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Advanced Health Assessment > Week 8 ped differences HEENT > Flashcards

Week 8 ped differences HEENT Flashcards

1
Q

infant head

A

fontanels are open

suture lines palpable until about 6 months

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2
Q

infant neck

A

trachea is more cylindrical

lies deeper and is more flexible

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3
Q

child head

A

fontanels closed by 18-24 months

subtle changes in facial and skull bones

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4
Q

child neck

A

nose and thyroid cartilage enlarge in adolescent

trachea grows

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5
Q

infant lymphatic system

A

same distribution of nodes as in adult
small, mobile nodes may be palpable
unable to produce antibodies

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6
Q

child lymphatic system

A

tonsils may be enlarged

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7
Q

infant thyroid

A

difficult to palpate due to neck size

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8
Q

eye formation

A

during the first 8 weeks of gestation

  • lacrimal drainage complete at birth
    • by 2-3 weeks old gland begins producing full volume tears
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9
Q

vision development

A

term infants: hyperopic 20/400
peripheral vision fully developed at birth
- central vision develops later
3-4 months: binocular vision developed
6 months: infant can differentiate colors
4 years: adult visual acuity achieved

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10
Q

inner ear

A

development in 1st trimester

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11
Q

external auditory canal

A

shorter than in adults

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12
Q

eustachian tube

A

wider, shorter, and more horizontal than in adults

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13
Q

salvation

A

increased by 3 month

- more drooling

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14
Q

sinuses

A

maxillary and ethmoid present at birth, but small

frontal and sphenoid sinuses begin to develop around 3 years of age, complete development in late adolescence.

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15
Q

teeth

A

6-24 months: 20 deciduous teeth erupt
permanent teeth begin form in the jaw by 6 months old
- eruption begins around 6 years, completes around 14-15

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16
Q

plagiocephaly

A

head shape uneven on back of head

- cones out to one side

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17
Q

brachycephaly

A

flat back of head

- cones out laterally on both side

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18
Q

dolichocephaly

A

head shape cones out posteriorly

- long sides

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19
Q

Trisomy 21 signs

A 
depressed nasal bridge
epicanthal folds
mongoloid slant of eyes
low-set ears
large tongue
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20
Q

fetal alcohol syndrome signs

A 
poorly formed philtrum
widespread eyes
inner epicanthal folds
mild ptosis
hirsute forehead
short nose 
thin upper lip
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21
Q

Pierre-Robin sequence

A

triad of

  • micrognathia
  • glossoptosis
  • palatal clefting
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22
Q

positional molding

A

flattening

  • contralateral occipital bossing (outward)
  • ipsilateral ear displaced anteriorly
23
Q

unilateral lambdoid synostosis

A

flattening of back of head

  • parietal bossing (protrusion)
  • ipsilateral occipitomastoid bossing
  • ipsilateral ear displaced posteriorly (variable)
24
Q

cholesteatoma

A

trapped epithelial tissue behind the tympanic membrane that is often the result of untreated or chronic recurrent otitis media

25
Q

thyroglossal duct cyst patho

A

palpable cystic mass in then neck
- remnant of fetal development
– rises from the foramen cecum at junction of anterior 2/3 and posterior 1/3 of tongue.
-

26
Q

thyroglossal duct cyst subjective

A

tenderness, redness, swelling in midline of neck

difficulty swallowing or breathing

27
Q

thyroglossal duct cyst objective

A

freely moveable cystic mass in neck midline
moves upward with tongue protrusion and swallowing
may have small opening in skin, with drainage of mucus

28
Q

branchial cleft cyst patho

A

congenital lesion formed by incomplete involution of brachial cleft
- epithelium-lined cyst with or without a sinus tract to overlying skin

29
Q

branchial cleft cyst subjective

A

painless mass in lateral neck
may have intermittent swelling and tenderness
discharge if associated with a sinus tract

30
Q

branchial cleft cyst objective

A

oval, moderately movable smooth, non-tender fluctuant mass along anteromedial border of sternocleidomastoid muscle
usually asymptomatic
if infected: tenderness and erythema

