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Physical Assessment > Pediatrics > Flashcards

Pediatrics Flashcards

(100 cards)

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1
Q

What year of life has most rapid physical growth?

A

year 1

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2
Q

How does height and weight change in infancy

A

Ht: increased 50%
Wt: triples

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3
Q

What is infancy

A

first year of life

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4
Q

Infancy physical development

A

body proportions change

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5
Q

neuro development of infancy?

A

progresses central to peripheral

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6
Q

cognitive development in infants

A

-increase understanding of self and environment
-cause and effect (rattle=sount)
object permanence
strangers

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7
Q

language in infants

A

cooing 2mo
babbling 6 mo
1-3 words 1 yr

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8
Q

Social and emotional development of infants

A

Bonding, attachment and trust varied with temperments depending on environment

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9
Q

Rate of physical growth in early childhood

A

slows, about 1/2 of infancy

growth in spurts

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10
Q

early childhood

A

1-4 years

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11
Q

physical development in early childhood

A

walk: 15 mo
run: 2 yr
pedal and jump: 3 yrs
fine motor skills develop

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12
Q

sequence of exam

A

noninvasive nonthreatening first, painful last

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13
Q

neonatal age

A

first 28 days of life

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14
Q

When do you asses a newborn

A

immediately after birth and several hours later

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15
Q

What is APGAR used for

A

to asses adaption to extrauterine life at 1 min and 5 minutes after birth
-max points is 10, low score indicates medical emergency

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16
Q

what does APGAR stand for

A

Appearance skin color (blue/gray, acrocyanosis, normal)
Pulse (absent, below, above 100)
Grimace (reflexes)
Activity (muscle activity)- absent, arms/legs flexed, normal
Respiration absent, slow, crying

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17
Q

Ballard Scoring system

A

determine gestational age to see if size is consistent with dates

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18
Q

What age children should stay in parent’s lap for beginning of exam?

A

infancy and early childhood

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19
Q

At what age can you ask parents to leave

A

13, but make sure you get chaperone

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20
Q

how do you distract early childhood patients

A

simple conversation, engage mom in conversation and exam

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21
Q

what’s most important about assessing adolescents

A

comfortable and confidentiality

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22
Q

Best clue of illness in child

A

appearance

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23
Q

goals of observation

A
  1. sick or not sick (mood, activity level)
  2. family integrity (mom-child)
  3. age in yrs vs. demonstrates
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24
Q

how to measure somatic growth

A

height, weight, head circumference
compare with normal values, previous readings, patterns
-MEASURE CONSISTENTLY

