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Flashcards in Paediatrics Deck (38):
1

What is genu valgam?

Knock knees

2

Do insoles help in genu valgam?

No
(genu valgam is knock knees)

3

Which gender does anterior knee pain affect more?

Females

4

Where is the tenderness in anterior knee pain?

Patellar
Worse with stairs/squats

5

What investigation would you use for anterior knee pain?

X-ray
The pain may often be because of hip

6

Where is maximal tenderness at knee in anterior knee pain?

Superior pole patella
Inferior pole patella
Tibial tuberosity
Retropatella
Joint Line

7

Although curly toes generally resolve, which surgical procedure could you perform?

Tenotomy
-No splints

8

Which toes are commonly affected in curly toes?

3rd/4th toes

9

What age do children begin to run? And climb stairs using 2 feet?

2 years

10

By what age have children established an adult gait pattern?

8 years

11

Congenital orthopaedic conditions?

Club foot (CTEV)
Skeletal dysplasias
CVT (congenital vertical talus)
NF

12

What is CVT?

Congenital vertical talus

13

Neuromuscular orthopaedic conditions

CP (non walking)
CP (walking)
Tip toe walking
DMD
Cavus foot

14

What is postural talipes?

Positional talipes is a common condition caused by some tightness in the muscles around the ankle and the position the baby was in whilst in the womb. It is not caused by problems with the bones in their foot and will not cause any problems with walking

15

CTEV

Congenital talipes equinovarus (club foot)
Congenital talipes equinovarus is a common congenital orthopaedic condition. It is characterised by an excessively turned in foot (equinovarus) and high medial longitudinal arch (cavus)

16

National Institute for Health NF1

6 or more cafe au lait spots (pigmented birth marks)
>5mm pre puberty
>15 post puberty
2 or more Neurofibromas or 1 PFN
Axillary/groin freckling
2 or more Lisch nodules
Pseudarthrosis or thinning
Kyphoscoliosis or sphenoid dysplasia
1st degree relative
Known genetic mutation 17q11.2

17

What is neurofibromatosis?

Neurofibromatoses are genetic disorders that cause tumours to grow in the nervous system.
These produce abnormalities like skin changes and bone disorders

18

Pseudoarthrosis

A bone fracture that has no chance of mending without medical intervention

19

Known genetic mutation in NF1

17q11.2

20

Stature in skeletal dysplasia in relation to SD

Short stature <2SD

21

Gene involved in skeletal dysplasia?

FGFR3
Fibroblast growth factor receptor 3

22

Genu varum

Bow legs

23

Trident hand

Hand short with stubby fingers

24

Achondroplasia method of inheritance

Autosomal dominant

25

Tumour-like conditions

Diaphyseal Aclasia/MHE
Ollier’s Disease
Fibrous Dysplasia
Trevor’s Disease

26

Diaphyseal Achalasia / MHE

Multiple osteochondromas throughout the spine

27

Ollier's Disease

Multiple enchondromas

28

Cerebral Palsy

A persisting qualitative motor disorder appearing before the age of three years, due to non progressive damage to the encephalon occurring before the growth of the central nervous system is complete

29

Where does botox work?

Where the motor neuron enters the muscle

30

Where do benzodiazepines and baclofen work?

At the synapse

31

Why could you use a selective dorsal rhizotomy in cerebral palsy?

A rhizotomy (/raɪˈzɒtɵmi/ ry-zot-ə-mee) refers to a neurosurgical procedure that selectively destroys problematic nerve roots in the spinal cord, most often to relieve the symptoms of neuromuscular conditions such as spastic diplegia and other forms of spastic cerebral palsy

32

Positive Features of UMN syndrome

Spasticity
Hyperreflexia
Clonus
Co-contraction
(neural)

33

Negative features of UMN syndrome

Weakness
Fatiguability
Poor balance
Sensory deficit
(mechanical)

34

The child at risk in cerebral palsy

higherGMFCS
The higher the risk of dislocation
Prevention programme to prevent hip dislocation in children with cerebral palsy!

35

Treatment for walking cerebral palsy

GMFCS 1-III
Botox A
Orthotics
Physio
Surgery

36

Tiptoe walking

Usually idiopathic
Common before 3 years
Physio/observation
Splinting/casting
Botox
Surgery

37

DMD

X linked recessive
Boys (1 in 3,600)
Present 2-5 years
Dystrophin gene
Progressive
Gower’s / CPK

38

Cavus feet

High arch