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46 Cards in this Set
- Front
- Back
Newborn bones are mostly comprised of ______ |
cartilage - skeleton is flexible and joints are elastic |
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Bones store ____ and produce ____- |
Store Ca and phos; produce RBCs |
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Flexion |
bending a limb at a joint |
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Extension |
straightening a limb at a joint |
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Abduction |
moving a limb AWAY from the midline |
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Adduction |
moving a limb TOWARD the midline |
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Pronation vs Supination |
Pro - facing DOWNward Sup - facing UPward |
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Dorsiflexion |
Flexion toward the back, as in flexion of foot so that the forefoot is higher than the ankle |
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Plantar flexion |
Extension of the foot so that the forefoot is lower than the ankle |
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Rotation |
turning as in face to the side |
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Valgus |
Bent outward or twisted away from the midline of the body |
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Varus |
Turned inward (foot in - goes away with time/stretching) |
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Everted vs Inverted |
Everted - turning out and away from midline Inverted - turning inward toward the midline of the body |
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Are tremors with arms and legs with crying normal or not? |
Normal in 1st 4 days of life |
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Extremity position initially may reflect ____ |
intrauterine position (think breech) |
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Normal position of term infant (3) |
-Limbs flexed -Legs partially abducted at hips -Head turned to one side (usually R) |
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Torticollis |
Spasmodic, unilateral contraction of neck muscles -birth trauma/ischemia in utero -Not seen in immediate nbn period -Firm, fibrous mass or tightness in the sternocleidomastoid muscles at 2 weeks of age -1-2 cm mass that's hard, immobile in midportion of SCM muscle -R side usually more affected -Head tilted toward shoulder on affected side, chin rotated away from affected shoulder |
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Klippel-Feil Syndrome |
Defect of cervical vertebrae - reduction in # of vertebrae and fusion of 2 or more vertebrae -short neck, limited motion -confirm on x-ray -mistaken for torticollis |
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Sprengel deformity |
congenital structural abnormality of shoulder girdle, more common in males |
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Where's the most common fracture? What do you inspect/feel for? |
CLAVICLES Inspect & palpate for size, contour, and crepitus You will NOT see a callus @ birth, you FEEL crepitus Suspect fx with: difficult delivery, irregularity in contour, crepitus on palpation, tenderness on palpation |
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Failure to move an upper extremity? Think ____ (3) |
-spinal cord injury -brachial plexus paralysis -fracture |
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2nd most common bone fractured during birth? |
HUMERUS |
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Brachial palsy d/t |
Traumatic delivery / stretching injury to brachial plexus (c5-8, t1) 30% have complete recovery as edema resolves (don't do lots of stretching until edema gone). If fx doesn't return by 3 months - lookin gat long term sequelae (muscle atrophy, impaired bone growth, osteoarthritis, scapular winging, scoliosis) |
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Erb's vs Klumpke's palsy |
Erb - upper arm paralysis, arm adducted & internally rotated, NO moro, + grasp Klumpke - lower arm paralysis, wrist and hand are paralyzed, NO moro, - grasp |
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Horner's syndrome |
Ptosis of eyelid, iris changes color, smaller pupil Reflects injury to the sympathetic nerve at the C8-T1 level |
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Phrenic nerve palsy |
Cyanosis, increased WOB, asymmetrical chest movement -Usually resolves within in 3 months. If not = surgery |
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Palm creases are developed d/t ____ |
movement in utero, reason DS babies have simian crease |
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Macrodactyly |
enlargement of finger/toe - may be normal or sign of neurofibromatosis |
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Overlapping 2nd and 3rd fingers may be a sign of |
Trisomy 18 |
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Clinodactyly |
incurving of little finger - can be normal |
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Syndactyly |
congenital webbing of fingers or toes - more severe = greater likelihood of bone abnormalities Tx depends on severity Fx deteriorates when multiple digits are involved |
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Polydactyly |
Extra digits - more common in African American Most common - floppy digit or skin tag on ulnar side of hand MUST have x-ray to be sure you don't cut bone On thumb side? more likely a/c syndrome > 1 mm? Get ortho/plastics involved |
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Tethered cord - how does it affect infant |
puts traction on spinal column and they lose ability to move or go to the bathroom |
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What is a "simple dimple" |
One that is located within 2.5 cm of the anus - does NOT require further investigation higher up the dimple, more worrisome. Be sure you can see the base, no sinuses |
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Myelomeningocele |
congenital neural tube defect -caudal end of neural tube fails to close, permitting meninges and sometimes spinal cord to protrude into sac-like structure -functional defect of lower extremities -if level of defect is midback, check legs for muscle wasting/tone. Can baby void/stool? |
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meningomyelocele vs meningocele |
meningomyelocele - cord/nerves involved meningocele - sac, but no cord involved |
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Developmental dysplasia of the hip (DDH) occurs more often in _____ |
-1st born -females -infants in breech regardless of delivery |
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DDH (does / does not) always present in newborn period |
does NOT - check infant at every health visit for 1st year get us at 6 weeks and xray at 4 months |
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Are asymmetric gluteal folds always an indicator of hip dysplasia? |
NO! 25% of infants with normal hips have asymmetric creases |
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Barlow manuever vs Ortolani |
B - Bone (femoral head) clunks OUT of acetabulum; checks hip dislocation O - Bone (femoral head) clucks BACK INTO acetabulum; checks hip reduction Clicks & snap may be felt but are NOT a/c hp pathology. A distinct clunk will be felt for + sign |
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Pavlik harness |
keeps femoral head in acetabulum - if not, it becomes shallow and head won't go in anymore |
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Arthrogryposis |
contractures |
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Metatarsus adductus |
Most common foot anomaly, caused by intrauterine positioning. Can be structural - if foot cannot be brought past midline, it will not self correct |
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Flat footedness due to fat pad disappears at |
1 year of age |
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Club foot |
A/c LGA, smoking in 1st trimester, early amniocentesis Bony deformity - cast or surgery best intervention for club feet - start within 24 hr and cast while mothers hormones are on board |
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Sandal toe |
spacing between big toe and 2nd toe, may normal but up to 45% of downs babies have it |