NUR 555 TEST 3 _ PEDS GI/GU/ORTHO/PSYCH
STUDY GUIDE WITH 100% CORRECT
ANSWERS!!
1. Salter-Harris Fracture Classification: I: Straight across the plate - causing
separation.
II: Across plate and metaphysis.
III: Across plate and epiphysis.
IV: Through the metaphysis, plate, and epiphysis.
V: Compression fracture along plate.
2. Type I Salter-Harris Fracture: Fracture line extends through physis or within in
the growth plate
Ex: Slipped Capital Femoral Epiphysis (SCFE)
3. Type II Salter-Harris Fracture: Fracture extends through both the physis and
metaphysis
Most Common
Occur away from the joint space
Ex: Tibial metaphysis fracture, Proximal phalanx fracture, Distal Radius fracture.
4. Type III Salter-Harris Fracture: intra-articular fractures through the epiphysis
that extend across the
physis. Ex: Tillaux fracture of the ankle - Requires ORIF
5. Type IV Salter-Harris Fracture: A fracture through all three elements of the
bone, the growth plate,
,metaphysis, and epiphysis. Intra-articular Fx. Ex: Triplane fracture at the ankle.
REQUIRES ORIF.
6. Type V Salter-Harris Fracture: Rammed/Ruined/Crush or compression injury of
the growth plate
7. grade I sprain (mild): Tissue Stretching; Mildly swollen; MILD ROM and
strength loss (0-25%); no
decrease in stability
8. Grade II sprain (moderate): Moderate swelling: May look like a baseball;
Includes some ecchymosis;
Moderate ROM and strength loss (25-75%); some decrease in stability
9. Grade III sprain (severe): -complete tear
-significant swelling
-painful ROM/movements
-inability to bear weight
-empty end feel
10. How do you know reducing an annular ligament displacement was successful?:
A palpable/audible "pop" or "click"
Child typically begins reaching for objects again
11. Osgood-Schlatter disease: inflammation or irritation of the tibia at its point of
attachment with the
patellar tendon
12. Osgood-Schlatter Disease -presentation: History:
Recent physical activity: track, soccer, football.
,Increased pain with activity, exacerbated with running, jumping, squatting and
stairs.
13. Osgood-Schlatter Disease - Physical Exam Findings: Pain reproduced when
extending
the knee against resistance, stressing the quadriceps, or squatting; focal point
tenderness/swelling/heat at the tibial
tuberosity; full knee ROM
14. Osgood-Schlatter disease - Diagnostics: History and Physical
15. Osgood-Schlatter disease - Treatment: self-limiting; symptom management;
Avoid activities
that cause pain; ice/cold therapy for inflammation; NSAIDs have questionable
benefits; Quadriceps - Stretching
exercises when acute symptoms subside; Neoprene sleeve to stabilize patella/strap
16. Scoliosis: lateral curvature of the spine in the frontal plane; Curvature > 10
degrees using the CObb method;
Idiopathic - most common type; 3 types based on age at onset; Congenital -
structural anomaly at birth; Neuromuscular - in non-ambulatory patients
17. Scoliosis - Evaluation: 12-14 years of age. Manifests itself at the time of peak
growth.
18. Scoliosis - Diagnosis: Observe the child who should be wearing only
underwear, from the back
Have the child bend over at the waist with arms hanging down and observe for
asymmetry of ribs and flank
19. Scoliosis - Physical Exam: Uneven shoulders/hips
Prominent scapula
Uneven leg lengths
, One sided rib hump
C or S-shaped curve of spine
20. Scoliosis - Management: close observation for >20 degrees of curvature
Spinal bracing for 20-49 degrees of curvature
Surgical correction for >50 degrees of curvature; Referral is necessary
21. Transient synovitis: -common insidious causes of hip joint pain *under 12
years old*
-sudden onset of pain and limited mobility
-The disease causes arthralgia and arthritis secondary to a transient inflammation
of the synovium of the hip
22. Transient Synovitis -demographics: Ages 3-8, have pain, limping
23. Transient Synovitis - Historical and Clinical Findings: Mild to moderate fever,
mild
irritability, and resolves in 1 week. Limited hip motion, ESR<25mm/h
Often with recent URI
24. Transient Synovitis - Management: NO NEED TO DO SYOVIAL FLUID
ASPIRATION LIKE FOR SEPTIC
ARTHRITIS
ALSO REM= SEPTIC ARTHRITIS= VERY HIGH NEUTROPHILS
GIVE IBUPORFEN= ANY NSAID OTHER THAN ASPIRIN
AND FOLLOWUP IN 1 WK
THIS IS ENOUGH TX TO RESOLVE SX IN 1-4 WKS
25. Complications of casting/splinting: Compartment syndrome
Ischemia
STUDY GUIDE WITH 100% CORRECT
ANSWERS!!
