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Peds Test 2 > Head, Ears, Nose, Throat > Flashcards

Head, Ears, Nose, Throat Flashcards

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0
Q

Differences in head

A

Cranial bones are soft and separated by sutures, sutures and fontanels permit skull expansion to accommodate brain growth, skull molding from birth through vaginal canal

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1
Q

What are differences in adults vs children

A

Changes in Eustachian tubes, obligate nasal breathers, small airway and enlarged tonsils

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2
Q

When do sutures ossify

A

6-18 years. Higher risk of head fracture under the age of 6

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3
Q

When do fontanels close

A

Posterior 2 months, anterior 2 years

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4
Q

What does skull molding from birth through vaginal canal allow for

A

Skull bones to shift and overlap , and normal shape and size resumed within days

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5
Q

Male adolescent facial changes

A

Nose and thyroid cartilage enlarge and facial hair appears

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6
Q

a serious condition that occurs when the body produces too much of the hormones that control growth.

A

Acromegaly

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7
Q

A rare genetic disorder characterized by premature joining of certain skull bones during development which has an impact on the shape of the head and face. Features include poor vision, hypoplasia of maxilla an impaired hearing. Not symmetrical

A

Craniofacial dystosis

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8
Q

Fetal alcohol syndrome facial characteristics

A

Small eye openings, smooth philtrum, and thin upper lip

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9
Q

a vertical groove in the middle area of the upper lip

A

Philtrum

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10
Q

Characteristics of Down syndrome

A

No nasal bridge, hypocanthal fold, hyperglossia

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11
Q

Differences in ears

A

Inner ear development in the first trimester, external auditory canal in infants shorter than in adults, Eustachian tubes in infants wider, shorter, more horizontal than in adults, salivation increased by 3 months (swallowing)

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12
Q

When does inner ear development start

A

First trimester

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13
Q

What are Eustachian tubes like in infants

A

Wider, shorter, more horizontal than in adults

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14
Q

When is salvation increased by

A

3 months, swallowing

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15
Q

When do sinus problems usually start

A

Around high school years

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16
Q

Can a 5 day old get a sinus infection

A

No! Maxillary and ethmoid sinuses are present at birth but they are very small

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17
Q

What sinuses are present at birth

A

Maxillary and ethmoid sinuses are present at birth but they are very small

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18
Q

What sinuses begin to develop at about 3 years of age and complete development in late adolescence

A

Frontal and sphenoid sinuses

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19
Q

When do permanent teeth begin forming in the jaw by

A

6 months of age

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20
Q

How many teeth usually erupt between 6 and 24 months of age

A

20 deciduous teeth

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21
Q

When does eruption of permanent begin? When is it completed?

A

Begins about 6 years and completed around 14-15 years

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22
Q

When should first dental visit be in most cases

A

3 years

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23
Q

Neural tube defect with protrusions of brain and membranes that cover it though openings in the skull

