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Pediatric Musculoskeletal 1

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juniperk's version from 2018-03-05 13:09

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Question Answer
Signs of Developmental dysplasia of the hip Shorter leg on the affected side, Unequal thigh and gluteal folds, Positive Ortolani's test (abduction with a "click" heard), Positive Barlow's test (adduction and back movement that moves the femoral head out of the acetabulum)
Interventions for developmental dysplasia of the hip0-6 months- Pavlik harness, 6-18 months - Hip spica cast for about 4 months
Congenital Clubfoot (talipes valgus, talipes varus, talipes equinus or talipes calcaneus)Deformity of the ankle and foot. Manipulation and casting of the foot for 12 weeks. Monitor for pain, parethesia on the casted foot
Signs of scoliosisAsymetry of the hips and ribs when child bends forward Lateral curvature of the spine
Non-surgical interventions for scoliosisBracing worn 23 hours/day to slow progression. Inspect skin for redness, breakdown. Wear soft clothing under brace. Exercise to strengthen spinal and abdominal muscles. Encourage adolescent to pick out own clothing to enhance body image
Post operative interventions after surgery to repair scoliosis (internal fixation-arthrodesis)Maintain alignment. Log roll. Assess feeling and pulses to extremities. Encourage use of spirometer & coughing, deep breathing. Assess dressing for signs of bleeding and infection. Assess for abdominal distention and vomiting & call HCP. Teach patient how to log roll, then come to a sitting position. Assist with ambulation
Juvenile arthritis: symptoms & interventionsDiagnosed by symptoms, elevated sed rate, Xray of soft tissue swelling Assist with ROM exercises Provide hot or cold packs for painful episodes Administer NSAIDs, methotrexate, corticosteroids as ordered
Duchenne's muscular dystrophy signs/symptomsGradual weakening of skeletal muscles. Affect brain, retinas, GI, respiratory and cardiac. Genetic x-linked recessive defective lack of dystrophin. Weakness begins in lower legs at about 3-5 years old. Waddling gait. Toe walking. Large, doughy fat deposits in muscles (starts in legs). Positive Gower's sign. Elevated serum cretinine kinase
Duchenne's muscular dystrophyProvide a safe environment (fall risk). Encourage independence & socialization. Assist with braces. Assist with mobility. Assess for inability to swallow as condition progresses (indicates impending inability to breath). Assist with BiPap or CPap & suction. Provide genetic counseling. Nutritional consults (avoid obesity)
Assessment of the deformities is described based on the position of the ankle and foot- talipes varus: talipes valgus: talipes equinus: talipes calcaneus:talipes varus: inversion or bending inward. talipes valgus: eversion or bending outward. talipes equinus: plantar flexion in which the toes are lower than the heel. talipes calcaneus: dorsiflexion in which the toes are higher than the heel
Abnormal development of the femoral head in the acetabulum.Hip Dysplasia
A congenital disorder of collagen synthesis that affects all connective tissue in the body?Osteogenesis Imperfecta
What is genu varum?"Bow-legged"
At what age should genu varum be evaluated?Walking
What is genu valgrum? "Knock-kneed"
At what age should genu valgrum be evaluated?2-7yr
What is a positive Allis sign?When one knee is lower than the other when both are flexed
What is slipped capital femoral epiphysis (SCFE)?A medical emergency in which the femoral head slips off the neck of the femur and there is a lack of circulation going to the femur head
When does slipped capital femoral epiphysis (SCFE) generally occur?During adolescent growth spurts, more commonly in boys than girls
What are the 3 clinical manifestations of slipped capital femoral epiphysis (SCFE)?Limp limb with loss of motion 2 knee, thigh, hip, or groin pain 3 inability to bear weight
How is slipped capital femoral epiphysis (SCFE) treated?Traction before surgery to relieve pain. Surgery for pinning.
What is torticollis?A mostly cosmetic disorder in which there is injury to the sternocleidomastoid and cervical injury during birth, leading to a head tilt
When is Bryant's traction most commonly used?When body weight is not sufficient enough to provide countertraction such as when the patient is under 3 years old or under 35 pounds, like with DDH and femur fractures
What are the 3 clinical manifestations for talipes deformities? Is bilater or unilateral genetic?Affected foot usually smaller and shorter. 2. Heel pad "empty" 3. If defect is unilateral- affected limb is usually shorter with calf atrophy. Bilateral is genetic
Talipes deformities- therapeutic mgmtSerial casting- adjust every 1-2 weeks while pt grows. 2. Surgery
Talipes deformities- Nursing mgmtCast care. 2. Passive ROM with diaper changes
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