Normal Infant in the First Week of Life Flashcards Preview

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Flashcards in Normal Infant in the First Week of Life Deck (2)
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1
Q

Describe how you’d undertake a normal baby check

A
  • General - sex, respiratory effort (flaring, subcostal retraction), posture and movement, colour, activity, cry
  • Measurements - weight, length, head circumference
  • Vitals - HR 120-160, RR 40-60, axilla temp 36.1-37)
  • Skin - haemangiomas, naevi, milia - white keratinous papules on nose/cheeks. Resolve in weeks
  • Head - fontanelles (anterior and posterior) and sutures for bulging/tenseness, caput (oedema, crosses sutures), cephalohaematomas (do not cross sutures), subgaleal haemorrhages (cross suture lines, firm and fluctuant. Life-threatening)
  • Face - facial palsies (especially in instrumental deliveries, better seen when crying. Self-resolving)
  • Eyes - spacing, symmetry, epicanthal folds, palpebral fissures, eye movement, sclerae, conjunctivae, corneas, pupils, red reflex (white - retinoblastoma, cataract)
  • Ears - position (level with outer canthus), size, appearance
  • Nose - patency
  • Mouth - epstein pearls (white cysts on the soft/hard palate junction. Benign), frenulum (tongue-tie), clefts
  • Neck - cystic hygromas (painless, transilluminable), branchial clefts (anterior SCM), haematomas, thyroglossal cysts (midline), lymphadenopathy, torticollis, excess skin (Turner’s/Down’s), clavicles (absence or fracture)
  • Chest - size, symmetry, structure, movement, lactation (can be normal due to maternal hormones for weeks)
  • Lungs - 40-60 breaths per minute normal, respiratory distress, grunting
  • Cardiovascular - 120-160 bpm, apex beat (LLSE), murmurs, pulses
  • Abdomen - shape, diastasis recti, palpation (liver 1-3 cm below ribs, kidneys palpable), umbilical cord for size, discharge, vessels
  • Genitalia - female for labia, clitoris, meatus, vaginal opening, hymen (look for imperforate). Male for testes position (normally descend by 6/12), penis length, scrotum, foreskin, position of urethral opening. Check for ambiguous genitalia (CAH)
  • Anus - patency (don’t assume pre-mec)
  • Trunk and spine - palpate spine and check for neural tube defects (also between gluteal folds for sacral ones)
  • Pulses - femoral, apex
  • Extremities - hands and feet for syndactyly/polydactyly/talipes, palmar creases (single associated with Down’s), movement for symmetry
  • Hips - for developmental dysplasia
  • Neurological - passive and active tone (stepping, head control, suspension), reflexes
2
Q

When does the suck reflex develop in a foetus? Why is this relevant?

A
  • 34 weeks
  • Prems may have feeding difficulties

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