Deck 6: Musculoskeletal System: Considerations and Interventions for Specific Pediatric Pathologies

Question 1

Arthrogryposis

A) is characterized by an asymmetrical pattern of contractures and joint involvement.
B) typically has associated cognitive impairments.
C) may be related to a lack of fetal movement.
D) is a progressive disorder.

Answer 1

C
Explanation: The joint restrictions seen in arthrogryposis are believed to be due to a fetal muscular problem that decreases the amount of fetal movement. The lack of movement doesn't break down the mesenchyme for joint formation. Arthrogryposis is a nonprogressive disorder, associated with a symmetrical pattern of muscle contractures and joint involvement. Cognitive impairments are not typically associated with this disorder.

Question 2

A unilateral limitation in hip abduction could be an indication of

A) developmental hip dysplasia.
B) slipped capital femoral epiphysis.
C) Legg-Calvé-Perthes disease.
D) osteomyelitis of the hip.
E) All of the above

Answer 2

E
Explanation: Asymmetrical abduction is a common finding in all of the diseases.

Question 3

Which following disorder can cause fractures early in life, and children younger than 3 are typically investigated for child abuse?

A) Osteogenesis imperfecta
B) Cerebral palsy
C) Legg-Calve-Perthes
D) Juvenile idiopathic arthritis

Answer 3

A
Explanation: OI is a genetic collagen mutation that results in fragile bones. More severe forms of OI present with multiple fractures as a result of the birthing process, whereas more mild forms may result in frequent fractures as a result of mild, seemingly insignificant injuries.

Question 4

Name two pediatric diagnoses where limitation in range of motion is a common characteristic.

Question 5

Which of the following is an unlikely cause of a leg length discrepancy?

A) Inflammatory hyperemia
B) Hemimelia
C) Joint contracture
D) Stress fracture of bone diaphysis

Question 6

Children with cerebral palsy

A) commonly retain neonatal levels of hip retroversion.
B) have atypical muscle composition so strengthening is not advocated.
C) have a higher incidence of scoliosis than the general population.
D) characteristically have intellectual disabilities.

Question 7

Methods to promote bone mineralization include

A) impact exercise.
B) weight-bearing exercise.
C) upright standing frames.
D) running.
E) All of the above
Short Answer

Question 8

Why should children with arthrogryposis be evaluated for an early intervention program?

A) Arthrogryposis is generally associated with intellectual impairment.
B) Arthrogryposis is a progressive, debilitating condition.
C) Weakness and contractures at birth may delay motor milestone acquisition and lead to disuse weakness.
D) Physical therapy intervention can correct the deformities.

Question 9

Children with Duchenne muscular dystrophy

A) will have increased base of support, lateral trunk sway, and toe-walking during the late ambulatory stage.
B) will have loss of upper extremity function, scoliosis, and contractures during the late nonambulatory stage.
C) will have increased lumbar lordosis and weakness in the hip extensors and ankle dorisflexors
D) All of the above

Question 10

Select the correct statement(s) regarding Duchenne muscular dystrophy (DMD). Children with DMD

A) develop hypertrophy of the gastrocnemius as a method to compensate for progressive weakness.
B) should avoid resistive activities and eccentric contractions as this can cause further muscle breakdown.
C) require use of ankle foot orthoses to maintain walking past 12 years of age.
D) will not get muscle contractures if parents perform passive stretches weekly.

Question 11

Wayne Stuberg and colleagues demonstrated that a standing program could facilitate hip development in children with developmental disabilities. The program recommended was:

A) 30 min, 2 days per wk.
B) 30 min, 5 days per wk.
C) 60 min, 1 day per wk.
D) 60 min, 3 days per wk.

Question 12

Which type of juvenile idiopathic arthritis involves the most joints and is the most debilitating?

Question 13

Select the correct statement regarding congenital muscular torticollis.

A) It can be associated with developmental dysplasia of the hip.
B) The muscle tightness will spontaneously resolve by 12 months of age.
C) It is characterized by tightness of the sternocleidomastoid muscle resulting in decreased lateral flexion and rotation to the same side.
D) Torticollis is caused by prematurity.

Question 14

Pseudohypertrophy is commonly seen in children with

A) Duchenne muscular dystrophy.
B) Ehlers-Danlos syndrome.
C) juvenile idiopathic arthritis.
D) Blout disease.

Question 15

Young boys having Duchenne muscular dystrophy tend to use the Gower maneuver to rise from the floor because of weakness in

A) knee extensors and flexors.
B) hip extensors and flexors.
C) distal leg musculature.
D) upper extremity musculature.

Question 16

Moderate exercise for children with juvenile idiopathic arthritis usually leads to

A) increased joint pain.
B) increased joint inflammation.
C) improved fitness.
D) increased joint bleeds.

Question 17

Name two diagnoses where heightened reaction to trauma is common.

Question 18

Which of the following conditions can present as toe-walking?

A) Cerebral palsy
B) Duchenne muscular dystrophy
C) Idiopathic toe walking
D) All of the above

Question 19

Select the most accurate statement about exercise and children.

A) Children with Duchenne muscular dystrophy should participate in intense regular exercise to improve muscle bulk and slow the progression of the disease.
B) Children with juvenile idiopathic arthritis should only perform non-weight-bearing exercises to avoid increasing joint pain.
C) Children with cerebral palsy typically have poor aerobic and muscular endurance.
D) Children with Ehler's Danlos syndrome should not participate in sports due to risk of joint damage.

Question 20

Children with juvenile idiopathic arthritis in their hips

A) exacerbate (cause to flare up) their symptoms with exercise.
B) should lie in prone every day.
C) have lifelong joint inflammation.
D) should use a wheelchair as their main means of mobility.