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Flashcards in Child Abuse Deck (44)
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1

True or false... an injured upper labial frenulum is very concerning

False. Its likely due to trauma

2

What are the most common type of injuries in abused children?

Bruises

3

What are the most common injuries in non-abused children?

Bruises

(They are the most common in abused and non-abused children)

4

The greatest % of children with bruising are of the recruiser, cruiser, or walker age?

Walkers

5

What age are children most likely to be bruised?

Preschool-school age


Infants are not very likely

6

Bruising is rare in ___.

Bruising is more common when?

What is it meant by"don't cruise, don't bruise"

Infants/precruisers

As children age (are more mobile)

Children who do not move about do not get bruises. If they do, consider abuse AND potentially some other underlying condition

7

What are some locations of bruises that would be suspected of being non-intentional

Forehead

Vertex of chin

Elbows

Knees/shins

8

What are some locations of bruises that are more likely to be intentional?

Ears

Neck

Upper arms/legs

Abdominal wall

Buttocks and anus

Genitalia

9

___ tend to be bruised accidentally in ambulatory kids

___ areas tend to be bruised from abusive mechanisms

Bony prominences

Soft tissue

10

Bruising resolution is dependent on many factors such as...

Attachment of tissue injured

Thickness of tissue injured

Type of injuring force

Depth of the injury

Vascularity of the injured/surrounding tissues

Underlying color of the injured persons skin

Age of pt

Underlying medical conditions can delay healing

11

Can be bruises be dated?

Not really. Assessment of the age of a bruise in children is inaccurate and has no scientific basis

12

Why does a bruise form a red outline?

The blood is shifted away from the object, leading to patterned bruising

13

Bruising reflect impact in one plane and should not follow the ___ of the affected region

Curvature

14

What does a patterned injury to the buttocks typically look like?

Often a distinct line of vertical bruising/petechiae seen

15

True or false... patten bruising can happen with accidents

True. Such as a seatbelt

16

What are some cultural practice that can produce bruising/bruise-like lesions?

Cupping

Coining (gua sha)

Fire-burning

17

What are some systemic diseases that can produce bruise-like lesions?

Henoch schonlein purpura

Dermal melanosis (bruising can overly melanosis)

Erythema multiforme


18

What are some other things that can mimic bruises?

Purpura fulminans (DIC and fatal)

Phytophotodermatitis (citrus and sun)

Allergic dermatitis

Insect bites

Self-inflicted bruises or cutting

Abdominal striae

Diaper dermatitis

19

What are some coagulation disorders that can cause bruising?

Hemolytic uremic syndrome

Thrombocytopenia

Vitamin K deficiency

Hemophilia

Von willebrand

Leukemia

Factors 13 deficiency

20

Central ecchymosis can be caused by...

Negative pressure o suction or tongue thrust (hickey)

Disruption of blood vessels enclosed within the area of the bite

21

How can you tell the difference between an adult-inflicted bite and a child-inflicted bite?

Adult inflicted:

Bites often only distinct in one arch

Average maxillary intercuspid distance of 33mm

Teeth tend to be rectangular

Child inflected:
Bites are often distinct in both arches

Intercuspid distance of less than 30mm

Teeth tend to be more rounded

22

What do animal-inflicted bites look like?

Generally tear in skin

Much narrower arch with elongated anterior-posterior aspect than human bites

23

Where do bite injuries most frequently occur?

When do they most likely occur?

Occur most frequently on upper extremities

May occur during play, fight, sports, or sex (lolz)

24

Developmental biting behavior in ___ age is often seen with ___

Preschool age

Frustration/anger

25

When do adults typically bite their children?

"To stop biting behavior" ...smh..

26

Abusive injuries to the ____ region are among the most common seen in abused children

Head and neck (specifically orofacial injuries)

27

What are the mechanisms of injury for trauma of the mouth?

Blunt impact

Insertion of object into mouth (forceful feeding)

Sexual abuse

Burns with hot liquids or caustic agents

Tongue lacerations may be caused by bites (curvature of the bite mark is helpful in determining if self inflicted)

28

What is the differential diagnosis for a lingual frenulum tear?

Congenital anomalies (midline sinus)

Infections, such as herpes or coxsackie virus

Accidental trauma (simple falls in ambulatory child, striking face against an object, iatrogenic (endotracheal intubation, nasogastric tube insertion))

Non-accidental trauma (blow to mouth, forced feeding, forced oral sex)

29

What do you do when you see a non-ambulatory child with a lingual frenulum tear?

They should be evaluated for abuse

30

True or false.. no studies define the incidence of torn labial frenula in abused children. Current literature does not support the diagnosis of abuse based on a torn labial frenulum in isolation in an ambulatory child.

True