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Flashcards in Pediatrics Deck (37)
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1
Q

What is the sequence of sinus development

A

Maxillary - birth
Ethmoid - birth
Sphenoid - 5yo
Frontal - 10yo

2
Q

What drains into the osteomeatal complex?

A

Maxillary sinus
Anterior ethmoids
Frontal sinus

3
Q

What three structures bound the osteomeatal complex, and therefore can occlude it via mucosal hypertrophy or anatomic enlargement

A

Ethmoid bulla
Uncinate
Middle turbinate

4
Q

At which age does the pinna reach almost full adult size?

A

4-5 yo, full at 9

5
Q

What allows establishment of a nasopharyngeal airway in infants?

A

The more superior cervical postition of the larynx and overlap of the epiglottis and velum (palate)

6
Q

At what level is the pediatric larynx located at rest and with swallowing?
Adult?

A

Peds: at rest - 3rd-4th vertebrae, swallowing - 1st-2nd
Adult: 5th

7
Q

Chonal atresia is a potential manifestation of which syndrome, whose presence may make other intervention necessary prior to repair of atresia?

A

CHARGE

Coloboma, Heart defects, Atresia of the choanae, Retardation, Genital abnormalities, Ear abnormalities

8
Q

What should be ruled out in the setting of pyriform aperature stenosis?

A

Holoprosencephaly (central mega-incisor syndrome): get CNS imaging

9
Q

What are the three main types of congenital nasal masses that typically present with s/s nasal obstruction?

A

Encephaloceles
Gliomas
Dermoids

10
Q

Location of lymphatic vascular malformations often defines if the lesion is macrocystic or microcystic. Where are each more commonly found?

A

Macrocystic: Infrahyoid and extrinsic to the laryngotracheal airway
Microcystic: Suprahyoid and involved with the laryngotracheal airway

11
Q

What study is important in a child with bilateral VF paralysis?

A

MRI to r/o posterior fossa abnormalities

12
Q

What is the major source of saliva production at rest? During mealtime?

A

Rest: submandibular gland
Meals: parotid gland

13
Q

During normal nasal development (weeks 4-12), what provides communication between the prenasal space and the anterior neuropore?

A

Foramen cecum

14
Q

What are the two thickenings of the frontonasal prominence which burrow to form nasal pits, flanked by the medial and lateral nasal prominences

A

Nasal placodes

15
Q

What is the name of the primitive oral cavity

A

Stomodeum

16
Q

What is the mandibular arch subdivided into?

A

Mandibular and maxillary processes

17
Q

Oral-nasal patterning of the palate and oral cavity/tongue devlopment is under the control of what gene?

A

Sonic hedgehog (Shh)

18
Q

What 4 regions fuse to form the tongue?

A

Lateral lingual swellings: 1st arch, oral tongue, ant 2/3
Midline lingual swelling: 1st arch, oral tongue, ant 2/3
Hypobranchial eminence: 2nd-4th arch, oropharyngeal, post 1/3

19
Q

What is the V shaped sulcus that seperates the anterior 2/3 from the posterior 1/3 of the tongue? What lies at the center?

A
Sulcus terminalis
Foramen cecum (origin of the mesodermally derived thyroid)
20
Q

What is a mass of normal tissue in an abnormal location that is classified based on the predominant epithelial lining?

A

Choristoma

21
Q

Where do most oral choristomas occur?

A

Near the ventral reflection of the tongue onto the FOM

22
Q

What is the mechanism by which vallecular cysts cause stridor and respiratory distress?

A

Mass forces the epiglottis into the laryngeal inlet

23
Q

Is congenital or acquired subglottic stenosis more common?

A

Congential is 1/10 as common as aquired SGS

24
Q

What is the initial therapy for subglottic hemangiomas?

A

Propranolol (others include steroid injection, systemic steroids, laser ablation, and open resection with LTR)

25
Q

Laryngeal cleft can occur in isolation, or in association with one of the following syndromes (3)

A

Pallister-Hall: hypothalamic hamartoma, polydactyly, bifid epiglottis
Opitz-G: midline abnormalities- optic hypertelorism, LTE defects, and hypopspadias
VACTER/VACTERL

26
Q

Classification system for laryngeal clefts

A

Benjamin Ingles Classification
Type I: deep interarytenoid notch
Type II: extends into but not through cricoid
Type III: through cricoid into cervical trachea
Type IV: into thoracic trachea/bronchi

27
Q

What percent of patients with TEF have esophagial atresia?

A

95%

28
Q

What is the most common of the 5 types of TEF?

A

Esophagial atresia with distal TEF

29
Q

What is the only type of TEF that may remain occult and present with aspiration pneumonias?

A

H type

30
Q

What imaging should be performed in the setting of tracheal stenosis?

A

CTA with 3D recon

31
Q

What is cyclical cyanosis indicative of?

A

Complete nasal obstruction–cyanosis that resolves with crying

32
Q

What is piriform aperature stenosis associated with?

A

Single upper central incisor

33
Q

Findings of micrognathia and glossoptosis in a neonate with airway obstruction is pathognomotic for:

A

Robin sequence

34
Q

What worsens the stridor causes by laryngomalacia

A

Feeding
Agitation
Supine positioning

35
Q

Infants with persistent ‘croup’ sx should be suspected of having

A

Subglottic hemangioma

**physical exam will reveal a cutaneous hemangioma of the H&N in 50% of cases

36
Q

What is the tx of choice for complete tracheal rings?

A

Slide tracheoplasty

37
Q

What is the MCC tracheomalacia

A

Secondary tracheomalacia 2/2 vascular compression