MCCN SDAP X - Pediatrics Exam 2
Questions and answers graded A+
Developmental Dysplasia of the Hip (DDH) - correct answer ✔✔Variety of conditions in which
the acetabulum and femoral head are improperly aligned. More common in girls and on the left
side.
S/S: limited abduction, asymmetry of the gluteal and thigh folds (Galeazzi test), + Trendelenburg
sign (pelvis tilts down when legs are raised)
Dx: ultrasound as bones are too cartilaginous for X-ray until 4 months of age
Tx under 6 months: Pavlik Harness
Tx over 6 months: Spica cast or (Bryant) skin traction
Dislocation - correct answer ✔✔Displacement of the bone from its normal articulation of the
joint
Subluxation - correct answer ✔✔A partial dislocation
Dysplasia - correct answer ✔✔Abnormal cellular or structural development
Ortolani-Barlow maneuver - correct answer ✔✔Movements to detect "clicks" or mild
dislocations of the hip, Ortolani (abduction), Barlow (adduction and push down)
Pavlik Harness - correct answer ✔✔A splint that allows hip flexion and abduction but does not
allow extension or adduction
Bryant Traction - correct answer ✔✔Used for developmental dysplasiea of the hip or a fractured
femur. Legs are wrapped from foot to thigh with elastic bandages. Hips are flexed at 90-degree
, angle with knees extended, this position is maintained by attaching the traction appliance to
weights and pulleys. The buttocks do not rest on the mattress but are slightly elevated off the
bed.
Legg-Calve-Perthes (LCP) Disease - correct answer ✔✔Condition in which there is necrosis of
the femoral head, results from an interruption of the blood supply to the femoral epiphysis,
25% of cases are preceded by a mild traumatic injury. Affects mostly boys ages 4-8 years old.
Prognosis is good if the femoral head can be contained within the hip socket long enough for
proper healing to occur. Toronto or Scottish-Rite Braces, or Petrie casting are used. In severe
cases surgery is necessary with pin placement or to release adductor muscles.
S/S: Limp, hip discomfort, decreased ROM "activity=pain; rest=relief"
4 Stages of LCP - correct answer ✔✔*1. Necrosis/Avascular (3-6 mos.)*: asymptomatic, head of
femur is intact but avascular
*2. Revascularization (1-4 yrs.)*: pain and limited ROM, X-ray shows new bone deposition and
dead bone resorption.
*3. Reparative*: Reossification, pain decreases
*4. Regenerative*: No pain, improvement in joint function occurs
Slipped Capital Femoral Epiphysis (SCFE) - correct answer ✔✔Condition occurring in adolescent
growth spurt when the femoral head is spontaneously displaced from the femoral neck.
*Obesity, endocrine* disorders, and trauma are risk factors. Tx is surgical pinning.
Duchenne's Muscular Dystrophy - correct answer ✔✔X-linked recessive gene mutation results
in absence of dystrophin, progressive degeneration of muscles, onset boys 3-6 yrs.
S/S: muscle weakness, mental delat, heart and rest muscle weakness, *Gower sign* (need to
push up on their knees just to stand)
Dx: Muscle biopsy for dystrophin, EMG to test for ascending paralysis
Tx goal: independent and functional as much as possible
Questions and answers graded A+
Developmental Dysplasia of the Hip (DDH) - correct answer ✔✔Variety of conditions in which
the acetabulum and femoral head are improperly aligned. More common in girls and on the left
side.
S/S: limited abduction, asymmetry of the gluteal and thigh folds (Galeazzi test), + Trendelenburg
sign (pelvis tilts down when legs are raised)
Dx: ultrasound as bones are too cartilaginous for X-ray until 4 months of age
Tx under 6 months: Pavlik Harness
Tx over 6 months: Spica cast or (Bryant) skin traction
Dislocation - correct answer ✔✔Displacement of the bone from its normal articulation of the
joint
Subluxation - correct answer ✔✔A partial dislocation
Dysplasia - correct answer ✔✔Abnormal cellular or structural development
Ortolani-Barlow maneuver - correct answer ✔✔Movements to detect "clicks" or mild
dislocations of the hip, Ortolani (abduction), Barlow (adduction and push down)
Pavlik Harness - correct answer ✔✔A splint that allows hip flexion and abduction but does not
allow extension or adduction
Bryant Traction - correct answer ✔✔Used for developmental dysplasiea of the hip or a fractured
femur. Legs are wrapped from foot to thigh with elastic bandages. Hips are flexed at 90-degree
, angle with knees extended, this position is maintained by attaching the traction appliance to
weights and pulleys. The buttocks do not rest on the mattress but are slightly elevated off the
bed.
Legg-Calve-Perthes (LCP) Disease - correct answer ✔✔Condition in which there is necrosis of
the femoral head, results from an interruption of the blood supply to the femoral epiphysis,
25% of cases are preceded by a mild traumatic injury. Affects mostly boys ages 4-8 years old.
Prognosis is good if the femoral head can be contained within the hip socket long enough for
proper healing to occur. Toronto or Scottish-Rite Braces, or Petrie casting are used. In severe
cases surgery is necessary with pin placement or to release adductor muscles.
S/S: Limp, hip discomfort, decreased ROM "activity=pain; rest=relief"
4 Stages of LCP - correct answer ✔✔*1. Necrosis/Avascular (3-6 mos.)*: asymptomatic, head of
femur is intact but avascular
*2. Revascularization (1-4 yrs.)*: pain and limited ROM, X-ray shows new bone deposition and
dead bone resorption.
*3. Reparative*: Reossification, pain decreases
*4. Regenerative*: No pain, improvement in joint function occurs
Slipped Capital Femoral Epiphysis (SCFE) - correct answer ✔✔Condition occurring in adolescent
growth spurt when the femoral head is spontaneously displaced from the femoral neck.
*Obesity, endocrine* disorders, and trauma are risk factors. Tx is surgical pinning.
Duchenne's Muscular Dystrophy - correct answer ✔✔X-linked recessive gene mutation results
in absence of dystrophin, progressive degeneration of muscles, onset boys 3-6 yrs.
S/S: muscle weakness, mental delat, heart and rest muscle weakness, *Gower sign* (need to
push up on their knees just to stand)
Dx: Muscle biopsy for dystrophin, EMG to test for ascending paralysis
Tx goal: independent and functional as much as possible
