Peds Head, Neck, and Ears

Question 1

When do you perform measurements of head circumference?

Answer 1

Birth to 24 months

Question 2

Transillumination of the skull of an infant for what?

Answer 2

excess fluid accumulation

Question 3

An infant’s head is

__ of body length and __ of body weight at birth

Answer 3

1/4 of body length, 1/3 of body weight

Question 4

Why do infants need to be placed backwards in car seats for the first two years of life?

Answer 4

Their heads are heavy and has no support structure thus whiplash during an accident when car seat is facing forward will be fetal.

Question 5

Bones are separated by membranous tissue spaces called __

Answer 5

sutures

Question 6

The areas where sutures intersect are known as ___

Answer 6

fontanelles

Question 7

anterior fontanelle closes at __ months

Answer 7

18

Question 8

Posterior fontanelle closes at __ months

Answer 8

2

Question 9

Fontanelle is a measure of what?

Answer 9

intracranial pressure

Question 10

What does dehydration in an infant cause?

Answer 10

sunken fontanelle

Question 11

Increased intracranial pressure causes what?

Answer 11

bulging fontanelle, also occurs when the infant is coughing, vomiting and crying

Question 12

Hydrocephalus is caused by

Answer 12

increased intracranial pressure from deficient spinal fluid circulation causes enlargement of the calvarium before the sutures are closed.

Question 13

Hydrocephalus

Answer 13

enlarged head, bulging fontanelle and dilated scalp veins

Question 14

Caput succedaneium (scalpedema)

Answer 14

Subcutaneous edema over the presenting part of the head at delivery (not worrisome)

Usually occurs over the occipitoparietal area and crosses suture lines

Transluminates

Question 15

Cephalhematoma

Answer 15

subperiosteal collection of blood (not edema)

caused by ‘trauma’ of vaginal delivery

does not cross over suture lines

commonly found in parietal region

does not transluminate

may not be obvious at birth because they may be overlapping scalpedema

Question 16

molding (cone head)

Answer 16

repositioning of the cranial bones to allow passage of the baby through the birth canal

Question 17

How long does it take for cephalohematoma to resolve?

Answer 17

10-14 days

Question 18

Plagiocephaly

Answer 18

occurs when an infant lies on the same side constantly

it’s misshapen head, not micros or hydro

Question 19

What’s the treatment for plagiocephaly?

Answer 19

parental education and different holding patterns, placing objects of interest opposite normal head rotation

it will self resolve with age and more upright, active babies

Question 20

Craniosynostosis

Answer 20

premature closure of sutures, can cause asymmetry

early closure of fontanelles

Question 21

Brachycephaly

Answer 21

premature closure of coronal suture

Question 22

How should the infant be positioned when palpating their neck?

Answer 22

the infant should be in supine position

Question 23

Congenital muscular torticolis

Answer 23

injury and possible bleed into SCM at birth

treatment is with stretching exercises

Question 24

In relation to eyes, upper portion of the ear should be where?

Answer 24

The upper portion of the auricle should be at the same level at eyes

Question 25

How often should pneumatic otoscopy be performed in children?

Answer 25

Every exam of the ear

Question 26

Diminished movement of tympanic membrane is indicative of what?

Answer 26

Ear effusions, acute otitis media

Question 27

it is important to occlude one nare to observe breathing patterns in newborns, why?

Answer 27

Newborns are "obligate" nose breathers

Question 28

A crease on a child's nose could be indicative of what?

Answer 28

Allergies. The crease develops from them shoving their hand up outside of the nose

Question 29

Darkness under the eyes can be indicative of what?

Answer 29

venous pooling, which can result from chronic congestion

Question 30

When does the maxillary sinus develop?

Answer 30

one year of age

Question 31

When does the sphenoid and ethmoid sinuses develop?

Answer 31

six years of age

Question 32

When does the frontal sinus start to develop?

Answer 32

Ten years of age

Question 33

When are all the sinuses fully developed?

Answer 33

21 years of age

Question 34

Where should you inspect for cleft?

Answer 34

Inspecting the lips AND palate (inside the mouth) for any cleft

Question 35

What might you find in an infant's mouth that is abnormal?

Answer 35

antenatal teeth they need to be extracted as they may pose as choking hazards

Question 36

At what age are the tonsils at its peak size?

Answer 36

between 2- 6 years of age

Question 37

``` The following numbers are used for grading tonsils, what do they mean? 1+ 2+ 3+ 4+ ```

Answer 37

``` Tonsils grading: 1+ barely visible 2+ will mostly see in 2-6 year olds 3+ moving into uvula 4+ touching the uvula ```

Question 38

Teeth begin to appear when?

Answer 38

6-7 months with upper and lower central incisors

Question 39

How often are teeth coming in?

Answer 39

4 teeth added every 4 months

Question 40

Full complement of teeth occurs at what age?

Answer 40

2-3 years

Question 41

Shedding of primary teeth usually occurs when?

Answer 41

5 years of age

Question 42

Secondary teeth usually begin at what age?

Answer 42

6-7 years of age

Question 43

Halitosis

Answer 43

bad breath

Question 44

Halitosis with chronic unilateral rhinitis is usually due to what? Occurs in what age group?

Answer 44

foreign object | 9 months to 5 years

Question 45

Describe the tympanic membrane of acute otitis media

Answer 45

TM is bulging

Question 46

Describe the tympanic membrane of otitis media with effusion

Answer 46

TM is neutral or retracted

Question 47

What is otitis media?

Answer 47

middle ear inflammation

Question 48

Indications of otitis media

Answer 48

``` upper respiratory tract infection unaccustomed tugging of the ears irritability difficulty sleeping fever otalgia otorrhea hearing loss ```