head, neck, face PEDS

Question 1

microcephalic

Answer 1

small head

Question 2

macrocephalic

Answer 2

enlarged head

Question 3

when to palpate fontanels? when do they close?

Answer 3

• palpate in sitting position
• don’t palpate when crying or screaming b/c they bulge out
• firm, slightly concave
• posterior fontanel closes by 1-2
• anterior fontanel closes 9 months to 2 yrs

Question 4

flattening of the head can occur because of what?

Answer 4

• rickets

- intellectually diability

Question 5

bulging fontanels is due to what?

Answer 5

increase ICP

Question 6

sunken in fontanels is due to what?

Answer 6

• dehydration

- malnutrition

Question 7

delayed closure of fontanels is due to what?

Answer 7

• hydrocephalus
• downs syndrome
• hypothyroidism
• rickets

Question 8

small fontanels can be a sign for what?

Answer 8

microcephaly

Question 9

tonic neck reflex may indicate what?

Answer 9

brain damage

Question 10

what causes a head tilt?

Answer 10

• habit spasm
• poor vision
• brain tumor

Question 11

what may head lag beyond 4 months indicate

Answer 11

motor or mental disability

Question 12

what is the allergic salute?

Answer 12

-crease on tip of nose

Question 13

head, face, and neck history for infants and children?

Answer 13

• use of alcohol or drugs during pregnancy
• vaginal or c-section delivery
• baby’s growth
• head growth
• fontanels closure
• what age baby can control head

Question 14

when does the head size reach 90% of its final size?

Answer 14

6 years

Question 15

what is cephalohematoma?

Answer 15

• subperiosteal hemorrhage
• causes skull shape to look asymmetric
• appears several hours after birth and gradually increases in size
• will reabsorb during 1st week of life without treatment

Question 16

what is an infant more at risk for with cephalohematoma?

Answer 16

• jaundice

- RBCs in the hematoma are broken down and reabsorbed

Question 17

what is molding? when does it happen?

Answer 17

• overriding of the cranial bones
• happens during engagement and passage through birth canal
• head feels asymmetric and ridges more prominent
• resolves within a week

Question 18

when might an infant have a flattened side of their head?

Answer 18

sleeping in one position

Question 19

what might you see in the anterior fontanel?

Answer 19

arterial pulsations

Question 20

what can an infant do by 2 weeks? 4 months?

Answer 20

• turn head side to side

- head control is achieved

Question 21

what is tonic neck reflex?

Answer 21

• the extension of the same arm and leg, flexion of opposite arm and leg when supine and the head is turned to one side
• disappears between 3-4 months

Question 22

what is craniosynostosis?

Answer 22

• marked symmetry of the skull
• severe seformity caused by premature closure of the sutures
• results in long, narrowing of head

Question 23

what should you note about wrinkling in infants?

Answer 23

• symmetry while crying and smiling

- should be symmetric on both sides of face and forehead

Question 24

when is the parotid gland enlargement seen best?

Answer 24

• when child sits and looks up

- swelling appears below angle of the jaw

Question 25

how do you palpate the trachea in an infant?

Answer 25

• support shoulders
• tilt head back slightly
• feel for row of cartilaginous rings in the midline or slightly to the right of the midline

Question 26

what may pain when flexing the infant’s head an neck indicate?

Answer 26

• meningeal infection

- meningitis

Question 27

are cervical lymph nodes normally palpable in infants? children? what size is normal?

Answer 27

• no
• yes
• less than 3mm