31
Q

torticollis patho

A

shortening or excessive contraction of the sternocleidomastoid muscle
- often result of birth trauma or inter-uterine malposition
Acquired: tumor, trauma, CN IV palsy, muscle spasms, infection, drug ingestion

32
Q

torticollis subjective

A

stiff neck, dec. ROM in neck

possible vision problem

33
Q

torticollis objective

A

head tilted and twisted toward affected muscle with chin elevated and turned toward opposite side
hematoma may be palpated shortly after birth, and within 2-3 weeks
firm, fibrous mass may be felt in muscle

34
Q

encephalocele patho

A

neural tube defect with protrusion of brain and membranes that cover it through openings in the skull

  • failure of the neural tube to close completely during fetal development
  • can occur anywhere on scalp
  • genetic component: FHX of spina bifida or anencephaly
35
Q

encephalocele subjective

A

before birth are visible only by intrauterine US or seen immediately after birth

36
Q

encephalocele objective

A

visible sac of tissue protruding through skull
craniofacial abnormalities or other brain malformations
- hydrocephalus

37
Q

hydrocephalus patho

A

problem in the formation, flow, or absorption of CSF that leads to an increase in volume of the CSF

  • congenital malformation, infections
  • acquired: intracranial mass, intracranial hemorrhage, meningitis, trauma
38
Q

hydrocephalus subjective

A

poor feeding
irritability
dec. activity
vomiting

39
Q

hydrocephalus objective

A 
head enlargement
separation of cranial sutures
dilated scalp veins
tense anterior fontanelle 
sunsetting sign
inc. muscle tone: spasticity
macewen sign
40
Q

microcephaly patho

A

circumference of head is smaller than normal because the brain has not developed properly or has stopped growing
- present at birth, may develop in first few years of life
Congenital: infections, neuroanatomic abnormalities

41
Q

microcephaly subjective

A

intellectual disability

42
Q

microcephaly objective

A

head circumference is 2-3 SD below mean for age

43
Q

Craniosynostosis patho

A

premature closure of one or more cranial sutures before brain growth completes
- leads to misshapen skull

44
Q

craniosynostosis subjective

A

abnormally shaped skull, usually not accompanied by intellectual disability

45
Q

craniosynostosis objective

A

skull growth restricted perpendicular to fused suture

if multiple sutures fuse while brain is still growing, intracranial pressure can increase.

46
Q

retinoblastoma patho

A

embryonic malignant tumor arising from the retina

  • develops during first 2 years of life
  • autosomal dominant trait or chromosomal mutation (RB1 gene on chromosome 13)
47
Q

retinoblastoma subjective

A

FHX of retinoblastoma

white reflex on photographs

48
Q

retinoblastoma objective

A

leukocoria, a white reflex
ill-defined mass arising from retina on funduscopic examination
- chalky white areas of calcification

49
Q

retinopathy of prematurity patho

A

disruption of normal progression of retinal vascular development in preterm infant
- abnml proliferation of blood vessels

50
Q

retinopathy of prematurity subective

A 
low birth weight
preterm
other associated factors
- anemia
- poor wt gain
- blood transfusion
- resp. distress
- breathing difficulties
51
Q

retinopathy of prematurity objective

A

straight, temporally diverted blood vessels on funduscopic examination
- can be mild with no visual defects, or refractive error, amblyopia, or progress to retinal detachment and blindness

52
Q

retinal hemorrhages in infancy patho

A

abnml bleeding of the blood vessels in the retina

  • shaken baby syndrome
  • HTN
  • bleedin problems/leukemia
  • meningitis/sepsis/endocarditis
  • vasculitis
  • retinal disease
  • anema
  • hypoxia
53
Q

retinal hemorrhages in infancy subjective

A

altered responsiveness without good explanation

- suspicion of physical abuse

54
Q

retinal hemorrhages in infancy objective

A

dilated funduscopic examination shows retinal hemorrhages

Advanced Health Assessment (57 decks)

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