PE of Newborn Flashcards by CABS Cabanela

normal frontal circumference at term

32-37 cm

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normal length at term

48-52 cm

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normal chest circumference at term

30-35 cm

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landmarks for head circumference

glabella/supraorbital ridge anteriorly

most prominent part of the occiput posteriorly

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t/f the new ballard score is performed as soon as possible after initial stabilization or 12 hours after birth

true, consists of neuromuscular maturity and physical maturity

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components of new ballard score

neuromuscular: posture, square window (wrist), arm recoil, popliteal angle, scarf sign, heel to ear
physical: skin, lanugo, plantar surface, breast, eye/ear, genitals

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infant classification and maturity by gestational age

pre-term <37 w
term 37- 41 6/7 w
post term >42 w

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abnormal skin findings in newborn

pallor = low hgb
cyanosis = hypoxemia
plethora = polycythemia, over oxygenated, overheated

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jaundice due to elevated bilirubin is most commonly observed beyond ___

the first 24 hours of life

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clinical estimation of degree of jaundice

face only 5-8 mg/dl
face and upper trunk 8-12 mg/dl
lower trunk and extremity >12 mg/dl

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t/f acrocyanosis is normal immediately after birth or few hours after birth

true, but can also be secondary to cold stress

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t/f perioral cyanosis is always abnormal

false, common after birth

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differential cyanosis points to

r-l shunt through pda

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harlequin sign may be due to

immaturity of hypothalamic center that controls the dilatation of peripheral blood vessels

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a reticular, lacy red pattern of the skin, marbled, purplish skin discoloration due to thermoregulation instability

cutis marmorata

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a greasy white substance covering the skin, provides moisture barrier

vernix caseosa

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when a baby’s skin resembles parchment

collodion infant

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tiny sebaceous retention cysts that disappear a few weeks after birth

milia

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numerous small areas of red skin with a yellow white papule in the center which contain eosinophils

erythema toxicum

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skin lesion that does not blanch with pressure and does not disappear with time

port wine stain

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mongolian spots disappear before age

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small, flat, bright red umbilical lesions seen on occipital area, eyelids, and glabella

macular hemangioma

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microcephaly vs macrocephaly

macro > 2 sd above mean

micro < 2-3 sd below mean

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rate of hc increase

1 cm per month for first year (2 cm/mo for first 3 mo and then slower)

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when do the fontanelles close

anterior (diamond) 9-18 mos | posterior 2-4 mos

head lesion that crosses the suture line and spontaneously resolves within days

caput succedaneum

what is a cephalhematoma

- secondary to rupture of bv that traverse the periosteum - does not cross suture lines - resolves in 2-3 w

what is molding

- temporary asymmetry of the skull due to birth (prolonged labor) - normal in 1 wk

what is subgaleal hematoma

- caused by asphyxia, vacuum extraction, forceps delivery, or coagulopathy - crosses suture lines and onto neck/ear - progresses after birth

congenital cataracts occur due to

maternal infection with rubella

abnormal findings in the shapes of the eyes

lateral upward slope with inner epicanthal fold: trisomy 21 | narrow palpebral fissure: fetal alcohol syndrome

what is mobius syndrome

symmetric facial palsy caused by absence or hypoplasia of 7th nerve nucleus

cause of facial nerve palsy

compression of facial nerve against sacral promontory or trauma with forceps

how to measure position of ears

draw imaginary line from inner and outer canthi of eyes across face

keratin containing cysts located on the hard and soft palate

epstein pearls

cystic swelling in the floor of the mouth which disappears spontaneously

ranula

small lesion on the oral mucosa secondary to trauma to the salivary glands

mucocele

diseases with macroglossia

beckwith's sydnrome and congenital hypothyroidism

the scm is palpated to check for:

hematoma, thyroid enlargement, and thyroglossal duct cysts

t/f cc should be 5 cm less than hc

false, 2 cm

normal rr and hr

rr 30-60 rpm | hr 120-140 bpm

signs of respiratory distress

retractions, nasal flaring, grunting, tachypnea

absent or unequal breath sounds may indicate ___

pneumothorax or atelectasis

absent breath sounds with presence of bowel sounds indicates __

diaphragmatic hernia

t/f a murmur does not always signify the presence of heart disease and absence is not a reassurance of normalcy

true

the most common murmur in the immediate newborn are ___ that represent thee transition from __ to ___

flow murmurs that represent transition from fetal to neonatal circulation

scaphoid abdomen is associated with

congenital diaphragmatic hernia

t/f a smooth scrotum suggests prematurity

true

normal penile length at birth

2 cm, abnormally small = reduced androgen effect

t/f hydrocele is uncommon

false, it's common and disappears by 1 year

t/f labia minora of term infants are enlarged and reddish in color

false, labia majora

meconium should pass within ___

48 hours of birth

abnormalities in the pulses

diminished in all extremities = poor co or peripheral vasoconstriction absent or diminished femoral pulses = coarctation of aorta

abnormal pigmentation or hairy patches over lower back suggests

spina bifida

sacral or pilonidal dimple suggests

meningocoele

best time to do a neuro exam

prior to feeding

primitive reflexes

check slide

t/f fine tremors are abnormal, and clonic movements are normal

false, fine tremor is usually normal, clonic movements are not normal and may have seizures

erb duchenne paralysis involves

5th and 6th cn and is the most common brachial plexus injury (check slide)

klumpke paralysis involves

7th and 8th cn and 1st thoracic nerve (+ horner's syndrome)

what is physiologic weight loss

loss of not more than 10% of body weight and recovered by 2nd week (30g/d)

factors suggesting non-physiologic jaundice

check slide

deep redness or purple lividity in a crying infant whose color may darken profoundly with closure of glottis preceding a vigorous cry

vasomotor instability

what causes pseudomenses

withdrawal of maternal hormones

what causes witch's milk

elevated circulating endogenous steroid hormone and withdrawal of androgen after delivery

elevations in temp noted on the 2nd-3rd day of life

inanition fever

cause for inanition fever

low intake of fluids or exposed to high environmental temps,

t/f 80% of newborns exhibit physiologic desquamation

false, 60%

umbilical cord sloughs within ___, vessels functionally close but remain patent for ___

2 wks | 10-20 d

t/f normal newborns have higher hg and hct with larger rbcs than older children and adults

true