Newborn Infant Flashcards
fine, soft immature hair
frequently covers the scalp and brow and may also cover the face of premature infants
LANUGO
Cheese like material that covers the normal term infant in varying amounts
VERNIX CASEOSA
Purplish reticulated pattern noted on the skin of neonate when exposed to COLD
Mottling of the skin w/ venous prominence
CUTIS MARMORATA
Slate-blue, well-demarcated areas of pigmentation seen over the buttocks, back
MONGOLIAN SPOTS
Division of the body from the forehead
to the pubis into red and pale halves
HARLEQUIN COLOR CHANGE
Benign rash, persists for as long as 1 wk
SMALL WHITE PAPULES on an erythematous base develop 1-3 days after birth in newborns
contains EOSINOPHILS
ERYTHEMA TOXICUM
Present at birth as a vesiculopustular eruption around the chin, neck, back, extremities, and palms or soles
contains NEUTROPHILS
PUSTULAR MELANOSIS
Temporary accumulations of EPITHELIAL CELLS on the hard palate on either side of the raphe
EPSTEIN PEARL
Pearly white papules seen mostly on the CHINS and around the CHEEKS
MILIA
Pink macular lesions on the nape, glabella, upper eyelids or nasolabial region
NEVUS SIMPLEX (SALMON PATCH)
Thick, white, creamy material in term infants
Covers large areas of the skin in preterm infants
Usually ABSENT in POSTterm infants
VERNIX CASEOSA
Caused by scalp pressure from the uterus,
cervix, or pelvis
can EXTEND across suture lines
CAPUT SUCCEDANEUM
Presents as a well-circumscribed fluid-filled
mass that DOES NOT cross suture lines
CEPHALOHEMATOMA
Beneath epicranial aponeurosis
Not restricted by the boundaries of the
sutures
SUBGALEAL HEMORRHAGE
Suggests the absence of
cataracts and intraocular pathology
(+) bilateral red reflexes
Suggests cataracts, tumor, chorioretinitis, retinopathy of
prematurity, or a persistent hyperplastic primary vitreous
leukokoria (white pupillary reflex)
Causes the HEAD to turn TOWARD and the
FACE to turn AWAY from the affected side
CONGENITAL TORTICOLLIS
"port wine stain" Congenital vascular malformation Dilated capillary-like vessels Capillary hemangioma Face or trunk Darker w/ increasing post-natal age
Sturge-Weber syndrome
Area of ophthalmic branch of trigeminal nerve (V1)
Intracranial or spinal vascular malformations, seizures, intracranial calcifications
Nevus flammeus
20% of newborns Appears after 1-2 wks of life Virtually never present at birth Lesions are comeones Inflammatory pustules & papules may be present No treatment necessary
NEONATAL ACNE
Microcephaly
Head circumference below 10th %
CAUSES Familial Structural brain malformations Chromosomal & malformation syndromes Congenital infections (CMV, toxo) Fetal alcohol syndrome
PREMATURE fusion of the cranial sutures
Abnormal shape & size of skull
CRANISYNOSTOSIS
Soft areas of the skull w/ “ping-pong ball” feel
Occur in the PARIETAL bones
CRANIOTABES
5 newborn anomalies of the mouth
Clefts Micrognathia Macroglossia Neonatal teeth Epstein pearls
types of clefts can be present in the newborn
Clefts of the lip & soft/hard palates
Inspection
Submucous clefts in the soft portion of the palate
Digital palpation
SMALL CHIN
PIERRE ROBIN SYNDROME Micrognathia Cleft palate Glossoptosis: downward displacement or retraction of the tongue Obstruction of the upper airway
MICROGNATHIA
MACROGLOSSIA
Beckwith-Wiedemann syndrome
Hemi-hypertrophy
Visceromegaly
Macroglossia
Hypothyroidism
Mucopolysaccharidosis
neonatal teeth typically seen
LOWER incisors
5 abnormalities that can be found on neck & clavicle examination
Lateral neck cysts/sinuses
Branchial cleft cysts
Cystic hydromas
Midline clefts or masses
Neonatal torticollis
Edema & webbing of the neck
Turner syndrome
Clavicles (rule out fractures)examples of congenital deformities of the chest
PECTUS CARINATUM
Prominent & bulging sternum
Benign
PECTUS EXCAVATUM
Depressed sternum
Benign
CHEST ASSYMETRY
Absence of formation of ribs
More serious
POLAND SYNDROME
Agenesis of the pectoralis muscle
More serious
RESPIRATORY DISTRESS
Tachypnea (RR >60 breaths/min) Deep respirations Cyanosis Respiratory gruntint Intercostal or sternal retractions
Preterm infants: periodic breathing
Short, apneic bursts
<5-10 seconds
No clinical significance
Cardiac exam in a newborn
Heart rate
Normal: 95-180 beats/min
Varies during feeding, sleep, crying
Rhythm
Assessment of murmurs & peripheral pulses
Diminished femoral pulses
Coarctation of the aorta
Increased femoral pulses
Patent ductus arteriosus6 possible anomalies on abdominal examination of the newborn
Diastasis recti Umbilical hernia Omphalocele & gastroschisis Persistent urachus Meconium plug, meconium ileus Abdominal mass
The umbilical cord should be inspected to confirm the presence of _______ & _______ and the absence of the ________.
2 arteries and 1 vein
absence of urachus
1 umbilical artery = congenital renal anomalies
Separation of the L & R side of the rectus abdominus at the midline of the abdomen
DIASTASIS RECTI
Incomplete closure of the umbilical ring
Soft swelling beneath skin around umbilicus
Protrudes during crying or straining
UMBILICAL HERNIA
Complete failure of the urachal duct to close
Fistula between bladder & umbilicus
Urine drains from umbilicus (pressure)
PERSISTENT URACHUS
Occlusion of the distal ileum
Inspissated (thick/dry) & viscid meconium
Deficiency of pancreatic enzymes
High protein content of intestinal secretions
MECONIUM ILEUS
Obstruction of the L colon & rectum
Dense dehydrated meconium
MECONIUM PLUG
Abdominal masses
Hydronephrosis (most common)
Multicystic kidneys
Ovarian cysts
Liver on L side
Situs inversus
Asplenia
Polysplenia syndrome2 newborn abnormalities of female genitalia
Hypertrophied clitoris
Hydrometrocolpos
Virilization from androgen excess
Virilizing adrenal hyperplasia
Premature infants
HYPERTROPHIED CLITORIS
Imperforate hymen w/ retention of vaginal secretions
Small cyst btwn labia at the time of birth [OR]
Lower midline abdominal mass during childhood
HYDROMETROCOLPOS
4 newborn abnormalities of male genitalia
Hypospadias
Epispadias
Hydrocele
Cryptorchidism
Urethral meatus on the VENTRAL surface of the penis in varying locations along the shaft
HYPOSPADIA
Urethral meatus located on the DORSAL surface of the penis
Often associated w/ BLADDER EXTROPHY y (bladder protrusion from the abdominal wall w/ exposure of its mucosa)
EPISPADIA
Scrotal swelling caused by fluid accumulation in the tunica vaginalis adjacent to the testis
HYDROCELE
How do you evaluate general appearance in a newborn
CAREFUL OBSERVATION
Spontaneous activity, passive muscle tone, respirations, abnormal signs (cyanosis, intercostal muscle retractions, meconium staining)
APGAR SCORES
Assessment of intrapartum stress & neurologic depression at birth
1-5 min after birth
Continue every 5 min until final score >7
