Newborn Exam Flashcards
Describe TORCH infections
Toxoplasmosis Other (e.g. syphilis, parovirus, varicella) Rubella Cytomegalo virus Herpes simplex
cogenital infections that disrupt fetal development
Describe symmetric IUGR
head circumference proportional to that of body
- less common
- more concerning
- occurs earlier and throughout gestation
What may be causes of symmetric IUGR?
- TORCH infections
- single gene defect
- chromosomal/aneuploidy
Describe asymmetric IUGR
aka “head-sparing”
head circumference > abdominal circumference
- more common
- occurs later in gestation
What may cause asymmetric IUGR?
extrinsic factors
- malnutrition
- poor placental perfusion
- cHTN
What is the incurving reflex?
infant turns head to side that is stroked
What may hypertonia be related to?
- CNS irritability
- hemorrhage
- infection
What may hypotonia be related to?
- immaturity
- hypoxemia
- sepsis
When does crying duration peak?
4-5 months
What is expected weight gain in a NB?
0.5-1 oz/day
- regain birth weight by 2 wks
- double birth weight by 1yo
At which point is acrocyanosis pathologic?
> 24-48h
What is Harlequin sign?
harmless, unilateral color change d/t autonomic vasomotor instability; lasts 10-20mins
What is erythema toxicum?
generalized yellow or white papules 1-3mm in diameter EXCEPT for on palmar surfaces
When should strawberry hemangioma be referred?
when located near eyes
What can mottled skin indicate?
cold stress/hypothermia
What is average NB weight?
2500-4000g
5lbs 8oz - 8lbs 13oz
What is average NB length?
46-56cm
18-22in
What is average NB head circumference?
31-38cm
12-15in
Describe normal fontanelles
anterior = 1-4cm diamond
posterior = triangle
Posterior fontanel closes (before/after) anterior fontanel.
before
When should molding resolve?
b/w 24-48h
How far can NBs see?
8-10in from face
When do NBs develop their permanent eye color?
3-6mo
What is normal chest measurement?
AP diameter 1:1
circumference = 33cm (or 2cm less than head circumference)
When should one be able to auscultate bowel sounds?
1-2h of life
When will the cord fall off?
7-10 days
Describe Barlow and Ortolani maneuvers
assess for hip dysplasia
B: dislocates hip
O: reduces hip
Describe a NB neuro exam
1) reflexes
2) cranial nerves
3) Brazelton neonatal behavioral assessment scale = behavioral capabilities
What are NB reflexes?
1) Moro reflex (birth –> 6-8mo)
2) Glabellar tap reflex = facial nerve; tap on forehead b/w eyes
3) blinking reflex (25wks GA)
4) pupillary (red) reflex
5) gag reflex (36wks GA)
6) swallowing reflex (12wks GA)
7) cough reflex
8) walk/step reflex
9) plantar grasp reflex (birth –> 8-10mo)
10) trunk incurvation/Galant reflex (birth –> 2mo)
11) Babinski reflex (birth –> 8-9mo)
12) rooting reflex (birth –> 3-4mo)
13) suck reflex
14) palmar grasp reflex
15) crossed extensor
16) tonic neck/fencing reflex
Differentiate among pre-term GAs
Extreme PT: <28wks
Very Pt: 28-32wks
Late PT: 34-36wks
Differentiate among term GAs
Early term: 37-38wks
Term: 39-40wks
Post-term: >42wks
When is the Dubowitz/Ballard scores most accurate?
12-48h of life
When should the anterior fontanel close?
by 12-18mo
How long do NBs sleep?
first few days: 16-18h/day
by 4wks: 8-20h/day
