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Pediatrics > Neuromuscular/Musculoskeletal Disorder > Flashcards

Neuromuscular/Musculoskeletal Disorder Flashcards

1
Q

Types of Neuromuscular Disorders

A
  • neurologic insult
  • genetic dysfunction
  • structural abnormality
  • autoimmune in nature
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2
Q

Neurologic Insult

A

trauma or hypoxia to the brain or spinal cord

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3
Q

Anatomic Differences in Child vs Adult

A
  • child’s spinal cord is more mobile
  • myelination is incomplete
  • full ROM present at birth
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4
Q

What would indicate an abnormality?

A

sluggish deep tendon reflexes

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5
Q

What are 2 abnormal findings?

A

hypertonia or hypotonia

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6
Q

What history would we ask about for presence of neuro disorder?

A
  • changes in gait
  • recent trauma
  • poor feeding
  • lethargy
  • fever
  • weakness
  • alteration in muscle tone
  • history of developmental milestones
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7
Q

Inspection and Observation

A

motor function
reflexes
sensory function

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8
Q

Palpation

A

muscle strength and tone

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9
Q

Auscultation

A

lungs for adventitious sounds

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10
Q

What is considered normal to be seen in toddlers?

A

lordosis

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11
Q

When may kyphosis become evident?

A

adolescence

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12
Q

Internal Tibial Torsion/ Genu Varum

A

normal variation in infants lower limbs rotated inward

resolves by 2-3 yrs

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13
Q

When should Genu Valgum/Knock Knees by resolved?

A

7-8 years

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14
Q

Interventions for Preventing Complications of Immobility

A
  • turning/repositioning q 2 hours
  • assessing skin for redness/breakdown
  • performing ROM exercises
  • keep skin clean and dry
  • encourage intake of fluids
  • encourage coughing/deep breathing q 2 hours prn
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15
Q

Cerebral Palsy S/S

A

motor impairments including spasticity, muscle weakness, and ataxia

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16
Q

Complications of Cerebral Palsy

A 
mental impairments
seizures 
growth problems
impaired vision or hearing 
abnormal sensation or perception 
hydrocephalus
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17
Q

Focus of Nursing Care w/ Cerebral Palsy

A

promoting growth and development
promoting mobility
maintaining optimal nutritional intake
providing support and education

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18
Q

What are two acquired disorders for children?

A

Rickets

SCFE

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19
Q

Rickets

A

soft bones from inadequate calcium and vitamin D

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20
Q

SCFE

A
  • femoral head dislocates
  • cause unknown
  • early surgical intervention will decrease risk of long term deformity
  • sudden pain, unable to bear weight
  • ages 9-16, sedentary, overweight, African-American or Polynesian
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21
Q

Teaching Topics for parents of Children w/ Myelomeningocele

A
  • positioning
  • preventing infection
  • feeding
  • promoting urinary elimination through intermittent catheterization
  • preventing latex allergy
  • preventing s/s of complications
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22
Q

Interventions for Neurogenic Bladder

A
  • clean intermittent catheterization
  • meds such as oxybutynin chloride (Ditropan) to improve bladder capacity
  • prompt recognition and treatment of infection
  • surgical interventions
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23
Q

Lab Tests for Myelomeningocele

A

MRI
CT
Ultrasound
Myelography

24
Q

Lab Tests for Spinal Muscular Atrophy

A 
Creatinine kinase: elevated w/ muscular damage 
Genetic Testing
Muscle Biopsy 
Nerve Conduction Velocity test 
Electromyelogram
25
Q

Structural Disorders

A

Spina bifida occulta
Meningocele
Myelomeningocele

26
Q

Genetic Neuromuscular Disorders

A

Various types of muscular atrophy

Spinal muscular atrophy

27
Q

Pectus Excavatum

A
  • a depression in the chest that sinks inward
  • does NOT resolve as child grows
  • observation, PT, surgical correction before puberty
28
Q

