newborn congenital conditions & infx Flashcards
brachycephaly, epicanthal folds, brushfield spots (on iris)
down syndrome
-hypoglossal nerve w/ tongue out (Co + jaw)
rare form of neurofibromatosis with painful tumors on cranial, spinal, periph nerves but spares CN VIII
schwannomatosis
baby swollen head crosses suture lines
scalp edema caput succedaneum (cone head)
swollen baby head doesnt cross sutures
cephalhematoma
C5-7 (upper brachial plexus)
waiter’s tip
what nerves affected MC?
erb’s palsy
suprascap, axillary, musculocutaneous
C7-T1
claw hand
klumpke’s paralysis
occurs when shoulder gets lodged against moms pubic bone, caught in birth canal
shoulder dystocia
DT hypoxia
flaccid til 5m, then spastic
CP
tx sacral decomp
Condition with neurological lesion in cerebrum and pyramidal pathways
incr DTRs
spastic CP
muscle will resist in all ROM, diffuse brain damage
rigid CP
AVN risk
more inguinal folds
allis knee lower
leg length >2cm diff
congenital hip dysplasia
putti’s triad
putti’s triad
small femoral head
shallow acetabulum
sup/lat dislocated femoral head
lines used for CHD
hilgenreiner (horiz)
perkins (vertical)
creates 4 quads
angle on fem neck <120*
infantile coxa vara
abnormal larynx dev, inc ICP causes
cri du chat
hyperextension dt meningeal/dural tension
ant occ or C1 opp
opisthotonus
weight falls <50th %
fails to double wt by 4m
fails to triple by 1y
failure to thrive
most severe spina bifida
SB myelomeningocele
post aspect of the skull contains neural tissue from brain
encephalocele
excessive laxity of what ligament causes atlantoaxial instability
posterior transverse lig (odontoid to C1)
this renders the transverse atlantal lig incompetent, pt’l for signif neuro insult from small trauma, HVLA contraindicated, consider neurosurgical consult, vertebral artery compression
odontoid process anomalies
traumatic C2 anomaly, >80% have AA instability
os odontoideum
MC frx of c spine in children
odontoid frx
congenital block vert has this appearance
wasp waist
DDX for hemivertebra
compression frx
single long L thoracic curve that most occurs during the first year of life
infantile scoliosis
less common but more serious form of meningitis, rec ER, death or brain dmg
bacterial
congenital opening/shunt bt esoph and trachea, maybe in downs
tracheoesophageal fistula
regurgitation progressed to projectile vomiting
RUQ LUMP, dehydration, weight loss
pyloric stenosis
Condition in GI with vomiting, no dehydration, dec weight gain
GERD
Condition in GI with vomiting, normal wt gain, DEHYDRATION
gastroenteritis
red eyes, cheeks, rash
strawberry tongue
<5yo mc
kawasaki dz
mottle skin cold baby
cutis marmorata
port wine stain is ____ and strawberry hemangiomas _____
permanent
go away with age
telangiectatic nevi
stork bite
forefoot adducted at birth dt in utero pressure
metatarsus adducted
MC > clubfoot
big toe med deviated, all others in alignment, seen in downs
metatarsus primars varus
congenital dt in utero medial plantar displacement of talocalcaneonavicular and calcaneocuboid jt
talipes equinovarus / clubfoot
-can be postural as well
baby will have blue feet & lips with this heart defect
patent foramen ovale
MC heart defect that may lead to CHF
ventricular septal defect (VSD)
opening permits blood flow from lt atrium to right
exercise intolerance
atrial septal defect (ASD)
MC heart defect in skinny girls, tetralogy of fallot
patent ductus arteriosus (PDA)
pulmonary valve thickens and constricts ability to reach lungs
pulmonary stenosis
-no exercise or PE with severe
MCC of heart failure in first month of life
coarctation of aorta
intussusception is MC bt
3-12m
MCC of neonatal jaundice
ABO issue
in torticollis, atlas goes to the ____ side in kids, and prominent ___ on opp side of head tilt, and is MC in frank breech
low side
C2
with torticollis must rule out {4}
