Orthopedics Across The Lifespan Flashcards by sophia carrasco

What is the most common 1st intervention of a 14 m old with a L: articen type C PPFD

Extension prosthesis with prosthetic knee

How well did you know this?

Not at all

Perfectly

What disgnoses are common in new born

clubfoot
AMC (arthrogryposis multiplex congenita)
CP
PFFD (proximal femoral focal deficiency)

How well did you know this?

Not at all

Perfectly

What disgnoses is common in childhood

shin splints
relapsing clubfoot
CP

How well did you know this?

Not at all

Perfectly

What diagnoses is common in adolescents

CP
regional pain syndrome
ehlers danlos syndrome (joint hypermobilty)
sports medicine

How well did you know this?

Not at all

Perfectly

What are common diagnoses of connnective tissue across the lifespan

▪ Ehlers-Danlos Syndrome (EDS) – joint hypermobility
▪ Juvenile Idiopathic Arthritis (JIA) (joint pain)
▪ Hemophilia (blood doesn’t clot normally- easy bruising and bleeding)

How well did you know this?

Not at all

Perfectly

What are common bone disgnoses across the life span

▪ Legg Calve Perthes (LCP)
▪ Slipped Capital Femoral Epiphysis (SCFE)
▪ OI
▪ Congenital Talipes Equinovarus (Clubfoot & Relapsing clubfoot)
▪ Blount Disease – Tibia Varia
▪ Epiphyseal Fracture
▪ Scoliosis
▪ DDH – Developmental Dysplasia of the Hip

How well did you know this?

Not at all

Perfectly

What are common disorders of the leg and foot across the lifespan

▪ DDH – Developmental Dysplasia of the Hip
▪ Congenital Talipes Equinovarus (Clubfoot & Relapsing clubfoot)
▪ Blount Disease – Tibia Varia

How well did you know this?

Not at all

Perfectly

What is ARTHROGRYPOSIS MULTIPLEX CONGENITA (AMC)

Congenital anomaly that casues permanent tightening of infants mm , skin and tendons that make them short and stiff (fx and contractures)

How well did you know this?

Not at all

Perfectly

What kind of deficit is in ARTHROGRYPOSIS MULTIPLEX CONGENITA

Motor unit deficits that lead to severe fetal weakness

How well did you know this?

Not at all

Perfectly

What does fetal immobility lead to for ARTHROGRYPOSIS MULTIPLEX CONGENITA

Hypo plastic join development and contractures

How well did you know this?

Not at all

Perfectly

What is pterygium (in AMC)

When the knee is a triangular membrane with shortness of skin and other soft tissues on the back o the leg

How well did you know this?

Not at all

Perfectly

What is the typical infant PT manangement for ARTHROGRYPOSIS MULTIPLEX CONGENITA

▪ ROM or stretching
▪ Caregiver Education
▪ Splinting
▪ Orthotic Intervention

How well did you know this?

Not at all

Perfectly

T/F: sx is common for AMC

False

How well did you know this?

Not at all

Perfectly

Pediatric sports medicine specialists recognize that children are not just small ___ and
therefore may need an approach to treatment which may be different than the way adults
would be treated.

adults

How well did you know this?

Not at all

Perfectly

In addition to treating sports related injuries, sports medicine focuses on the prevention of
What

sports related injuries, balancing nutrition, and physical rehabilitation.

How well did you know this?

Not at all

Perfectly

What is the prosper of society for pediatric research in spotrs medicine society

lead interdisciplinary research, education, and
advancement in pediatric and adolescent sports medicine

How well did you know this?

Not at all

Perfectly

When does neuromuscular control improve for pediatrics (pertaining to sports)

When they play multiple sports

How well did you know this?

Not at all

Perfectly

What is the growth spurts for girls and boys and what is decreased

▪ Age 10-12 for girls; age 12-14 for boys
▪ Decreased coordination

How well did you know this?

Not at all

Perfectly

How much training will increase risk of overuse and injuries

> 16 hours

How well did you know this?

Not at all

Perfectly

What are 3 reason for increased risk for injury

sports specialization
rapid growth spurts
increased trinaing volume

How well did you know this?

