Musculoskeletal

Question 1

Lateral curvature of the spine and spinal rotation that causes rib asymmetry

Answer 1

Scoliosis

Question 2

Who is most likely to get scoliosis

Answer 2

Genetic tendency, more common in girls 8-15

Question 3

Assessment findings for scoliosis

Answer 3

• asymmetry in scapula/ribs/hips, one pant leg shorts than the other, school screening

Question 4

What can we do to slow the curvature caused by scoliosis?

Answer 4

Bracing

Question 5

When do we do surgical interventions for scoliosis?

Answer 5

If >45 degrees

Question 6

Surgical/post op considerations for scoliosis

Answer 6

go to ICU- rod placement surgery very invasive 
	◦  PCA pump
	◦  Supine 
	◦  Log-rolling every 2 hours
	◦ Skin integrity  
	◦ indications of bleeding/infection

Question 7

Type of break that can result in altered bone growth

Answer 7

Epiphyseal plate injury

Question 8

Type of fracture: compression of bone resulting in a bulge or raised area at the fracture site

Answer 8

Buckle( torus )

Question 9

Type of fracture: bone is bent no more than 45 degree without breaking

Answer 9

Plastic deformation (bend)

Question 10

Type of fracture: incomplete fracture of the bone

Answer 10

Greenstick

Question 11

Type of fracture: break is straight across the bone

Answer 11

Transverse

Question 12

Type of fracture: break is diagonal across the bone

Answer 12

Oblique

Question 13

Type of fracture: breaks in spiral around the bone

Answer 13

Spiral

Question 14

Type of fracture: small fractures/cracks in the bone due to repeated muscle contractions

Answer 14

Stress

Question 15

Type of fracture: bone fragments are separated

Answer 15

Complete

Question 16

Type of fracture: bone fragments are still attached

Answer 16

Incomplete

Question 17

Type of fracture: fracture occurs with an open wound and bone protruding

Answer 17

Open or compound

Question 18

Type of fracture :

fracture results in injury to other organs/tissues

Answer 18

Complicated

Question 19

Type of fracture: includes small fragments of bone that lie in surrounding tissue

Answer 19

Comminuted

Question 20

Priority assessments for fracture

Answer 20

Circulation, neuro (CMS from med surg)

Question 21

How to provide a traumatic care for casting?

Answer 21

Place cast on doll first

Question 22

What is skin traction?

Answer 22

No pins!

Weighs attached to skin with tape or straps

Question 23

What is skeletal traction?

Answer 23

Continuous pulling force through rods/pins in bone

Question 24

What is halo traction?

Answer 24

Halo screwed into skull bones, halo attached to vest or bed traction

Question 25

Assessment for traction with pins

Answer 25

Infection!

Question 26

5ps of compartment syndrome

Answer 26

‣ pain- unrelieved with elevations/ analgesics that worsens with passive movement ‣ pulselessness: distal to fracture (late finding) ‣ pallor- pale skin ‣ paralysis ‣ parasthesia - numbness (early finding)

Question 27

Bone infection secondary to infection from outside source?

Answer 27

Osteomyelitis

Question 28

A chronic autoimmune inflammatory disease affecting joint function and tissue

Answer 28

Juvenile idiopathic arthritis

Question 29

When will pain worst with juvenile idiopathic arthritis ?

Answer 29

After rest/morning

Question 30

Labs associated with juvenile idiomatic arthritis?

Answer 30

Elevated: C reactive protein ESR WBC

Question 31

Goal of managing juvenile idiopathic arthritis?

Answer 31

Preserve function, control pain and inflammation

Question 32

Interventions for managing pain and inflammation with JIA

Answer 32

Warm moist heat NSAIDS – take with food to minimize GI irritation Prednisone DMARDS

Question 33

How do we dose prednisone for kids with JIA?

Answer 33

Lowest effective dose for short-term therapy b/c of adverse effects (ex. take on an alternate day schedule) • weight gain, alteration in growth

Question 34

What about psychosocial considerations with JIA?

Answer 34

encourage participation in school activities

Question 35

Inherited disorders with progressive degeneration of symmetric skeletal muscle groups • Causes progressive muscle weakness and wasting

Answer 35

Muscular dystrophy

Question 36

Most common type of muscular dystrophy

Answer 36

Duchenne

Question 37

Muscular dystrophy type: X recessive, onset b/w 3-5 yr, fat tissue replaces muscle in lower limbs, live into early adulthood

Answer 37

Duchenne

Question 38

Type of muscular dystrophy : autosomal dominant, onset adolescence, slow progression, facial weakness, inversion of shoulders

Answer 38

Facioscapulohumeral muscular dystrophy

Question 39

Type of muscular dystrophy autsomal dominant and recessive, later in childhood onset, slow progression

Answer 39

Limb girdle muscular dystrophy