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59 Cards in this Set
- Front
- Back
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What is the treatment for a congenital hip disorder?
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Triple diaper goal to abduct
Infant abduct with pillow splint or pavlick harness for 3-6 months Toddler traction to lengthen contracted muscles (bryants). Cast immobilization until joint stable. Open reduction if joint is not stable. |
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What is Talipes?
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Talipes is club foot. It is a congenital skeletal deformity. True clubbed foot is in a fixed position and it cant be moved to normal position.
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What is Talipes Equinovarus?
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foot bent inward
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Talipes Valgus?
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bent out
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Talipes Equinus
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Plantar flextion where toes are lower than heel
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Talipes Calcaneous
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Dorsal flexion where toes are higher than heel
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What is the treatment for club foot?
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Dennis Brown splint shoes go on opposite feet. It is a surgical intervention done from 4 months to 1 year to fix the length of the ligaments, then a cast is put on. Change the cast q week.
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What curvature is considered abnormal for scoliosis?
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10%
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What curvature demands treatment in scoliosis?
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20%
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What percentage curvature requires rods for scoliosis?
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40%
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What are symptoms of scoliosis?
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Unevenness @ hip level and shoulders
Asymmetrical rib cage Scapula is uneven Child does not complain of pain |
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What is the goal of wearing a brace for scoliosis?
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Stop progression of scoliosis. It will not reverse condition.
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What is the Milwaukee brace?
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A brace for scoliosis that goes up to and pushes up on the neck.
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What is the Boston brace?
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Torso brace to treat scoliosis.
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Babies with scoliosis braces are prone to what?
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Pneumonia
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What is Legg-Calve-Perthes disease?
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Disturbance in blood supply to the bone causing aseptic necrosis of the femoral head
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Who does Legg-Calve-Perthes disease affect?
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mostly boys.
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What are the symptoms of Legg-Calve-Perthes disease?
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Limp
Pain Cant move leg Child favors affected leg to avoid discomfort |
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What are the stages of Legg-Calve-Perthes disease, how long does it take, and describe the stages.
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3 stages each lasting 9 months for a total of 27 months
Aseptic necrosis blood supply cut off; bone breakdown occurs. Revascularization vessels regenerate Reparative & Regenerative bone repairs itself |
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What is the treatment for Legg-Calve-Perthes disease?
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Stay off leg!
Dx with x-ray Surgically rebuild head of femur |
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What is Osgood-Schlatter Disease?
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Inflammation of tibial tuberosity resulting in a lump right below the patella
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What are symptoms and what do you do about it?
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Symptom is pain and treatment includes staying away from sports and staying off feet for 4-8 weeks until inflammation subsides.
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What is a slipped capital femoral epiphysis?
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Spontaneous displacement of proximal femoral epiphysis usually occurring in obese individuals.
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What are the symptoms of
slipped capital femoral epiphysis? |
Limp
Cant externally rotate leg Lay w/ external rotation in supine position Pain in hip medial to thigh Shortened leg on affected side |
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Describe Pauciarticular juvinile rheumatoid arthritis.
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affecting 4 or less joints.
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Describe Polyarticular juvinile rheumatoid arthritis.
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Affects 5 or more joints; accounts for 40% of all cases of JRA
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Describe Systemic juvinile rheumatoid arthritis.
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Sustemic variable arthritic symptoms
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What are symptoms of JRA?
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-Pain in joints
-Causes inflammation of iris and ciliary body -Rash -Nodules over joints -Contracted fingers |
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What diagnostic studies are used for JRA?
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-ESR for inflammation
-INA, IGM, IGA, IGG immunoglobulin -Rheumatoid factor |
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What does treatment of JRA consist of?
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-NSAIDS to treat inflammation
-Slow acting anti-rheumatic -Immune modulators -Cytotoxic drugs -Steroids, but not long term -Tumor necrotic factor when others fail -PT/OT -ROM is painful, but necessary |
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What do you check when a child is in traction?
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Circulation
Mobility Sensation |
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Who gets Muscular Dystrophy and why?
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Boys get M.D. from their mothers because it is x-linked recessive.
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What is the age of onset in M.D.?
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1-3 years old
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What is the biggest sign of M.D. for a mother to see?
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Delayed walking
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What are 2 hallmarks of M.D.?
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-Lordosis (waddling gait)
-Difficulty rising from floor |
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What can be done for kids with M.D.?
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Not much. P/T to keep unaffected muscles from atrophy.
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What happens with temperature in ICP?
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Goes up
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What happens to pulse in ICP?
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Can go up or down
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What happens to respirations in ICP?
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can go up or down
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What does an open suture line mean in a 3 year old?
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Increased intracranial pressure
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Which cranial nerves are affected in ICP?
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3 - occumotor
4 - troclear 5 - abducens |
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What are chief normal characteristics of cerebral spinal fluid?
-Specific gravity -Color -Ph -WBCs and RBCs -Protein & glucose |
-Specific gravity 1.004-1.008
-Colorless -Ph alkaline -Few WBCs and no RBCs -Lots of protein & glucose |
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What happens in an aseptic CSF invasion
to glucose and WBCs? |
WBCs under 500
No change in glucose |
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What happens to glucose and WBCs in CSF during a bacterial invasion?
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WBCs over 500, lots of bands
Low glucose |
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What is Kernig's sign and what does it indicate?
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-Knees resist extension
-Indicates ICP |
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What is Brezenski's sign and what does it indicate?
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-Head elevated, knees up
-Indicates ICP |
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What are opisthatonas and what does it indicate?
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Lockjaw and arched back caused by tetanus or meningitis
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What's papilledema indicate in a small child?
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-Large optic disk , rupture of optic vessels
-Shaken baby syndrome, ICP. |
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What's the 1st sign of ICP?
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Decreased LOC
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What do you give an ICP kids as far as oxygen goes?
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O2 @ 100%
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How do you monitor ICP?
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-Intraventricular catheter
-Glasgow coma scale -Vitals -Get pt to hyperventilate because CO2 causes vessel dilation |
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Body management of ICP pt?
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-HOB 30 degrees for venous drainage
-avoid neck/hip flexion -Passive ROM -Stool softeners to avoid straining -Decrease environmental stimuli |
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What types of meds are given to ICP pt?
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-Osmotic diuretic
-loop diuretic -corticosteroid -Abx -Antiepileptic -Barbituate coma -Pain meds |
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What is an idiopathic seizure?
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siezure with unknown cause
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What is an acquired seizure?
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Seizure with a known cause
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What is a Tonic-Clonic Seizure?
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Tonic = arched
Clonic = straight armed -Can last 30 minutes -Occurs w/o warning -eyes roll w/immediate change in LOC -decreased movement |
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Describe absence seizures
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5-10 second LOC
"Daydreaming stare" Minimal loss of muscle tone 5-9 yrs of age May appear confused after event Abnormal EEG |
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Infantile Spasms are what?
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-seizure between 6 and 8 months of age
-Looks like a morro response -Usually w/ menal disability or LD child |
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Why not give tylenol to febrile seizure pt?
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Febrile seizures are d/t spike in temp, not degree of temp
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