Transcript CH. 50 MUSCULOSKELETAL

MUSCULOSKELETAL
DISORDERS
THE MUSCULOSKELETAL
SYSTEM
• Bones and bone growth
– Epiphyseal plates…bone
growth occurs here and
when these seal over,
there is no more growth
– Ages 17-18 for males,
about 2 years after
menarche for females
DISORDERS OF BONE
DEVELOPMENT
• Flat feet
• Bowlegs (Genu
Varum)
• Knock knees (Genu
Valgum)
• Toeing in
• Limps
• Growing pains
DISORDERS OF BONE
DEVELOPMENT
• Osteogenesis imperfecta
– Bones are easily broken
– May be treated with growth hormone, calcitonin,
biphosphonates
• Legg-Calve-Perthes disease
– Avascular necrosis of the femoral head
– More common in boys 4-9
– S/S…limp, possible refusal to walk, and pain. No fever, no
obvious signs of inflammation
– Treatment
• If over six…brace, if under six, observe
DISORDERS OF BONE
DEVELOPMENT
• Osgood-Schlatter disease
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Thickening and swelling of tibial tuberosity
Occurs in adolescence or preadolescence
Sports related
More common in males 10-13
Treatment usually is limiting activity
• Slipped capital femoral epiphysis
– Avascular necrosis may occur
– Need early detection
– More common in males and obese adolescents with sedentary
lifestyle
– S/S…onset of unilateral hip pain
– May need surgery and pinning
INFECTIOUS AND
INFLAMMATORY DISORDERS OF
THE BONES AND JOINTS
• Osteomyelitis
– Often caused by staph
– Very common after stepping on a nail that goes through a
tennis shoe
– Very difficult to treat…IV antibiotics, maybe for 6 weeks.
Bone cells have little capacity to replace bone destroyed by
infection
DISORDER OF SKELETAL
STRUCTURE
• Scoliosis: functional
– Caused by unequal leg length or visual problems
– Compensatory mechanism used by child
• Scoliosis: structural
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Permanent curvature of spine
Peaks age 8-15
More common in females
Assessment done during PE starting age 10
• Look for…
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Shoulder height
Shoulder prominence
Leg lengths
Rib prominence
– Treatment is surgery for >40 degree curvature or a
brace for >20
DISORDERS OF THE JOINTS
AND TENDONS
• Juvenile Arthritis
– Probably autoimmune
– Subtypes pg. 1434
– S/S
• Persistent fever and rash
• Joint swelling
– Treatment
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Exercise
Heat
Nutrition
Meds
– NSAIDS
– DMARDS
DISORDERS OF THE
SKELETAL MUSCLES
• Muscular Dystrophy
– Duchenne’s is the most common form
– Sex-linked recessive
– Gower’s sign-pressing hand against ankles,
knees, and thighs to rise to stand
– Calf muscles are hypertrophied, shoulder
muscles are weak
– Death occurs around age 20 due to heart
failure
Fractures
• Fractures
– Break in the continuity of the bone
– Common fractures in childhood
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Forearm
Clavicle
Femur
Dislocation of Radial Head
Salter-Harris
– Fracture of the growth plate
– Graded from I-V