1. Salter-Harris Fracture Classification: I: Straight across the plate - causing
separation.
II: Across plate and metaphysis.
III: Across plate and epiphysis.
IV: Through the metaphysis, plate, and epiphysis.
V: Compression fracture along plate.
2. Type I Salter-Harris Fracture: Fracture line extends through physis or within in
the growth plate
Ex: Slipped Capital Femoral Epiphysis (SCFE)
3. Type II Salter-Harris Fracture: Fracture extends through both the physis and
metaphysis
Most Common
Occur away from the joint space
Ex: Tibial metaphysis fracture, Proximal phalanx fracture, Distal Radius fracture.
4. Type III Salter-Harris Fracture: intra-articular fractures through the epiphysis
that extend across the
physis. Ex: Tillaux fracture of the ankle - Requires ORIF
5. Type IV Salter-Harris Fracture: A fracture through all three elements of the
bone, the growth plate,
,metaphysis, and epiphysis. Intra-articular Fx. Ex: Triplane fracture at the ankle.
REQUIRES ORIF.
6. Type V Salter-Harris Fracture: Rammed/Ruined/Crush or compression injury of
the growth plate
7. grade I sprain (mild): Tissue Stretching; Mildly swollen; MILD ROM and
strength loss (0-25%); no
decrease in stability
8. Grade II sprain (moderate): Moderate swelling: May look like a baseball;
Includes some ecchymosis;
Moderate ROM and strength loss (25-75%); some decrease in stability
9. Grade III sprain (severe): -complete tear
-significant swelling
-painful ROM/movements
-inability to bear weight
-empty end feel
10. How do you know reducing an annular ligament displacement was successful?:
A palpable/audible "pop" or "click"
Child typically begins reaching for objects again
11. Osgood-Schlatter disease: inflammation or irritation of the tibia at its point of
attachment with the
patellar tendon
12. Osgood-Schlatter Disease -presentation: History:
Recent physical activity: track, soccer, football.
,Increased pain with activity, exacerbated with running, jumping, squatting and
stairs.
13. Osgood-Schlatter Disease - Physical Exam Findings: Pain reproduced when
extending
the knee against resistance, stressing the quadriceps, or squatting; focal point
tenderness/swelling/heat at the tibial
tuberosity; full knee ROM
14. Osgood-Schlatter disease - Diagnostics: History and Physical
15. Osgood-Schlatter disease - Treatment: self-limiting; symptom management;
Avoid activities
that cause pain; ice/cold therapy for inflammation; NSAIDs have questionable
benefits; Quadriceps - Stretching
exercises when acute symptoms subside; Neoprene sleeve to stabilize patella/strap
16. Scoliosis: lateral curvature of the spine in the frontal plane; Curvature > 10
degrees using the CObb method;
Idiopathic - most common type; 3 types based on age at onset; Congenital -
structural anomaly at birth; Neuromuscular - in non-ambulatory patients
17. Scoliosis - Evaluation: 12-14 years of age. Manifests itself at the time of peak
growth.
18. Scoliosis - Diagnosis: Observe the child who should be wearing only
underwear, from the back
Have the child bend over at the waist with arms hanging down and observe for
asymmetry of ribs and flank
19. Scoliosis - Physical Exam: Uneven shoulders/hips
Prominent scapula
Uneven leg lengths
, One sided rib hump
C or S-shaped curve of spine
20. Scoliosis - Management: close observation for >20 degrees of curvature
Spinal bracing for 20-49 degrees of curvature
Surgical correction for >50 degrees of curvature; Referral is necessary
21. Transient synovitis: -common insidious causes of hip joint pain *under 12
years old*
-sudden onset of pain and limited mobility
-The disease causes arthralgia and arthritis secondary to a transient inflammation
of the synovium of the hip
22. Transient Synovitis -demographics: Ages 3-8, have pain, limping
23. Transient Synovitis - Historical and Clinical Findings: Mild to moderate fever,
mild
irritability, and resolves in 1 week. Limited hip motion, ESR<25mm/h
Often with recent URI
24. Transient Synovitis - Management: NO NEED TO DO SYOVIAL FLUID
ASPIRATION LIKE FOR SEPTIC
ARTHRITIS
ALSO REM= SEPTIC ARTHRITIS= VERY HIGH NEUTROPHILS
GIVE IBUPORFEN= ANY NSAID OTHER THAN ASPIRIN
AND FOLLOWUP IN 1 WK
THIS IS ENOUGH TX TO RESOLVE SX IN 1-4 WKS
25. Complications of casting/splinting: Compartment syndrome
Ischemia
