Jarvis Quiz 3 Flashcards
The fine downy hair of a newborn infant
Lanugo
The thick, cheesy white substance made up of sebum and sheds epithelial cells in newborns
Vernix caseosa
Describe a baby’s skin, compared to an adult’s skin.
More permeable, sebum is present for the first few weeks which may cause cradle cap and milia, poor temperature regulation, eccrine glands dont respond to heat until first few months.Skin cannot contract and shiver because subQ layer is ineffective, pigment system is inefficient
What happens to the child’s skin as they mature?
Epidermis thickens, toughens, and darkens. The skin becomes better lubricated. Hair growth accelerates. Apocrine and sebaceous glands respond to heat to form sweat, body odor, and acne. SubQ fat deposits increase
What are some additional assessments for infants and children r.t skin?
Birthmarks? Jaundice? Cyanosis? Rash/sores? Burns, bruises. Scabies, lice, impetigo? Habitual movements such as nail biting? How do you reduce the risk of sun exposure in your child?
What additional skin assessment should take place for an adolescent?
Acne, blackheads
Describe the Mongolian spot
Variation of hyperpigmentation in babies of different nationalities. Macular. Not to confuse with a bruise. Caused by deep dermal melanocytes. Usually goes away within a year.
Describe the cafe au lait spot
Normal, Round/oval patch of light brown pigmentation, usually present at birth. 6 or more of them indicates neurofibromatosis, an inherited neurocutaneous disease.
Why does a baby have a beefy red flush for the first day of life?
Vasomotor instability
What is the harlequin color change?
Occurs when baby is laying on its side. Lower Half of the body turns red, and the upper half blanches with a distinct demarcation line down the midline. Cause unknown.
What is erythema toxicum?
Common rash that occurs in the first 3-4days of life. Called flea bite rash or newborn rash. Tiny puncture macules and papules on cheeks, trunk, chest, back, and buttocks. Cause unknown,. No t(x) needed.
What is acrocyanosis?
Bluish color around the lips, hands, and fingernails, and feet and toenails. May last a few hours and disappear with warming.
What is cutis marmorata?
Mottling of the trunk and extremities in response to cooler room temperatures. Reticulated, red or blue pattern over the skin. Persistent or pronounced cases found with Down Syndrome or prematurity.
What does green-brown discoloration of the skin, nails and cord of an infant indicate?
Passing of meconium in utero, and fetal distress is present as a result
When does physiological jaundice usually occur in newborns? What causes the yellow discoloration? What may be indicative of jaundice during the first day of life? What about if it is present after 2wks?
After the 3rd or 4th day r/t increased number of RBCs that hemolyze after birth. Jaundice during day one could be a hemolytic disease. After two weeks, presence could indicate biliary tract obstruction.
What is carotenemia? What causes it? When/how does it go away?
Yellow-orange color in light skinned persons with NO yellowing of sclera or mucous membranes. R/t ingestion of large amount of foods containing carotene, vitamin A. inhanced by mashing/pureeing baby foods, and cooking. Will fade after 2-6wks once carotene rich foods are drawn from the diet
What may excessive sweating in children indicate?
Hypoglycemia, heart disease, and hyperthyroidism
What is milia?
Tiny white papules on the cheeks and forehead and nose and chin caused by sebum the occludes the opening for hair follicles. Tell the rents to not squeeze the lesions. Resolves spontaneously over a few weeks.
What is a stork bite?
Vascular birthmark. Flat, irregularly sapped red or pink patch found on the forehead, eyelid, or upper lip but mostly on the back of the neck. Fades usually during the first year.
Scalp hair may be lost in the first few weeks after birth, but
It will grow back slowly. Nail beds may be blue for the first couple hours.
What creates acne? What is a Whitehead called? what about a blackhead? Describe acne. When does it most commonly occur?
Sebaceous gland activity creates acne. Whitehead= closed comedones, blackhead= open comedone. Involves pustules, papules, and nodules. May appear 7-8y/o, peak at 14-16 in girls and 16-19 in boys
Talk about a strawberry mark. What is it also called?
Immature hemangioma: raised, bright red area with well-defined borders, 2-3cm in diameter. Does not blanch. Consists of immature capillaries, present at birth or develops in first few months and disappears by age 5-7 y.o. Requires no treatment
What is a cavernous hemangioma (mature)?
Reddish-blue, irregularly shaped and solid/spongy mass of blood vessels. May be present at birth and enlarge in first 10-15 mos. Does not involute on its own.
Describe diaper dermatitis
Red. Moist. Maculopapular patch with poorly defined borders in the diaper area. History of infrequent diaper change, or occlusive diapers. Inflammatory disease caused by skin irritation from ammonia, heat, moisture, and occlusion.
What is intertrigo also called? What is it?
Candidiasis. Scalding, red moist patches with sharply demarcated borders and some loose scales. usually in the genital area. Aggravated by urine, feces, heat and moisture. Candida fungus infects the superficial skin layers
Describe impetigo
Moist, thin roofed vesicles with thin, red base. Rupture to form honey colored crust. Highly contagious bacterial infection by direct contact.
What is another name for atopic dermatitis? Describe it.
Eczema. Erythematous papules and vesicles with weeping, oozing, and crusts. Itching involved. Family history of allergies
What is another name for cradle cap?
Seborrheic dermatitis. Thick, yellow-to-white greasy adherent scales with mild yellow erythema on scalp and forehead. Pruritis present. Looks like eczema, but greasy and not associated with family history of allergies.
What separates parts of the skull in youngsters? Talk about them
Sutures and fontanelles (soft spots). They allow for brain growth during the first year. The posterior triangle fontanel closes by 1-2mos. The anterior diamond fontanel closes between 9mos-2yrs.
Talk about head size in fetuses, infancy, and children.
Fetal head growth predominates. Head size is greater than chest circumference at birth. Head size grows during childhood, reaching 90% by 6 yo. Trunk growth predominates during infancy.
Describe the facial bones in toddlers
Nasal and jaw bones grow at varying rates. The mandible and maxilla are small, and the nasal bridge is set low.
Talk about child lymphoid tissue
Well developed at birth and frowns to adult size until 6yo. Exceeds growth of adults by age 10/11 y.o, and slowly atrophies after that.
Talk about the sequence of facial hair growth in adolescent males. What causes the voice to get deeper?
Above the lip, then on the cheeks and below the lip, and last on the chin. Thyroid cartilage enlarges and the voice deepens
How often should you measure a baby/child;s noggin? How big should a baby’s head be?
At each visit up to 2yrs of age, then annually up to age 6. Newborns head should be 32-38cm and is 2cm larger than chest circumference. Both chest and head should be the same by age 2.
What are frontal bulges of the skull called in babies? What might they indicate?
Bossing r/t prematurity or rickets
What is a cephalhematoma? What causes it? What are these babies at risk for?
A subperiosteal hemorrhage r/t birth trauma. Well defined over one cranial bone. Occurs several hours after birth, may last a few weeks, three months at most. Reassure parents of this. At risk for jaundice.
