Summary Final year MD notes - paediatric orthopaedics
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Course
Institution
Macquarie University (MQ
)
A collection suite of final paediatric MD notes to ace your penultimate and final year exams!
Look no further and save the stress of accessing multiple resources as this PDF collates and summarises information from several resources including but not limited to:
-Talley and O’Connor clinica...
Development of the spine
spine derived from notocord (from ectoderm) è notocord secretes Shh (sonic hedgehog) to stimulate ectoderm to produce neural tube,
Week 2:
somite and subsequent sclerotome
Paraxial mesoderm develops into segments of somite è divides into sclerotome (vertebra/ribs), dermatome (skin) and myotome
(muscle)
Week 3: • Myotome ® SKM of neck, trunk and limbs
• Dermatome ® CT, dermis of skin
• Scleroteome ® vertebra, thoracic ribs and Cartilage (brown) derived from sclerotome surrounds neural tube
spinous process and vertebral body develops as well as nucleus pulposus (formed from notocord)
• Upper limbs buds develop 1st (2 days before lower limbs) è digit formmation
Week 4:
o Incomplete apoptosis = syndactylyl or polydactyly
• Closure of neural tube to protect spinal cord è failure = spina bifidia occulta è hunched back, lower limb paralysis
• RIBS: develop from transverse processes of thoracic vertebrae
a. Fibrous septa between body wall muscle è becomes cartilaginous è start to ossify by week 8.
Week 4-5:
• STERNUM: Parallel fibrous sternal bars è become cartilaginous è start to ossify by week 8.
• 2 manubrium and 2 left/right sternum fuse by birth (BUT ossification not completed as xiphisternum ossifies later in life)
Week 6 Synovial joints develop ® peripherally forms joint capsule and centrally disappears to form joint cavity
Motor axons from spinal cord enter the limb buds
Week 5-7
• Sensory axons enter the limb after the motor axons
(a)What induces the neural tube to form? (b) what vitamin is essential? (c) name a neural tube defect.
(a) Notocord
(b) Neural Tube Defects è linked to insufficient maternal intake of folate acid (vitamin B9)
(c) Spinal bifida occulta, meningocoele (i.e. meninges + CSF bulging out), anencephaly
What problem can a cervical rib cause?
• if cervical transverse process develops a cervical rib è thoracic outlet syndrome è occupies space in thoracic outlet
and compress neurovascular structures
Have the left and right sternal bars fused by birth?
Yes, but no ossification
o if no fusion èsternal cleft è gap between ribs è abnormal respiration and no protection of heart and lungs
o if incomplete fusion è sternal foramina (holes in sternum)
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