312 Unit 2 - Alterations in Musculoskeletal System

Bones complete their growth around age:

a. 15

b. 18

c. 20

d. 25

c. 20

true or false: poor healing of the epiphyseal plate greatly increases the chance of interference with future bone growth

true

fractures are rare in infants with what exception?

motor vehicle crashes

what is the healing period for a fracture in an infant?

a. 2-3 weeks

b. 4 weeks

c. 6-8 weeks

d. 8-12 weeks

a. 2-3 weeks

what is the healing period for a fracture in early childhood?

a. 2-3 weeks

b. 4 weeks

c. 6-8 weeks

d. 8-12 weeks

b. 4 weeks

what is the healing period for a fracture during later childhood?

a. 2-3 weeks

b. 4 weeks

c. 6-8 weeks

d. 8-12 weeks

c. 6-8 weeks

what is the healing period for a fracture during adolescence?

a. 2-3 weeks

b. 4 weeks

c. 6-8 weeks

d. 8-12 weeks

d. 8-12 weeks

what is the priority intervention when dealing with fractured bones?

a. maintain alignment and immobilize extremity

b. provide adequate calcium intake

c. splint it immediately

d. monitor for compartment syndrome

a. maintain alignment and mobilize extremity

what are the five Ps if assessing for signs of compartment syndrome?

1. pain

2. pulse distal to fracture site

3. pallor - red, pale, blue...

4. paresthesia (numbness and tingling)

5. paralysis - distal to fracture site

what is the goal of peddling a spica cast?

a. prevent tearing of clothes

b. keep the cast material clean and intact

c. allow for easier application and removal

d. provide additional support to the area

b. keep the cast material clean and intact

which system should be assessed after application of a spica cast?

respiratory - cast can get too tight on the trunk region

what is the purpose of traction?

a. pull bones back into place

b. keep child upright to promote blood flow

c. provide rest, proper positioning, and prevent contractures

d. prevent breakdown of the skin during the healing process

c. provide rest, proper positioning, and prevent contractures

what age group is Bucks traction used for?

over age two

what age is Bryant's traction used for?

two and under

____________ traction is used for kids needing spinal alignment or decompression

cervical

(kyphosis/lordosis) is outward curvature of the upper spine

kyphosis

(kyphosis/lordosis) is inward curvature of the LUMBAR region

Lordosis

unlike kyphosis and lordosis, ________________ is lateral curvature of the spine; can be seen in either S or C like curves

scoliosis

abnormal curvature of the spine is considered to be anything greater than ______ degrees

10

10-20 degree curvature of the spine requires:

a. some kind of PT for correction

b. a body jacket/TLSO

c. surgical intervention for spinal fusion

a. some kind of PT for correction

20-40 degree spinal curvature requires:

a. some kind of PT for correction

b. a body jacket/TLSO

c. surgical intervention for spinal fusion

b. a body jacket/TLSO

40+ degree spinal curvature requires: ]a. some kind of PT for correction

b. a body jacket/TLSO

c. surgical intervention for spinal fusion

c. surgical intervention for spinal fusion

screening for scoliosis is done at what two grade levels?

5th and 7th

____________ is the most common congenital food disorder involving inward turning of the foot

metatarsus adductus

a greater than 15 degree turn in patients with metatarsus adductus requires:

a. weekly massage

b. orthopedic shoes

c. special exercises

d. serial casting

d. serial casting

true or false: metatarsus adductus increases risk for DDH

true

______________ is a congenital disorder in which the foot is twisted involving muscle, bone, and tendons from the knee down; more common in boys

clubfoot

true or false: clubfoot does not need to be treated with casting, it can be corrected by orthopedic shoes and exercise

false

genu (varum/vulgum) is otherwise known as bowlegs and common until 2-3 years of age

varum

genu (varum/vulgum) is otherwise known as knock-knees and common up to age 4-5 years

vulgum

______________ is a condition in which the femoral head and acetabulum are not aligned properly causing instability, dislocation, or subluxation of the hip joint

developmental dysplasia of the hip (DDH)

what two maneuvers are done at birth to assess for DDH?

ortolani and barlows

what kind of treatment is used for infants under 3 months old diagnosed with DDH

a. pavlik harness

b. spica cast

c. braces

d. surgery

a. pavlik harness

_______________ is a condition characterized by avascular necrosis of the femoral head resulting in poor blood flow to the femoral epiphysis

legg-calve-perthes disease

which stage of legg-calve-perthes disease involves beginning of leg pain and limp along with damage occuring when blood flow to hip ceases?

a. onset

b. fragmentation

c. reconstitution

d. residual

a. onset

which stage of legg-calve-perthes disease is the body's attempt to repair itself yet results in the highest amount of fragmentation and collapse

a. onset

b. fragmentation

c. reconstitution

d. residual

b. fragmentation

what is the main goal of treatment during the fragmentation phase of legg-calve-perthes disease?

keep the ball of the femur in the socket

which stage of legg-calve-perthes disease occurs when all the dead bone that appears white on x-ray has been dissolved and new bone begins to fill in missing portions

a. onset

b. fragmentation

c. reconstitution

d. residual

c. reconstitution

which stage of legg-calve-perthes disease occurs when the ball has been completely replaced with new bone?

a. onset

b. fragmentation

c. reconstitution

d. residual

d. residual

_________________ is the most common hip disorder in adolescents that occurring during the growth spurt when the femoral head displaces the femoral neck

slipped capital femoral epiphysis (SCFE)

_____________ is a chronic autoimmune disorder involving an antigen-antibody complex deposited in connective tissue causing a multi-system inflammatory response most commonly affecting kidneys, skin, and joints

systemic lupus erythematosus (SLE)

what is the number one cause of death in SLE patients that needs to be monitored very closely?

infection

what special teaching can be provided to SLE patients on steroids?

a. alternate day schedule to minimize side effects

b. drink with a full glass of water due to size of oral tablets

c. rinse mouth after administration to prevent oral thrush

d. use a pill organizer to manage the medication regimen

a. alternate day schedule to minimize side effects

_______________ is a chronic autoimmune disorder characterized by joint inflammation, decreased mobility and pain that now has potential for life-long remission

juvenile idiopathic arthritis (JIA)

what is of high concern with patients diagnosed with JIA?

skin infections

NSAIDs, DMARDs, and steroids used for JIA can cause what symptom requiring use of PPIs?

a. stomach ulcers

b. neuropathy

c. N/V/D

d. cataracts

a. stomach ulcers

________________ is the infection of bone that can result from any kind of break in the skin often with a bacterial causative agent

osteomyelitis

a patient with osteomyelitis should make sure they are up to date on their _____________ immunization

tetanus

true or false: the antibiotic regimen for osteomyelitis is IV and oral so patients will go home with a PICC line

true

_______________ is an infection of the joint that can be drained via aspiration, open drainage and irrigation, and IV antibiotics

septic arthritis

__________________ is a genetic condition affecting collagen production making the bones very brittle and easily broken

osteogenesis imperfecta

what are some ways patients with osteogenesis imperfecta prevent deformities and maximize mobility while decreasing the risk of fractures?

1. cap teeth

2. rods in long bones

3. pamidronate