Neonatology Flashcards
Neonatal examination
First step after consent
wash hands and dry them
Neonatal examination
What should be done if the baby is quiet
auscultate the heart first
Neonatal examination
Signs to look about the baby’s skin color
- Pink
- Deep redness or purple color
- Acrocyanosis
- Pallor
Neonatal examination
signs to look for the appearance of skin
- Vernix
- Lanugo hair
- Nails
- Pustular melanosis
- Milia
- Oral thrush
- nappy rash
- amoniacal dermatitis
- Erythema toxicum
- Mongolian blue spots
- Seborrhoeic dermatitis
- Hemangioma
*
Neonatal examination
Fontanelle features
- wide
- Bulging
- Closed
- Sunken
Neonatal examination
Fontanelle is also known as
- Soft spot
- Thel wala
Neonatal examination
Reason for wide fontanelle
- Sutures seperating due to increased ICP
- Bone not formed- rickets
Neonatal examination
normal size of fontanelle
2 fingerbreaths
Neonatal examination
Purpose of fontanelle
to allow room for the brain to grow
Neonatal examination
Reason for bulging fontanelle
Increased ICP( meningitis, Bleeding)
Neonatal examination
Reason for sunken fontanelle
Dehydrated - Reduced breastfeeding
Neonatal examination
Features to look for in the head
- Occipitofrontal circumference
- Fontanelle size
- Sutures- overriding, widely seperated
- Craniotabes
- Cephalhematoma
- Caput succedaneum
Neonatal examination
Cephalhematoma
Bleeding under the periosteum on the parietal bones
Neonatal examination
Caput succedaneum
Ecchymotic, edematous swelling of soft tissues
Neonatal examination
Difference between cephalhematoma and caput succedaneum
cephalhematoma does not cross the midline and caput cross the midline
Neonatal examination
Causes of the large anterior fontanelle
- congenital hypothyroidism
- Hydrocephalus
Neonatal examination
Reasons for a small anterior fontanelle
- Microcephaly
- Craniosynostosis
Neonatal examination
Features of face
- Dysmorphic features- epicanthic folds, microophthalmia, low set ears
- Eyes- Jaundice, Eye discharges, conjunctival/ retinal hemorrhages, red reflex, leukorrhea
- SIgns of facial nerve palsy
Neonatal examination
Leukorrhea causes
- cataracts
- Tumors- retinoblastoma
- Persistent hyperplastic primary vitreous
Neonatal examination
Ear
- Deformities
- Pre- auricular skin tags
Neonatal examination
Mouth
- Precocious dentition
- Cleft lip/ palate
Neonatal examination
Precocious dentition
- feeding difficulties
- risk of aspiration
Neonatal examination
Chest
- Breast- hypertrophy, mastitis neonatorum, super numerary nipples
- Deformities- pectus excavatum, carinatum
- breathing pattern
- dyspnea, grunting
- Heart- location, HR, peripheral pulses
Neonatal examination
Risk of super numerary nipples
more than 2 nipples- can cause CA
Neonatal examination
ABD features
- Abd distension
- Scaphoid abdomen
- palpable liver
- unusual masses
Neonatal examination
Umbilicus
- Umbilical sepsis
- Omphalocele
- Gastrochiasis
- Umbilical hernia
Neonatal examination
Exstrophy
- Bladder
- cloaca
Neonatal examination
Groin
- femoral pulses- CoA
- Hip- CDH
Neonatal examination
Genitalia
- Non- purulent discharge
- Ambiguous genitalia
- Undescended testes
- Hypospadias
- Epispadias
- Hydrocele
- Imperforated anus
- Inguinal hernia
- Withdrawal bleeding from vagina
- Hyperpigmented scrotum
Neonatal examination
Limbs
- Polydactyly
- Syndactyly
- Talipes equino varus
- Erb’s palsy
Neonatal examination
Erb’s palsy
palms turned backwards
Neonatal examination
Spine
- Kyphoscoliosis
- Tuft of hair
- Meningomyelocele
Neonatal examination
Maneuvers done to check hip joint
- Ortolani
- Barlow
