Tunica vaginalis, 408 Turner syndrome, 162 , 218 , 337 , 344 Turpentine, 337 Two-thumb–encircling (Thayer) technique, 66 Tympanic membrane (TM), 389 , 391 f, 1112 Tympanitic abdominal distension, 87 Tympanometry, 225 Tyrosine catabolic intermediate fumarylacetoacetate, 337 Tyrosinemia, 337 Tzanck smear test, 450 , 501 , 1343 U Ulcer disease, 727 Ulceroglandular tularemia, 253 , 721 Ulna fractures, 1194 –1196 Ulnar collateral ligament (UCL), 1148 Ultrasound, 1e –19e administrative aspects of, 1e –2e basic controls in, 2e –3e in bladder catheterization, 16e –17e in central venous cannulation, 14e –17e diagnostic applications of, 3e –9e equipment considerations, 1e –2e evaluation of joints by, 19e genitourinary, 9e –14e appendicitis, 13e bladder ultrasound, 12e first trimester ultrasound, 9e –10e hypertrophic pyloric stenosis, 12e intussusception, 13e kidney ultrasound, 10e –12e pediatric abdomen, 12e lumbar puncture guidance, 16e –17e for nerve blocks, 19e overview of, 1e for paracentesis, 19e for pericardiocentesis, 19e in peripheral venous cannulation, 13e –17e physics of, 2e , C142 e142.2f procedural applications of, 13e scanning techniques, 3e soft tissue, 17e –19e foreign-body identification and removal, 18e –19e soft tissue infections, 17e –19e in thoracentesis, 15e Umbilical artery catheterization, 9e –11e Umbilical cord anomalies, 34e –37e appearance, 33e –35e granuloma, 34e omphalitis, 35e omphalomesenteric duct remnants, 35e treatment, 33e urachal anomalies, 34e Umbilical cord management, 65 Umbilical granuloma, 1353 Umbilical hernias, 1310 Uncircumcised male infant, penile care in, 1333 –1334 Uncompensated shock, 73 , 73 f Unconjugated bilirubin, 289 Unconjugated hyperbilirubinemia, 294 –300 approach clinical pathway for neonates, 298 , 299 f for patients beyond neonatal period, 299 –300 differential diagnosis decreased bilirubin conjugation, 295 excess bilirubin production, 294 –295 impaired bilirubin excretion, 295 –296 evaluation, 296 –297 history, 296 imaging studies, 297 laboratory testing, 296 physical examination, 296 management discharge from ED, 298 exchange transfusion, 297 hydration, 298 phototherapy, 297 –298 pathophysiology, 294 signs of ABE, 296 total serum bilirubin (TSB) in, 296 –297 Uncuffed endotracheal tubes (ETT), 36 Undescended testis, 1338 –1339 Unilateral cervical lymphadenopathy, 166 Unilateral isolated deficiency of adduction, 180 Unilateral laterothoracic exanthem (ULE), 475 , 476 f Unilateral lymphadenopathy, 909 Unilateral tonsillar hypertrophy, 909 Uninhibited bladder contractions, 530 Universal pregnancy testing, 537 Unstable pelvic injury, 1176 , 1196 , 1197 f Upper airway foreign-body aspiration, 206 –207 Upper extremity injuries, 1155 , 1182 motor nerve physical examination, 1193 f neurologic examination, 1186 t nondisplaced, 1175 nursemaid’s elbow, 1191 Upper extremity motor nerve, 1193 f Upper GI bleeding causes common, 215 t life-threatening, 215 t differential diagnosis, 214 etiology of, 214 t evaluation and decision diagnostic approach, 216 –217 , 217 f history and physical examination, 215 –216 laboratory, 216 in older children and adolescents, 215 in preschool (2 to years), 215 Upper lobe pneumonia, 329 Upper respiratory infection, 134 t, 168 , 199 Urea cycle defects, 121 Ureaplasma urealyticum, 545 Uremia, 340 , 421 , 560 Ureteral injuries clinical recognition, 1136 evidences, 1136 management/diagnostic testing, 1136 treatment goal, 1136 Ureteropelvic junction (UPJ) disruptions, 1133 , 1307 f obstruction, 1307 f Urethral bleeding, 535 Urethral catheterization, 1137 Urethral injuries assessment/diagnostic testing, 1139 clinical recognition, 1138 evidences, 1138 female urethral injuries, 1139 male lower urinary tract, sagittal section of, 1138 f management, 1139 posterior urethral disruption/pelvic fracture, 1139 f retrograde urethrogram, 1139 treatment goal, 1137 –1138 Urethral prolapse, 535 , 765 –766 , 1339 Urethral syndrome, 530 Urethritis, 383 , 384 t Uric-acid nephropathy, 931 Urinary bladder catheterization, in abdominal trauma, 1087 Urinary frequency differential diagnosis, 529 –531 evaluation and decision, 531 –532 interpretation of urinalysis, 531 , 532 f laboratory evaluation of urinary frequency, 531 extraurinary system, 530 –531 , 530 t pathophysiology, 529 Urinary retention, acute background, 1340