NURS 535 CORE MAIN QUESTIONS AND
ANSWERS SET A+
✔✔Gross motor development - ✔✔1 month - + head lag, head to one side
3 months - head midline, kicking legs, no head lag, can lift head and butt
6 months - roll to one side or the other, brace with shoulders
6-9 months - roll back to stomach, sit alone
9-12 months -crawls and can walk holding on to stuff
12-18 months -walk no support, and runs
18-24 months - kick ball, runs with minimal falls, and walk up stairs
24-36 months -climb on play equipment, stand on 1 foot no support
3-4 years - tricycle, hop 1 foot no support
4 -5 years - skips and broad jumps
✔✔Fontanel closure - ✔✔Back of head 1 - 2 months
Front of head 7 - 19 months
✔✔What doesn't show up on X rays - ✔✔Salter Harris 1, stress fractures, nondisplaced
fractures
✔✔Bone development - ✔✔4th week:
Limb buds
Vertebral body development
Neural tubes close
,✔✔Clubfoot - ✔✔A fixed congenital defect of the ankle and foot
✔✔Metatarsus adductus - ✔✔Most common deformity of the foot, marked by the middle
bones of the foot pointing in toward the body
✔✔Medial tibial torsion - ✔✔in-toeing
-associated with pronation
✔✔Femoral anteversion - ✔✔Internal rotation of the hips greater than external rotation
✔✔Genu valgum - ✔✔knock knees
✔✔Blounts disease - ✔✔Growth disorder of the tibia that causes the lower leg to angle
inward
✔✔X-linked hypophosphatemia - ✔✔Calcium-normal
Phosphate-decreased
1-25 Vit. D-normal
25 Vit. D-normal
✔✔Skeletal dysplasia - ✔✔abnormal growth and density of cartilage and bone
✔✔Legg-Calve-Perthes Disease - ✔✔avascular necrosis of the femoral head
✔✔Slipped Capital Femoral Epiphysis - ✔✔occurs when the head of the femur
becomes displaced due to a separation at the growth plate
✔✔Disruptions - ✔✔Trauma while in the womb
✔✔Developmental dysplasia of the hips - ✔✔RF: Breech, first born, female, family
history
Physical exam: Galeazzi signs, ortolani, barlow test
✔✔Bone formation - ✔✔Ossification: Long bones develop first
Infancy: Metaphysis
Diaphysis: Middle of bone
✔✔Fracture classification - ✔✔Closed vs Open: Bone through the skin
Spiral fracture: produced by twisting or rotational force. Often caused by indirect force.
, Greenstick fracture: occurs when bone is bent and fails on the side subjected to
compression.
Torus fracture: caused by compression force on the long axis of the bone in children.
(Boxer FX)
Bowing Fracture: force on long axis and bends
Apophoseal avulsion - overuse Fx like Osgood slaughter
✔✔Ligament injuries - ✔✔Cruciate Ligaments - quick stops and turns
Anterior Cruciate Ligament -
- most common - sports related
- stop short and turn
- jump and land funny
- usu hear POP and then pain / swelling
Posterior Cruciate Ligament
- Trauma or MVA
- Pain behind Knee and instability
✔✔spina bifida myelomeningocele - ✔✔protrusion WITH SPINAL CORD, sensory &
motor deficits, LE paralysis, incontinence
✔✔Idiopathic Scoliosis Treatment - ✔✔-prevention/early intervention
-exercise
-bracing
-surgery
✔✔Scoliosis treatment - ✔✔Focus of tx: determined based on magnitude of the curve
and the degree of progression
If the curve is not progressing, generally no formal action is taken
PT tx includes muscle strengthening and flexibility exercises, shoe lifts and bracing
A spinal orthosis is often warranted with a curve that ranges between 25 and 40°
-Surgical intervention may be required with curves greater than 40 degrees
✔✔Osgood-Schlatter disease - ✔✔Inflammation or irritation of the tibia at its point of
attachment with the patellar tendon
