Exam 3 Flashcards
differences between neck anatomy for pediatrics and adults
pediatric:
- airway is smaller
- larynx positioned higher in the neck
- cricoid cartilage the narrowest point of the airway
- larger epiglottis
adult:
- larger airway
- vocal cords are the narrowest point
differences between pelvis anatomy for pediatrics and adults
pediatric:
- smaller pelvis
- less developed
- unfused growth plates in hip bones
adult:
- larger pelvis
- fully developed
- fused growth plates
differences between spine anatomy for pediatrics and adults
pediatric:
- spine is less ossified
- larger intervertebral discs
- shallower facet joints
- larger volumes of total CSF (50%)
- center of rotation is C2-C3
adults:
- spine is ossified
- 33% volume of CSF
- center of rotation is C5-C6
differences between extremities anatomy for pediatrics and adults
pediatric:
- presence of growth plates (open)
- more flexible bones
- larger heads and shorter limbs compared to body size
- diaphysis, metaphysis, and epiphysis
adults:
- closed growth plates
- bones are dense and rigid
- only metaphysis and diaphysis are present
why is soft tissue important in pediatric imaging?
because soft tissue and ligament injuries are more common than osseous fractures
1/3 of all skeletal injuries to children, at the growth plates, and commonly the ankle and wrist
salter-harris fracture
separated growth plate injury
salter-harris type 1
above growth plate injury
salter-harris type 2
below growth plate injury
salter-harris type 3
through growth plate injury
salter-harris type 4
erasure of growth plate injury
salter-harris type 5
- happen when the bending resistance is exceeded and the bone bows without breaking
- usually happen in the forearm or clavicle
bow fracture
happens when a ligament or tendon pulls a small piece of bone away from the main bone mass
avulsion fracture
Type of greenstick fracture
- The load on the bone is the same direction as the diaphysis, causing the cortex to fold back on itself
- Usually happens when falling and landing on out-stretched hands
torus fracture
happens when one cortex of the bone’s diaphysis breaks and the other side remains intact
greenstick fracture
- a subtle, non-displaced, oblique fracture of the distal tibia in children
- 9 months - 3 years
- lower tibia
toddler’s fracture
Most common elbow fracture in children
- 60% of all pediatric elbow fractures
- Ages 3-10
- Child falling on an outstretched hand with hyperextension of the elbow
supracondylar fracture
Standard procedure to find bone growth anomalies among infants and children
- Images of the hand are compared with standard images for specific ages
- Always left hand PA image
bone age assessment
pediatric pelvis landmarks:
pubis symphysis, ASIS, greater trochanters
curves of scoliosis:
- Levoscoliosis – curvature towards the left
- Dextroscoliosis – curvature towards the right
scoliosis imaging:
- long full spine PA
- sometimes lateral
- lateral bending images to see how fixed a curve is
- to evaluate presence of structural bony abnormalities and major/minor curves
abnormal curvature of the spine
scoliosis pathology
the most pronounced curve – main structural abnormality
(scoliosis)
primary curves
non-structural curve that develops above or below the primary curve to maintain balance
(scoliosis)
secondary curves
causes of scoliosis
- Neuromuscular
- Congenital body
- Tumor or treatment
- Infection
Conditions causing deficits that result in asymmetric muscular tone resulting in spinal curvature
- Cerebral palsy, Chiari malformation, syringomyelia, tethered cord, muscular dystrophies, spinal muscular atrophy, traumatic paralysis
neuromuscular
An underlying bony abnormality of the vertebra which results in a fixed spinal curve
- Segmentation and fusion abnormalities (hemivertebrae), skeletal dysplasia
congenital body
Adjacent tumor, or previous treatment
- Osteoid osteoma, osteoblastoma, metastases, neurofibromas
- Meningioma, neurofibroma, astrocytoma, ependymoma
tumor or treatments
Causing bony abnormalities
- Pyogenic osteomyelitis, tuberculous spondylitis
infection
collection of pus that forms behind the back wall of the throat, in the space between the pharynx and the vertebrae
retropharyngeal abscess
infection that causes inflammation (redness and swelling) of the tonsils
tonsillitis
- life threatening disease, requires emergent intubation
- great risk for complete airway obstruction
- symptoms: abrupt onset of stridor, dysphagia, fever, restlessness, increase in respiratory distress when recumbent
- diagnosed by a single upright lateral radiography of the neck
epiglottitis
- a collection of pus in the parotid glad located in front of the ear
parotid abscess
- common in children between 6 months & 3 years old
- round foods are the most frequently aspirated
- symptoms: stridor, wheezing cough, recurrent pneumonia, hemoptysis
- common location: bronchial tree (usually right main stem bronchus)
- imaging: AP chest, AP abdomen, lateral soft tissue neck
foreign body airway obstruction
