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Exam #4 - Musculoskeletal

Describes a variety of hip abnormalities in which there is a shallow acetabulum, subluxation or dislocation Developmental dysplasia of the hip
What is the most significant risk factor for DDH? Family history
This form of DDH is mildest and is characterized by a femoral head still in the acetabulum but has a risk for coming out Acetabular dysplasia
This form of DDH is the most common type where there is partial displacement of the acetabulum Subluxation
This form of DDH is where the femoral head loses contact with the acetabulum Dislocation
How is DDH diagnosed? Primarily from a physical exam
What two distinct tests are performed to assess for DDH? Barlow's test is to determine if it's dislocatable and Ortolani's test is to determine if the hip is dislocated and reducible (will "clunk" back into place)
Up until what age is DDH assessed? 2 years
What is the Pavlik Harness? Most popular management of DDH for newborns to 6 months where the hips are kept in the flexed position which keeps the femoral head in contact with the acetabulum
How is DDH managed in an older child who is walking? Surgery is needed
For a 6 to 18 month old with DDH, what are their management options? Gradual reduction with traction, hip spica cast or fixed orthosis, surgical release of hip adductor or ileopsoas, or open reduction using pins inserted into the hip
Is DDH more common in males or females? Females, 6:1
Describes a deformity involving the ankle and foot where the foot is pointed downward and inward Congenital Talipes Equinovarus (Clubfoot)
What is the most popular management correction of clubfoot? A series of casts
Describes a lateral curvature of the spine Scoliosis
Is clubfoot more common in males or females? Males, 2:1
Is scoliosis more common in males or females? Females, 7:1
This is the most common orthopedic deformity in childhood and adolescence Scoliosis
Name the two types of scoliosis Functional and structural
This type of scoliosis involves changes outside of the spine Functional
This type of scoliosis involves a change in the spine itself Structural
This is the cause of 80% of all scoliosis cases Idiopathic origins
What is the treatment for functional scoliosis? Exercise
What is the most used treatment for structural scoliosis? Bracing
This type of brace to treat scoliosis applies pressure to the curve with corrective pads custom fit to the patient Thoraco-Lumbo-Sacral-Orthosis (TLSO) also known as the Boston brace
Does the TLSO brace correct the scoliosis curvature? No, it only halts its progression
This type of brace is used for higher thoracic scoliosis curves and it has a traction component to it Cervico-Thoraco-Lumbo-Sacral-Orthosis also known as the Milwaukee brace
Does the Milwaukee brace correct the scoliosis curvature? No, it only halts its progression
When is surgical repair of scoliosis used? For moderate to severe cases of scoliosis
What are the five P's that get assessed with fractures? Pain, pallor, pulse (distal to the injury), paralysis, paresthesia (sensation)
This type of fracture produces separate bone fragments Complete
This type of fracture produces fragments that are attached Incomplete
This type of fracture is a break crosswise (right angle) to the length of the bone Transverse
This type of fracture is an off-kilter break Oblique
This type of common childhood break is seen in younger children Bend
This type of common childhood break produces a raised projection on the bone Buckle
This type of common childhood break is like breaking the limb on a tree that is still green Greenstick
This type of common childhood break leaves the membrane still intact Periosteal
Traction needs this to work Countertraction
Name the two types of traction Skin and skeletal
Name the three types of skin traction Bryant's, Buck's, and Russell
Name a type of skeletal traction Ninety-ninety
What is Bryant's skin traction used for? Femoral fractures in the very young
In this type of traction, hips are flexed at 90 degree angle and knees are extended and attached to pulleys Bryant's traction
What is Buck's skin traction used for? Keep hip joint immobilized and to correct severe contratures
In this type of traction, the legs are extended and the hips are not flexed Buck's traction
What is Russell's skin traction used for? Contractures of the knee area
In this type of traction, there are two lines of pull where one is longitudinal and the other is perpendicular Russell's traction
This is the most popular type of traction used Ninety-ninety
In this type of traction, Steinmann pins are put in the distal portion of the femur and it is attached to a pulley system Ninety-ninety
This is a fracture complication that involves increased pressure due to swelling from a constricture like a cast or a tight dressing Compartment syndrome
This is a fracture complication that involves growth plate damage that can be seen on an x-ray Epiphyseal damage
Long bone fractures put a person at greater risk for this fracture complication Pulmonary or fat embolus
What does it mean to say "petal the cast?" Smooth-out the rough edges of the cast
What is another name for Juvenile Idiopathic Arthritis? Juvenile Rheumatoid Arthritis
Describes a chronic inflammatory disease Juvenile Rheumatoid Arthritis
Does juvenile rheumatoid arthritis affect males or females more? Females, 2:1
Why aren't rheumatoid factors used to diagnose juvenile rheumatoid arthritis? The factors are not specific enough
Heat and exercise are encouraged in the nursing care of what disease? Juvenile rheumatoid arthritis
What does SAARDs stand for? Slower-acting Antirheumatic Drugs
Besides SAARDs, what other medication treatments are there for juvenile rheumatoid arthritis? NSAIDs, biologic agents and corticosteroids
Describes a progressive, muscular weakness and wasting with contractures Duchenne Muscular Dystrophy
What is the age of onset for MD? Between 3 and 5 years
When does the loss of ambulation occur in a child with MD? Between 9 and 12 years of age
Name the two most common causes of death for a person with MD Respiratory tract infection or cardiac failure
This describes a characteristic manner of rising from a squatting or sitting position that is common with MD Gower's sign
Describes when the muscles, especially in the calves, thigh and upper arms become enlarged from fatty infiltration in a person with MD Pseudohypertrophy
Name six complications of MD Contractures, scoliosis, disuse atrophy, infections, obesity and cardiac failure
Passive ROM exercises, stretching and active exercises are effective in treating this complication of MD Contractures
This MD complication is caused by muscle imbalance Scoliosis
These type of infections become increasingly frequent in a child with MD Pulmonary infections
This complication of MD contributes to premature loss of ambulation Obesity
These two medications can be used in the early stages of cardiac failure in a child with MD Digoxin and diuretics
This is the most significant complication of MD Cardiac failure
Created by: ssbourbon