what age?
  38. Tx for Genu Valgus
    Braces, possible surgery
  39. Genu recurvature (back knee)
    backward curvature o fknee
  40. Femoral head and acetabulum not properly aligned
    Developmental dysplasia of Hip
  41. Assemetry of thigh and gluteal folds seen in
    Developmental dysplasia of Hip
  42. Limited abduction of the hip
    Developmental dysplasia of Hip
  43. Apparent shortening of the femur
    Developmental dysplasia of Hip
  44. Positive ortolani's sign is an assessment findings of
    developmental dysplasia of Hip
  45. Allis sign
    Shortening of affected leg
  46. Allis sign an assessment finding in
    developmental dysplasia of the hip
  47. Waddling gait in older children is an assessment finding of
    Developmental dysplasia of hip
  48. Pavik harness used to treat
    DDH (developmental dysplasia of the hip)
  49. Why do you use Palvik harness
    <3 mo allows some movement, allows flexion and abduction not extension or adduction
  50. Closed reduction of hip is used as a treatment of
    Developmental dysplasia of Hip
  51. Age to used closed reduction of hip
    6-18 mo.
  52. how long is a Pavik harness used?
    24 hrs a day for 3-4 months
  53. Child in supine position with both legs flexed slightly less than 90 degrees.
    Bryant traction
  54. Used to treat developmetnal hip dysplasia and fractured femurs in children youngger than
    2-3 years of age
  55. Even if one leg is broken both legs are suspended, in what kind of traction
    Bryant traction
  56. Risk of using bryant traction
    can create a tourniquet
  57. How long does it take for a cast to dry?
    24-48 hours
  58. How to reduce swelling and improve circulation in a cast
    elevate cast on a pillow at above the lefel of the heart
  59. Avoid getting plaster casts wet, T or F
  60. How to protect the child's skin from rough and irritating edges
    Petal the edges with moleskin or adhesive tape
  61. Importatnt to assess neurovascular status where on the cast?
    distal to the cast
  62. do not use small or sharp objects under the cast because
    it can damage skin
  63. How to fix itching in a cast
    • Set hairdryer on cool.
    • Use of antihistamine
  64. Smelly casts may indicate
    infection or skin breakdown
  65. Bleeding, excessive pain or swelling indicate
    problem not to be ignored
  66. Report any slipping, cracking and softenes sof a cast to
    healthcare provider
  67. Spica casting used for
    treatment of DDH, developmental dysplasia of the hip
  68. How often to check straps on pavlik harness
    q 2 weeks. Skin care important, and use of special car seat
  69. Known as osteochondroisis of the femoral head
    Legg-Calve-Perthes Disease
  70. Avascular necrosis of the femoral head
    Legg-Calve-Perthes disease
  71. Seen in boys 4 x as often
    Legg Calve Perthes disease
  72. Complains of hip or thigh pain, limp, weakness spasms and pain
    Legg Calve Perthes Disease
  73. How to dx Legg Calve Perthes disease
    Xray, bone scan, arthrogram, MRI
  74. Goal in treatmetn of Legg Calve Perthes disease
    Keep femoral head in acetabulum until ossification complete
  75. Used to treat Legg Calve Perthes Disease
    Traction, casting, bracing or surgery
  76. Tx for Lgg calve Perthes disease
    • Antiinflammatory
    • Physical therapy
  77. Physical therapy for how long to treat legg calve perthes
    18mo - 2 years
  78. Femoral head displaced from femoral neck
    Clipped Capital Femoral Epiphysis
  79. Common during addolescent growth spurts
    Slipped Capital Femoral Epiphysis
  80. Limp, pain, loss of hip mobility seen in
    Slipped Capital Femoral Epiphysis
  81. Stabilize femoral head and maintain hip function is the goal in
    Slipped Capital Femoral Epiphysis
  82. Screws/pins through physis into epiphysis to stabilize femoral head; and traction
    Surgery/traction for slipped capital femoral epiphysis
  83. Open correction (Osteotomy) may be performed for chronic cases of
    Slipped Capital Femoral Epiphysis
  84. Lateral curvature of spine with vertebral body rotation > 10 degrees
  85. Truncal asymmetry classic sign of
  86. Assymmmetric shoulders and hips
    Classic signs of scoliosis
  87. One sided rib hump classisc sign of
  88. Prominnent scapula classic sign of
  89. A& P xrays used in dx of
  90. placed on the back
    and used to measure the apex (the highest point)
    of the curve
  91. MRI and CT used to diagnose
  92. Mild scoliosis
    10-11 degree curvature
  93. Moderate scoliosis
    24-40 degree curvature
  94. Exercise may improve muscle tone, and preent atrophy of spind and improve flexibility of spine in which degree of scoliosis?
