NEWBORN ASSESSMENT PT.3 Flashcards
SHOULDER, SHOULDERS, ARMS, ARMS, AND ANDHANDSHANDS
Clinical Assessment
* Length
* Proportions
* Symmetry, Structure
and number of digits
shoulder - Indications for further investigation
Urgent follow-up
Swelling over
clavicle/ fractured
clavicle
Hypotonia
Palsy (e.g. Erb’s palsy
Contractures
Palmar crease pattern
The palms of the hands should
have creases. A single straight palmar
crease, a ________ _______, is an abnormal
finding that is associated with Down’s
syndrome.
Simian Crease or SIngle Palmar
decreased muscle tone
Hypotonia
xiphoid process
is prominent
Chest movements should be
equal bilaterally and
synchronous with the
abdomen.
The anteroposterior and lateral diameters of the chest
are equal, making
the chest appear barrel shaped.
a rare
genetic
disorder
with
autosomal
recessive
inheritance
Perlman
syndrome
as “Milk resembling colostrum sometimes secreted from
the breasts of newborns of either sex three to four days after birth
and lasting no longer than two weeks, due to endocrine stimulation
from the mother before birth.”
witch’s milk
CHEST, CARDIO-RESPIRATORY
Indications for further investigation
Urgent follow-up
Signs of Respiratory Distress
o Apneic episodes
Weak or absent pulses
o Positive pulse oximetry screen
(if performed)
Indications for further investigation
Urgent follow-up for abdomen
- Organomegaly
- Gastroschisis/ exomphalos
- Bilious vomiting
The newborn’s abdomen is
domeshapedandprotuberant.
A normal umbilical cord is well
formed and has
three vessels.
Respirations are
typically ,
whichmake them
appear abdominal in
nature
diaphragmatic
Peristaltic
waves should
not
be visible
Bowel sounds
should be
audible within
hours of birth.
2
The abdomen
should be soft to
palpation
without
palpable masses
Indications for further
investigation
Urgent follow-up
GENITO-URINARY
- No urine passed within 24 hours
- Ambiguous genitalia
- Bilateral undescended testes
- Testicular torsion
The newborn shouldvoidwithinthefirst __
hours oflife.
24
a
blood-tinged mucous discharge from the vagina
(resultsfrom the sudden withdrawalof maternal
Pseudomenstruation
if the opening islocated
abnormally on the dorsal (upper) surface of the
glans penis
Epispadia
occurs when the opening to
the urethra is on the ventral (under) surface of
the glans
Hypospadias
, tightly adherent foreskin, is a
normal condition in the term newborn.
Phimosis
testes do not
descend into the scrotalsac
during fetal life. This condition
requires medical evaluation.
Cryptorchidism
-fluid within the
scrotal sac, may be present and
should be noted.
Hydrocele
Clinical Assessment hips legs and feed
Use Ortolani and
Barlow’s
maneuvers
* A firm surface to examine
hips is necessary
* Assess legs and feet for
length, proportions,
symmetry, structure, and
number of digits
Thetermnewborn maintains
a posture offlexion
A strongbrachial
pulse witha weak
femoral pulse is
abnormal and should
be
reported.
refers to fusion or webbing of the toes or fingers
Syndactyly
is the medical term for extra digits.
Polydactyly i
Elicit ___ to evaluate the hip
for signs of dislocation or
subluxation (partial dislocation).
A positive sign is associated
with subluxation.
Ortolani’s maneuver and
Barlow’s sign
Other signs of a dislocated hip
uneven gluteal folds
one knee that is lower than the
other when the newborn is
supine with both knees flexed
are carried out as part of the routine
newborn examination todetecthipjointinstability and dislocation.
Barlow’s and Ortolani’s tests
The feet may appear
to turn inward
becauseofthewaythe
fetus waspositionedin
thewomborbirth
canal.
clubfoot
Indications for further
investigation
Urgent follow-up
Anus
No meconium passed within
24 hours
Passage of Meconium should occur w/in the first
24-48 hours
: a thick black tarry substance composed of dead cells,mucus, and bile that
collectsin the rectum of the fetus.
Meconium:
Spinal column
o Scapulae and buttocks
for symmetry
o Skin –*birthmarks..
clinical assessment for back
normal findings of back
The newborn’s spine is straight and flat.
The lumbar and sacral curves do not appear until the
infant beginsto use his back to sit and stand uprigh
normal findings of back
:There should be no masses, openings,
dimples, or tufts of hair.
Any of these findings may be associated with spina bifida
(an opening in the spinal column)