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25
most common cause of deviant measurement
technical errors | -REPEAT!!!
26
How do you measure height >2 yo
have patient stand bare foot against the wall with heels, back and shoulders against wall -make sure head straight forward and midline!!!
27
how do you measure height <2 yo
supine on measuring board with legs fully extended
28
Rule of thumb average weight at birth, 1 year, 5 year and 10 year
Birth: 3.5 kg 1 yr: 10 kg 5 yr: 20 kg 10 yr: 30 kg
29
How do you measure head circumference
paper tape around eyebrows back to occipital prominence, then plot on chart
30
how long do you measure head circumference
until 2yo
31
causes of microencephaly
congenital, familial, chromosomal disorders
32
causes of macroencephaly
subdural hematoma, tumor, familial, hydrocephalus
33
When do you determine BMI
2 yo
34
BMI in children with percentils
underweight: 85% overweight: >95%
35
infant blood pressure
80/60
36
preschool BP
90/75
37
adolescent BP
100/75
38
diastolic BP in children
60 in infants increases to 75 in childhood
39
Respirations in newborns
30-60
40
Respiration in early childhood
20-40
41
late childhood respiration
15-25
42
At what age is rectal temperature recommended
<2 mo
43
What is considered a fever?
rectal >100.4 F, 37 C
44
head inspection
sutures, symmetry, fontanelles, facies
45
neck exam
``` nodes masses mobility nuchal rigidity assess clavicles in newborns ```
46
Important eye exam in infants
Gaze, EOM, red reflex, fundoscopic exam
47
Normal variants for eye in infants
``` nystagmus for first few days cross gaze for 3 mo edema after birth subconjunctival hemorrhage common pupilllary asymmetry ```
48
infant cloudines of cornea
congenital glaucoma
49
dark light reflex in infants
cataracts | retinopathy of premie
50
white light reflex in infant
cataract retinal detachment chorioretinitis retinoblastoma
51
eye exam early childhood
acuity | gaze
52
late childhood/adolescent eye exam
annual acuity | same exam as adults
53
infant ear exam
patency gross hearing inspect position, size, shape
54
ear indication of defect
low set, small, deformed may indicated defects
55
Early childhood ear exam
examine drum | >4yo need acoustic screening
56
late childhood and adolescent ear exam
same as adult
57
Nose and paranasal infant exam
patency | nasal septum
58
which sinuses are only present at birth?
ethmoid
59
Nasal exam for early/late childhood
inspect nose and mucosa
60
development of sinuses
Ethmoid: birth Maxillary 4yo Sphenoids: 6 yo Frontal 6-7
61
by what age do you have all of your sinuses?
6-7
62
which sinus develops last?
frontal
63
at age 4 which sinuses do you have?
ethmoid and maxillary
64
Mouth and pharynx exam
Infant: inspect, palpate and note cry quality Childhood: inspect uvula, tonsils, teeth, gums, note voice quality and breath odor
65
Heart exam in children
inspect palpate auscultate
66
Which cyanosis in newborns is normal? abnormal?
acrocyanosis normal | central cyanosis abnormal
67
what pulses do you evaluate in infants
brachial | femoral
68
at what age do you take BP
3 yo
69
PMI in infant
unreliable
70
normal variant in children heart rhythm
sinus dysrhthmia, common
71
Which is split S1 or S2
S2
72
Breasts in newborn children
often enlarged "witch's milk"
73
common onset of puberty in breast development
8-13 yo, average of 11 may develop asymmetrically at first -males can have gynecomastia during puberty
74
protuberance in newborn
normal
75
inspecting the umbilical cord in newborns
2 thick wall arteries and 1 large thin walled vein at 12:00 | -look for hernias
76
childhood abdominal exam
inspect palpate percuss
77
What are you asessing for male genitalia exam in newborn and infants
hypospadias, chordee foreskin not usually retratable testes in scrotum, hernias, hydroceles
78
size of the penis in childhood
not important unless enlarged
79
Male genitalia tanner stages
1. prepubertal testes 2mL, no hair 2. enlargement of testes >4mL, redenned scrotum, few hairs at base of penis 3. lengthening of penis, enlarge to 6-10mL, curly hair across pubes 4. broadening of glans penis, growth 10-15mL, small adult hair
80
Puberty in males onset and termination
onset: 10-13 yrs | complete 14-18
81
inspection of female genetalia infants
``` size of clitoris color, size of labia majora (rashes, lesions) urethral orifice and labia minora hymen d/c? ```
82
what position do you perform childhood female genital exam
parents lap or knee, chest to examine external structurs, d/c or lesions NOT IN STIRRUPS
83
Female Tanner stages
1. Prepubertal: no breast tissue or PH 2. areolar enlargement with bud, few dark hairs on labia 3. single mound areolar, breast with curly ph 4. projection of areola, double mound, small adult ph 5. adult single contour breast with adult PH
84
Rectal exam
not apart of routine peds PE | done when intra-abdominal, pelvic or perirectal dz
85
Two tests done in infants to test for hip sublux
ortolani's and barlow's
86
Ortolani's
tests for presence of posterior dislocation | -hip, knees flexed at 90 degrees, ABduct both until lateral leg hits exam table
87
Barlow's
same position as ortolani's but tests for ability of unstable hip to sublux -pul one leg forward and ADduct with a posterior force, no movement means stable hip
88
Most common congenital foot disorder
club foot
89
Neuro exam in infants
infantile refleces
90
childhood neuro exam
modified glassgow
91
Rooting
stroke perioral skin with hand, infant will turn head twd stimulus, open mouth and suck
92
when does rooting disappear
3-4 month
93
When does sucking diappear
10-12 months
94
when does palmar grasp and plantar grasp disappear
palmar: 3-4 mo plantar: 6-8 mo
95
tonic neck (fencing)
turn head and hold head and shoulder down, ipsalateral arm will extned, other will flex
96
when does fencing diappear
2 months
97
moro (startle)
support supine and drop about two feet, arms will extend and abduct, hands open, legs flex, cry
98
when does moro diappear
4 months
99
when does babinski disappear
2 years
100
when does stepping reflex diappear
2-6 mo

Physical Assessment (4 decks)

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