MSK CCP 4?

Question 1

important componenets of Hx for limping child

Answer 1

age
pain or weakness
trauma

Question 2

PE for limping child

Answer 2

gait- barefoot
inspection- abdomen, pelvis, back and extremities
palpation ROM
Neurovascular- strength, sensation, DTRs

Question 3

at what age should a child walk without support

Answer 3

12-15 mo

Question 4

at what age should a chile have reciprocal arm swing with gain

Answer 4

2 yeras

Question 5

the neuro growth coordination balance of a child has to do with what process

Answer 5

myelinization in cephalocaudal pattern

Question 6

when do children gain the adult gait pattern

Answer 6

8-10 yrs old

Question 7

what is the stance phase

Answer 7

weight bearing phase of walking

heel strike to toe off

Question 8

what is the swing phase of walking

Answer 8

toe off to heel strike

rotation and tiliting of pelvis and stability lumbar spine and abomen

Question 9

what are the 5 key maneuvers in gait assessment

Answer 9

cadence
stride length
velocity
single limb support time
support base width

Question 10

what can cause antalgic gait

Answer 10

pain, less time in stance phase

Question 11

what can cause trendelenburg limp

Answer 11

stance phase body sway away from weak hip abductor and swing phase will droop off weak side

Question 12

what can cause waddling gate

Answer 12

b/l hip involvement or neuro

Question 13

what can cause stiff leg gait

Answer 13

knee extension and circumduction with pelvic elevation on affected side

Question 14

causes of toe walking gait

Answer 14

habitual or due to muscle contractures, spasticity or puncture wound on heel

Question 15

causes of steppage gait

Answer 15

difficulties with dorsiflexion

peroneal neuropathies

Question 16

causes of stooped gait

Answer 16

abdominal pathology

Question 17

generalized muscle weakness gait

Answer 17

muscular dystrophy or metabolic

Question 18

0-4 yr old child limping what could be development or trauma cause

Answer 18

hip dysplasia

fracture, wound, sprain, contusion

Question 19

0-4 yr old limping child

infecitous causes

Answer 19

osteomyelitis
septic arthritis
transient/toxic synovitis
discitis

Question 20

4-10 yr old limping child infectious causes

Answer 20

transiet toxic synovitis
septic arthritis
osteomyelitis

Question 21

inflammatory cause of limping 4-1o year old

Answer 21

juvenile idiopathic arthritis

Question 22

osteochondroses cause of limping child 4-10 years old

Answer 22

legg calve perthes disease

Question 23

what neoplasm could cause limping in 4-10 year old

Answer 23

leukemia

Question 24

what trauma on ddx for limping child 10-18 yr old

Answer 24

slipped capital femoral epiphysis
fracture
sprain
contusion

Question 25

infectious causes of limping in child 10-18 yrears olf

Answer 25

osteomyelitis septic arthritis lyme arthritis gonococcal arthritis

Question 26

microtrauma causing limping in 10-18 year old

Answer 26

stress fracture

Question 27

risk factors hip dysplasia

Answer 27

``` genetic large birth weight oligohydramnios female first born breech ```

Question 28

which hip is more common in hip dysplasia

Answer 28

L>R

Question 29

barlow and ortolani, galeazzi sign

Answer 29

hip dysplasia

Question 30

toddler with pain, refusal to walk | swelling over tibia and pain with palpation

Answer 30

spiral fracture tibia

Question 31

gender more likley to have salter harris fracture

Answer 31

boys

Question 32

stress fracture

Answer 32

small crack overuse, high impact 2nd-3rd metatarsal most common

Question 33

where does osteomyelitis infect

Answer 33

metaphysis of long bone

Question 34

Tx osteomyelitis

Answer 34

IV antibiotics | usually s aureus

Question 35

Sx septic arthritis

Answer 35

``` monoarticular erythema swelling pain dec ROM ```

Question 36

Tx septic arthritis

Answer 36

IV or PO antibiotics

Question 37

Tx transient toxic synovitis

Answer 37

5-7 days | NSAIDs

Question 38

what is legg calve perthes disease

Answer 38

lack of blood flow to femoral head causes collapse | blood supply returns in mo and new bone replaces old

Question 39

Sx legg calve perthes disease

Answer 39

limp pain in knee thigh or groin limited ROM leg length discrepency

Question 40

Tx legg calve perthes disease

Answer 40

meds/ reduce activity to dec pain | splinting or surgery to keep hip stable

Question 41

What is a slipped catpital femoral epiphysis

Answer 41

noninflammatory condition femoral head displaced from neck b/l ages 10-14

Question 42

assoc with slipped capital femoral epiphysis

Answer 42

overweight boys shear stress endocrine disorders primary hypothyroid and HGH deficiency

Question 43

Sx slipped capital femoral epiphysis

Answer 43

insidious, complaing of pain in hip and limp

Question 44

Tx slipped capital femoral epiphysis

Answer 44

surgical stabilization

Question 45

joint effusion, pain limited ROM warmth morning stiffness chronic pain for > 6 weeks

Answer 45

juvenile idiopathic arthritis

Question 46

growing pains are what

Answer 46

Dx by exclusion

Question 47

type of pain in growing pains

Answer 47

pain at night and limited to calf thigh or shin

Question 48

what helps growing pains

Answer 48

heat, massage, or mild analgesics

Question 49

common causes septic arthritis

Answer 49

staph aureus | a beta hemolytic strep

Question 50

common septic arthritis in neonate

Answer 50

group B strep, staph

Question 51

common septic arthritis in infant

Answer 51

strep, staph, influenza

Question 52

common septic arthritis in child

Answer 52

s aureus, strep pneumonia, group A strep

Question 53

sickel cell patient with septic arthritis

Answer 53

think about salmonella

Question 54

puncture wound septic arthritis

Answer 54

think about pseudomonas

Question 55

What can destory articular cartilage in septic arthritis

Answer 55

the leukocytic cytokines TNF a and IL-1

Question 56

at risk for what with septic arthritis

Answer 56

avascular necrosis femoral head

Question 57

definitive Dx septic arthritis

Answer 57

aspiration and culture

Question 58

Tx for septic arthritis

Answer 58

cefotaxime IV with improvement change to PO total Tx 4-6 weeks

Question 59

mild slipped capital femoral epiphysis

Answer 59

up to 1/3 diameter femoral head | 0-30 degrees

Question 60

severe SCFE

Answer 60

2/3- all of diameter femoral head | 60-90 degrees

Question 61

Tx SCFE

Answer 61

non weight bearing until assessed by ortho

Question 62

Tx for SCFE

Answer 62

surgical fixation with central screw or gone graft epiphysiodesis