Flashcards in Perinatal/ Newborn health screening Deck (50):
What % is appropriate for gestational age?
between 10th and 90th
What % is LGA
weight >90th percentile
What % is SGA
Weight ,10th percentile. Symmetric vs symmetric
Average length of newborn
average weight of newborn
average head circumference
vital sign of newborn
temp .100.4 considered fever, pulse 120-170 BPM, Respiration 30-80 BMP, blood pressure ,112/74 mmHg
milia in the newborn
pinpoint white papules on face, prominent on cheeks, nose, chin, and forehead.
Spontaneously disappears within 3-weeks of life. If persists or widespread distribution, may indicate a genetic syndrome
obstructed sweat (eccrine gland) ducts, sometimes referred to as prickly heat
most common newborn rash, usually appears between 2 to 5 days after birth, characterized by blotchy red spots on the skin with overlying white or yellow papules or pustules, resolves on the 14th day. If fever or appetite changes, needs medical
vascular birthmark (malformation) consisting of superficial and deep dilated capillaries in the skin; produce a reddish to purplish discoloration of the skin; permanent
What do you need to rule out for port-wine stains?
Rule out sturge-Webber: serious neuro condition with seizures- ocular (glaucoma) characteristics
How should hips be during neuro exam of the newborn?
Hips should be adducated and partially flexed with knees flexed, arms adducted, elbows flexed, and fists clenched
Rooting reflex, how to elicit, when appears and disappears
appears in newborns, disappears by 3-4months, elicit by stroking cheek, newborn should turn head to that side
sucking reflex, how to elicit, when appears and disappear
Appears in newborn, disappears 3-4 months. Elicited by anything touching root of mouth
moro reflex, how to elicit, when it appears and disappears
appears in newborn, diapers in 3-4 months, elicited by The Moro reflex is elicited by taking the baby in both hands, the head being supported by one hand and the buttocks by the other. With the baby’s head in a midline position, the hand supporting it is quickly dropped to a position approximately 10 cm below its original supporting position, and the head is caught by the hand in its new position. In response, the baby will throw out both arms and legs symmetrically.The legs and head extend while the arms jerk up and out with the palms up and thumbs flexed. Shortly afterward the arms are brought together and the hands clench into fists, and the infant cries loudly.
grasp reflex (palmar; plantar). How to elicit, when appears and disappears
appears in newborn. Palmar disappears 3-6months, plater disappears in 4 months. elicit by placing finger n center of babes hand or ball of foot.
pacing/ stepping reflex, appears, disappears and how to elicit
appears in newborns, disappears in 1-2 months. Elicit by holding baby under arms and placing soles to flat surface
tonic neck. Appears, disappears, and eliciting
Appears in newborn, disappears by 3 months, and elicit by With this reflex, tilting the head back while lying on the back causes the back to stiffen and even arch backwards, causes the legs to straighten, stiffen, and push together, causes the toes to point, causes the arms to bend at the elbows and wrists, and causes the hands to become fisted or the fingers to curl. The presence of this reflex beyond the newborn stage is also referred to as abnormal extension pattern or extensor tone.
fanning of toes. appears in newborns, disappears in 12 months or when walking. the Babinski reflex is also present at birth and fades around the first year. The Babinski reflex appears when the side of the foot is stroked, causing the toes to fan out and the hallux to extend. The reflex is caused by a lack of myelination in the corticospinal tract in young children. The Babinski reflex is a sign of neurological abnormality in adults.
The lateral side of the sole of the foot is rubbed with a blunt implement so as not to cause pain, discomfort or injury to the skin; the instrument is run from the heel along a curve to the metatarsal pads. There are three responses possible:
1. Flexor: the toes curve inward and the foot everts; this is the response seen in healthy adults.
2. Indifferent: there is no response.
3. Extensor: the hallux dorsiflexes, and the other toes fan out - the Babinski's sign indicating damage to the central nervous system.
As the lesion responsible for the sign expands so does the area from which the afferent Babinski response may be elicited. The Babinski response is also normal while asleep and after a long period of walking.
crosses midline (fluid under the skin, simple swelling). Resolves in 2-3 days
does not cross midline (blood under periosteum); requires closer examination
more than 1 hair whorl meaning
could mean poor brain growth
largest fontanel (2-5cm), closes by about 18 months
may not be palpable at birth, closed by 2-3 months
Common causes of wide fontanels
prematurity, IUGR, hydrocephalus, down syndrome, hypothyroidism
red reflex replaced by a black spot
means no clear pathway from the lens to the retina
red reflex replaced by a whitish color
may suggest retinoblastoma or congenital cataracts
if sclera is deep blue
osteogenesis should be ruled out
colobomas (embryonic fissure defect)
mild forms only affect the iris. In more sever cases, the choroid and optic nerve can be involved with suspicion for CNS midline defects such as optic nerve hypoplasia
different eye color
salt and pepper speckling
brshfield spots of the iris is associated with down syndrome
narrowing or blockage of the nasal airway by tissue, present at birth
small mouth, is observed in trisomy 13 and 18
recessed chin- seen in pierre-robin syndrome, treater-collins syndrome, hallermann-streiff syndrome
normal breathing for newborns
are abdominal breathers
abnormal breathing patterns
retractions, stridor, grunting, breast enlargement
radio-femoral pulse delay
consider coarctation, pulse oximeter reading of all 4 extremities
% of newborns that have murmurs
3rd and 4th intercostal space (ICS), left midclavicular like (LMCL)
normal abdominal contour in newborns
umbilical cord number of vessels
2 arteries, 1 vein
developmental dysplasia of the hips (DDH). How to test
With hips flexed at 90 degrees and knees together, begin by abducting, then adduct while the examiners fingers are over the greater trochanter
a click is heard or felt as dislocation is reduced (when abduct then adducting)
barlows maneuver and tx
feeling of a slip as the femoral head slips away from the acetabulum causing the dislocation. tx: abduct with harness or surgery
+=+, if the patient has, it is positive
-=-, if the patient does not have, it will be negative
Mandatory screening for all 50 states
PKU, galactosemia, hemoglobinopathies (sickle cell, thalasemmia), congenital hypothyroidism