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N114 Skeletal
N114 - Skeletal Dysfunction
| Question | Answer |
|---|---|
| Dysplasia of the hip | Femoral head has abnormal relationship to the acetabulum (hip socket) |
| Hip dysplasia patho | Maternal hormone secretion relaxin, frank breech birth, twins, large infant |
| Degrees of DDH | Dislocatable - mildest form, Sublaxation - most common, Luxation - complete dislocation |
| DDH treatment - newborn | Pavlik harness worn for 3-6 months |
| DDH treatment - infant to toddler | Gradual reduction by traction |
| DDH treatment - older child | Involves operation to release muscles & tendons |
| Barlow maneuver | Unstable femoral head is pushed out of acetabulum by gentle lateral pressure |
| Ortolani maneuver | Relocation of femoral head by abduction & external rotation |
| Clubfoot | Congenital deformity of the foot |
| Clubfoot patho | Foot points downward, forefoot turns inward, sole of foot turns inward, foot is rigid & fixed |
| Clubfoot treatment | Serial casting, changed every 1-2 weeks |
| Osteogenesis Imperfecta | Brittle bone disease |
| Osteogenesis imperfecta symptoms | Little pain at fracture site, dental deformities, blue sclera, thin skin. Child bruises easily |
| Osteogenesis imperfecta treatment | Early treatment of fractures & prevention of abnormalities |
| Kyphosis | Excessive convex curvature of spine |
| Congenital kyphosis | Failure of formation or segmentation of vertebral structure |
| Postural kyphosis | Occurs in pre-adolescent years among girls who are self-conscious |
| Kyphosis treatment | Optionss include no treatment, exercising, bracing or surgical intervention |
| Lordosis | Concave curvature of lumbar spine - normal finding in toddlers |
| Lordosis treatment | Postural exercises. Bracing & surgery are rarely needed |
| Scoliosis | Spinal deformity, lateral curvature of the spine with vertebral rotation |
| Scoliosis patho | On concave side, muscles & ligaments become contracted & thickened. On convex side they become thin & atrophied |
| Scoliosis symptoms | Unequal shoulder & hip level, pain is uncommon until deformity is advanced |
| Scoliosis treatment | Orthotic intervention - bracing, Boston & Milwaukee brace and surgical spinal fusion |
| Boston brace | Underarm prefabricated plastic shell - low thoracolumbar & lumbar curves |
| Milwaukee brace | High thoracic curves - plastic & metal w/chin extension |
| Harrington rod | Used to fuse vertebrae |
| Slipped femoral capital epiphysis | Slipping of proximal femoral epiphysis in a posterior & inferior direction |
| Slipped femoral incidence | Occurs during adolescent growth spurt, occurs in very tall & obese adolescents |
| Slipped femoral symptoms | Limp, referred pain to groin, hip or knee, limited ROM, external rotation of leg |
| Slipped femoral treatment | Surgery is required, pre-surgical bed rest/traction, pin across growth plate, not-weight bearing |
| Rheumatoid Arthritis patho | Chronic inflammation of a joint |
| Rheumatoid symptoms | Morning immobility or stiffness & joint pain, joint swelling & heat, not red |
| Rheumatoid tests | Elevated erythrocyte sedimentation rate, elevated c-reactive protein, elevated WBC & platelets |
| Rheumatoid treatment | NSAIDS, Methotrexate - chemo drug, corticosteroids, physical therapy |
| Muscular dystrophy | Degenerative inherited muscle wasting disease, x-linked recessive |
| Muscular dystrophy patho | Absence of muscle protein dystrophin, results in degeneration of muscles |
| Muscular dystrophy symptoms | Between 2-4, pelvic muscles weaken, difficulty climbing stairs, running |
| Gower sign | Process that children use to stand up |
| Muscular dystrophy progression | Enlargement of calves & wasting of thighs, 9-12 walking becomes impossible, breathing becomes difficult, heart weakens |
| Fractures | Rarely occur in infants - usually a result of abuse |
| Simple fracture | Skin remains intact |
| Compound fracture | Broken bone protrudes through skin |
| Transverse fracture | Fracture that is at right angles to long axis of bone |
| Oblique fracture | Slanting or diagonal fracture across bone |
| Spiral fracture | Circular or twist to fracture - commonly seen in abuse |
| Greenstick fracture | Break through bone where one side only bends |
| Traction | Immobilize fractures, realign the bone, decrease muscle spasm |
| Skin traction | Applied directly to the skin |
| Skeletal traction | Uses pins, wires or other apparatus that have been surgically placed |
| 5 P's of circulatory checks w/traction | Pain, paresthesia (tingling), paralysis, pulse, pallor |
| Hazards of Immobility | Encourage coughing & deep breathing, wasting of bone, functional loss,urinary stasis, constipation |
Created by:
jrb265
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