Peds Head, Neck, and Ears Flashcards
When do you perform measurements of head circumference?
Birth to 24 months
Transillumination of the skull of an infant for what?
excess fluid accumulation
An infant’s head is
__ of body length and __ of body weight at birth
1/4 of body length, 1/3 of body weight
Why do infants need to be placed backwards in car seats for the first two years of life?
Their heads are heavy and has no support structure thus whiplash during an accident when car seat is facing forward will be fetal.
Bones are separated by membranous tissue spaces called __
sutures
The areas where sutures intersect are known as ___
fontanelles
anterior fontanelle closes at __ months
18
Posterior fontanelle closes at __ months
2
Fontanelle is a measure of what?
intracranial pressure
What does dehydration in an infant cause?
sunken fontanelle
Increased intracranial pressure causes what?
bulging fontanelle, also occurs when the infant is coughing, vomiting and crying
Hydrocephalus is caused by
increased intracranial pressure from deficient spinal fluid circulation causes enlargement of the calvarium before the sutures are closed.
Hydrocephalus
enlarged head, bulging fontanelle and dilated scalp veins
Caput succedaneium (scalpedema)
Subcutaneous edema over the presenting part of the head at delivery (not worrisome)
Usually occurs over the occipitoparietal area and crosses suture lines
Transluminates
Cephalhematoma
subperiosteal collection of blood (not edema)
caused by ‘trauma’ of vaginal delivery
does not cross over suture lines
commonly found in parietal region
does not transluminate
may not be obvious at birth because they may be overlapping scalpedema
molding (cone head)
repositioning of the cranial bones to allow passage of the baby through the birth canal
How long does it take for cephalohematoma to resolve?
10-14 days
Plagiocephaly
occurs when an infant lies on the same side constantly
it’s misshapen head, not micros or hydro
What’s the treatment for plagiocephaly?
parental education and different holding patterns, placing objects of interest opposite normal head rotation
it will self resolve with age and more upright, active babies
Craniosynostosis
premature closure of sutures, can cause asymmetry
early closure of fontanelles
Brachycephaly
premature closure of coronal suture
How should the infant be positioned when palpating their neck?
the infant should be in supine position
Congenital muscular torticolis
injury and possible bleed into SCM at birth
treatment is with stretching exercises
In relation to eyes, upper portion of the ear should be where?
The upper portion of the auricle should be at the same level at eyes
How often should pneumatic otoscopy be performed in children?
Every exam of the ear
Diminished movement of tympanic membrane is indicative of what?
Ear effusions, acute otitis media
it is important to occlude one nare to observe breathing patterns in newborns, why?
Newborns are “obligate” nose breathers
A crease on a child’s nose could be indicative of what?
Allergies. The crease develops from them shoving their hand up outside of the nose
Darkness under the eyes can be indicative of what?
venous pooling, which can result from chronic congestion
When does the maxillary sinus develop?
one year of age
When does the sphenoid and ethmoid sinuses develop?
six years of age
When does the frontal sinus start to develop?
Ten years of age
When are all the sinuses fully developed?
21 years of age
Where should you inspect for cleft?
Inspecting the lips AND palate (inside the mouth) for any cleft
What might you find in an infant’s mouth that is abnormal?
antenatal teeth
they need to be extracted as they may pose as choking hazards
At what age are the tonsils at its peak size?
between 2- 6 years of age
The following numbers are used for grading tonsils, what do they mean? 1+ 2+ 3+ 4+
Tonsils grading: 1+ barely visible 2+ will mostly see in 2-6 year olds 3+ moving into uvula 4+ touching the uvula
Teeth begin to appear when?
6-7 months with upper and lower central incisors
How often are teeth coming in?
4 teeth added every 4 months
Full complement of teeth occurs at what age?
2-3 years
Shedding of primary teeth usually occurs when?
5 years of age
Secondary teeth usually begin at what age?
6-7 years of age
Halitosis
bad breath
Halitosis with chronic unilateral rhinitis is usually due to what? Occurs in what age group?
foreign object
9 months to 5 years
Describe the tympanic membrane of acute otitis media
TM is bulging
Describe the tympanic membrane of otitis media with effusion
TM is neutral or retracted
What is otitis media?
middle ear inflammation
Indications of otitis media
upper respiratory tract infection unaccustomed tugging of the ears irritability difficulty sleeping fever otalgia otorrhea hearing loss
