Physical Assessment Flashcards
Transilluminator
Light indicates fluid
No light indicates solid
Hydroceles, hydrocephalus
Ophthalmoscope
Red reflex - light reflects off fundus of eye (red appears as indication of lack of opacity - cataracts, glaucoma, retinal blastoma)
APGAR
HR, respiratory efforts, gone, reflex irritability, color
Scored 0-2
HR - 1 for <100, 2 for >100
Hypotelorism
Close set eyes
Hypertelorism
Far set eyes
Ear issues
Can mean renal issues, developed at the same time
Philtrum
Flattened can be associated with fetal alcohol syndrome
Cystic hygroma
Fluid filled sacs result from blockage in lymphatic system, may require immediate intubation or trach
PMI
left of sternum, 4th intercostal space
Pulse pressure
Diff between systolic and diastolic, term should be 25-30, premature 15-25
Gest age
Murmur
Murmur
Turbulent blood flow
Thrill - palpable turbulence
P wave
Depolarization of atria
QRS
Depolarization of ventricles
T wave
Repolarization of ventricles
Simean crease
Single palmar crease
Can indicate Down syndrome
Asymmetry of gluteal folds
Hip dislocation
Ortolani and Barlow maneuvers
Talipes equinovarus
Club foot
Erythema toxicim
Benign
Small white pinpoint papules (red elevation of skin)
Milia
Yellow or white papules, due to retained keratin and secretions of sebaceous glands
Epstein pearls
Milia in mouth
Hyperpigmented macule
Mongolian spot, usually on butt flanks or shoulders
Transient neonatal pustular melanosis
Similar to Milia but present at birth, will rupture within 48 hours
Contains neutrophils
Nevus simplex
Stork bite
Nevus flammeaus
Port wine
TTN
Chest X-ray - overexpansion, haziness, increased vascular markings, fluid in the fissures
Meconium aspiration xray
Hyper inflation, patchy infiltrates
RDS XRAY
atelectasis, air bronchograms, diffuse granular infiltrates
Turner syndrome
Occurs in females, SGA, broad chest, wide spaced nipples, edema in extremities, short webbed neck
Trisomy 18
Prominent occiput, low set ears, small eyes and jaw, clenched hands with overlapping fingers, rocker bottom feet
Trisomy 21
Brushfield spots, small ears, simean creases, excess skin at nape of neck, large tongue
Klinefelter syndrome
Males, long limbs, elbow dysplasia, clinodactyly of 5th finger
Transposition of great vessels
Aorta arises from right ventricle and pulmonary artery arises from left ventricle
Marked cyanosis because aorta carried deoxygenated blood from right ventricle to systemic circulation
Aortic stenosis
Reduces blood flow to body
Usually asymptomatic at birth
Pallor, mottling, poor perfusion May develop when PDA closes
Coarctation of the aorta
Cafe au lait
Presence of 6 or more associated with neurofibromatosis
Craniotabes
Soft spots on the skull that collapse and recoil with pressure
Result from bone reabsorption due to pressure of skull against maternal pelvis
Cicatricial scarring
Finding of congenital varicella
10-12 inches
Newborns can focus on objects at this distance
Erbs palsy
Injury to brachial plexus, shoulder dystocia
Asymmetric Moro reflex
Bell’s palsy
Damage to facial nerve caused by pressing against maternal pelvis
Neonatal myoclonus
Episodes of repetitive jerking or jitteriness that doesn’t stop with restraint
Congenital syphalis
Purple by or bloody nasal discharge and copper colored maculopapular rash that blisters and peels
CMV symptoms
Blueberry muffin and hepatosplenomegaly
Positive direct antigen test (DAT)
Presence of maternal antibodies causing hemolysis
Immune mediated hemolysis
Transient neonatal pustular melanosis
More common in pigmented skin
Mixture of vesicle and pustules and pigmented macules
Port wine stains
Can indicate sturge Weber syndrome is over trigeminal area
Can indicate underlying hemangiomas
Congenital hypothyroidism
If symptoms are present, include large fontanelle, umbilical hernia, coarse facial features, thick skin, delayed bone age
Congenital adrenal hyperplasia
Female - abnormal genitalia
Male - may be undiagnosed until 7-24 days, symptoms after that are hypoglycemia, hyponatremia, hypotension, shock
Prader Willi syndrome
Rare genetic syndrome, hypogonadism, lethargy, hypotonia, feeding difficulty
Chlamydia eye
Symptoms at 5-7 days, conjunctivitis, edema, purulent discharge
Stepping reflex
Supporting infant under arms and placing foot on edge of surface, infant should support own weight and make stepping motion
Babinski reflex
Foot goes into plantar flexion after stimulation of sole
Galant reflex
Apply pressure on spine, pelvis should flex toward side of spine stimulated
Tonic neck reflex
Turning head to one side, infant should extend upper extremity to side where head is turned and flex opposite extremity
