NYU peds exam II neuro/musculoskeletal set copy

Increased ICP early sx

H/A

Increased ICP late sx

decreased HR + RR

Increased ICP interventions

elevate HOB

Brain tumor sx

H/A

Hydrocephalus

enlargement of ventricles due to increase in CSF (too much production or too little absorption)

Hydrocephalus Tx

fix cause

ventriculoperitoneal shunt

to drain CSF

Brain surgery TX

HOB elevated

Thermoregulation in brain surgery

may be high or low because of surgery and anesthias

Report : brain surgery

Drainage and odor - could be CSF or infection

Bacterial Meningitis infant SX

fever

Bacterial Meningitis Children/Adult SX

stiff neck

Bacterial Meningitis Interventions

Minimize stimuli

Bacterial Meningitis Test

WBC

Bacterial Meningitis RX

antibiotics

Head injury SX

hx

Head injury Interventions

concussion scale

Pediatric coma scale

eye opening

liner skull fracture

minor

Depressed skull fraccture

forceful impact from blunt object

Diastatic skull fracture

most common in Lamboid sutures (back top)

Compound skull fracture

liner or depressed

Basilar skull fraccture

severe blunt trauma w/ significant force

Basilar skull fracture SX

CSF rhinorrhea + otorrhea

Subdural Hematoma SX

vom

Subdural hematoma patho

dura still attached to skull

Epidural hematoma Sx

voom

Epidural hematoma patho

middle meningeal artery rupture

Epidural hematoma complications

compression occurs rapidly and can cause impairment of brain stem

Epidural hematoma TX

prompt surgical evacuation and cauterization of artery

Spina Bifida

neural tube fails to close as a fetus

Spina bifida SX

neural tube abnormalities

flaccid paralysis

absence of reflexes

Spina bifida complications

mobility

Spina bifida DX

prenatal

assess: movement of extremities + anal reflex

Spina bifida interventions

infection control - sterile gauze

surgical prep + fam comfort

folic acid (leafy greans

fruits

Club foot

mal-aligned feet that resist being moved into normal position

Club foot causes

fetal positioning

Club foot assessment

anteroposterior Xray w/ Steeple sign

ultrasound

Club foot TX

serial casting

surgery + PT

Developmental dysplasia of hip

subluxation of complete dislocation of hip

girls > boys

fetal positioning

Developmental dysplasia of hip appearance

asymetric fold of thighs

Barlow

knees in

Ortolani

knees out

Developmental dysplasia of the hip DX

screening - clunk

Developmental dysplasia of the hip TX

Pavlik harness

Pavlick Harness

continuous < 6mo of age

monitor skin - no lotion or powders

clinic visits q1-2wks

Duchenne muscular dystrophy

progressive loss of function due to muscle loss

hereditary

X-linked

Duchenne muscular dystrophy SX

normal initial development

3yo - loss of function previously attained fine motor -> gross

Gower's sign

Difficulty rising to standing position; has to walk up legs using hands; occurs in Muscular dystrophy

Duchenne muscular dystrophy teen years

wheelchair

Duchenne muscular dystrophy appearance

shoulder's + arms held back awkwardly when walking

Duchenne muscular dystrophy DX

screening tools

Duchenne muscular dystrophy TX

upright position to maintain cardio

deep breathing

chest PT/coughing

persevere ambulation + ADLs

overnight bed rails

monitor for depression

Cerebral Palsy

non-progressive permanent disability

movement

speech

DX from hypoxia

monoplegia cerebral palsy

one limb

Hemiplegia Cerebral Palsy

one side

Diplegia Cerebral Palsy

both arms or both legs

Quadriplegie cerebral palsy

all limbs

Cerebral palsy TX

IM botulin toxin (promote mobility)

Cerebral palsy common complications

deaf

Slipped Capital Femoral Epiphysis

head of femur separated from the rest of the femur at growth plate

Slipped Capital Femoral Epiphysis risk factors

overweight

Slipped Capital Femoral Epiphysis SX

painful limp w/ referred pain to thigh or knee

tenderness

painful ROM

Slipped Capital Femoral Epiphysis AX

hx of obesity

Slipped Capital Femoral Epiphysis tx

immediate surgery

Scoliosis

lateral curvature and rotation of the spine

Scoliosis SX

uneven posture

severe: cardiac + resp compromised

back pain

Scoliosis AX

screening (touch toes)

Scoliosis TX

brace - prevents worsening

surgery if >45 degress

rod replacement and bone grafting

Fracture SX

tenderness

Fracture AX

xray

Non-displaced Fracture TX

casting - non painful

cast gets warm when forming

may take time to dry

Fracture TX

comfort - sedation

traction - pulling

external fixation devices

bone skrewed into external

Cast teaching

do not stick anything in cast

check cap refill

Osteomyelitis

bacterial infection in bone + tissue around bone