  95. Brace to prevent increase in curvature (which won't correct, but slows progress of Scoliosis)
    Moderate scoliosis
  96. Bending brace for small flesible curves
    Charleston brace
  97. Brace hidden under clothes
  98. Most effective braces
    Charleston and boston
  99. Poor compliance, can't hide, and has a flat bar on front for chin rest...what kind of brace?
  100. MMuscles contacrat at regular intervals and causes spine to sraighten
    electrical stimulation
  101. Osteopyelitis
    Infection of long blones caused by microorganism which my abe bacterial, viral or fungal.
  102. Osteomyelitis caused by
    Contaminated surgery, open wounds and trauma
  103. Exogenous osteomyelitis
    from other infection
  104. Hematogenous osteomyelitis cased by
    respiratory or tooth decay
  105. Assessment for osteomyelitis in newborn
    Fussiness when moved, immobility of limb and poor feeding. Assess site for inflammation.
  106. Prohpylactic antibiotics with bone surgery is tx for
  107. Antibiolics used for osteomyeleits
    Vancomycin or clindomycin.
  108. Sterile dressing changes important in treatment of
  109. surgical drainage prn
  110. Check eosinophil sedamentary rate in
    • osteomyelitis
    • 12-16
  111. Check CBC -wbc in
    • Osteomylitis
    • WBC - 4300-10800
  112. Xray used for dx of
  113. ct used for dx of
  114. mmage fluids and diet important in
  115. manage pain in
  116. Scoliosis greater than 45 degree curvature requires
    surgery, traction may be used prior
  117. Removal of vertebral process replaced with autograph from hip/spine
    Spinal fusion for severe scolios
  118. Instrumentation-Harrington rods
    Inserted to stabilize spine and improve alignment, correction of spin is usually 50%...used for tx of severe soliosis
  119. Infantile scoliosis
    • rare
    • 2-3 yo
  120. May require serial castin
    Milwaukee brace
    Spinal fusion
    Infantile scoliosis
  121. Visual spine and scapula when child bends 90 deg a twaist, curavatre great than 50 is abnormal
    Schueurmann kyphosis (hunchback)
  122. Treatment of scheurmann kyphosis if no pain
    Exercise regimimen and antiinflamatory agents, brace worn utnil child reaches skeletal maturity
  123. Swayback, excessive concave curvature of lumbar spine
  124. back and hip pain
  125. Lordosis dx
    visual, xray
  126. tx of lordosis
    postureal exercieses
  127. Lordosis normal in school age and should disappear by
    school age
  128. Inheritated autosomal dominant
  129. Effects connective tissue
    Marfan syndrome
  130. Mitral valve prolapse, aorta regurtigation, abnormal aortic root dimensions, big aorta
  131. May hear murmor at assessment, adn risk of aorti dissection
    Marfan syndrome
  132. Pectus excavatum, long arms, dital infarct, scoliosis, elaongated head, long slender face, high arched palate
  133. Ocular lens subluxation
  134. pneumothorax, respiratory problem found in
    Marfan's syndrom
  135. No cure
  136. Defect in collagen, a biochemical defect
    osteogenesis imperfeta
  137. Blue sclera
    Osteogenesis imperfectal
  138. poor teeth enamel,
    osteogenesis imperfecta
  139. thin soft skin
    osteogenesis imperfecta
  140. Enlarged anterior fontnel
    osteogenesis imperfecta
  141. weak muscles, hearing loss, short stature, decreased ROM
    osteogenesis imperfecta
  142. No cure and may be dx in ureto w/u/s or callagen analysis of chorionic villi
    osteogenesis imperfecta
  143. Dient importatn in
    osteogenesis imperfecta
  144. Pamidronate- bone resorption inhibitor IV q 6 mo. reduces fx adn pain....tx for
    osteogenesis imperfecta
  145. Telescoping rods inserted into long bones
    osteogenesis imperfecta
  146. Hematologic Stem Cell transplant, tx for
    osteogenesis imperfecta
  147. No cure, and most severe and common form of Muscular Dystophy
    Duchenne muscular dystrophy
  148. Pseudohyertrophy
    Replaement of muscle tissue with fatty deposits and connective tissue.
  149. Muscle fiber degeneration, muscle wasting and weakenss
    Duchenne muscular dystrophy
  150. Dystrophin
    Mutation of gene that decodes dystrophin a protein product in skeletal muscle resulting in degeneration of voluntarrly muscles that control movement
  151. X lihked disorder
    Duchenne muscular dystrophy
  152. Almost seen only in males...females are the cariers; 1/3 no family history
    Duchennne Muscular dystrophy
  153. 2-4 years pelvic muslce weakness
    duchenne muscular dystrophy
  154. difficulty walking, running, waddling gain and frequent falls
    Duchenne muscular dystrophy
Card Set
Musculoskeletal Alterations
Musculoskeletal Alterations