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Lifespan > Week 12 - MS conditions in Children > Flashcards

Week 12 - MS conditions in Children Flashcards

1
Q

When does musculosckeletal system begin growth?

A

First trimester of pregnancy

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2
Q

When are all systems formed with tissue and organ differentiation complete?

A

8 weeks

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3
Q

What development is seen in first 4 weeks gestation?

A

Matrix skeleton laid down

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4
Q

What development is seen in the 4rth week?

A

Limb buds arise

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5
Q

What are the 2 genes that convey body plan, position information and limb development?

A
  1. Homeobox

2. Sonic hedgehog

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6
Q

When are type 1 and type 2 muscle fibres formed?

A

type 1 - 12 weeks

type 2 - 30 weeks

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7
Q

Describe important dynamic factors of bone in childhood and adolescence

A
  1. Longitudinal at growth plates
  2. radial by bone modelling
  3. Bone modelling - formation by osteoblast and reabsorption by osteoclasts increasing mass and alters shape
  4. bone remodelling - weight bearing or muscle pull stimulate new growth/bone strength by replacing old micro damaged bone
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8
Q

When is skeletal growth most rapid

A

first 2-3 years (1/2 adult height)

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9
Q

What is the normal shape of leg up to 18 months?

A

genu varum

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10
Q

What is the shape of the leg 18 months to 4 years?

A

straight

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11
Q

What shape does the leg have at 4 years old?

A

genu valgus

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12
Q

What is the normal shape of leg at adulthood (>7)

A

Straight

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13
Q

What factors form the basis for paediatric physiotherapy treatment implementation of EBP? (5)

A

SCORR

  1. Clinical observation
  2. Clinical reasoning
  3. Theoretical concepts
  4. Research
  5. Systematic review
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14
Q

What developmental factors should be considered in the 3rd trimester?

A
  1. Greater force on cartilaginous foetal skeleton can lead to musculoskeletal/postural deformation
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15
Q

What are the normal alignment of limbs at birth?

A
  1. Kyphosis from c-spine to sacrum
  2. hip flexion and external rotation
  3. Internal rotation of lower leg
  4. inversion of feet
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16
Q

What week does heart development finish at?

A

week 6 embryonic development

17
Q

What week does lower limb development finish?

A

Week 7 of embryonic development

18
Q

What two areas of the skull does positional plagiocephaly occur and what are their names?

A
  1. lateral deformational plagiocephaly (3 levels of severity)
  2. Posterior defermational plagiocephaly (brachycephaly)(3 levels of severity)
19
Q

List the prevention and treatment for Mx of positional plagiocephaly (7)

A

(educate, 2 positions, in envitonment, assess, treat, refer clinic)

  1. Education
  2. active positioning
  3. counter positioning
  4. environmental set-up
  5. assess for related factors (torticollis, dev delay)
  6. treat the related factors
  7. craniofacial clinic - helmet therapy
20
Q

Define and describe congenital muscular torticollis (CMT)

A

Shortened sternocleidomastoid (SCM) causing ipsilateral flexion onside and contralateral rotation on opposite side

21
Q

What are the 3 causes of CMT?

A
  1. Postural - no PROM limitation
  2. musclular - PROM limitation
  3. SCM mass - PROM limiation
22
Q

What risk factors associated with CMT? (3)

A
  1. First born
  2. Plagiocephaly/facial asymmetery
  3. birth trauma
23
Q

list ways of treating CMT (5)

A
  1. Play (env’t set-up)
  2. sleep
  3. stretching
  4. strengthening - sidelying
  5. Tummy time
24
Q

Define and describe Neonatal brachial plexus palsy (Erbs/Klumpke)

A

traction injury to the brachial plexus during delivery contributing BP injury (often large baby, associated with prolonged labour)

25
Q

What treatment is used for neonatal BPP? (6)

A
  1. Positioning and handling for infants (ie. tummy time)
  2. Maintain PROM (stretch ER, P/S forearm, extension of elbow), Serial casting if contracture
  3. Facilitate active movements by getting to reach for things want to do (task and context specific, progress to elimate gravity then against gravity)
  4. Strengthening
  5. surgery - nerve transfer (12 months), tendon transfer
  6. splinting
26
Q

Define and describe developmental hip dysplasia (DDH)

A

born with shallow acetabulum which causes a mismatch between head of femur and acetabulum (maybe due to ligament laxity)

27
Q

What are the risk factors associated with DDH? (6)

A

FFFSIN

  1. Intrauterine restriction
  2. Females
  3. First borns
  4. Family hx
  5. swaddling - brining hips in
  6. Neuro conditions
28
Q

What are signs of DDH

A
  1. Limited ab of hip (major)
  2. shortened femoral length
  3. asymmetrical skin creases
  4. prominent greater trochanter
29
Q

What are the special tests for DDH (3)

A
  1. Barlow
  2. Ortolani
  3. Hip U/S
30
Q

What is the treatment for DDH? (5)

A

OPSEH

  1. paediatric orthopod
  2. pavlik harness/abduction brace
  3. surgery - closed reduction + hip spica
  4. education
  5. handling
31
Q

List the common postural and structural MS conditions of the foot (6)

A

MA, TCV, TEV, CTEV, CVT,
Postural:
1. Metatarsus adductus - MT adducted position (flexible or rigid)
2. Talipes Calcaneovalgus - forefoot lateral, hindfoot valgus, foot dorsiflexion
3. positional talipes equinovarus (PET) - inverted or varus, can stretch out foot passively

Structural:

  1. Congenital talipes equinovarus (CTEV, clubfoot) - 6-8 weeks post conception
  2. Congenital vertical talus (CVT) - dorsiflexion from mid foot (looks like calcaneovalgus)
  3. Other deformities - refer to orthod
32
Q

List steps of a foot assessment

A
  1. ROM (50% PF, Eversion, Inversion) - look at creases

2. Heel bisector line (Metatarsus adducts)

33
Q

What does the Ponseti method treatment for?

A

Congenital talipes equinovarus (club foot) using series of casts, surgery, bracing (boots & bars) for 23 hours per day for 3 months post-surgery and then 12 hours nightly until age 4

34
Q

How many stages are involved in the Ponseti method and how long does the take?

A

5 stages taking 4-6 weeks

35
Q

What positional changes occur when treating CTEV?

A

inversion/adduction to eversion/abduction

36
Q

What factors indicate the foot ready for surgery? (4)

A
  1. > 45 deg abduction
  2. Lateral head of talus no longer palpable in corrected position
  3. heel valgus
  4. anterior end of calcaneus out from under the head of talus (calcaneus shifted posteriorly)

Lifespan (11 decks)

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