Musculoskeletal Outline

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created 4 years ago by kamne
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updated 4 years ago by kamne
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pediatrics
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1

Physical Assessment of Infants

Look at general movement, assess muscle strength, use of extremities, muscles, and joints, look for head lag, and check for torticollis

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Physical Assessment of Toddlers

Most significant finding - broad based on "toddling" gate. Bowleggedness decreases, walking develops, muscles develop in lower back and legs. By 18-24 mos, knees may look "knock-kneed." Feet are still flat, need to walk for a few years to see an arch

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Physical Assessment of Children 2-7 years

Knock-knees are normal until about the age of 7. Posture is much more graceful and balanced. Look for muscle strength, joint mobility. Check spine for any curvature - thoracic spine has a bit of kyphosis (normal in the age group), and lumbar spine and lumbar spine has a bit of lordosis

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Physical Assessment of Adolescents

Slumping of shoulders, check for scoliosis

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Skin Traction

1) Correct alignment of shoulders, hips, and knees. 2) CMS checks. 3) Skin care/ace wraps. 4) Let weights hang freely

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Skeletal Traction

1) Correct alignment of shoulders, hips, and knees. 2) CMS checks. 3) Skin care, under sling. 4) Let weights hang freely. 5) Pin care. 6) Monitor for signs of infection

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Congenital Hip Dysplasia/Developmental Hip Dysplasia

Related to acetabular dysplasia or preluxation, subluxation, or dislocation

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Congenital Club Foot

Rigid deformity - cannot passively manipulate foot to a neutral position. Most common: talipes equinovarus - foot is pointed downward and inward in varying degrees of deformity

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Metatarsus adductus

Very common, often r/t intrauterine position. Medial adduction of toes + forefoot. Frequently associated with inversion and convexity of the lateral border of the foot. Often causes pigeon toed gait

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Muscular Dystrophy

Characterized by progressive weakness and wasting of symmetrical groups of skeletal muscles. Most common: Duchenne's. Dystrophin, a protein product in skeletal muscle, is missing

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Osteogenesis Imperfecta

Caused by a dominant mutation to type 1 collagen genesis. Main sx is fragile bones that break easily

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Legg-Calve-Perthes Disease

Aseptic necrosis of the femoral head as a result of insufficient blood supply. This is a self limiting disease, but has the potential for structural abnormality of the hip. Etiology is unknown

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Slipped Capital Femoral Epiphysis (SCFE)

Displacement of the head of the femur from the neck of the femur---prior to displacement the epipyseal plate widens---weakens. most cases are idiopathic

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Osteomyelitis

Infectious process in the bone which can occur at any ages. Etiology: many organisms can cause osteomyelitis like S.Aureus and Group B streptococci

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Osgood Schlatter's Disease

Avulsion fractures at distal portion of patella tendon, partial separation of tibial tuberosity---separation caused by sudden or continuous stress on the patella tendon during periods of rapid growth. Most common in males.

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Examples of Congenital Orthopedic Disorders

Developmental Hip Dysplasia, congenital club foot, metatarsus adductus, muscular dystrophy, and osteogenesis imperfecta

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Examples of Acquired Musculoskeletal Disorders

Legg-Calve-Perthes Disease, lipped capitol femoral epiphysis, osteomyelitis, Osgood Schlatter's disease, and scoliosis

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Scoliosis

Lateral curvature of the spine. Eventually causes cosmetic and physiologic alterations of the spine, chest, pelvis, any age - usually adolescent females