WEEK 9

Question 1

Vital statistics measured in a newborn are

Answer 1

weight, length, and head and chest circumference

Question 2

Weight

Answer 2

mature female newborn in the United States is
3.4 kg (7.5 lb);

for a white, mature male newborn, it is
3.5 kg (7.7 lb).

Question 3

Head Circumference

Answer 3

34 to 35 cm (13.5 to 14 in).

Question 4

Chest Circumference

Answer 4

2 cm (0.75 to 1 in)

Question 5

Temperature

Answer 5

99° F (37.2° C)

Question 6

Pulse

Answer 6

120 to 160 beats per minute (bpm).

Question 7

Respiration

Answer 7

80 breaths per minute.

30 to 60 breaths per minute

Question 8

Blood Pressure

Answer 8

approximately 80/46 mm Hg at birth

Question 9

serves the same purpose as it does in an adult—to protect the eye from any object coming near it by rapid eyelid closure. It may be elicited by shining a strong light such as a flashlight or an otoscope light on an eye.

A sudden movement toward the eye sometimes can elicit it

Answer 9

Blink Reflex

Question 10

If the cheek is brushed or stroked near the corner of the mouth, a newborn infant will turn the head in that direction.

This reflex serves to help a newborn find food: when a mother holds the child and allows her breast to brush the newborn’s cheek, the reflex makes the baby turn toward the breast.

The reflex disappears at about the sixth week of life. At about this time, newborn eyes focus steadily, so food source can be seen, and the reflex is no longer needed.

Answer 10

Rooting Reflex

Question 11

When a newborn’s lips are touched, the baby makes a sucking motion.

The reflex helps a newborn find food: when the newborn’s lips touch the mother’s breast or a bottle, the baby sucks and so takes in food.

begins to diminish at about 6 months of age.

It disappears immediately flex disappears at about the sixth week of life.

Answer 11

Sucking Reflex

Question 12

same as in the adult.

Food that reaches the posterior portion of the tongue is automatically swallowed.

Gag, cough, and sneeze reflexes also are present in newborns to maintain a clear airway in the event that normal swallowing does not keep the pharynx free of obstructing mucus.

Answer 12

Swallowing Reflex

Question 13

A newborn extrudes any substance that is placed on the anterior portion of the tongue. This protective reflex prevents the swallowing of inedible substances. It disappears at about 4 months of age. Until then, the infant may seem to be spitting out or refusing solid food placed in the mouth.

Answer 13

Extrusion Reflex

Question 14

Newborns grasp an object placed in their palm by closing their fingers on it. Mature newborns grasp so strongly that they can be raised from a supine position and suspended momentarily from an examiner’s fingers. This reflex disappears at about 6 weeks to 3 months of age. A baby begins to grasp meaningfully at about 3 months of age.

Answer 14

Palmar Grasp Reflex

Question 15

Newborns who are held in a vertical position with their feet touching a hard surface will take a few quick, alternating steps. This reflex disappears by 3 months of age. By 4 months, babies can bear a good portion of their weight unhindered by this reflex

Answer 15

Step (Walk)-in-Place Reflex.

Question 16

When an object touches the sole of a newborn’s foot at the base of the toes, the toes grasp in the same manner as do the fingers. This reflex disappears at about 8 to 9 months of age in preparation for walking. However, it may be present during sleep for a longer period.

Answer 16

Plantar Grasp Reflex

Question 17

When newborns lie on their backs, their heads usually turn to one side or the other.

The arm and the leg on the side toward which the head turns extend, and the opposite arm and leg contract.

If you turn a newborn’s head to the opposite side, he or she will often change the extension and contraction of legs and arms accordingly.

This is also called a boxer or fencing reflex, because the position simulates that of someone preparing to box or fence. It may signify handedness.

The reflex disappears between the second and third months of life.

Answer 17

Tonic Neck Reflex

Question 18

initiated by startling a newborn with a loud noise or by jarring the bassinet.

The most accurate method of eliciting the reflex is to hold newborns in a supine position and allow their heads to drop backward about 1 inch.

In response to this sudden head movement, they abduct and extend their arms and legs.

Their fingers assume a typical “C” position.

It is strong for the first 8 weeks of life and then fades by the end of the fourth or fifth month, at the same time an infant can roll away from danger.

Answer 18

Moro Reflex

Question 19

When the sole of the foot is stroked in an inverted “J” curve from the heel upward, a newborn fans the toes (positive Babinski sign)

. This is in contrast to the adult, who flexes the toes. This reaction occurs because nervous system development is immature.

It remains positive (toes fan) until at least 3 months of age, when it is supplanted by the downturning or adult flexion response.

Answer 19

Babinski Reflex

Question 20

If pressure is applied to the soles of the feet of a newborn lying in a supine position, he or she pushes back against the pressure.

This and the two following reflexes are tests of spinal cord integrity.

Answer 20

Magnet Reflex

Question 21

If one leg of a newborn lying supine is extended and the sole of that foot is irritated by being rubbed with a sharp object, such as a thumbnail, the infant raises the other leg and extends it, as if trying to push away the hand irritating the first leg.

