head, lymph, neck, thyroid

Question 1

when does the posterior fontanelle close?

Answer 1

2 mos

Question 2

when does the anterior fontanelle close?

Answer 2

15 mos to 2 years

Question 3

headache red flag signs

Answer 3

onset after age 50
acute onset (hrs)
markedly elevated BP - HTN crisis
s/s of infx or rash - meningitis
HA w pregnancy - preeclampsia
vomiting - IICP
head trauma

Question 4

most frequently fractured facial bone

Answer 4

nasal bone

Question 5

4 types of skull fractures

Answer 5

linear
depressed
basal
diastatic

Question 6

linear fracture

Answer 6

most common, traveses full thickness of bone with radiating fracture lines away from point of impact

Question 7

derpressed fracture

Answer 7

skull indentation from direct blow

Question 8

basal skull fracture

Answer 8

affect base of skull, causes bruising behind ears (battle’s sign) and/or bruising around eyes (Racoon eyes)

Question 9

diastatic fracture

Answer 9

occurs along a suture line, more likely to occur in infants and children

Question 10

epidural hematoma

Answer 10

severing of middle meningeal artery due to blunt trauma or injury of the skull

Question 11

craniosyntosis

Answer 11

early fusion of the bones of the skull; results in intracranial pressure or skull abnormalities

check fontanelles!

Question 12

fetal alcohol syndrome

Answer 12

smooth philtrum, thin upper lip, flat nasal bridge, short or upturned nose, and wide-set eyes with eipcanthal folds

Question 13

caput

Answer 13

“finger indent”/edema in scalp after birth

common

Question 14

cephalohematoma

Answer 14

bulging of head structures due to suction during birth

concerning if it crosses the suture line or is present months after birth

Question 15

molding

Answer 15

head structure change due to pressures from birth process

resolves quickly

Question 16

red flag lymph node characteristics

Answer 16

VISIBLE, hard, fixed, matted, >1cm in size, unilateral, generalized

rEDNESS, EDEMA, ERYTHEMATOUS LINES

Question 17

where are the preauricle lymph nodes

Answer 17

in front of ear

Question 18

where are the post auricle lymph nodes

Answer 18

behind ear

Question 19

where are the upper cervical lymph nodes

Answer 19

behind jaw near ear

Question 20

where are the posterior lymph nodes

Answer 20

side of neck

Question 21

where are the supraclavicular lymph nodes

Answer 21

above clavicle

Question 22

where are the submental lymph nodes

Answer 22

below chin

Question 23

where are the submandibular lymph nodes

Answer 23

under jaw

Question 23

where are the submandibular lymph nodes

Answer 23

under jaw

Question 24

shotty

Answer 24

cluster of multiple, small, contiuous lymph nodes along chain

Question 25

pediatric change for lymph

Answer 25

ages 4-8 commonly have palpable cervical lymph nodes

should not be tender, should be symmetrical

Question 26

lymphadenitis

Answer 26

enlarged lymph node

Question 27

lymphangitis

Answer 27

inflammation of lymph node

Question 28

pediatric change of neck

Answer 28

weaker neck muscles until adolescence - higher risk of C spine injury

Question 29

torticollis

Answer 29

tilt to one side

Question 30

posterior approach for thyroid palpation

Answer 30

stand behind pt, hold below cricoid cartillage, ask pt to swallow

Question 31

peds thyroid consideration

Answer 31

shorter necks as infants

Question 32

pregnancy thyroid considerations

Answer 32

abnormal thyroid function may mimic pregnancy

hyperthyroidism - incresed risk of complications from preeclampsia

symmetrical enlargement is expected

Question 33

older adult thyroid consideration

Answer 33

changes to endocrine system - fibrotic thyroid

medications
thyroid disease may present differently
thyroid disease common

Question 34

hypoparathyroidism

Answer 34

decreased secretion of PTH leading to hypocalcemia

commonly caused by accidental removal of PTH glands

Question 35

hyperparathyroidism

Answer 35

enlarged parathyroid glands produce excess PTH, resulting in hypercalcemia

early sign of malignancy