ANSWERS SET A+
✔✔Gross motor development - ✔✔1 month - + head lag, head to one side
3 months - head midline, kicking legs, no head lag, can lift head and butt
6 months - roll to one side or the other, brace with shoulders
6-9 months - roll back to stomach, sit alone
9-12 months -crawls and can walk holding on to stuff
12-18 months -walk no support, and runs
18-24 months - kick ball, runs with minimal falls, and walk up stairs
24-36 months -climb on play equipment, stand on 1 foot no support
3-4 years - tricycle, hop 1 foot no support
4 -5 years - skips and broad jumps
✔✔Fontanel closure - ✔✔Back of head 1 - 2 months
Front of head 7 - 19 months
✔✔What doesn't show up on X rays - ✔✔Salter Harris 1, stress fractures, nondisplaced
fractures
✔✔Bone development - ✔✔4th week:
Limb buds
Vertebral body development
Neural tubes close
,✔✔Clubfoot - ✔✔A fixed congenital defect of the ankle and foot
✔✔Metatarsus adductus - ✔✔Most common deformity of the foot, marked by the middle
bones of the foot pointing in toward the body
✔✔Medial tibial torsion - ✔✔in-toeing
-associated with pronation
✔✔Femoral anteversion - ✔✔Internal rotation of the hips greater than external rotation
✔✔Genu valgum - ✔✔knock knees
✔✔Blounts disease - ✔✔Growth disorder of the tibia that causes the lower leg to angle
inward
✔✔X-linked hypophosphatemia - ✔✔Calcium-normal
Phosphate-decreased
1-25 Vit. D-normal
25 Vit. D-normal
✔✔Skeletal dysplasia - ✔✔abnormal growth and density of cartilage and bone
✔✔Legg-Calve-Perthes Disease - ✔✔avascular necrosis of the femoral head
✔✔Slipped Capital Femoral Epiphysis - ✔✔occurs when the head of the femur
becomes displaced due to a separation at the growth plate
✔✔Disruptions - ✔✔Trauma while in the womb
✔✔Developmental dysplasia of the hips - ✔✔RF: Breech, first born, female, family
history
Physical exam: Galeazzi signs, ortolani, barlow test
✔✔Bone formation - ✔✔Ossification: Long bones develop first
Infancy: Metaphysis
Diaphysis: Middle of bone
✔✔Fracture classification - ✔✔Closed vs Open: Bone through the skin
Spiral fracture: produced by twisting or rotational force. Often caused by indirect force.
, Greenstick fracture: occurs when bone is bent and fails on the side subjected to
compression.
Torus fracture: caused by compression force on the long axis of the bone in children.
(Boxer FX)
Bowing Fracture: force on long axis and bends
Apophoseal avulsion - overuse Fx like Osgood slaughter
✔✔Ligament injuries - ✔✔Cruciate Ligaments - quick stops and turns
Anterior Cruciate Ligament -
- most common - sports related
- stop short and turn
- jump and land funny
- usu hear POP and then pain / swelling
Posterior Cruciate Ligament
- Trauma or MVA
- Pain behind Knee and instability
✔✔spina bifida myelomeningocele - ✔✔protrusion WITH SPINAL CORD, sensory &
motor deficits, LE paralysis, incontinence
✔✔Idiopathic Scoliosis Treatment - ✔✔-prevention/early intervention
-exercise
-bracing
-surgery
✔✔Scoliosis treatment - ✔✔Focus of tx: determined based on magnitude of the curve
and the degree of progression
If the curve is not progressing, generally no formal action is taken
PT tx includes muscle strengthening and flexibility exercises, shoe lifts and bracing
A spinal orthosis is often warranted with a curve that ranges between 25 and 40°
-Surgical intervention may be required with curves greater than 40 degrees
✔✔Osgood-Schlatter disease - ✔✔Inflammation or irritation of the tibia at its point of
attachment with the patellar tendon
