ortho Flashcards Preview

PEDIATRIC BRS > ortho > Flashcards

Flashcards in ortho Deck (99):
1

this is the most common cause of a painful limp in TODDLERS

transient synovitis

2

this is idiopathic avascular necrosis of the femoral head

Legg-Calve- Perthes disease

3

Legg - Calve - Perthes disease pain occurs on internal or external rotation?

Internal

4

what is the hallmark sign on radiograph of legg calve perches disease?

Crescent sign

" AP and frog leg lateral radiograph show an increased density int he affected femoral head or a crescentic subchondral fracture int he femoral head"

5

what is the management for legg calve parties disease?

physical therapy and restriction of excursive

6

the typical patient for this is an OBESE ADOLESCENT BOY

slipped capital femoral epiphysis

7

endocrine disorder related to SCFE

obese adolescent boy

8

true or false a klein line crosses the epiphysis in a SCFE?

false, it does NOT cross the epiphysis at all

9

name 4 complications of SCFE

1. avascular necrosis of the femoral head
2. chondrolysis
3. Limb length discrepancy
4. Osteoarthritis

10

this is an infection of the bone

osteomyelitis

11

pathogen for osteomyelitis w/ sickle cell?

salmonella

12

what are the lab studies for osteomyelitis?

elevated WBC

13

MRI/BONE SCAN/ PLAIN RADIOGRAPH to diagnose osteomyelitis?

MRI/BONESCAN

- not plain radiograph because it is not a good initial study

14

what 2 things may cause chronic osteomyelitis

sequestrum and involucrum

15

metatarsus adductes causes ?

intoning of the foot

16

how can you distinguish clubfoot w/ intoe?

clubfoot cannot dorsiflex

17

what is the management of a intoefoot that can overcorrect?

observation

18

what is the management of intoe foot that cannot over correct but is flexible?

stretching excersizes

19

what is the management of stiff foot that cannot be straightened?

refer to pediatric orthopedic specialist

20

talipes equinovarus AKA?

club foot

21

management of club foot?

casting and then surgical correction

22

this form of intoe is caused by utero position?

internal tibial torsion

23

what is the management for internal tibial torsion?

observation only

24

what is the difference in incidence age of internal tibial torsion and femoral ante version?

femoral anteversion >2 years
internal tibial torsion

25

if a child prefers to sit in a W position vs. a cross legged position what may he have?

femoral anteversion

26

clinical presentation of calcaneovalgus foot

foot is excessively dorsiflexed

27

ghetto walk of african american boys? Lateral thrust with gait?

Blount's disease

28

etiology of blunts disease?

overload injury to the medial tibial growth plate causing inhibited growth only on the medial side

29

when should blounts disease be considered in a child ?

anyone with leg bowing after 2 years old

30

this is inflammation or micro fracture of the tibial tuberosity caused by overuse injury?

osgood shatter disease

31

true or false, radiographs diagnose osgood shatter disease?

FALSE - too small to be seen

32

lateral position of the patella causing knee pain in girls

patellofemoral syndrome ( patellar chondromalacia)

33

what is the timing of growing pains?

bilateral leg pain occurring in LATE AFTERNOON OR EVENING ( DONT INTERFERE W/ PLAY )

34

open vs closed fracture?

closed- skin intact
open - skin broken (need antibiotics)

35

A. nondisplaced
B. displaced
C. Angulated
D. Overriding

fracture ends that are shifted

B. Displaced

36

A. nondisplaced
B. displaced
C. Angulated
D. Overriding

Fracture ends that are well approximated

A. Non displaced

37

A. nondisplaced
B. displaced
C. Angulated
D. Overriding

fracture ends that override w/out cortical contact

D. Override

38

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

Occur w/ twisting injuries common in child abuse

E. Spiral

39

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

horizontal fracture

c. transverse

40

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

buckle fracture occurring under a compressive force in the metaphysis?

a. torus

41

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

incomplete fracture where one side side of cortex is fractured and the other side is intact causing angulation. may require fracturing the other side to minimize angulation

b. greenstick

42

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

type of fracture w/ many pieces?

f. comminuted

43

a. torus
b. greenstick
c. transverse
d. oblique
e. spiral
f. comminuted

diagonal fracture across a bone

oblique

44

the salter harris classification system describes what?

fractures involving the growth plate

45

bone growth is affected in all grade ____ -_____ fractures?

grade IV (through and through)
grade V ( Crush )

46

SALTR stands for?

