assessing head shape and size Flashcards

1
Q

normal infant skull

A
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2
Q

what is microcephaly

A

too small head

OFC 2SD or below the mean = mild

OFC 3SD below the mean = mod/severe

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3
Q

what is macrocephaly

A

too big head

OFC 2SD above the mean

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4
Q

how do the fontanelles close

A

posterior closes 2-3m/o

sutures gradually fuse

anterior closes 1-3y/o

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5
Q

measurements of the head

A

occipitofrontal circumference

repeat 2-3x for consistent reading/avg

  • measure and plot parental head sizes to interpret - is the child’s in keeping with the rest of the family
  • is it too big/small or odd shape
  • sutures and fontanelles
    • look at facial features, any asymmetry?
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6
Q

when is the head measured

A
  • routine between birth-3yrs
  • if any child with neurological symptoms or developmental complaints
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7
Q

what does microcephaly indicate

A

usually indicates small brain - micranencephaly

  • is it prenatal/postnatal onset - is it crossing centiles downwards
    • timing of onset may be clue to cause
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8
Q

causes of microcephaly

A

antenatal

postnatal

genetic

environmental

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9
Q

assessing macrocephaly

A

is it crossing centiles upwards - underlying brain/CSF is expanding abnormally

separation of sutures, large fontanelles - indicate very large head size

  • familial
  • hydrocephalus
  • large brain

is development normal?

  • consider other physical abnormalities - facial features, hepato splenomegaly, bony deformities etc
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10
Q

when do head shape problems generally occur

A

often in first year of life

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11
Q

assessing head shape probelms

A
  • timing of onset
  • is it getting better/worse with age
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12
Q

what is plagiocephaly

A

flat head

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13
Q

what is brachycephaly

A

short head or flat at back

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14
Q

what is scapocephaly

A

boat shaped skull

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15
Q

what is craniosynostosis

A

premature fusion of cranial sutures

brain doesn’t have enough space to grow

shape depends on which suture has closed too early

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16
Q

deformational plagiocephaly

A

often due to the position that the child is in - child often lies on that side of head

‘parallelogram’ type shape

may not be apparent at birth and becomes more prominent in 1st year of life