Flashcards in Child Abuse Deck (44)
True or false... an injured upper labial frenulum is very concerning
False. Its likely due to trauma
What are the most common type of injuries in abused children?
What are the most common injuries in non-abused children?
(They are the most common in abused and non-abused children)
The greatest % of children with bruising are of the recruiser, cruiser, or walker age?
What age are children most likely to be bruised?
Infants are not very likely
Bruising is rare in ___.
Bruising is more common when?
What is it meant by"don't cruise, don't bruise"
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
What are some locations of bruises that would be suspected of being non-intentional
Vertex of chin
What are some locations of bruises that are more likely to be intentional?
Buttocks and anus
___ tend to be bruised accidentally in ambulatory kids
___ areas tend to be bruised from abusive mechanisms
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
Can be bruises be dated?
Not really. Assessment of the age of a bruise in children is inaccurate and has no scientific basis
Why does a bruise form a red outline?
The blood is shifted away from the object, leading to patterned bruising
Bruising reflect impact in one plane and should not follow the ___ of the affected region
What does a patterned injury to the buttocks typically look like?
Often a distinct line of vertical bruising/petechiae seen
True or false... patten bruising can happen with accidents
True. Such as a seatbelt
What are some cultural practice that can produce bruising/bruise-like lesions?
Coining (gua sha)
What are some systemic diseases that can produce bruise-like lesions?
Henoch schonlein purpura
Dermal melanosis (bruising can overly melanosis)
What are some other things that can mimic bruises?
Purpura fulminans (DIC and fatal)
Phytophotodermatitis (citrus and sun)
Self-inflicted bruises or cutting
What are some coagulation disorders that can cause bruising?
Hemolytic uremic syndrome
Vitamin K deficiency
Factors 13 deficiency
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
How can you tell the difference between an adult-inflicted bite and a child-inflicted bite?
Bites often only distinct in one arch
Average maxillary intercuspid distance of 33mm
Teeth tend to be rectangular
Bites are often distinct in both arches
Intercuspid distance of less than 30mm
Teeth tend to be more rounded
What do animal-inflicted bites look like?
Generally tear in skin
Much narrower arch with elongated anterior-posterior aspect than human bites
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)
Developmental biting behavior in ___ age is often seen with ___
When do adults typically bite their children?
"To stop biting behavior" ...smh..
Abusive injuries to the ____ region are among the most common seen in abused children
Head and neck (specifically orofacial injuries)
What are the mechanisms of injury for trauma of the mouth?
Insertion of object into mouth (forceful feeding)
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)
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)
What do you do when you see a non-ambulatory child with a lingual frenulum tear?
They should be evaluated for abuse