Examination

Question 1

What should you look for on head?

Answer 1

Circumference (50th centile =35cm)
Shape - odd shapes from difficult labour soon resolve
Fontanelles (tense if crying or RICP, sunken if dehydrated)

Question 2

Eyes?

Answer 2

Red reflex (absent in cataract and retinoblastoma)
Corneal opacities
Conjunctivitis

Question 3

Ears?

Nose?

Answer 3

Shape
Postion
Low set - below eyes

Tip of nose, when pressed shows jaundice in white babies
Breathing out of nose (close mouth) for choanal atresia
Otoacousitci screening test

Question 4

Mouth?

Answer 4

Look inside
Insert finger - palate intact
Suck good
Baby’s face look normal

Question 5

Arms and hands?

Answer 5

Single palmar creases
Does baby look like parents
Waiter’s tip sign os Erb’s palsy - C5, C6 tunes
Number of fingers
Clinodactyly (5th finger curved towards the ring finger)

Question 6

Thorax?

Answer 6

Watch respirations
Grunting
Intercostal recession
Palpate the precordium and apex beat
Listen to heart and lungs
Inspect the vertebral column for neural tube defects

Question 7

Abdomen?

Answer 7

Feel liver
Inspect umbilicus
Lift skin to assess turgor
Inspect genitalia and anus
Patent orifices?

Passed urine and stool?
Displaced urinary meatus?
Testes descended

Question 8

Legs?

Answer 8

Test for DDH - Barlows, Ortalani
Femoral pulse palpation - to exclude coarctation
Toes

Question 9

Buttocks/sacrum

Answer 9

Anus?
Mongolian blue spots
Tufts of hair ± dimples suggest spina bifida occult
Pilonidal sinus

Question 10

CNS?

Answer 10

Assess posture
Handle baby
Jittery (hypoxia, encephalopathy, hypoglycaemia, infection, hypocalcaemia)
Limbs normally move
Tone floppy or spastic
Responses?
Moro reflex - sitting baby at 45 supporting head
Momentarily remove support arms will abduct and hands open and then arms adduct

Stroke palm to elicit grasp reflex

Size