klippel feil
spregels
hemivert
sc tumor
persistent torticollis with flx of hand, foot or knee
arthrogyroposis
seen in 20-25% of klippel feil cases
sprengle’s deformity
distal phalanx of 5th digit deviated radially into volar flx, hereditary, bilat
kirner’s deformity
tall narrow head, type c
scaphocephaly
backward sloped forehead, flat back of head, small face, type B
brachycephaly
premature closure of metopic suture
trigonocephaly
flattened occiput, short AP diameter, wide transverse diameter
type f skull
MC dt fetal head constraint, no soft spots, no growth in head size
craniosynostosis
finding with CP, autism, CHARGE syndrome, chin up
AS occiput
coloboma in eye, choanal atresia, unusual ears, organ system problem, gene CHD7 mutation
CHARGE syndrome
converging strabismus is an issue with what muscle/nerve
lateral rectus / Cn VI (abducens)
- lat eye dev/elevating is SO/IV trochlear
- lat/inf eye dev is CN III oculomot
Gait sign of CP, autism, AS occ, club foot, language/speech delays
persistent toe walking
brain tumor indicated with ___ nystagmus
vertical
MCC bact of osteomyelitis, checked via radionuclide bone scan, and what bone is the MC place
staph aureus
innominate bone
Virus, fluid based transmission via delivery or breastfeeding and is worst to fetus if exposed in T1, causes hepatosplenomeg, growth restrict, etc
CMV
congenital infx that can cross placenta
varicella zoster
herpes simplex can get in utero and is MC transmitted
during labor
bronchiolitis/RSV MC age
<6m
life threatening infx in a newborn that can cause mental delay and sensory impairments
group b strep
MC infx in childhood
acute OM
-adjust 3x2
this tx shows improvement in 87% of acute OM cases
food allergy avoidance
queasy, crappy, diarrhea that occurs when ear infx is draining
brenneman’s belly
HIB, sudden fever, cough, drooling, tripod - get to the ER
epiglottitis
fecal transm/raw shellfish - flue like sx, n/v/pn, fever
hep a
transm via blood/body fluid, birth
hep b
body fluid, tattoos, piercings, drugs causes cirrhosis, few s/s
hep c
most musckuloskeletal infx in kids are dt skin lesions or __ infx
staph
MCC of sebhorrheic dermatitis
yeast infx
rash on convex surfaces, MC 9-12mo
candidiasis
-tx with probiotics high dose
enlarged lymph nodes on RT side only check
C2 spinous Rt
teething, mouth issues dec HCL prod, zn def, rx infx, fever, abd pn psyc Are all reasons for:
Pediatric decreased appetite
all nutrients absorbed incl H20, electrolytes
small intestine
absorbs H20, electrolytes, some vit (K, B1,2,12)
large intestine
if neuro or motor issues for pushing motion cause constipation, try to suck something while bearing down, due to a potential:
increased SNS
MCC of diarrhea in infants
rotavirus
baby hates tummy time, check
bilat posterior occiput
ears too low: ____
too small: ____
abnormal shape: ____
down syndrome
renal issues
FAS
colic stats, needs to be crying for:
3h/d, 3d/wk, 3w-3m
-check c1
first bone to ossify is ___ and the last is ___
atlas
ilium
CN affected by sphenoid work
II optic III oculomotor IV trochlear V trigeminal VI abducens
CN affected by temporal bone
VII facial
-can correct strabismus and nystagmus
CN affected by occiput
IX glossopharyngeal
X vagus
XI accessory
XII hypoglossal
post fontanelle closes at ___
anterior closes at ____
3 mo
1 yr
____ directs facial bones
sphenoid
leaves of the ___ attach to sphenoid, temporal, parietal, occipital bones
tentorium cerebelli
tension on this results in dysfx of CN IX, X, XI & XII and can cause colic, nursing and swallowing issues, heart-lung-digestive probs (cant survive without last 4 CN)
falx cerebelli
this controls sleep hormones
pineal gland
increased SNS tone, adjust
mid T/spine and C1
refusing pacifier, reflux, gas pains
difficulty swallowing, gulping with nursing
excess spit up
indicate a problem with
jugluar foramen
