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MS Test 3 Part 2

Peds stuff

another name for clubfoot talipes equinovarus
clubfoot rx done in infancy. stretching, splinting, taping, serial casting, possibly sx
torticollis wry neck-shortening/contracture of sternocleidomastoid mm, can be congenital. in infants can lead to head & neck asymmetry
torticollis posture head sidebent to shortened side + turned away
torticollis rx in children teach parents: 1)stretching ex 2)position to stretch 3)how to hold & carry the child 4)encourage the child to turn head to midline
developmental coordination disorder clumsy child, cause unknown, non-progressive
developmental coordination disorder clinical pic learning disabilities, attn deficits, sensory integration probs, perceptual probs, jt hypermobile, winging scap, proximal wkness, freq falls, delayed automatic postural adjustments, poor rhythm, poor motor planning, awkward, probs run, jump, climb
developmental coordination disorder PT interventions inc into play: balance activities, running, jumping, climbing, music, rhythm, proximal/trunk strengthening, fine motor skills, rx perceptual deficits (sensory integration)
cystic fibrosis (CF) life-threatening congenital disorder of the exocrine glands characterized by the production of copious amounts of abnormally thick mucus, especially in the bronchus & lungs. clogs the pancreas, blocks food absorption
cystic fibrosis (CF)respiratory symptoms wheezy respirations, dry cough, dyspnea, tachypnea, and frequent lung infections
cystic fibrosis (CF) GI symptoms vomiting, constipation, electrolyte imbalance, and inability to absorb fats
cystic fibrosis (CF) dx tests 2 positive sweat tests using a sweat inducer. one of the following:obstructive pulmonary dx, confirmed pancreatic insufficiency or failure to thrive & family hx of CF. DNA testing may be done prenatally. chest xray & pulmonary function test may be ordered
cystic fibrosis (CF) meds antibiotics (to prevent lung infections, mucus thinning drugs, bronchodilators, vitamin & oran pancreatic enzymes (omega-3) & anti-inflammatory drugs
cystic fibrosis (CF) other medical rx positive expiratory pressure therapy PEP, chest therapy (to combat pulmonary dysfunction, loosening and removing mucopurulent secretions), O2 therapy, gene therapy, (may correct the defective CFTR protein made by CF gene), lung transplt, increase calories
cystic fibrosis (CF)rx interventions post drainage, low impact endurance program:bike, swimming & walking (use RPE scale & pulse ox), increase calorie & fluid intake
hip dysplasia dx test- Ortolani's 1)hip flex & abduct w/downward pressure dislocates the hip. 2)hip flex, abduct & slight traction and then you hear a click
hip dysplasia dx test- Barlow's click hold the hips & knees @ 90 degrees of flex while exerting a bkwd pressure down & laterally, slowly adduct the hip & note any feeling of the femoral slipping postolaterally
hip dysplasia appearance asymmetries in gluteal folds (higher on affected side), extra thigh skin folds, leg length discrepancy
hip dysplasia posture lumbar lordosis
hip dysplasia jt mob/ROM physical asymmetries in ROM (esp limitation of hip abduction)
hip dysplasia strength decreased, esp in glute med
hip dysplasia gait waddle or compensated trendelenburg in patients w/bilateral dysplasia or limp & + trendelenburg in stance phase in pts w/unilateral
hip dysplasia medical rx hip harness (Pavlik):infant must wear continuously for 3-9 mos & wean to night time only; stabilizes the hip in flex, ER & ABD for correct alignmnt, sx-traction, closed reduction, open reduction, tenotomy of contrct mm, osteotomy of femur or acetabulum
hip dysplasia prognosis if rx relates to childs age & start of rx:reversible & 95% chance of normal hip if corrected in first few wks of life, 80% satisfaction if sx is required. 7% risk for avascular necrosis & 18% for premature physeal arrest during growth
hip dysplasia prognosis if not rx DJD, hip pn, antalgic gt, scoliosis, back pn, and need for THR may be prevalent
hip dysplasia rx interventions use of Pavlik harness in infants (flex hip to 100 degrees & ABD 90 degrees, gt trning w/AD PRN, may use spica cast post op, can't really sit, may use reclining WC
spinal mm atrophy anterior horn cells undergo progressive degeneration, usually both parents carry the gene/trait that causes
spinal mm atrophy mental status developmental delay, mental retardation
spinal mm atrophy ROM decreases due to contractures, hip 1st then moves distally
spinal mm atrophy type I acute prognosis poor death usually within 2-3 years
spinal mm atrophy type 2 chronic prognosis depends on degree & frequency of pulmonary complications
spinal mm atrophy type 3 Kugelberg-Welander can reach adulthood
spinal mm atrophy type I acute rx interventions developmental posture trng, family edu, position in sidelying, use of slings
spinal mm atrophy type 2 chronic rx interventions reaching activities, deep breathing, postural drng, use of orthotics for trunk support
spinal mm atrophy type 3 Kugelberg-Welander rx interventions strengthening ex, gt trng, use & pt ed of orthotics/WC/AD
Arthrogryposis Multiplex Congenita (AMC) initial/chief complaint decreased fetal mvmt in utero, multiple contractures present at birth
Arthrogryposis Multiplex Congenita (AMC) posture jack knife:flexed/dislocated hips, ext knees, clubfeet, IR shd, flex elbows, flex/ulnar dev wrist; Frog leg: abd/ER hips, flex knees, clubfeet, IR shd, ext elbows, flex/ulnar dev wrists
Arthrogryposis Multiplex Congenita (AMC) medical rx sx:for clubfoot should occur when child is strong enough and wants to walk; by 2 yrs; scoliosis, mm lengthening, capsulotomy, osteotomy, serial casting; splinting;walkers
Arthrogryposis Multiplex Congenita (AMC) rx interventions stretching program (3-5x day), functional positioning, prone position program for life, head/trunk control activities, jt preservation, energy conservation, AD's, splinting, WC trng, orthotics
osteogenisis imperfecta Type I characteristics: AD, mild to mod fragility. severity:mildest
osteogenisis imperfecta Type II characteristics: AD, in utero fx. severity:most severe, lethal
osteogenisis imperfecta Type III characteristics: AD, progressive. severity:intermediate
osteogenisis imperfecta Type IV characteristics: AD, moderately severe fragility. severity: more severe than type I
osteogenisis imperfecta mental status average or above average intelligence
osteogenisis imperfecta appearance short stature, bowing of long bones, ligamentous joint laxity, chest wall deformities & kyphoscoliosis
osteogenisis imperfecta wound assessment skin assessment for swelling, redness, and warmth and assess orthotic for excessive pressure
osteogenisis imperfecta medical rx HKAFO, pelvic band, prone stander, intramedullary rod fixation, special telescoping rods (allows the child's bones to grow with the rod in place)
osteogenisis imperfecta rx interventions pool ex, AROM straight plane only, light wts placed close to jts, protective WB in stander, dev activities (may roll to move), orthotic &/or WC edu, energy conserv, adaptive equip, deep breathing
osteogenisis imperfecta edu protective carrying on pillow or custom-molded carrier, padding hard surfaces, no extra force when putting on or removing orthoses, proper handling, dressing, positioning. in hospital often
Created by: jessigirrl4



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