Not at all

Perfectly

What is known as RED-s

Relative energy deficient in sport

How well did you know this?

Not at all

Perfectly

What is Impaired physiologic function including, but not limited to, metabolic rate, menstrual function, bone health, immunity, protein
synthesis, and cardiovascular health caused by relative energy deficiency

RED-S

How well did you know this?

Not at all

Perfectly

RED-S is Common among adolescent athletes in sports which emphasize a ___ body weight

what sports

Lower

▪ Gymnastics
▪ Figure skating
▪ Ballet
▪ Diving and swimming
▪ Long distance running

How well did you know this?

Not at all

Perfectly

What are physcial therapt implications for RED-S

▪ Decreased muscular strength and
endurance performance
▪ Chronic fatigue
▪ Bone loss leads to increased risk of
stress fractures
▪ Physiological stress, depression, and
anxiety

How well did you know this?

Not at all

Perfectly

Whar are **high risk** for RED-S assessment and return to play

* anorexia nervosa (eating disorders) * extreme weight loss leading to dehydration

What are **sports implications** for RED-S

* no competiiton * supervise training allowed when medically cleared for adapted training

What are **medium risk** for RED-S

* prolonged atypical % body fat * substantial weight loss * abnormal menstruation and hormone function * reduced BMD * disordered eating

▪Healthy eating habits with appropriate energy availability ▪Normal hormonal and metabolic function ▪Healthy BMD as expected for sport, age, and ethnicity ▪Healthy musculoskeletal system What risk factor are these people for RED-S q

Low

When should u **screen** fro RED-S

For pateints who have recurrent injuries (often stress fractures)

What is the **treatment** for RED-S

Restore regular menstrual cycle and enhance BMD through diet and exercise

What is the **FEMORALACETABULAR IMPINGEMENT**

Decreased hip ROM due to altered alignment of the femoral head and acetabulum

who has an **increased** risk of **FAI**

If peons has hx of altered development of the hip

What kind of **diagnosis** is **FAI**

Diagnosis of exclusion

In pediatric patients, presenting with hip pain or difficulty weightbearing or unknown onset of limping, the PT must rule out what 2 things

* slipped capital femoral epiphysis * legg calve perthes ( good to rule out femoral neck stress fx and acetabular labral path)

▪Both **SCFE** and **LCP** involve **collapse** of the ___ ___

femoral head

What is SCFE

Disorder where the proximal femoral epiphysis in the femoral head slip off the femoral neck

**When** and **who** is **SCFE** most common in

Males between 10 -16

What **ROM** is **loss** with **SCFE**

IR and adduction

While S****CFE presents as **loss of hip ROM (IR & ADDUCTION)** with possible limping, it is also common to complain of only ____ ___

knee pain

Is SCFE normal or an emergency

Emergency …need XRAY or MRI

What is **legg calve perthes**

Childhood disorder associated with avascualar necrosis of the femorla head — usually idiopathic in nature

The **blood flow** disruption in **LCP** is typically in what artery

Medial circumflex

Who is **LCP** typically present in

Child 3-12 with a hx of limping or trendelenburg gait and hip pain

What **ROM** is typically limited for **LCP**

IR and ABDuction SCFE is IR and ADD!!!!! Remember the difference

What is the **treatment** for **LCP**

* periods of NWB * LW strengthening in an open kinetic chain * aquatic PT - self healing in 1-3 years

What may **LCP** lead to **later in life**

FAI

What is a common sign or symptom for **femoral neck stress fx**

Deep hip pain with WB and during sport

Who is **femoral neck stress fx common** in

Female endurance athletes presenting with RED-S

What presents with **complaints of intra articular clicking** and catching

Acetabular labral pathology

Who is **acetabular labral path** common in

Athletes that perform excessive ROM like dancers or perform excessive rotation of acetabulum on femur w pivoting and cutting (soccer and bball)

How can a **acetabular labral path** be **ruled out**

With MRI or MRA

What is the **etiology** of **FAI**

knee pain

What are the 2 common impingement for FAI

Cam and pincer

What is the **cam impingement**

Enlarger femoral head

What is the **pincer impingement**

Rim of acetablum is extended and casues “over coverage” of femoral head

What are **congential deformities** from **FAI**

* hip dysplasia * coxa vara * coxa valga

What is the difference between coxa vara and valga

Vara: decreased angle of inclination between the neck and head of the femur Valga: increased angle of inclination

