BODY SYSTEMS (things not on charts) Flashcards
surfactant
lining of the lungs that occurs in the 3rd trimester; premies do not have as much and that’s why they have more trouble breathing
smaller/larger (Resp)
smaller lower airways and cartilage, tonsillar tissue enlarged (kids lymph on the whole is very large)
under 6 years use these mm to breathe
abdominal
we count for a full minute with children due to
periodic breathing
TRUE APNEA signs
- how long the pause in breathing is (generally longer than 10 secs)
- a cyanosis (circumoral – around the mouth)
- a bradycardia
tracheal tug
kids who are having trouble breathing willl tug at their neck
croup
often disease of toddlers or preschoolers
low-high temp 38.5 ish
croup can move on to epiglottitis
epiglottitis
PAEDS EMERGENCY
40-41 temp
leaning forward in tripod position, tongue sticking out, pale, drooling
RSV
respiratory synctial virus
babies presenting w it cough a lot and have a lot of phelgm
CHD/cardiac problems in babies and children
congenital heart disease
tend to be long, skinny babies and feeding tends to be difficult bc it takes up so much of their work/energy because theyre not getting the proper oxygen supply
cant always keep up in play (children show things behaviourally)
can often have Coarctation ofthe Aorta (means narrowing of the aorta, its recommended children have a comparison of arm and leg BPs at least once during childhood)
innocent/innocuous murmurs
do not have a physiological consequence, often genetic and run in families “soft murmurs”
count apical pulse for a full minute because of
sinus arrhythmia
radial is not used, its not accurate
BP assessment procedures
any child under 3 who has risk factors should be checked for BP at every HC visit
risk factors for high BP
prematurity/birth
cardiac/renal problems
family hx
any severe disorders
primary hyperT
cause is either a disease (underlying physiological reason) or how we are treating a disease*; children have a higher rate of primary hyperT than adults
secondary hyperT
due to lifestyle/diet/etc
adults vs child water percentage
male: 60&, female: 55%, premie: 80%
less at risk for dehydration after age
2
assessment for dehydration
eyes fontanelles voiding skin weight loss
early signs: mild dehydration
5%
thirst, dry mouth, less urine, wt loss
late signs: moderate dehydration
10%
sunken fontanelle, sunken eyes (one of the best indicators for dehydration, rapid/deep breathing (acidotic), loss of skin elasticity (done on abd, not hands)
late signs: severe dehydration
15%; almost always fatal
signs of shock: rapid, weak pulse; cyanosis, cold limbs
potential for coma
dehydration tx
fluid replacement (IV, replace what theyve lost over 24 hrs depending on renal/cardiac status) NPO short term clear fluids/electrolyte replacement BRAT/RAB diet when introducing food back (bananas rice applesauce toast)
visual ability at 4 months
20/50 - 20/80
visual ability at 5 YEARS
20/20 - 20/50
age eye colour will show (true colour)
at 6 months; most children born with blue eyes
can get: strabismus
eye oscillates
can also get: oculomotor dyskinesia
they suddenly lose control of their eye muscles (perfectly normal otherwise)
colour blindness most common
red/green
x linked dx; expressed by males and carried by female
otitis media
ear infections
acute ear infx
dont miss, ear drum can actually rupture, screaming, fever
chronic infx
subclinical and no matter what antibiotics given they just wont go awya
outer “swimmer’s ear”
often most painful
infection of the ear canal
stomach round and protruberant
wilm’s tumour is a renal cancer; the #1 sign of it is increased abd girth (diaper doesnt fit even though child hasnt grown much) – WILL metastasize on palpation, no one palpates abdomen, very curable even in latest stages
pyloric stenosis
pyloric sphincter can become so tight that it closes off – common in infants under 6 months of age, higher incidence in first born males (vomiting is more projectile)
projectile vomiting in anyone indicates
a NEURO problem (concussed, migraine)
intusscesseption
in adults intestines are well-adhered, in a baby theyre not. one part of the intestine can transverse another part and cut it off; causes projectile vomiting
* cranberry jelly stool is diagnostic and not part of any other disorder; no more tests needed but does require surgery
rate of propulsion will be increased by
a fever
lower GI in neonate:
large intestine short, reduced epithelial lining; stools soft
on breastmilk alone stools mustard yellow and soft
children are prone to constipation
soft tissues in children are
very resilient (hardly any sprains, etc)
greenstick fractures
their bones are soft; a # occurs on one side/shreds the bone slightly and the other side remains intact
common dx: congenital dislocation of hip
every baby tested for it at birth (click is heard if present)
lay them on their stomachs and their folds of skin on the back of legs should be symmetrical
8x more common in girls
if not treated will need hip replacements EARLY (35-40), uneven gait, etc
tx: triple diapers, follow with xrays (usually works)
if it doesnt, a Hip Spica cast used
common dx; scoliosis
girls more likely to have it
internationally adopted girls tangent:
35-40% of endocrine consults are from this popoulation – risk for retardation
if nutrition is very poor in the first few years, what happens is their brain is kind of “reset” which impacts later when they hit puberty (usually around the same time as other girls), they go through it very quickly and when menarche hits the estrogen cuts off the growth of long bones and these girls can end up very short, socially impacting short, and should be offered growth hormone (purely a growth issue that needs to be screened for)
puberty normally takes years (breast budding then 2-3 years for menarche)
should be monitored when they go through puberty or even before – parents should be counselled
risk factors: orphanage, low nutrition
mongolian spots
darker patches of skin along the buttocks, back; NOT a sign of abuse
with time they go away, it’s the melanin containing cells that are migrating to the neural crest
cafe au lait spots
little brown spots, surface looking (a small number is considered normal, ie 6-8, but a larger number is linked to a number of neurological disorders). not raised.
dennie morgan lines (an atopic sign)
extra fold of skin immediately below the eyes, due toa little bit of swelling that causes the skin to fold (as the sinuses get bigger and they get older they may go away)
rabbit nose
may twitch their nose like a rabbit to sniffle/clear an obstruction/nasal mucus
allergic shiners
dark rings under the eyes
allergic salute
children use the palm of their hand to rub the tip of their nose to itch/congestion/wipe away mucus
