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Nur-425
Exam #4 - Musculoskeletal
Term | Definition |
---|---|
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 |