Flashcards in Musculoseketal Dysfunction - Part 2 - Unit 4 Deck (44)
What are the forms of congenital clubfoot?
Talipes varus, talipes valgus, talipes equinus, talipes calcaneus
What is talipes varus?
inversion or bending inward of feet.
What is talipes valgus?
Eversion or bending out of feet.
What is talipes equinus?
Plantar flexion with toes lower than the heel.
What is talipes calcaneus?
Dorsiflexion with toes higher than the heel.
What are the 3 classifications of congenital clubfoot?
Positional, syndromic, congenital
What is positional clubfoot?
Mild/postural - may correct spontaneously or require passive exercise or serial casting.
What is syndromic clubfoot?
Tetralogic - associated with other congenital anomalies. Usually require surgical correction with high incidence of recurrence.
What is congenital clubfoot?
Idiopathic - bony abnormality almost always requiring surgical intervention.
What is legg-calve perthes disease?
Affects children between 2-12 and especially boys between 4-8. Avascular necrosis of femoral head. There's a disturbance in circulation that causes ischemia to femoral epiphysis producing hip deformities due to restricted bone growth.
100% of cases of legg-calve perthes disease have bilateral hip involvement. T?F?
FALSE - 10%
What are some clinical manifestations of legg-calve perthes disease? How is it diagnosed?
History of limp, soreness/stiffness, limited ROM, vague history of trauma, pain and limp most evident on arising and at end of activity...diagnosed by XRay.
If a deformity is going to occur in a child diagnosed with legg calve perthes disease, at what point in the disease process will it occur?
How do we treat legg calve perthes disease?
Keep head of femur in acetabulum, containment with various appliances and devices, rest, no weight bearing initially, surgery in some cases, home traction in some cases.
What is the most common type of spinal deformity?
What is scoliosis?
Complex spinal deformity involving curvature and spinal rotation. Classified according to age of onsert.
When is scoliosis more common?
When do we screen for scoliosis (age?)
Girls - 10 & 12
Boys - 13 & 14
When top removed for scoliosis screening, what do we do?
Observe FRONT and BACK and use a scoliometer to measure degree of curvature (referral needed for >7 degrees).
How do we treat scoliosis?
Bracing and exercises (20-40 degrees - must be worn 23 hours a day), surgery for >40 degrees, and posture/pain/respiratory compromise are possible long term complications.
What are some nursing caring things for scoliosis?
Assessment and screening, education and support, preoperative care (autologous blood transfusion), postoperative in PICU, chest tube, PCA, assess for hemorrhage, neurovascular assessment, prevention of respiratory complications (positioning and ambulation), prevention, UTI, prevention of constipation)
What is osteomyelitis?
Infectious process in the bone.
Osteomyelitis - signs/symptoms begin abruptly and resemble what?
Osteomyelitis - marked leukocystosis. T/F?
Osteomyelitis - bone cultures obtained from biopsy or aspirate. T/F?
Osteomyelitis - early x-ray films may appear normal. T/F?
What is the most common organism responsible for osteomyelitis?
What are the two types of osteomyelitis?
Acute hematogenous (from a blood borne bacteria like tonsils, abscessed teeth, etc.) and exogenous (fracture or puncture wound to the bone)
How do we manage osteomyelitis?
May have subacute presentation with walled-off abscess rather than spreading infection, prompt/vigorous IV antibiotics for extended period (3-4 weeks), monitor blood, immobilize limb, pain management, psychosocial needs.
What is achondroplasia?
Genetic condition that results in an adult height of 58 inches or less. Short arms and legs with normal sized head and torso...LARGE, prominent forehead. Just support them!