Podcast
Questions and Answers
A patient presents with a stiff gait, but is otherwise independent. This manifestation of cerebral palsy would be classified as:
A patient presents with a stiff gait, but is otherwise independent. This manifestation of cerebral palsy would be classified as:
- Moderate, impacting daily activities.
- Severe, requiring full-time care.
- Mild, with minimal impact on function. (correct)
- Non-existent, as stiff gait is unrelated to cerebral palsy.
Which of the following factors differentiates structural scoliosis from non-structural scoliosis?
Which of the following factors differentiates structural scoliosis from non-structural scoliosis?
- The degree of spinal curvature.
- The impact on ambulation.
- The presence of pain.
- The involvement of vertebral rotation. (correct)
A 13-year-old patient with Duchenne muscular dystrophy is experiencing increasing difficulty walking. This progression is most likely due to:
A 13-year-old patient with Duchenne muscular dystrophy is experiencing increasing difficulty walking. This progression is most likely due to:
- Cerebral palsy development
- Increased dystrophin production.
- Degeneration of the pelvic girdle muscles. (correct)
- Non-structural scoliosis.
A patient with Duchenne muscular dystrophy is undergoing surgery. Which of the following anesthetic complications is of particular concern?
A patient with Duchenne muscular dystrophy is undergoing surgery. Which of the following anesthetic complications is of particular concern?
A child is diagnosed with scoliosis alongside cerebral palsy. This is an example of what?
A child is diagnosed with scoliosis alongside cerebral palsy. This is an example of what?
What is the primary mechanism by which long bones increase in length until an individual reaches adult stature?
What is the primary mechanism by which long bones increase in length until an individual reaches adult stature?
A newborn is diagnosed with a severe form of osteogenesis imperfecta. What is the likely prognosis for this infant?
A newborn is diagnosed with a severe form of osteogenesis imperfecta. What is the likely prognosis for this infant?
A child presents with numerous fractures and is suspected to have a bone dysplasia. Which condition should be considered, especially if the fractures were initially mistaken for non-accidental trauma?
A child presents with numerous fractures and is suspected to have a bone dysplasia. Which condition should be considered, especially if the fractures were initially mistaken for non-accidental trauma?
Which of the following is the primary cause of rickets in children?
Which of the following is the primary cause of rickets in children?
What is the best description of 'subluxated' in the context of hip dysplasia?
What is the best description of 'subluxated' in the context of hip dysplasia?
When is the recommended age for surgical correction of syndactyly, especially in cases involving the upper extremity?
When is the recommended age for surgical correction of syndactyly, especially in cases involving the upper extremity?
At what age range does an individual typically reach peak bone mass?
At what age range does an individual typically reach peak bone mass?
Bone diameter increases through which of the following processes?
Bone diameter increases through which of the following processes?
Flashcards
Scoliosis
Scoliosis
Rotational curvature of the spine, often seen in the anterior and posterior plane.
Non-structural Scoliosis
Non-structural Scoliosis
Scoliosis due to causes other than the spine's structure, like posture or leg length.
Structural Scoliosis
Structural Scoliosis
Scoliosis with vertebral rotation, indicating a structural issue within the spine.
Cerebral Palsy
Cerebral Palsy
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Duchenne Muscular Dystrophy (DMD)
Duchenne Muscular Dystrophy (DMD)
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Bone Formation Timing
Bone Formation Timing
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Growth Plate (Physis)
Growth Plate (Physis)
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Bone Diameter Growth
Bone Diameter Growth
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Peak Bone Mass Age
Peak Bone Mass Age
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Syndactyly
Syndactyly
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Hip Dysplasia Types
Hip Dysplasia Types
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Osteogenesis Imperfecta
Osteogenesis Imperfecta
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Rickets
Rickets
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Study Notes
- Bone formation starts at six weeks gestation
- By the end of gestation, secondary ossification centers start laying down bone at the cartilage model ends
- The articular cartilage covers the bone's free ends
- The epiphyseal plate (growth plate) sits between the epiphysis
- Long bones grow in length at the epiphyseal plate until adulthood
- Bone diameter increases as new bone is deposited on existing bone surfaces
- Osteoblasts lay down the bone matrix then calcification
- Bone reabsorption occurs on the inner surface, expanding marrow cavity diameter
- Peak bone mass is reached in the mid to late 20s
Musculoskeletal Alterations in Children
- Syndactyly is the most common congenital upper extremity defect
- Surgical correction typically happens between six months and one year old
- Complex syndactyly involves fused bones, nails, and soft tissues
- Surgery mainly targets improved function and appearance
Hip Dysplasia
- Subluxated hip: partial contact is maintained
- Dislocated hip: no contact is maintained
- Acetabular dysplasia: shallow, underdeveloped acetabulum
Osteogenesis Imperfecta
- It is a collagen-related bone dysplasia
- Severe forms: stillbirth or early death
- Less severe forms: evident when walking begins, leading to fractures
Rickets
- Rickets involves failure of growing bone mineralization
- Rickets results in soft bones and skeletal deformities
- Causes include vitamin D deficiency or insensitivity, kidney issues, or absorption problems
Scoliosis
- Scoliosis is the rotational curvature of the spine
- Visible in the anterior and posterior plane
- Non-structural scoliosis stems from issues outside the spine like posture, leg length, or pain
- Structural scoliosis involves vertebral rotation
- Bracing or surgical spinal fusion may be needed
Cerebral Palsy
- Cerebral palsy is a non-progressive movement/posture disorder
- Results from developing CNS injury or malformation
- Severity varies from stiff gait to wheelchair dependence
- Common co-occurring conditions: intellectual disability, seizures, scoliosis, hearing/vision loss
- Treatment focuses on maximizing function; there is no cure
Duchenne Muscular Dystrophy
- Duchenne muscular dystrophy has the largest gene in the body
- Dystrophin, a membrane stabilizing protein, is encoded by that gene
- It is present in normal muscle cells but absent in Duchenne muscular dystrophy
- Weakness begins in the pelvic girdle, then loss of walking by ages 12-15
- Cognitive dysfunction is common
Duchenne Muscular Dystrophy Anesthetic Concerns
- Common complications include rhabdomyolysis, hyperkalemia, and cardiac arrest
- Intraoperative/post-operative hyperthermia has been reported
- Possible difficulty intubating due to macroglossia
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Description
Overview of bone formation during gestation and growth, including ossification and the role of the epiphyseal plate. Discussion of musculoskeletal alterations in children, focusing on syndactyly and hip dysplasia.
