NU665C/ NU 665C Exam 1: (New 2025/ 2026 Update) Family Psychiatric Mental Health | Qs & As| Grade A| 100% Correct (Verified Answers)- Regis

NU665C/ NU 665C Exam 1: (New 2025/ 2026 Update) Family Psychiatric Mental Health | Qs & As| Grade A| 100% Correct (Verified Answers)- Regis Hip examination - CORRECT ANS1. Galeazzi - can signal conditions that cause leg-length discrepancies; includes flexing the hips and knees while the infant or child lies supine, placing the soles of the feet on the table near the buttocks, and then looking at the knee heights for equality -Positive if the knee heights are unequal 2. Barlow - assess for dislocation of a nondisplaced hip in an infant during the first month of life; the infant should be unclothed and supine with knees flexed; the hip is flexed and the thigh is brought into an adducted position while applying gentle downward pressure; the hip would slip out of the acetabulum or can be pushed out of the socket; this is a positive; the dislocation is palpable; the hip relocates after release 3. Ortolani - reduces a posterior dislocated hip and is performed gently to reduce a recently dislocated hip; the infant is in a supine position with both knees flexed; the providers thumb is placed near the lesser trochanter and the pad of the second finger is position on the bony prominence of the greater trochanter; the leg is flexed at the hip and then abducted while pushing up -A palpable clunk as the femoral head is relocated is a positive; a high-pitched hip click may be audible or felt at the end of abduction 4. Klisic test - an observational sign of hip placement; the PCP places the tip of the third finger of one hand over the greater trochanter and the index finger of the same hand on the anterosuperior iliac spine -If the hip is dislocated, the trochanter is elevated and the imaginary line points halfway between the umbilicus and the pubis 5. Trendelenburg sign - can be used to identify conditions that cause weakness in the hip abductors; by having the child stand and raise one leg off the ground; if the pelvis drops on the side of the raised leg, the sign is positive and indicates we Costochondritis - CORRECT ANS-Common cause of chest pain in children and adolescents -Inflammation of one or more of the costochondral cartilages that causes localized tenderness and pain in the anterior chest wall -Caused by trauma and unaccustomed physical effort -Treatment - mild analgesia and NSAIDS to relieve discomfort and avoiding strenuous activity; cough suppressants if cough is aggravating; stretching exercises and ice -Not related to cardiac disease Scoliosis - CORRECT ANS-A lateral curvature of the spine; of more than 10 degrees -Testing - standing AP and lateral radiographs of the entire spine; MRI to find the cause; -Interventions - observation for curves less than 20 degrees, bracing, and surgery if they do not respond to bracing and curves are more than 45-50 degrees Developmental dysplasia of the hip - CORRECT ANS-Anatomical abnormalities in which the femoral head and acetabulum are in improper alignment and/or grow abnormally -A hip examination should be done on children as part of their well-child supervision until the child begins to walk -Ortolani and Barlow in first month; other tests - Klisic and Galeazzi after; ultrasound is suspicious -In the older infant - 6-18 months - may see limited abduction of the affected hip and shortening of the thigh and a positive Galeazzi sign -Other symptoms include asymmetry of inguinal or gluteal folds, unequal leg lengths -In the ambulatory child - positive Trendelenburg sign, marked lordosis or toe walking, painless limping or waddling gait with child leaning to the affected side -Management - restore the articulation of the femur within the acetabulum; most resolve spontaneously by 6-8 weeks so close observation is recommended; -Refer infant to orthopedist if the newborn exam is positive; follow up at 2 weeks with a thorough hip exam - if positive or inconclusive - refer -Treatment is a Pavlik harness for subluxation and reducible dislocations worn 24 hours a day except for bathing, the 6-18 month old - closed manipulation or open reduction and a spica cast -Annual or biannual radiographs to the point of skeletal maturity is recommended to evaluate for late asymmetric epiphyseal closure Tibial torsion - CORRECT ANS-Twisting of the long bone along its long axis -Congenital, developmental, or acquired -Most common cause of in-toeing during the second year of life and is noted around 6-12 months -In most causes it resolves by 8 years of age -Signs - in toeing -Refer to orthopedist if the problem is significant (TFA 20 degrees by 3 years of age); stretching exercises or external rotational splints; surgery for severe cases that persist into late childhood and cause functional problems Talipes Equinovarus (clubfoot) - CORRECT ANS-The ankle is in equinus (foot in a pointed toe position), the sole of the foot is inverted as a result of hindfoot varus or inversion deformity of the heel, and the forefoot has the convex shape of forefoot adduction -From environment and genetics -AP and lateral radiographs are recommended with the foot held in a normal position -Refer to an orthopedist upon diagnosis, ideally shortly after the infant is born, because the joints are most flexible in the first hours and days of life -Nonoperative treatment should begin ASAP after birth -Tapping and strapping; manipulation; and serial casting -Ponseti method - manipulation and serial casting - weekly cast changes with up to 5-10 casts; full time bracing for three months and then night time bracing for 3 5 years Annular ligament displacement injury - CORRECT ANS-Nursemaids elbow -A frequent injury that occurs in children 6 months to 5 years of age -Occurs when traction is applied to the arm of a young child, which is most often the result of pulling a child by the hand or grasping a child's hand to prevent a fall -The annular ligament slides over the head of the radius, where it becomes entrapped in the radiohumeral joint when the distal traction is released -The child refuses to use the arm, pain when moved, particularly the elbow; swelling and ecchymosis are not always present -Can do supination and flexion or pronation; do not attempt with epitrochlear tenderness -A palpable or audible click usually signals successful reduction; the child will reach for objects again with the arm within 15 minutes; if this is done - no further treatment is necessary -Several attempts may be needed; if normal use does not follow reduction attempts - immobilization with a sling with prompt orthopedic follow-up is indicated -More prone to to get this once you've had it Legg-Calve-Perthes Disease - CORRECT ANS-Childhood hip disorder that results in infarction of the bony epiphysis of the femoral head; avascular necrosis of the femoral head -Cause is insufficient blood supply to the femoral head; the area revascularizes and the necrotic bone is replaced by new bone which can take 18-24 months -Intermittent limp especially after exertion, with mild or intermittent pain; persistent pain in the groin, anterior hip region, or laterally around the greater trochanter; limited ROM -Muscle spasms, antalgic gait with limited hip movement, Trendelenburg gait, atrophy of gluteus, quadriceps, and hamstring muscles -Routine AP pelvis and frog-leg lateral views are used to confirm, stage, and follow disease progression -Referral to an orthopedist is required for the management of LCPD - activity limitation, protected weight bearing, use of NSAIDS and PT to maintain hip motion and bed rest with traction, or casting to maintain hip abduction; surgical approaches involve pelvic and femoral osteotomies of the proximal femur or pelvis Slipped capital femoral epiphysis - CORRECT ANS-Salter-Harris stage 1 fracture through the proximal femoral physis; stress around the hip causes a shear force to be applied at the growth plate -Occurs just after the onset of puberty, often in overweight and slightly skeletally immature boys; also see in boys where puberty is delayed -A vague history of antecedent trauma, pain in affected hip, groin, thigh, or knee; limping or gait abnormalities -Plain radiography - AP, pelvis, frog-legged and lateral views of pelvis -Refer immediately to orthopedic surgeon; needs crutches or wheelchair; non weight bearing to prevent further slippage; hospital and bed rest -Percutaneous pinning and placement of a single can