A

Encephalocele

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24
Circumference of the head is smaller than normal because brain has not developed properly or has stopped growing
Microcephaly
25
Premature closure of one or more cranial sutures before brain growth complete, leads to misshapen skull
Craniosynostosis
26
What should you do on otoscopic examination
Note presence of cerumen, discharge, inflammation, or foreign body in ear canal
27
What should you visualize in tympanic membrane
Color landmarks, and light reflex, a well as presence of perforation, scars, bulging, or retraction
28
Common medical treatments for ear disorders
Pressure-equalizing (PE) tubes, hearing aids, cochlear implants (more permanent for of hearing aids)
29
How is hearing impairment measured
Decibels (dB)
30
How much of daily conversation does somebody with mild hearing loss miss? What can this lead to?
Mild hearing loss: 26-40 dB misses 50% of daily conversation and is at a HIGH RISK for school failure
31
What are common causes of conductive hearing loss
Impacted cerumen, otitis externa, trauma, foreign body
32
How much of hearing loss is genetic? Environmental causes at birth? Unknown?
50% genetic, 25% environmental causes at birth, 25% unknown
33
What can be heard if somebody is considered deaf? How much loss?
Greater than 90 dB, no sound at all heard
34
When do we normally do hearing screen
16-24 months
35
If high risk when should you do hearing screen
Before hospital discharge or no later than 3 months
36
When can you use pure tone audiometry
After age 3- when they are old enough to follow directions
37
Hearing screening tests
Pure tone audiometry (after 3), pneumatic otoscopy, tympanometry
38
Clinical signs of hearing impairment
lack or startle or blink reflex in infant, failure to localize sound by 6 months, absence of babble or inflections by age 7 months, lack of response to spoken words, failure to develop intelligible speech by 24 months, inactive, dreamy
39
Hearing and speech development milestones newborn-4 months
Reacts to loud noises, responds with smile to voice
40
Hearing and speech development milestones 4-8 months
Turn head to sound, recognizes moms voice, babbles
41
Hearing and speech development milestones 8-12 months
Makes various noises, imitates smile sounds, responds to name and no-no or bye-bye
42
0 to 20 dB
Normal
43
20 to 40 dB
Mild loss
44
40 to 60 dB
Moderate loss
45
60 to 80 dB
Severe loss
46
Greater than 80 dB
Profound loss
47
Results when transmission of sound through the middle ear is disrupted, as in the case of otitis media externa
Conductive hearing loss
48
Caused by damage to hair cells in the cochlea or along the auditory pathway
Sensorineural hearing loss
49
Occurs when the cause may be attributed to,both conductive and sensorineural problem
Mixed hearing loss
50
Goal of vision/hearing screening
Prevent long term development of learning problems and refer for further evaluation
51
What medications can cause tinnitus or hearing loss
Lasixs if given quickly, antibiotics if given quickly or early
52
Nursing care for a child with hearing impairment
Face child when speaking, eye/eye contact, don't talk louder, use sign language interpreter, write
53
Nursing care for a child with vision impairment
Speak when approaching and explain procedures before touching
54
Inflammation of middle ear
Otitis media
55
Risk factors of otitis media
Cigarette smoke, day care center, increased pacifier use, bottle propping
56
Symptoms of otitis media
Ear pain, fever, irritability, rubbing or pulling at ears, disturbed sleep, URI symptoms, feeding changes, diarrhea and vomiting, MAYBE ASYMPTOMATIC
57
Are there always symptoms with otitis media
No, may be ASYMPTOMATIC. They can have hearing loss without knowing they had frequent ear infections
58
Treatment of chronic otitis media
Tympanostomy (tube placement)
59
Complications of otitis media
Hearing loss and perforation (ear drum hole)
60
Who is otitis media with effusion common in
Under the age of 15 and often in males
61
Onset of otitis media with effusion
Gradual and insidious onset
62
Symptoms of otitis media with effusion
Difficulty hearing or fullness
63
What will you see with otitis media with effusion
TM opaque or dull and retracted or convex | may see air fluid level or bubbles, landmarks blurred, mobility decreased, positive weber to involved ear
64
Treatment of otitis media with effusion
Watchful observation
65
Collection of fluid in the middle ear behind the tympanic membrane which is not infected
Otitis media with effusion
66
What is otitis externa also known as
Swimmers ear
67
Inflammation of skin and surrounding soft tissue of the ear canal
Otitis externa
68
Symptoms of otitis externa
Pain and itching especially if pressing on tragus or moving pinna; ear canal swollen and red
69
Treatment of otitis externa
Steroid ear drops to decrease inflammation. Antibiotic ear drops if bacterial infection suspected. Ibuprofen/Tylenol for pain control
70
What do you need to do with otitis externa
Keep ear canal dry
71
Who should you refer a child to who has otitis externa frequently
ENT
72
Problems with nose/mouth/throat
Epitaxis, URI, sinusitis, pharyngitis, tonsillitis
73
Who is epitaxis common I'm
School agers and in males
74
Treatment of epistaxis
Sit upright with head forward and squeeze and apply pressure (external or internal) for 10-15 minutes (WILL BE PAINFUL) if bleeding persists after 10-15 may swab with epinephrine or cauterize
75
Is anterior or posterior bleeding more problematic?
Posterior because it is hard to get direct pressure. Posterior bleeding must be packed and may have N/V due to swallowing blood
76
A patent calls and tells you child had a nose bleed and now they are Coughing up blood and have dark black stool. Should you be concerned.
No tell them this is because of swallowing all the blood during the nose bleed
77
Causes of sinusitis
Strep pneumoniae, H. Influenzae, moraxella catarrhalis
78
Symptoms of sinusitis
Usually URI for 10 days with persistent cough, malodorous breath, mouth breathing, increased purulent nasal drainage, facial pain, headache, fever, cervical lymphadenopathy, hyponasal speech
79
Treatment of sinusitis
Antibiotics and antipyretics
80
Infection affecting the pharynx and tonsils
Pharyngitis
81
What do we know pharyngitis as
Sore throat
82
When do we see pharyngitis frequently in ? Who do we not usually see it in?
Frequently we see in children ages 4-7. Rarely see less than 1 year
83
Major complaint with pharyngitis
Sore throat
84
Causes of pharyngitis
Viral - enteroviruses | Bacterial- group A Beta-hemolytic Streptococcus (GABHS)
85
Is viral or bacterial pharyngitis the one where the fever is greater than 101 F
Bacterial
86
Which type of pharyngitis has abrupt onset
Bacterial
87
Which type of pharyngitis is fever less than 101 F
Viral
88
Which type of pharyngitis may you hear hot potato voice
Bacterial
89
Nasal congestion, mild sire throat, conjunctivitis, cough, hoarseness are symptoms of white type of pharyngitis
Viral
90
What is a aphthous ulcer also known as
Cold sore
91
What is tonsillitis
Recurrent infection or inflammation of the palatine tonsils caused by viruses or bacteria
92
Symptoms of tonsillitis
Frequent throat infections with breathing and swallowing difficulties, persistent redness of anterior pillars, enlargement of the cervical lymph nodes
93
Treatment of tonsillitis
Antibiotics if bacterial and otherwise comfort measures (salt water, honey, Tylenol) and surgery
94
What reason is tonsillectomy frequent
Increased swelling and swallowing difficulty (don't want things in way of airway) and fluid balance in young children
95
What will somebody who had a tonsillectomy have? What songs should you watch for?
Will have sore throat but also may have ear pain. Assess for bleeding- frequent swallowing. Late symptoms are hypotension and tachycardia it's bad if you let it get here
96
How long does sore throat usually last after tonsillectomy
7-10 days
97
Tonsillar infection that has spread to surrounding tissues and causes cellulitis or retropharyngeal abscess
Peritonsillar abscess
98
What is a retropharyngeal abscess
Infection of lymph nodes that drain the adenoids, nasopharynx and paranasal sinuses
99
What does cleft lip and palate effect
Feeding
100
Where should you check for a parotid mass
Between ear and cheek
101
What is torticollis
Twisting of the neck

Peds Test 2 (4 decks)

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