What is the **normal amount** of **angle of inclination**

130° > = valga (more letters so increased ) <= vara

What are **signs and symptoms** for **FAI** (7)

* anterolaterla hip pain - “C sign” * pain with hip flexion and IR * limited hip ROM * short hip flexors * (+) FADIR and/or FABER * trendelenburg sing * weakness inc ore and LE postures chain mm

What is the **PT mangement** for **FAI**

* restore hip joint mobility and mm flexibility * core stability and strengthening exercises * strength hip externsor and abductors * neuro re ed * pateint education

What **mm** is there a dysfucntion wiht **medial tibial stress syndrome ( shin splints)**

* post TiB * TiB ant * soleus

What is **MEDIAL TIBIAL STRESS SYNDROME** (SHIN SPLINTS) caused by

Alteration in tibial loading- chronic , repetitive loads

Is MEDIAL TIBIAL STRESS SYNDROME (SHIN SPLINTS) more common in males or females

Females

What are **signs and symptoms** of **MEDIAL TIBIAL STRESS SYNDROME (SHIN SPLINTS)** (7)

* vague , diffuse pain in LE (on medial side) * pain with running * pain worse at beginning of exercise and subsides during trianing or at the end * TTP alone medial ridge of tibia * hyper pronation of subtalar joint * weakness or core and hips * impaired flexibility of triceps surae

What does PT treatment for shin splints depend on

The age and etiology

What is the **general PT treatment** for **shin splints**

* rest and ice * modify training * treat key mm imbalance and flexibility * proper shoes

When is the **peak incidence** of **ankle sprains**

Between 15-19 y/o

What is a **lateral ankle sprain** due to

Inversion of foot with associated ER of ankle joint

What ligament is usually injured with **lateral ankle sprain**

ATFL ## Footnote anterior talofibular lig

What are **signs and symptoms** of **lateral ankle sprain**

* hx of recurrent ankle sprains or chronic instability * pain , swelling and bruising around ankle * (+) anterior drawer test if ATFL * (+) talar tilt test if CFL * weak ankle mm and short gastroc

What is the **PT management** for **lateral ankle sprain**

* early motin * proprioception * normal gait * strengthen mm

What is the **function** of the **ACL**

Resist anterior translation of the tibia ont he femur and provides rotational stability of the knee

Is ACL Injury more common in males and females

Females

For an **outside cut ACL injury** what is the **knee** position

Varus - IR

What are pediatric considerations for ACL reconstruction

* growth plates are located in the knee (weakest part of bone) * growth plates are where they drill hokes * commonly occur with a fx in growth plate

▪ 9-year-old skeletally immature male presenting to physical therapy clinic for this first post-operative visit five days after ACL reconstruction due to a left ACL tear What are the precautions post op

* be sure pt understanding post op protocol * monitor activities * prevent anterior knee shear forces * progress pre surgeon protocol

What is post concussion syndrome

Persistent SYMTOMS beyond typical 7-10 day time recovery period following a concussion , symptoms include fatigue , sleep problems, headache e, dizzy , concentration difficulty , memory problems

In peds with **concussion** what is **associated** with **prolonged recovery**

LOC and dizziness

What are precautions for post concussion syndrome

Avoid over stimulation during rehab that may trigger HA , dizzy or nausea

What are **complications** for **post concussion syndrome**

* pre existing conditions of anxiety or depression * eye alignment issues *amblyopia) * learning disabilities * ADHD * hx of migraines

Estimated that 65% of all **concussions** occur in children between what **ages**

4-15

What are the 4 **patient severity out come measures** for **PCS**

1. The verbal rating scale for ranking of symptoms 2. PCSS: Post-Concussion Symptom Scale 3. ImPACT 4. DHI: Dizziness Handicap Inventory

What does Vestibular/Ocular-Motor Screening (VOMS) screen

* smooth pursuits * horizontal and vertical saccades * convergence * horizontal VOR

Orthopedics Across The Lifespan Flashcards

(84 cards)