Exam #4 - Musculoskeletal
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| Describes a variety of hip abnormalities in which there is a shallow acetabulum, subluxation or dislocation | Developmental dysplasia of the hip
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| What is the most significant risk factor for DDH? | Family history
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| 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
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| This form of DDH is the most common type where there is partial displacement of the acetabulum | Subluxation
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| This form of DDH is where the femoral head loses contact with the acetabulum | Dislocation
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| How is DDH diagnosed? | Primarily from a physical exam
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| 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)
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| Up until what age is DDH assessed? | 2 years
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| 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
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| How is DDH managed in an older child who is walking? | Surgery is needed
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| 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
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| Is DDH more common in males or females? | Females, 6:1
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| Describes a deformity involving the ankle and foot where the foot is pointed downward and inward | Congenital Talipes Equinovarus (Clubfoot)
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| What is the most popular management correction of clubfoot? | A series of casts
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| Describes a lateral curvature of the spine | Scoliosis
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| Is clubfoot more common in males or females? | Males, 2:1
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| Is scoliosis more common in males or females? | Females, 7:1
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| This is the most common orthopedic deformity in childhood and adolescence | Scoliosis
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| Name the two types of scoliosis | Functional and structural
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| This type of scoliosis involves changes outside of the spine | Functional
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| This type of scoliosis involves a change in the spine itself | Structural
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| This is the cause of 80% of all scoliosis cases | Idiopathic origins
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| What is the treatment for functional scoliosis? | Exercise
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| What is the most used treatment for structural scoliosis? | Bracing
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| 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
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| Does the TLSO brace correct the scoliosis curvature? | No, it only halts its progression
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| 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
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| Does the Milwaukee brace correct the scoliosis curvature? | No, it only halts its progression
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| When is surgical repair of scoliosis used? | For moderate to severe cases of scoliosis
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| What are the five P's that get assessed with fractures? | Pain, pallor, pulse (distal to the injury), paralysis, paresthesia (sensation)
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| This type of fracture produces separate bone fragments | Complete
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| This type of fracture produces fragments that are attached | Incomplete
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| This type of fracture is a break crosswise (right angle) to the length of the bone | Transverse
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| This type of fracture is an off-kilter break | Oblique
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| This type of common childhood break is seen in younger children | Bend
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| This type of common childhood break produces a raised projection on the bone | Buckle
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| This type of common childhood break is like breaking the limb on a tree that is still green | Greenstick
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| This type of common childhood break leaves the membrane still intact | Periosteal
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| Traction needs this to work | Countertraction
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| Name the two types of traction | Skin and skeletal
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| Name the three types of skin traction | Bryant's, Buck's, and Russell
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| Name a type of skeletal traction | Ninety-ninety
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| What is Bryant's skin traction used for? | Femoral fractures in the very young
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| In this type of traction, hips are flexed at 90 degree angle and knees are extended and attached to pulleys | Bryant's traction
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| What is Buck's skin traction used for? | Keep hip joint immobilized and to correct severe contratures
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| In this type of traction, the legs are extended and the hips are not flexed | Buck's traction
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| What is Russell's skin traction used for? | Contractures of the knee area
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| In this type of traction, there are two lines of pull where one is longitudinal and the other is perpendicular | Russell's traction
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| This is the most popular type of traction used | Ninety-ninety
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| 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
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| This is a fracture complication that involves increased pressure due to swelling from a constricture like a cast or a tight dressing | Compartment syndrome
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| This is a fracture complication that involves growth plate damage that can be seen on an x-ray | Epiphyseal damage
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| Long bone fractures put a person at greater risk for this fracture complication | Pulmonary or fat embolus
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| What does it mean to say "petal the cast?" | Smooth-out the rough edges of the cast
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| What is another name for Juvenile Idiopathic Arthritis? | Juvenile Rheumatoid Arthritis
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| Describes a chronic inflammatory disease | Juvenile Rheumatoid Arthritis
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| Does juvenile rheumatoid arthritis affect males or females more? | Females, 2:1
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| Why aren't rheumatoid factors used to diagnose juvenile rheumatoid arthritis? | The factors are not specific enough
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| Heat and exercise are encouraged in the nursing care of what disease? | Juvenile rheumatoid arthritis
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| What does SAARDs stand for? | Slower-acting Antirheumatic Drugs
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| Besides SAARDs, what other medication treatments are there for juvenile rheumatoid arthritis? | NSAIDs, biologic agents and corticosteroids
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| Describes a progressive, muscular weakness and wasting with contractures | Duchenne Muscular Dystrophy
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| What is the age of onset for MD? | Between 3 and 5 years
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| When does the loss of ambulation occur in a child with MD? | Between 9 and 12 years of age
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| Name the two most common causes of death for a person with MD | Respiratory tract infection or cardiac failure
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| This describes a characteristic manner of rising from a squatting or sitting position that is common with MD | Gower's sign
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| Describes when the muscles, especially in the calves, thigh and upper arms become enlarged from fatty infiltration in a person with MD | Pseudohypertrophy
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| Name six complications of MD | Contractures, scoliosis, disuse atrophy, infections, obesity and cardiac failure
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| Passive ROM exercises, stretching and active exercises are effective in treating this complication of MD | Contractures
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| This MD complication is caused by muscle imbalance | Scoliosis
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| These type of infections become increasingly frequent in a child with MD | Pulmonary infections
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| This complication of MD contributes to premature loss of ambulation | Obesity
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| These two medications can be used in the early stages of cardiac failure in a child with MD | Digoxin and diuretics
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| This is the most significant complication of MD | Cardiac failure
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