OAT Peds Flashcards
Anterior fontanelle closing:
12-36 months
Posterior fontanelle closing:
2-3 months
Sphenoid fontanelle closing:
6 months
Mastoid fontanelle closing:
6-18 months
What is the most commonly dysfunctional cranial bone in infants? What can it lead to?
occiput (most likely squished)
CN9,12: poor suck
CN 10: reflux, vomiting, colic
CN 11: colic, muscular dysfxn
What cranial bone affects the most cranial nerves in infants?
Temporal bone
What does internal rotation of the temporal bone in infants lead to?
increases likelihood of otitis media/ ear infections
What CNs can affected from operative vaginal delivery via forceps/vacuum?
CN6–> lateral rectus palsy
CN 7–> facial palsy
why do kids get otitis media so easily?
eustachian tube is flatter in infants than adults or other children without IR temporal bone
TM findings in acute (supporative) otitis media?
erythematous, bulging, with purulent effusion
other findings: ear pain
TM findings for Viral URI with serous effusion?
pearly, translucent, intact with effusion (could see a fluid bubble)
other: clear runny nose, congestion, HA, mild cough; not as active and less appetite
What positional head deformity is associated with torticollis?
plagiocephaly (parallelogram head)
Plagiocephaly is associated with ___ strain
lateral strain
Brachycephaly is associated with ___ strain
vertical strain or flexion strain
Scaphocephaly is associated with ___ strain
extension strain
brachycephaly appearance
WIDER > long; back of head = flat
scaphocephaly appearance
head = LONG and NARROW
Torticollis:
may be due to irritation of spinal accessory n. (jugular formane)
SCM might be shortened or ropy
tx: OA region, clavicles; ME, ST, CS, MFR
What treatments are best for infants?
indirect treatments (BMT on cranial SD, condylar decompression, BLT, MFR to diaphragms + jxns, lymphatics prn)
School age children:
cranium fully ossified, sinuses form, epiphyseal plates still open (rapid growth–> growing pains, may develop leg length discrepancy, short leg syndrome, functional scoliosis)
URI in kids (how often + tx)
kids get 6-8 per year
TREATMENT: LYMPHATICS!! thoracic inlet; sympathetic T1-4, Parasympathetic CN7
treatment for bacterial sinusitis?
lymphatics
URI syx >10 days; URI improves then worsens; fever/purulent discharge>3 days w/ facial tenderness or HA
Treatment for asthma?
diaphragm (mechanical); OA (parasympathetics- be careful), accessory muscles of resp (scalenes, SCM), C3-5 (diaphragm), t1-12 + ribs (T2-8 symp innerv)
FIRST line = albuterol; OS equivalent = rib raising
CP: nasal sinuses
anterior: inferomedial clavicle, lateral to SC jxn (nasal sinuses), superior second rib at midclavicular line (all sinuses)
posterior: mastoid process
