Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
65 Cards in this Set
- Front
- Back
|
What is the bible of child abuse?
|
Quick Reference Child Abuse, by James Montelone.
|
|
|
Is a physician mandated to report any suspected child abuse cases?
|
YES
|
|
|
Who whom should a child abuse case be reported to?
|
Child Protective Services
|
|
|
What determines whether the police or child protective services investigate abuse cases?
|
Depends on whether the suspect is in the home or not.
|
|
|
What happens if a physician (or other worker under this law) does not report when signs of abuse should have been caught?
|
Misdemeanor, Heavy Fine
|
|
|
How is child abuse suspected?
|
Must effectively eliminate the potential of an accident as causing the presenting injuries.
|
|
|
Most accidental injuries of children involve what?
|
Kids are forward and frontal explorers. Most accidental injuries involve only the frontal plane of the body.
|
|
|
What areas on the body are particularly prone to injury on children?
|
Areas where bone is closest to skin.
|
|
|
Injuries to the buttocks, genitalia, abdomen, back and lateral areas of the body especially the lateral sides of the face inidcate what?
|
Frequently indicate abuse!!
|
|
|
What do injuires involving more than one plane of the body indicate?
|
Abuse
|
|
|
Is abdominal bruising normal even with blunt trauma?
|
NO
|
|
|
Are spankings that cause bruising considered abusive?
|
YES
|
|
|
What is normal anal pigment? What is abnormal anal pigment?
|
Normal: Brown
Abnormal: Red or blue |
|
|
What does the rate of healing of a bruise depend on?
|
1.Location of bruise. Some places bruise more easily han others
2.Depth of the bruise 3.Amt. of bleeding 4.Circulatory status of area 5.Pigmentation of skin |
|
|
If one finds bruises of different ages on one part of the body, what is this suspicious for?
|
Abuse
|
|
|
Bruises that are different colors are suggestive of what?
|
Several separate beatings
|
|
|
What are places where we expect to see bruises?
|
Basically any place with a bony prominence.
|
|
|
If a child hits their forehead in the middle, what will happen?
|
The blood can drain down and give 2 black eyes.
|
|
|
If a child has 2 black eyes, how could they have been hurt? If a child has only 1 black eye, how could they have been hurt?
|
2 black eyes-->central forehead injury
1 black eye-->other ways the child could have been hurt |
|
|
Where do children often bruise themselves on their hands?
|
Area between the fingers is what is marked
|
|
|
What marks can be seen on the arms or trunk of a shaken child? They may be on one or both arms or on the trunk. Shaking can cause anterior or posterior rib fractures.
|
Grab marks
|
|
|
Where is a knuckle mark located?
|
On the abdomen
|
|
|
What is the difference between a dog bite vs. a human bite?
|
Dog bite: ovoid, marks of large canines can be seen
Humans: round |
|
|
If one suspects a human bit mark, what should one do?
|
Swab the area with 2 cotton swabs moistened with non-bacteriostatic saline and put them in an envelope or bag. Do NOT like the envelope or anything and WEAR GLOVES so you don't get your DNA on stuff.
-->Take pic. with camera. Be sure to put a size marker alongside the injury |
|
|
What is the abusive object: Bristles leave indentations?
|
Wire brush
|
|
|
What is the abusive object: Leave liner lesions and occasionally the buckle will leave a mark
|
Belt mark
|
|
|
What is the abusive object: Rope-like appearance
|
Cord Marks
|
|
|
What is the abusive object: Mark's around the child's wrist and forearm?
|
Ligature marks
|
|
|
What is the abusive object: Lots of marks on the feet of a child that was forced to walk through thorny vegetation from a minor offense?
|
Thorn marks
|
|
|
What is the abusive object: These are seen from sexual abuse, often from the mouth of the abuser?
|
Suction marks
|
|
|
What type of fracture can be caused by abuse?
|
Any fracture
|
|
|
In order to determine if a fracture is caused by abuse, what must be done?
|
Get a history.