SAME, ABOVE, LOW, THROUGH, cRUSH

47

FOOSH fracture?

supracondlar

48

why is supracondylar fracture an orthopedic emergency?

when it is DISPLACED or ANGULATED because risk of neuromuscular injury and compartment syndrome

49

how can you detect neuromuscular injury and compartment syndrome in Supracondylar fracture?

assess pulse, sensation and movement of fingers + passive extension

50

posterior fat gap sign shows what?

supracondylar fraacture

51

what do you never do in a supracondylar fracture?

never passively move the arm

52

this is a fracture to the distal radius

Colles fracture

53

fracture to the proximal ulna w/ dislocation of the radial head

monteggia fracture

54

fracture of the radius w/ distal radioulnar joint dislocation

galeazzi fracture

55

this is a ' tollders fracture' which occurs after a very mild or no identified trauma

spiral fracture of the tibia

56

upper brachial plexus injury involving c5 and c6 roots

erb's palsy

57

erbs palsy position?

waiters tip
extended pronated and flexed fingers

58

involves c7 and c6 nerve roots?

klumpke palsys

59

klumpke palsy position?

claw hand, decreased ability to extend elbow and flex wrist

60

what may be present in klumpke's palsy?

horners syndrome (ptosis, miosis and anhydrosis)

61

this is a subluxation of the radial head that occurs when pulling the toddler upward?

nursemaid's elbow

62

what is the most common shoulder dislocation?

anterior

63

true or false, recurrence is common with anterior shoulder dislocation?

true

64

defined as tilting of the head to one side?

torticollis

65

management of cervical torticollis?

stretching excersizes, if not helmet therapy by 4-6 months of age

66

what are complications of torticollis?

skull deformity and facial asymmtery (plagiocephaly)

67

altantoaxial instability is seen most w/ what anomaly?

down syndrome

68

if there is severe instability in the AA joint what is management?

c1 and c2 fusion

69

this is a failure of normal vertebral segmentation that results in relative fusion of the involved vertebrae?

klippel feil syndrome

70

klippel fiel syndrome is also related to what?

torticollis, genitourinary, hearing loss and sprengels deformity ?

71

what is sprengels deformity?

abnormality of the scapula where scapula is rotated laterally leading to shoulder asymmetry and diminished shoulder motion

72

how is the cobb angle measured?

line along the most angulated vertebra on either end of the curve

73

when does progression of scoliosis occur?

only during growth or if spinal curvature is greater than 50 %

74

so if a woman has had her period for 6 months and has scoliosis does it need to be managed?

no because all growth in females ceases between 6 months of menarche

75

this degree of scoliosis only requires observation

10-20 degrees

76

this degree of scoliosis requires bracing?

20-40 degrees

77

this degree of scoliosis requires surgery if still growing?

>40

78

what degree of scoliosis causes respiratory and CV compromise?

>60

79

backpain, urinary incontinence, and palpable step off in the limbo sacral area are a result of?

spondylolithesis

80

how can you distinguish between ankylosing spondylitis and spondylolithesis?

spondylolithesis will have a neurologic component

81

this is a infection caused by staph aureus of the intervertebral disk?

diskitis

82

what is treatment of a herniated disk in an adolescent?

bed rest unless abnormal neurologic examination

83

flat acetabulum and breech position cause?

developmental dysplasia of the hip

84

this maneuver attempts to dislocate a hip by pushing posterior and laterally?

barlow maneuver

85

this maneuver attempts to reduce a hip by pushing upward and medial

ortolani maneuver

86

how can you diagnose DDH in older infants?

assymmetric buttock folds

87

what is used to diagnose DDH in infants 4-6 months of age?

ULTRASOUND

88

if someone greater than 6 months is suspected of DDH, what do you order?

AP RADIOGRAPH

89

this holds the head of the femur against the acetabulum to stimulation formation of the normal cup shape of the acetabulum used in ages 2-3 months if dx by 6 months?

pavlik harness

90

if diagnosis is made beyond 6 weeks of age what is indicated in DDH?

surgery

91

what is most commonly affected in younger children w/ septic arthritis?

the hip

92

what is most commonly affected in older children w/ septic arthritis?

the knee

93

how is the hip held in septic arthritis?

flexion/abduction and external rotation

94

how are lab studies in septic arthritis?

elevated white blood cell count, elevated ESR and elevated CRP

95

what is the best imaging used for septic arthritis?

ultrasound

96

what should you do before ultrasound for septic arthritis?

synovial fluid aspiration

97

what is the management for septic arthritis?

1. surgical decompression
2. empiric antibiotics covering gram positive organisms

98

what usually processed transient synovitis?

URI and Diarrhea

99

what is the treatment for transient synovitis?

nsaids, bed rest and observation