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HNE - Börn Cheat Sheet (DRAFT) by

HÚÐ, AUGU, HÁLS, NEF OG EYRU BARNA

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Mat á starfsemi

Heibri­gðismat
Augu
Uppbygging og symmetry
Visual acuity screening test
Extroo­cular movements to all quadrants
Corneal light reflex, cover-­uncover test og visual fields
Ophtha­lmo­scope; red reflex bilate­rally
Aborma­lities
; eye drainage, cloudiness of lens, or abnormal eye movement.
Eyru
Staðse­tning og symmetry of the external ear.
Auditory screening test
Otoscope; evaluate the ear canal and tympanic membrane.
Ask about ear pain, drainage, and discom­fort.
Nef
Symmetry and placement of the nose.
Are the nares bilate­rally patent?
Are there lesions or drainage?
Are several smells identi­fied?
Are signs of sinus infection present
Munnur og háls
Are oral mucous membranes intact?
How many primar­y/s­eco­nda­ry/­loose teeth are present?
Are there visible caries? Are there broken or chipped teeth?
Evaluate the soft and hard palate for intact­ness.
Describe the throat and size/a­ppe­arance of tonsils.
Palpate cervical lymph nodes, noting size and tender­ness.”

Frávik í augum barna:

Perior­bital cellul­itis:
Sjóntruflun/skekkja:
Disorders of refraction
Hyperopia
Farsig­hte­dness; a refractive error where distant objects are seen more clearly than close objects, often due to the eyeball being too short or the cornea having too little curvature.
Myopia
Nearsi­ght­edness; a common refractive error where close objects are seen clearly, but distant objects are blurry.
Astigm­atism
A refractive error in the eye where the cornea or lens has an irregular shape, causing blurred or distorted vision at various distances.
Muscular or anatomic abnorm­ali­ties:
Strabismus
A condition in which the eyes are misaligned and do not point in the same direction. One eye may turn inward, outward, upward, or downward.
Amblyopia
Commonly known as "lazy eye," amblyopia is a vision develo­pment disorder where one eye does not achieve normal visual acuity, even with the use of corrective lenses.
Cataracts
Clouding of the eye's natural lens, leading to blurred vision. Cataracts are often associated with aging but can also result from injury or other medical condit­ions.
Glaucoma
A group of eye conditions that damage the optic nerve, often due to increased intrao­cular pressure. Glaucoma can lead to vision loss and blindness if not treated.
Retino­bla­stoma
A rare childhood cancer that develops in the retina, the light-­sen­sitive tissue at the back of the eye. It can occur in one or both eyes and may lead to vision loss or loss of the eye if not treated.
Litblinda:
Retino­pathy of premat­urity (ROP):
Sjónsk­erð­ing­/bl­inda:
Augnskaði:
Vökvamikið líffæri mikið augum. Getur komið sýking. Þvo augun. Sjónsk­ekkjur algengar.

Frávik í eyru

Eyrnabólga
Miðeyr­abólga
Algengi
Börn eru í aukinni hættu fyrir sýkingu vegna þess að kokhlustin er meira lárétt/flö
Sýklar
Bakteriur og veirur
Meðferð
Eftirlit, bíða og sjá í 2-3 ef vægt. Ef barnið er ekki betra, hefja per os sýklal­yfj­ame­ðferð
Ytra eyrnabólga
Orsök
Hlustin er mjög stutt hjá ungum börnum
Meðferð
Gefa eyrnadropa (sýkla­lyf­/bó­lgu­eyð­andi). Getur þurft að skola eyra með saltvatni.
Toga ytra eyra niður og aftur hjá börnum < 3ja ára Toga ytra eyra upp og aftur hjá börnum > 3ja ára
Fræðsla
Fræðsla um orsakir og forvarnir
Skert heyrn
Orsakir
Tíðar sýkingar geta valdið heyrna­rskaða. Meðfætt
Kembileit
Sjúkrahús. Langvinnar eyrnab­ólgur.
Eftirlit
Fylgjast með atferli sem gefur tilkynna skerta heyrn
Atferli sem gefur tilkynna skerta heyrn hjá ungbörnum
Vaknar aðeins við snertingu
Hrekkur ekki við hátt hljóð
Vaknar ekki við hávaða
Snýr ekki höfði að hljóð áreiti við 3-4 mánaða aldur
Staðsetur ekki hljóð við 6-10 mánaða aldur
Staðsetur ekki hljóð við 6-10 mánaða aldur
Atferli sem gefur tilkynna skerta heyrn hjá smá- og forskó­lab­örnum
Talar illski­lja­nlega eða ekki
Virðist þroska­ham­laður
Virðist tilfin­nin­galega vanþroska, öskrar óviðei­gandi
Bregst ekki við þegar sími/d­yra­bjalla hringir
Hefur meiri áhuga á hlutum en fólki
Tjáir sig með hreyfingum
Atferli sem gefur tilkynna skerta heyrn hjá skólab­örnum og unglingum
Biður um að setningar séu endurt­eknar
Svarar spurningum óviðei­gandi nema þegar horfir á viðmælanda
Tekur illa eftir og dreymir dagdrauma
Gengur illa í skóla eða skrópar
Er með talerf­iðleika
Situr nálægt TV eða hækkar í TV og útvarpi
Vill leika eitt
Skert heyrn
Meðferð
Meðferð fer eftir tegund og alvarleika
Varanleg skerðing á heyrn:
þverfa­glegt teymi
Heyrna­rtap: Alvarlegt
Cochlear implant (þurfa að vera amk 12 mán)
Heyrna­rtæki
Samski­pta­tækni (táknmál, varale­stur)
 

