Unit 5 Flashcards
cleft lift
incomplete fusion of maxillary/nasal strs
when in gestation does cleft lip occur
wk 5-8
et of cleft lip
congenital dt teratogen
how is cleft lip described
indent, fissure, uni or bilateral
incidence of cleft lip
1-700 life births
what teratogens may cause cleft lip
smoking
viral infc
folic acid def
cleft palate
incomplete fusion of palatine str
when in gestation does cleft palate occur
wk 9-12
what str is malformed in cleft palate
nasal str
occurance of cleft palate
1-2000
predispostions for cleft palate
smoking
tx for cleft palate
sx or graft
major issues with cleft palate
speech
breathing
pyloric stenosis
muslce hypertrophy and constriction at pyloric sphincter
what is obstructed with the constriction of the pyloric sphincter
entrance to duodenum
incidence of pyloric stenosis
1 in 1000 births
when does pyloric stenosis occur
2-8 weeks old NOT CONGENITAL
whats the ratio of males to females with pyloric stenosis
4:1
et of pyloric stenosis
idipathic
what 3 conditions are linked to pyloric stenosis
hypergastrinemia
PGE (prostaglandin E)
erythromycin exposure
which babies have inc incidence of PGE
babies with HF
patho of pyloric stenosis
hypertrophy -> constr -> inflm -> obstr
mnfts of pyloric stenosis
projectile vomitting
dehydration
malnourishment
dx of pyloric stenosis
Hx, Px
US
URQ palpation
what will an US in a babe with pyloric stenosis show
pyloric reigon enlargement
tx for pyloric stenosis
sx to remove excess m
when is there in a inc in gastroesophageal reflux
first 3m of life
et of gastroesophageal reflux
neuromuscular issue dt functional sphincter problem
what is happening with the distal esophageal sphincter in gastroesophageal reflux
incompetent and allows reflux
what sphincter is affected in gastroesophageal reflux
distal esophageal sphincter
how does esophagitis occur in gastroesophageal reflux
gi content enters esphogous causing inflm
what is the course of gastroesophageal reflux
self limiting within a year
tx for GE reflux
symptomatic tx
H2Ra, PPI
modify teaching
sev case: fundoplication
what teaching is modified for teaching about GE reflux
small meals
thicken feed
positioning
which babies have inc incidence of Hirschsprung disease
inc in male babies
incidence of hirschspruing disese HD
1 in 5000 births
et of HD
congenital/genetic
what gene mutates in HD
Ret proto onco gene (RET)
what chr is the RET gene on
10
what happens if RET gene is absent
problems signalling between cells, absence of PNS tissue, ganglia in colon
what happens in HD
absence of PNS tissue in ganglia resulting in localized area of colon with dec peristalsis
where is there abdm distention in HD
area BEFORE the spot in the colon with no PNS
tx of HD
sx to remove aganglionic segment of PNS
intussception
part of intestine invaginates into another part
where does intussception normally occur
at iliocelcal clave
why does intussception occur at the iliocecal valve
the smaller ilium is able to move into the larger cecum
incidence of intussception
1-4 in 1000
what does invagination lead to
obstr of lumen
what happens when the lumen is obstr
inflm -> edema into lumen
what happens when there is inc edema in lumen in intussception
inc intraluminal P -> ischemia -> necrosis, perf, peritonitis
why does ischemia occur when there is inc intraluminal P
the intraluminal P is > then the venous P causing stasis, no arterial blood moving in, necrosis
tx of intussusception
hydrostatic reduction
hydrostatic reduction
use of water soluble contrast medium and air P to gently dec intussusception with an endoscope
when DONT you use sx in intussusception
obstr/perf
when cant you use hydrostatic reduction for intussusception
if perforation is suspected
