Well Child 2 Flashcards
1
Q
Abdomen
- What are the vessels of the umbilical cord?
- Definition: develops at base of navel, pink granulation tissue formed during the healing process
A
- Cord: 2 umbilical arteries, 1 umb vein
- Umbilical granuloma
2
Q
What is this?
A
Umbilical Granuloma
- develops at base of navel
- pink granulation tissue formed during healing process
3
Q
Male GU
- Presence of testes, size of penis, appearance of scrotum
- 30% of pre term male infants are born w/ what?
- Definition: abnormal ventral placement (check before what?)
- Definition: abnormal dorsal placement (uncommon)
A
- 30%: undescended testicle
- Hypospadias (Hypo-below)
- Epispadias (Epi-eye)
4
Q
Male GU
- What are 2 common scrotal masses in newborns?
- What side are they most common on?
A
- hydroceles & inguinal hernias
- RIGHT
5
Q
Which mass?
- Overlie the testes & spermatic cord
- Not reducible
- Can be transilluminated
- Usually resolves by __ months
- Refer to urology to r/o what?
A
Hydrocele
- 18
- hernia
6
Q
Which mass?
- Separate from the testes
- Usually reducible
- Often DO NOT transilluminate
- Do not resolve
A
Hernias
7
Q
Female GU
- Often a milky white discharge present, but what may be present?
- Labial adhesions
- What may be noted at birth?
A
- Blood tinged
- imperforate hymen
8
Q
Anus / Spine
- Imperforate anus is not always obvious. Cannot assume until baby passes what? Usually passes within how many hours?
- If there is a sacral dimple, must get what test?
A
- Meconium / 48 hours
- US (to check for spina bifida)
9
Q
Extremities
- Count fingers/toes
- Check for what 2 things?
A
- Syndactyly (webbed or conjoined fingers or toes)
- Palmar crease (single palmar crease - simian crease associated w/ trisomy 21)
10
Q
Hip
- Evaluation for what condition?
A
Developmental dysplasia of the hips (DDH)
11
Q
5 risk factors for Developmental Dysplasia of the Hips (DDH)
A
- breech
- caucasian
- 1st born female
- family hx
- prematurity
12
Q
Hip
- What would prompt a further work up of DDH?
- Which tests for ability to sublux or dislocate an intact, but unstable hip? (IN)
- Which tests for posteriorly discolated hip? (OUT)
- What other finding is suggestive of DDH?
A
- Audible “click” heard w/ maneuvers
- In: Barlow
- Out: Ortolani
- Asymmetry of leg creases
13
Q
Tx for DDH?
A
- Ortho eval & pavlik harness
- If untreated can lead to degenerative hip disease
14
Q
Palmar Grasp
- Primitive Reflex
- Place your finger into baby’s hand and press (baby will flex all fingers to grasp your finger)
- What age?
A
- Birth - 3/4 months
15
Q
Plantar Grasp Reflex
- Primitive Reflex
- Touch sole at base of toes
- Toes will curl
- Age?
A
- Birth - 6/8 months
16
Q
What reflex?
- Hold baby supine while supporting head, back, legs
- Abruptly lower entire body about 2 feet
- –> arms should abduct & extend
- –> hands open & legs flex (baby may cry)
- Age?
- Persistence beyond what age suggests what?
- Asymmetric response indicates what?
A
Moro Reflex (Startle Reflex)
- birth - 4 months
- 6 months –> neurological dz: CP
- Fx of clavicle or brachial plexus injury
17
Q
Which primitive reflex?
- with baby supine, turn head to one side, holding jaw over shoulder
- the arms/legs on side to which head is turned extend (think bow & arrow)
- the opposite arm/leg flex
- What age?
- Persistence beyond this age suggests what?
A
Asymmetric Tonic Neck Reflex
- Birth - 2 months
- asymmetric central nervous system development
18
Q
Which reflex?
- Hold the baby around the trunk & lower until the feet touch a flat surface
- the hips, knees & ankles extend & baby stands up, partially bearing weight, sags after 20-30sec
- What age?
- Lack of reflex = hypotonia or flaccidity
A
Positive Support Reflex
- Birth - 2/6 months