Polydactyly

A

extra digit on the hand or foot

-surgical removal

29
Q

Syndactyly

A

webbing of the fingers and toes

-no treatment required but can be done for cosmetic reasons

30
Q

Metatarsus Adductus

A

inward deviation of the forefoot w/ the hindfoot remaining normal position

  • common in utero position
  • most resolve w/o treatment
  • may need serial casting before 8 months
31
Q

Congenital Clubfoot

A
  • congenital anomaly
  • 1 of 1000 births
  • foot resembles golf clubs
  • more males
  • starts as soon after birth as possible
32
Q

What is typically done for Clubfoot?

A

weekly manipulation and serial casting q 2 weeks
shoes and braces
surgery

33
Q

Osteogenesis Imperfecta

A
  • genetic bone disorder
  • low bone mass
  • increased fragility
  • connective tissue problems
  • joint hypermotility
  • fractures
  • tooth enamels wear easily and brittle; discoloration
  • blue/gray sclera
34
Q

Developmental Hip Dysplasia

A

femoral head has an abnormal relationship to acetabulum

  • frank dislocation can occur
  • females
  • Pavlik harness
35
Q

Torticollis

A

painless muscular condition in infants and children w/ certain syndromes

36
Q

What may cause congenital torticollis?

A

From position in utero

37
Q

What can be done for torticollis?

A

stretching exercises

surgery in preschool years

38
Q

Pectus Excavatum

A

a depression in the chest that sinks inward

-does not resolve as child grows

39
Q

What can be done for pectus excavatum?

A
  • observations
  • PT
  • surgical correction before puberty
40
Q

Muscular Dystrophy

A

a group of inherited conditions that result in progressive muscle weakness and wasting

41
Q

What may be the causes of muscular dystrophy?

A

x-linked
autosomal dominant
recessive

42
Q

What is the most common neuromuscular disorder of childhood?

A

Duchenne Muscular Dystrophy

43
Q

Duchenne Muscular Dystrophy is usually fatal by what age?

A

20-25 years old

44
Q

What is the hallmark finding of Duchenne Muscular Dystrophy?

A

presence of Gowers Sign

45
Q

Nursing Management Goals for a Child w/ Duchenne Muscular dystrophy

A
  • Promoting mobility
  • maintaining cardiopulmonary function
  • preventing complications and maximizing quality of life
46
Q

How to promote mobility for DMD?

A
  • administering corticosteroids and calcium supplements

- perform passive stretching and strengthening exercises

47
Q

How to help maintain cardiopulmonary function for DMD?

A
  • teach deep breathing exercises

- performing chest physical therapy

48
Q

How to help prevent complications and maximize quality of life for DMD?

A
  • developing a diversional schedule

- provide emotional support

49
Q

Spinal Muscular Atrophy

A

genetic motor neuron disease that affects the spinal nerves ability to communicate w/ muscles
-autosomal recessive mechanism

50
Q

Death usually occurs at what age for Spinal Muscular Atrophy?

A

2

51
Q

Legg-Calve Perthes

A

avascular necrosis of the femoral head

  • painless limp which may be intermittent for months
  • mild hip pain or referred knee pain
52
Q

When does Legg-Calve Perthes usually occur?

A

4-8 years old

More often males

53
Q

Transient Synovitis of Hip

A

hip pain limping

-self limiting, resolves w/in week but may last 4 weeks

54
Q

When does transient synovitis of hip occur?

A

3-8 years old

55
Q

Scoliosis

A

curvature of the spine

56
Q

Signs and Symptoms of Spinal Cord Injury

A
  • inability to move or feel extremities
  • numbness
  • tingling
  • weakness
57
Q

Teaching Topics to Prevent Spinal Cord Injury

A
  • vehicular safety
  • seat belts/age appropriate seats
  • sports safety
  • prevention of falls
  • violence prevention
  • water safety

Pediatrics (24 decks)

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