Physical and gestational age assessment of the newborn Flashcards Preview

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Flashcards in Physical and gestational age assessment of the newborn Deck (63)
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1

White or Asian: pink, reddish, pale
Black: warmish brown tone
All babies: more ruddy if crying, acrocyanosis

Healthy, well-oxygenated, full term - Color Changes & Skin Characteristics

2

especially if cold
lacy pattern of dark & light areas
vasomotor fluctuations

Mottling

3

vasomotor disturbance; blood vessels on one side of body dilate (deep pink), other side constrict (pale)
Single or multiple episodes

Harlequin sign

4

first detectable on face & mucus membranes of mouth
Blanch tip of nose, gum line, forehead, sternum
Also examine sclera

Jaundice

5

Non-pathologic
Unknown etiology
Seen in first few days of life
“flea-bite” dermatitis
No Rx, peaks 24-48 hours of life, then disappears in hours or days

Erythema Neonatorum Toxicum (“normal newborn rash”)

6

Assess over abdomen
Should be elastic
Used to evaluate hydration, need to initiate feedings, presence of infectious process

Skin Turgor

7

Covers fetus in utero
Lubricates skin
White, cheeselike substance
Term or postterm: less present

Vernix Caseosa

8

Exposed sebaceous glands
Raised white spots on face, especially nose

Milia

9

Reddened areas over cheeks & jaws
Seen with difficult forceps delivery
Disappear in 1-2 days
Rare: facial paralysis

Forceps Marks

10

“Marked from birth”
Frequent cause of concern, anxiety, and blame
Cultural context

Birthmarks

11

Birthmark; Pale pink or red spots
Seen on eyelids, nose, lower occipital bone, nape of neck
Light-complected newborn; more noticeable if cries
Blanch, no clinical significance, disappear around age 2

Telangiectatic Nevi (“stork bites”, salmon patches)

12

Grey-blue pigmented areas
Lumbosacral or buttocks
Dark-skinned & Asian newborns
Disappear in late infancy or early childhood

Mongolian Spots

13

Flat, purple-red, sharply demarcated
Most often on face
Do not blanch, fade, or increase in size
Can be disfiguring

Nevus Flammeus (“port-wine stain”)

14

Dark red, rough-textured, sharply demarcated, raised
Usually head or face
Grow for several months, then shrink, but can take 7-10 years to disappear

Nevus Vasculosus (“strawberry marks”)

15

Flat, pigmented, sharply demarcated, “coffee with milk”
1 in 5 have them
1-3 spots okay, ># or > 5 mm linked to neurofibromatosis

Café au Lait Spots

16

Head 1/3 adult size
Circumference: 32-38 cm
Head circumference 2-3 cm > chest circumference
Measure from most prominent part of occiput to just above eyebrows

Head Circumference

17

Average: 30-36 cm
Lower edge of scapula, bring around anteriorly over nipple line

Chest Circumference

18

Large, ¼ total body size
Palpate suture lines: open sutures or overriding?
Identify fontanels
Evaluate symmetry
Evaluate molding

Newborn’s Head

19

Diamond-shaped, 2-3 cm wide x 3-4 cm long
Flat, but may swell with stooling, crying
Depressed = dehydration
Can feel pulsation of heart through it
Closes within 18 months

Fontanels: Anterior

20

Smaller, triangular in shape

May be almost closed at birth, but will be fully-closed by end of 2nd month

Fontanels: Posterior

21

Overriding of skull bones
Occurs as head accommodates to diameters of birth canal
Head seems elongated
Disappears spontaneously within few days

Asymmetry of Head: Molding

22

Diffuse, soft-tissue edema of scalp
Caused by pressure on head in L & D
Crosses suture lines
Scalp ecchymosis ( blood into tissue) may be present
Resolves in a few days

Asymmetry of Head: Caput Succadaneum (“caput”)

23

Collection of blood due to rupture of blood vessels between skull and periosteum
No ecchymosis
Doesn’t cross suture lines
Slow process
Resolves slowly; 2-6 weeks

Asymmetry of Head: Cephalohematoma

24

Closed much of time
Most often blue or slate-gray at birth
Darker eyes in darker-skinned
Permanent eye color can take up to 1 year
White spots (Brushfield’s) in periphery of iris
Lacrimal glands immature

Eyes

25

“cross-eyes”; Transient
Immature neuromuscular control
Disappears by 3-4 months

Strabismus

26

eye bleeding; (black filled)
Harmless
Due to pressure
Disappear in about a week

Subconjunctival Hemorrhages

27

Red reflex: pupil appears red-orange when ophthalmoscope directed on it
Blink reflex: response to shining bright light into eyes

Eyes: Reflexes

28

Pink, moist mucosa
Inspect lips, gums, palates
Epstein’s pearls - white or yellow cystic vesicles (fluid)
Precocious teeth - removed to orevent aspiration
Tongue: midline, mobile, normal short frenulum

Mouth

29

“Tongue-tied”; TX: frenotomy (ingual frenulum is cut)

Ankyloglossia

30

Short compared to abdomen
Round chest, thin chest wall with little musculature
Ribs soft & compliant
Tip of xiphoid may protrude

Thorax