Newborn Examinations

Question 1

How do you conduct a newborn examination?

Answer 1

Prepare and inspect – general state, posture, movements, colour, skin marks, dysmorphic feature

Look at the hands

Look at the ears

Look at the eyes - red reflex (exclude cataracts and rb)

Feel for the anterior and posterior fontanelles
Head – measure , suture line, occipito-frontal circumference

Check mouth for cyanosis and membranous cleft mouth (and suck reflex)

Feel for the femoral and brachial pulses

Assess the abdomen and palpate the umbilicus . Abdomen – distension, umbilicus, masses, groin (pulses)

Assess the chest- clavicles, chest, auscultate, peripheral sats

Assess the genitalia, have the testes descended, hypospadias, has urine been passed.

Assess the anus, patency, whether meconium has been passed

Barlow and Ortalani Tests

Check the legs for any abnormalities

Ventrally suspend and assess the tone

Ventrally suspend and inspect spine until the sacrum

Primitive reflexes – neurology

Question 2

What is Barlow’s Test?

Answer 2

Adduct the hip, then apply a downward pressure over the knee with your thumb.

If the hip is unstable, the femoral head will slip out of the acetabulum, producing the palpable sensation of the hip dislocating.

If the hip is dislocatable, then Barlow’s test is positive.

Question 3

What is Ortalani’s Test?

Answer 3

Used to confirm the hip dislocation.

Flex the hips and knees to 90 degree, then apply an anterior pressure over the greater trochanter and gently adduct the leg with your thumbs.

If the hip was dislocated, a distinctive clunk will be heard as the hip relocates. This would be Ortalani’s test positive.

Question 4

What conditions are screened for in the new born spot test?

Answer 4

Sickle cell disease ( SCD )
Cystic fibrosis ( CF )
Congenital hypothyroidism ( CHT )
Phenylketonuria ( PKU )
Medium-chain acyl-CoA dehydrogenase deficiency ( MCADD )
Maple syrup urine disease ( MSUD )
Isovaleric acidaemia ( IVA )
Glutaric aciduria type 1 ( GA1 )