newborn congenital conditions & infx Flashcards by Leslie Ryan

brachycephaly, epicanthal folds, brushfield spots (on iris)

down syndrome

-hypoglossal nerve w/ tongue out (Co + jaw)

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rare form of neurofibromatosis with painful tumors on cranial, spinal, periph nerves but spares CN VIII

schwannomatosis

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baby swollen head crosses suture lines

scalp edema
caput succedaneum (cone head)

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swollen baby head doesnt cross sutures

cephalhematoma

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C5-7 (upper brachial plexus)
waiter’s tip
what nerves affected MC?

erb’s palsy

suprascap, axillary, musculocutaneous

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C7-T1

claw hand

klumpke’s paralysis

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occurs when shoulder gets lodged against moms pubic bone, caught in birth canal

shoulder dystocia

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DT hypoxia

flaccid til 5m, then spastic

tx sacral decomp

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Condition with neurological lesion in cerebrum and pyramidal pathways
incr DTRs

spastic CP

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muscle will resist in all ROM, diffuse brain damage

rigid CP

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AVN risk
more inguinal folds
allis knee lower
leg length >2cm diff

congenital hip dysplasia

putti’s triad

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putti’s triad

small femoral head
shallow acetabulum
sup/lat dislocated femoral head

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lines used for CHD

hilgenreiner (horiz)
perkins (vertical)
creates 4 quads

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angle on fem neck <120*

infantile coxa vara

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abnormal larynx dev, inc ICP causes

cri du chat

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hyperextension dt meningeal/dural tension

ant occ or C1 opp

opisthotonus

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weight falls <50th %
fails to double wt by 4m
fails to triple by 1y

failure to thrive

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most severe spina bifida

SB myelomeningocele

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post aspect of the skull contains neural tissue from brain

encephalocele

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excessive laxity of what ligament causes atlantoaxial instability

posterior transverse lig (odontoid to C1)

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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

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traumatic C2 anomaly, >80% have AA instability

os odontoideum

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MC frx of c spine in children

odontoid frx

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congenital block vert has this appearance

wasp waist

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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