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59 Cards in this Set

  • Front
  • Back
What is the treatment for a congenital hip disorder?
Triple diaper goal to abduct

Infant – abduct with pillow splint or pavlick harness for 3-6 months

Toddler – traction to lengthen contracted muscles (bryant’s). Cast immobilization until joint stable. Open reduction if joint is not stable.
What is Talipes?
Talipes is club foot. It is a congenital skeletal deformity. True clubbed foot is in a fixed position and it can’t be moved to normal position.
What is Talipes Equinovarus?
foot bent inward
Talipes Valgus?
bent out
Talipes Equinus
Plantar flextion where toes are lower than heel
Talipes Calcaneous
Dorsal flexion where toes are higher than heel
What is the treatment for club foot?
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.
What curvature is considered abnormal for scoliosis?
What curvature demands treatment in scoliosis?
What percentage curvature requires rods for scoliosis?
What are symptoms of scoliosis?
• Unevenness @ hip level and shoulders
• Asymmetrical rib cage
• Scapula is uneven
• Child does not complain of pain
What is the goal of wearing a brace for scoliosis?
Stop progression of scoliosis. It will not reverse condition.
What is the Milwaukee brace?
A brace for scoliosis that goes up to and pushes up on the neck.
What is the Boston brace?
Torso brace to treat scoliosis.
Babies with scoliosis braces are prone to what?
What is Legg-Calve-Perthes disease?
Disturbance in blood supply to the bone causing aseptic necrosis of the femoral head
Who does Legg-Calve-Perthes disease affect?
mostly boys.
What are the symptoms of Legg-Calve-Perthes disease?
•Can’t move leg
•Child favors affected leg to avoid discomfort
What are the stages of Legg-Calve-Perthes disease, how long does it take, and describe the stages.
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
What is the treatment for Legg-Calve-Perthes disease?
•Stay off leg!

•Dx with x-ray

•Surgically rebuild head of femur
What is Osgood-Schlatter Disease?
Inflammation of tibial tuberosity resulting in a lump right below the patella
What are symptoms and what do you do about it?
Symptom is pain and treatment includes staying away from sports and staying off feet for 4-8 weeks until inflammation subsides.
What is a slipped capital femoral epiphysis?
Spontaneous displacement of proximal femoral epiphysis usually occurring in obese individuals.
What are the symptoms of
slipped capital femoral epiphysis?
•Can’t externally rotate leg
•Lay w/ external rotation in supine position
•Pain in hip medial to thigh
•Shortened leg on affected side
Describe Pauciarticular juvinile rheumatoid arthritis.
affecting 4 or less joints.
Describe Polyarticular juvinile rheumatoid arthritis.
Affects 5 or more joints; accounts for 40% of all cases of JRA
Describe Systemic juvinile rheumatoid arthritis.
Sustemic variable arthritic symptoms
What are symptoms of JRA?
-Pain in joints
-Causes inflammation of iris and ciliary body
-Nodules over joints
-Contracted fingers
What diagnostic studies are used for JRA?
-ESR for inflammation
-INA, IGM, IGA, IGG immunoglobulin
-Rheumatoid factor
What does treatment of JRA consist of?
-NSAIDS to treat inflammation
-Slow acting anti-rheumatic
-Immune modulators
-Cytotoxic drugs
-Steroids, but not long term
-Tumor necrotic factor when others fail
-ROM is painful, but necessary
What do you check when a child is in traction?
Who gets Muscular Dystrophy and why?
Boys get M.D. from their mothers because it is x-linked recessive.
What is the age of onset in M.D.?
1-3 years old
What is the biggest sign of M.D. for a mother to see?
Delayed walking
What are 2 hallmarks of M.D.?
-Lordosis (waddling gait)
-Difficulty rising from floor
What can be done for kids with M.D.?
Not much. P/T to keep unaffected muscles from atrophy.
What happens with temperature in ICP?
Goes up
What happens to pulse in ICP?
Can go up or down
What happens to respirations in ICP?
can go up or down
What does an open suture line mean in a 3 year old?
Increased intracranial pressure
Which cranial nerves are affected in ICP?
3 - occumotor
4 - troclear
5 - abducens
What are chief normal characteristics of cerebral spinal fluid?

-Specific gravity
-WBCs and RBCs
-Protein & glucose
-Specific gravity 1.004-1.008
-Ph alkaline
-Few WBCs and no RBCs
-Lots of protein & glucose
What happens in an aseptic CSF invasion
to glucose and WBCs?
WBCs under 500
No change in glucose
What happens to glucose and WBCs in CSF during a bacterial invasion?
WBCs over 500, lots of bands
Low glucose
What is Kernig's sign and what does it indicate?
-Knees resist extension

-Indicates ICP
What is Brezenski's sign and what does it indicate?
-Head elevated, knees up

-Indicates ICP
What are opisthatonas and what does it indicate?
Lockjaw and arched back caused by tetanus or meningitis
What's papilledema indicate in a small child?
-Large optic disk , rupture of optic vessels

-Shaken baby syndrome, ICP.
What's the 1st sign of ICP?
Decreased LOC
What do you give an ICP kids as far as oxygen goes?
O2 @ 100%
How do you monitor ICP?
-Intraventricular catheter
-Glasgow coma scale
-Get pt to hyperventilate because CO2 causes vessel dilation
Body management of ICP pt?
-HOB 30 degrees for venous drainage
-avoid neck/hip flexion
-Passive ROM
-Stool softeners to avoid straining
-Decrease environmental stimuli
What types of meds are given to ICP pt?
-Osmotic diuretic
-loop diuretic
-Barbituate coma
-Pain meds
What is an idiopathic seizure?
siezure with unknown cause
What is an acquired seizure?
Seizure with a known cause
What is a Tonic-Clonic Seizure?
Tonic = arched
Clonic = straight armed

-Can last 30 minutes
-Occurs w/o warning
-eyes roll w/immediate change in LOC
-decreased movement
Describe absence seizures
5-10 second LOC
"Daydreaming stare"
Minimal loss of muscle tone
5-9 yrs of age
May appear confused after event
Abnormal EEG
Infantile Spasms are what?
-seizure between 6 and 8 months of age
-Looks like a morro response
-Usually w/ menal disability or LD child
Why not give tylenol to febrile seizure pt?
Febrile seizures are d/t spike in temp, not degree of temp