|
|
|
For a very young child, what is obvious on a head x-ray and could be mistaken for skull fracture lines?
|
Suture lines
|
|
|
What does it mean to have a diastatic fracture? Cause?
|
Pulled apart-->In skull often caused by increased intracranial pressure from an injury within.
|
|
|
What force could cause a depressed skull fracture?
|
A high force
|
|
|
What do rib fractures show on x-ray?
|
"puffy" cotton-candy nature of a healing fracture
|
|
|
What types of rib fractures are highly suggestive of abuse?
|
Anterior and posterior rib fractures, when both present, is very suggestive of abuse.
|
|
|
What are metaphyseal fractures also known as?
|
Bucket handle and corner fractures
|
|
|
What fractures are pathonomonic for child abuse?
|
Metaphyseal fractures
|
|
|
What types of fractures do not heal with a callous, so we do not get that clue and must actually see the fracture?
|
Metaphyseal Fractures
|
|
|
What is a bone scan used for?
|
Used to find hairline fractures or those that do not heal with a callous. These scans show areas of increased activity.
|
|
|
What areas on a bone scan will normaly light up due to increased activity?
|
High humerus, left ribs, and left scapula
|
|
|
Why do ear bruises take a long time to heal?
|
Low circulation-->immune capability is dimished with little blood flow. Antibiotics can't get there well.
|
|
|
What are ear bruises often associated with?
|
Head injury on the same side.
|
|
|
Where can ear bruising from pulling or boxing appear?
|
Inside the pinna
|
|
|
Where can pulling cause bruises?
|
Where the ear meets the head on the posterior side.
|
|
|
What tears are not accidental unless the child falls right onto their face?
|
Frenulum tears-->forceful penetration in mouth
|
|
|
Where are the frenula located?
|
Upper lip, one on your lower lip, and one under your tongue
|
|
|
What types of injuries can be caused by forcefully covering the child's mouth or from being punched?
|
Lip injuries
|
|
|
When a child is forced to drink a caustic substance for saying something bad or making a face, what type of abuse is this due to?
|
Chemical burns to the mouth
|
|
|
If a child has a chemical burn to the mouth, should you make the child vomit it back up?
|
NO, they may already have burns to the esophagus, these are very ER, medically, and surgically complicated
|
|
|
What are retinal hemorrhages often due to?
|
Shaken baby.
|
|
|
What condition is often seen in the newborn nusery, especially with preemies, due to an anoxic condition?
|
Retinal Hemorrhage
|
|
|
If one sees this condition, and it was not documented from the delivery/nursery, what should one be suspicious of?
|
Retinal hemorrhage
|
|
|
What injury is white and NOT dark on MRI?
|
subdural hematoma
|
|
|
In what injury can one see the shearing/breaking of the axons on a microscopic section?
|
Diffuse axonal injury
|
|
|
What is a classic child abuse burn, caused by forcing a part of the child's body into water that is too hot?
|
Glove and Stocking burn
|
|
|
Anything above what temperature will cause a more serious and faster burn?
|
120 degrees
|
|
|
What type of burn is worst at the top where the hot water contacts first then lessons in severity as one follows it down? Also, these burns can be accidental?
|
Splash burn
|
|
|
Picture of a child with a large burn from the nightgown being soaked with nail polish remover and ignited by a cigarette lighter. Very obviously intentional.
|
Flash burn
|
|
|
Picture of a child with a burn on the cheek from a heater grid, what type of burn?
|
Grid burn
|
|
|
These burns are rarely accidental and are typically 8mm in diameter.
|
Ciagarette burn
|
|
|
These burns are worse at the point of exit.
|
Electrical burn
|
|
|
A picture of a child that sat on a hot radiator. If a child has a radiator burn on their buttocks then someone had to put them up there. An investigative child is more likely to get the burn on their hands from the radiator. What burn?
|
Contact burn
|
|
|
A picture of a child's hands that were burned symmetrically by a cigarette lighter. What burn?
|
Symmetrical burn
|