Nef og háls

Blóðnasir (epist­axis)
Dry air or low humidity. Nosepi­cking
Nefkok­sbólga (nasop­har­yng­itis)
Caused by various viruses, with rhinov­iruses being the most common
Kokbólga (phary­ngitis)
Can be caused by viral or bacterial infect­ions. Common viral causes include rhinov­irus, influenza virus, and adenov­irus. Bacterial causes may include Strept­ococcus pyogenes (group A strept­oco­ccus), which can lead to strep throat
Hálski­rtl­abólga (tonsi­llitis)
Tonsil­litis often results from viral or bacterial infect­ions. Viral causes include adenovirus and Epstei­n-Barr virus. Bacterial tonsil­litis is commonly caused by Strept­ococcus pyogenes (group A strept­oco­ccus), which can lead to strep throat
Blóðnasir
Algengi
Algengt hjá börnum á skólab­örnum, sérsta­klega drengjum
Forvarnir
Rakt loft heima sérstakla yfir vetrar­tímann. Ekki bora í nef. Ekki setja hluti í nef
Meðferð
Kvíðas­til­ling, draga úr nefblæ­ðingi, varúða­rrá­stð­afanir
Nefkok­sbólga
Meðferð heima
Saltva­tns­dropar á 3ja – 4ra klst fresti fyrir ungbörn. Gefa áður en að barnið drekkur. Nefúði fyrir eldri börn - ekki lengur en 4 - 5 daga
Stoðme­ðferð
Drekka, handþv­ottur, parase­tamól, hvíld
Hálsbólga
Meðferð
Einken­nam­eðferð
Drekka vel, skola háls með saltvatni, parase­tamól, hvíld, rakt loft, tyggjó, handþv­ottur
Ef sýklalyf eru notuð
Leggja áherslu á að klára lyfskammt og skipta um tannbursta eftir 2 daga frá því að byrjar á sýklal­yfjum
Hálski­rtl­ataka
Fræðsla til foreldra
Hætta á blæðingu er mest fyrsta sólarh­ringinn og 7-10 daga eftir skurða­ðgerð þegar örvefur er að myndast
Aukave­rkanir:
Parase­tamól, kaldir drykkir, ekki súrir drykkir, hvíld, rólegheit

HÚÐ og vefir BARNA

Sýrustig húðarinnar
The acidity of children's skin is noted to be alkaline during the first week of life.
During the first week of life, a newborn's skin is alkaline. This is primarily because the acid mantle, which is a thin, protective layer on the skin's surface, takes time to develop. The acid mantle is crucial for protecting the skin from bacteria and other enviro­nmental factors. The alkaline nature of the skin in the initial days may make it more suscep­tible to irritation and microbial coloni­zation.
Þunnur epidermis
The epidermis in children is described as thin, making them more suscep­tible to blister formation.
The thinness of the epidermis in children, especially in newborns, makes their skin more fragile. The formation of blisters can occur more easily due to the delicate nature of the epidermal layer. Newborn skin is also more permeable than adult skin, which can affect the absorption of substa­nces.
Aðskilin húðlög
In newborns, the layers of the skin are not as well-i­nte­grated as in adults. The dermis and epidermis may not be fully connected, and this separation could affect the overall structural integrity of the skin.
Meiri millif­urm­uvökvi
This could affect the hydration and protective functions of the skin.
Children, especially infants, have a higher ratio of interc­ellular fluid compared to adults. This means there is more fluid between the skin cells. This increased interc­ellular fluid can contribute to the softness and pliability of children's skin, but it may also impact barrier function and dehydr­ation suscep­tib­ility.
Slímhúð
IgA nær sama gildi og hjá fullorðnum við 2-5 ár aldur
Immuno­glo­bulin A (IgA) is an antibody that plays a crucial role in mucosal immunity. The note that IgA levels in mucosa reach adult levels by 2-5 years indicates a maturation of the immune system in mucosal surfaces during early childhood. This maturation is essential for effective defense against pathogens.
Fituki­rtlar
Virkir fyrst eftir fæðingu, óvirkir til 8-10 ára
Sebaceous glands produce sebum, an oily substance that lubricates the skin and helps in mainta­ining its integrity. The inactivity of sebaceous glands until 8-10 years means that children may have drier skin compared to adults, and consid­era­tions for skin hydration become crucial, especially in the early years.
Apocrine kirtlar:
fara að svitna t.d. Undir höndum.
The activation of apocrine glands around 8-10 years indicates the onset of sweating in areas like the hands. Sweating is a critical mechanism for thermo­reg­ula­tion, helping the body cool down. The delayed activation suggests that children may have a different thermo­reg­ulatory mechanism until a certain age.
General Implic­ations:
Skin Vulner­ability in Infancy:
Separation of Skin Layers:
Immuno­logical Matura­tion:
Delayed Sebaceous Gland Activity:
Onset of Sweating in Late Childhood:

Breytingar á húð og vefjum

Nýburi
Húðin er mjög þunn, lítil fita undir húð
Eccrine svitak­irtlar mynda svita sem svörun við hita- og tilfin­nin­gaá­reitum
Apocrine svitak­irtlar eru litlir og óstarf­hæfir
Epidermis og dermis tengjast lauslega, mikill millif­rum­u-v­ökvi, núningur eykur hættu á blöðru­myndun
Minna magn melanin litarefnis í húð við fæðingu – húðin ljós
Unglingur
Húðin þykknar
Epidermis og dermis tengjast þétt – veitir viðnám fyrir sýkingum núningi og ertingu
Eccrine svitak­irtlar með fulla starfsemi, eftir kynþroska svitna drengir > stúlkur
Apocirne svitak­irtlar þroskast við kynþroska
Melanin það sama og hjá fullor­ðnum, veitir vörn gegn útfjól­ubláum geislum
 

Húðvan­damál barna

Húðbólga - dermatitis