Newborn Infant Flashcards by Jamaira Belmes

fine, soft immature hair

frequently covers the scalp and brow and may also cover the face of premature infants

LANUGO

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Cheese like material that covers the normal term infant in varying amounts

VERNIX CASEOSA

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Purplish reticulated pattern noted on the skin of neonate when exposed to COLD

Mottling of the skin w/ venous prominence

CUTIS MARMORATA

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Slate-blue, well-demarcated areas of pigmentation seen over the buttocks, back

MONGOLIAN SPOTS

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Division of the body from the forehead

to the pubis into red and pale halves

HARLEQUIN COLOR CHANGE

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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

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Present at birth as a vesiculopustular eruption around the chin, neck, back, extremities, and palms or soles

contains NEUTROPHILS

PUSTULAR MELANOSIS

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Temporary accumulations of EPITHELIAL CELLS on the hard palate on either side of the raphe

EPSTEIN PEARL

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Pearly white papules seen mostly on the CHINS and around the CHEEKS

MILIA

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Pink macular lesions on the nape, glabella, upper eyelids or nasolabial region

NEVUS SIMPLEX (SALMON PATCH)

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Thick, white, creamy material in term infants
Covers large areas of the skin in preterm infants
Usually ABSENT in POSTterm infants

VERNIX CASEOSA

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Caused by scalp pressure from the uterus,
cervix, or pelvis

can EXTEND across suture lines

CAPUT SUCCEDANEUM

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Presents as a well-circumscribed fluid-filled

mass that DOES NOT cross suture lines

CEPHALOHEMATOMA

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Beneath epicranial aponeurosis

Not restricted by the boundaries of the
sutures

SUBGALEAL HEMORRHAGE

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Suggests the absence of

cataracts and intraocular pathology

(+) bilateral red reflexes

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Suggests cataracts, tumor, chorioretinitis, retinopathy of

prematurity, or a persistent hyperplastic primary vitreous

leukokoria (white pupillary reflex)

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Causes the HEAD to turn TOWARD and the

FACE to turn AWAY from the affected side

CONGENITAL TORTICOLLIS

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"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

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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 arteriosus ```

6 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 syndrome ```

2 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