Musculoskeletal Dysfunction

Question 1

what is the assessment for musculoskeletal problems

Answer 1

hx
6p’s
skin

Question 2

what are the 6 p’s

Answer 2

pain, pallor, pulselessness, paresthesia, paralysis, pressure

Question 3

damage to the soft tissue, subcutaneous structures, and muscle

Answer 3

contusion

Question 4

what is a sprain

Answer 4

partial tear of ligament

Question 5

what is a strain

Answer 5

partial tear of a tendon/muscle

Question 6

what is the tx for sprains and strains

Answer 6

RICE

Question 7

compression of nerves, blood vessels, and muscle inside a confined place

Answer 7

compartment syndrome

Question 8

what are the causes of compartment syndrome

Answer 8

tight dressing, cast, hemorrhage, burns, surgery, massive IV infiltration

Question 9

compartment syndrome is a neurovascular _____ and can possibly _____ a limb

Answer 9

emergency; lose

Question 10

what are CM of fractures

Answer 10

generalized swelling
pain or tenderness
deformity or muscle splinting
diminished functional use
exxhymosis
muscle regidity
crepitus

Question 11

bone is bent but not broken *may bend up to 45 degrees

Answer 11

plastic deformations (bend)

Question 12

once side of the bone buckles (compresses upon itself *appears as raised or bulging projection at site of fracture

Answer 12

buckle (torus)

Question 13

bone cracks but does not break all the way through *incomplete fracture not all the way through

Answer 13

greenstick

Question 14

occurs from twisting motion *physically associated with physical abuse

Answer 14

spiral fracture

Question 15

what are the areas of developing cartilage tissue near the ends of long bones and the weakest points of bones

Answer 15

growth plate (physics)

Question 16

can lead to deformities and limb length discrepancies

Answer 16

growth plate fracture

Question 17

what types of traction are there

Answer 17

skin
skeletal
halo

Question 18

what is the purpose of traction

Answer 18

fatigue muscle to reduce spasms
realign bone
immobilize
prevent or improve deformity

Question 19

infection within the bone

Answer 19

osteomyelitis

Question 20

what is the most common cause in osteomyelitis

Answer 20

staphylococcus aureus

Question 21

what are CM of osteomyelitis

Answer 21

irritability
fever
tachycardia
edema
pain constant but increased with movement
decreased movement of area
warmth

Question 22

aseptic necrosis of the femoral head (no blood flow to the area)

Answer 22

legg- calve- perthes disease

Question 23

what is the definitive dx of legg-calve-perthes disease

Answer 23

MRI

Question 24

what are the symptoms of egg-calve-perthes

Answer 24

limp is more pronounced after activity

hip, thigh, knee pain

Question 25

what is the non-surgical containment of egg-calve-perthes

Answer 25

abduction brace, cast, harness sling

Question 26

complex deformity of the spine that also affects the ribs. characterized by lateral curvature of the spine and spinal rotation that causes rib asymmetry

Answer 26

scoliosis

Question 27

what would the back of a pt who has scoliosis look like

Answer 27

uneven shoulders and pelvic tilt

Question 28

what is the adams forward bend test

Answer 28

assess asymmetry of ribs and flanks in scoliosis

Question 29

what is the scoliometer

Answer 29

measures the angle of rotation in scoliosis

Question 30

what is the definitive dx of scoliosis

Answer 30

x-ray while child is standing

Question 31

what is the tx of scoliosis

Answer 31

curve less than 10 degrees= not worry about it just inform parents curve of 25-45 degrees= bracing curve more than 45 degrees= surgery

Question 32

what is the goal of bracing a scoliosis pt

Answer 32

to keep curve from progressing (won't undo curvature of spine)

Question 33

what is important to inform pt and family post op of scoliosis surgery

Answer 33

log roll pt

Question 34

spectrum disorder r/t abnormal development of the hip that may occur at any time during fetal life, infancy, or childhood

Answer 34

development dysplasia of the hip

Question 35

what are CM of DDH in infants

Answer 35

positive galeazze sign asymmetry of gluteal folds positive Barlow test positive Ortolani test

Question 36

what are CM of DDH in children

Answer 36

affected leg appears shorter trendelenburg sigh waddling gait limp

Question 37

what is the tx for newborn to 6months for pt with DDH

Answer 37

pavlik harness bryant traction hip spica cast

Question 38

what is the tx for 6-24mos for pt with DDH

Answer 38

surgical closed reduction | spica cast or abduction brace

Question 39

complex deformity of the ankle and foot

Answer 39

clubfoot

Question 40

what is the tx for clubfoot

Answer 40

ponseti method - serial casting for 6-10 wks and weekly gentle manipulation and stretching of the foot - percutaneous heel cord tenotomy at end of casting - long leg casting for 3 wks - orthotic device

Question 41

characterized by excessive fractures and bone deformity

Answer 41

osteogenesis imperfecta

Question 42

what are CM of OI

Answer 42

``` bone fragility bone deformity fractures blue sclera hearing loss discolored teeth ```

Question 43

what is important to do when caring for OI pt

Answer 43

careful handling to prevent fx | lift by butt or support with pillows for diaper changes

Question 44

what is one lab finding that will differentiate OI from non accidental trauma

Answer 44

elevated serum alkaline phosphatase

Question 45

chronic inflammation of the synovium with joint effusion and eventual erosion, destruction and fibrosis of the articulate cartilage

Answer 45

juvenile idiopathic arthritis

Question 46

what is the dx of JIA

Answer 46

arthritis in one or more joints for 6 weeks or longer | *no definitive test, worse in the morning