Answer 21

Crossed Extension Reflex

Question 22

When newborns lie in a prone position and are touched along the paravertebral area by a probing finger, they flex their trunk and swing their pelvis toward the touch.

Answer 22

Trunk Incurvation Reflex

Question 23

A newborn who is held in a prone position with a hand underneath, supporting the trunk, should demonstrate some muscle tone.

Babies may not be able to lift their head or arch their back in this position (as they will at 3 months of age), but neither should they sag into an inverted “U” position.

The latter response indicates extremely poor muscle tone, the cause of which should be investigated.

Answer 23

Landau Reflex

Question 24

leads to jaundice, or yellowing of the skin

This occurs on the second or third day of life in about 50% of all newborns, as a result of a breakdown of fetal red blood cells (physiologic jaundice).

The infant’s skin and the sclera of the eyes appear noticeably yellow.

This happens because the high red blood cell count built up in utero is destroyed, and heme and globin are released.

Answer 24

Hyperbilirubinemia

Question 25

usually the result of anemia.

Answer 25

Pallor

Question 26

Occasionally, because of immature circulation, a
newborn who has been lying on his or her side appears red on the dependent side of the body and pale on the upper side, as if a line had been drawn down the center of the body.

This is a transient phenomenon; although startling, it is of no clinical significance.

The odd coloring fades immediately if the infant’s position is changed or the baby kicks or cries vigorously.

Answer 26

Harlequin Sign

Question 27

a macular purple or dark-red lesion (sometimes called a port wine stain because of its deep color) that is present at birth.

These lesions typically appear on the face, although they are often found on the thighs as well.

Those above the bridge of the nose tend to fade; the others are less likely to fade.

Because they are level with the skin surface (macular), they can be covered by a cosmetic preparation later in life or removed by laser therapy, although lesions may reappear after treatment

Answer 27

Nevus Flammeus

Question 28

refers to elevated areas formed by immature capillaries and endothelial cells.

Most are present at birth in the term neonate, although they may appear up to 2 weeks after birth.

Typically, they are not present in the preterm infant because of the immaturity of the epidermis.

Formation is associated with the high estrogen levels of pregnancy.

Answer 28

Strawberry hemangioma

Question 29

are dilated vascular spaces.

They are usually raised and resemble a strawberry hemangioma in appearance.

However, they do not disappear with time as do strawberry hemangiomas.

Answer 29

Cavernous hemangiomas

Question 30

Mongolian spots are collections of pigment cells (melanocytes) that appear as slate-gray patches across the sacrum or buttocks and possibly on the arms and legs

Answer 30

Mongolian spots

Question 31

white, cream cheese–like substance that serves as a skin lubricant in utero.

Usually, it is noticeable on a newborn’s skin, at least in the skin folds, at birth.

Document the color of vernix, because it takes on the color of the amniotic fluid.

Answer 31

Vernix Caseosa

Question 32

fine, downy hair that covers a newborn’s shoulders, back, and upper arms.

It may also be found on the forehead and ears.

Answer 32

Lanugo

Question 33

Within 24 hours after birth, the skin of most newborns has become extremely dry.

The dryness is particularly evident on the palms of the hands and soles of the feet.

This results in areas of peeling similar to those caused by sunburn.

This is normal,

Answer 33

Desquamation

Question 34

All newborn sebaceous glands are immature.

At least one pinpoint white papule (a plugged or unopened sebaceous gland) can be found on the cheek or across the bridge of the nose of almost every newborn.

Answer 34

Milia

Question 35

In most normal mature infants, a newborn rash called erythema toxicum can be observed.

This usually appears in the first to fourth day of life but may appear up to 2 weeks of age.

It begins with a papule, increases in severity to become erythema by the second day, and then disappears by the third day.

It is sometimes called a flea-bite rash because the lesions are so minuscule.

One of the chief characteristics of the rash is its lack of pattern.

Answer 35

Erythema Toxicum

Question 36

newborns who suffered malnutrition in utero, who have difficulty sucking at birth, or who have certain metabolic disorders such as adrenocortical insufficiency.

Answer 36

Skin Turgor

Question 37

are the spaces or openings where the skull bones join

Answer 37

Fontanelles

Question 38

the separating lines of the skull, may override at birth because of the extreme pressure exerted on the head during passage through the birth canal

Answer 38

Sutures

Question 39

The part of the infant’s head that engaged the cervix (usually the vertex) molds to fit the cervix contours during labor.

After birth, this area appears prominent and asymmetric

Answer 39

Molding

Question 40

edema of the scalp at the presenting part of the head.

It may involve wide areas of the head, or it may resemble a large egg.

Answer 40

Caput Succedaneum

Question 41

collection of blood between the periosteum of a skull bone and the bone itself, is caused by rupture of a periosteal capillary because of the pressure of birth

Answer 41

Cephalhematoma

Question 42

localized softening of the cranial bones that is probably caused by pressure of the fetal skull against the mother’s pelvic bone in utero.

Answer 42

Craniotabes