Exam 2: Head, Ears, Nose, Throat Flashcards
What are three differences in children vs. adults?
changes in Eustachian tubes, nasal breathers, enlarged tonsils.
When do sutures ossify?
6-18 yrs
What are the male adolescent facial changes?
nose and thyroid cartilage enlarge, facial hair appears.
What is acromegaly?
some facial features are larger than normal.
what is craniofacial dystosis?
not symmetrical facial features.
What increased in infants by 3 months?
salivation.
What sinuses are present at birth but very small? which ones begin developing at 3 yrs?
maxillary, ethmoid; frontal, sphenoid
When do permanent teeth begin forming?
6 months of age.
When do you start getting permanent teeth and when is it completed?
6 yrs- 14 or 15 yrs
What is craniotabes?
softening of the outer table of the skull.
What are some common medical treatments for ear disorders?
pressure-equalizing (PE) tubes, hearing aids, cochlear implants.
what are some common drugs for ear and eye disorders?
antibiotics, antihistamines, analgesics
True or false: 1 million children are affected with hearing impairment.
true
What are some common causes of conductive hearing loss?
impacted cerumen; otitis externa, trauma, foreign body.
True or false you should get a language and hearing test if frequent otitis media or middle ear effusion > 3 months,
true
When are screening tests?
16-24 months
What are some signs of hearing impairment in an infant?
lack of startle reflex, failure to localize sound by 6 months, absence of babble or inflections by age 7 months, failure to speak by 24 months.
What age ranges do the following occur?
1) turns head to sound, recognizes moms voice; babbles
2) reacts to loud noises; responds with smile to voice.
3) makes varies noises; imitates simple sounds; responds to name and no-no or bye bye.
1) 4-8 months
2) newborn-4 months
3) 8-12 months
What are the levels of hearing loss?
1) severe loss
2) moderate loss
3) mild loss
4) normal
5) profound loss
6) death
1) 60-80 dB
2) 40-60 dB
3) 20-40 dB misses 50% of everyday convo.
4) 0-20 dB
5) > 80 dB
6) > 90 dB
What type of hearing loss results when transmission of sound through the middle ear is disrupted, as in the case of OME.?
Conductive hearing loss
What hearing loss is caused by damage to the hair cells in the cochlea or along the auditory pathway.?
sensorineural hearing loss
true or false if a child has hearing impairment it is important to face them when speaking.
true
What would an abnormal TM look like?
erythema, swollen, lost light reflex.
What are some risk factors of otitis media?
cigarette smoke, day care centers, increased pacifier use, bottle propping.
True or false: otitis media maybe asymptomatic which could lead to hearing loss.
true
What are some tx for otitis media?
tympanostomy- tube placement
analgesics, antipyretics, antibiotics.
antihistamines and decongestants are not effective.
who commonly gets otitis media with effusion?
under age 15; males
what are some symptoms of OM with effusion?
hearing loss, clogged ear, language delays, poor school performance, frequent OM, little or no pain.
What does TM of OM with effusion look like?
retracted or convex, may see air-fluid or bubbles, landmarks blurred, mobility decreased, + weber of affected ear.
What is Otitis Externa also known as?
swimmers ear
What is tx for otitis externa?
steroid(hydrocortisone) drops for inflammation, antibiotics if bacterial.
Who is epistaxis common in?
school-agers and males
What can cause nose bleeds in anterior nares?
veins irritated from dry air, foreign body, nose picking, coughing, allergies
True or false if epistaxis is a posterior problem it is usually more problematic.
true
Tx for a bloody nose?
sit up right with head forward and squeeze or apply pressure for 10-15 minutes.
What is the number one concern for peds?
URI
What are some symptoms of sinusitis?
usually URI for 10 days with persistant cough, malodorous breath, mouth breathing, increased purulent drainage, facial pain, HA, fever, cervical lymphadenopathy, hyponasal speech.
Tx for sinusitis?
antibiotics and antipyretics
What are some symptoms of viral pharyngitis?
nasal congestion, mild sore throat, pink eye, cough, mild pharyngeal redness, cervical lymphadenopathy, fever less than 101 F
What are some symptoms of strep or bacterial pharyngitis?
abrupt onset, tonsillar exudate, painful cervical lymphadenopathy, n/v, abdominal pain, HA, fever > 101 F, hot potato voice.
What do you assess for in a patient who had a tonsillectomy?
increased swelling and swallowing difficulty, fluid balance, will have sore throat and possible ear pain, assess for bleeding.
What are some early signs of bleeding with tonsillectomy? late?
frequent swallowing; hypotension, tachycardia
What is a tonsillar infection that has spread to surrounding tissues and causes cellulitis?
peritonsillar abscess
What is infection of the lymph nodes that drain the adenoids, nasopharynx, and paranasal sinuses?
retropharyngeal abscess.
