Week 11- Newborn Physical Exam

Question 1

Normal newborn head circ:

Answer 1

12-15 inches

Question 2

Normal newborn weight:

Answer 2

5lbs 8oz- 8lb 13oz

Question 3

Normal newborn length:

Answer 3

18-22 inches

Question 4

Normal newborn temp:

Answer 4

97.7-99 F

Question 5

Normal newborn HR:

Answer 5

80-180 bpm

Question 6

Normal newborn RR:

Answer 6

30-60 bpm

Question 7

When is the screening for congenital heart disease done after birth?

Answer 7

After 24 hours and before discharge

Question 8

What are normal results for the congenital heart screening?

Answer 8

Both pre and post ductal sats greater than 95% and less than a 3% difference between the hand and foot.

Question 9

This is a bluish discoloration of the hands and feet of newborns that is normal for the first 24-48 hours of life due to immature cardiac circulation and in older infants due to cold stress.

Answer 9

Acrocyanosis

Question 10

This is unilateral color change on one side of the newborns body and is more common in low birth weight infants.

Answer 10

Harlequin sign

Question 11

What is the harlequin sign due to and how long does it typically last?

Answer 11

Due to vasomotor instability

Transient, harmless, lasts 10-20 minutes

Question 12

This occurs in 30-70% of newborns and is white or yellow, 1-3mm papules over erythematous base. It can occur anywhere on the body, but usually spare the palmar surfaces.

Answer 12

Erythema toxicum

Question 13

This is exposed sebaceous glands that appear as whiteheads and disappear within the first month of life with no treatment.

Answer 13

Milia

Question 14

These are bluish-grey pigmentation of the skin that are typically located on the lower back, across shoulders, hips and legs. More common in dark skinned newborns and can fade over time.

Answer 14

Mongolian spots

Question 15

This is a raised capillary nevi that can occur anywhere on the body. Can increase in size over the first few months of life and generally disappear by age 10.

Answer 15

Strawberry hemangioma

Question 16

When do you refer with a strawberry hemangioma?

Answer 16

With orbital hemangioma, very large hemangiomas, or those with potential to interfere with the airway.

Question 17

These are pale pink or reddish discoloration of the skin normally located on the nape of the neck, the lower axillae, nasal bridge, or eyelids.

Answer 17

Stork bite or nevus flamus

Question 18

When do stork bites typically resolve?

Answer 18

2 years of age

Question 19

This is fine, soft hair that covers the newborn’a back, shoulders, cheeks, forehead, and scalp that is more common in premature infants. It disappears within first month of life.

Answer 19

Lanugo

Question 20

This is a line of increase pigmentation from umbilicus to genitalia. More common in darker skinned infants.

Answer 20

Linea nigra

Question 21

This is the cheesy, gray-white substance covering and protecting the skin during fetal life that diminishes near term.

Answer 21

Vernix caseosa

Question 22

This appears at 3-4 weeks of age and is caused by maternal hormones which stimulate the infants sebaceous glands. It is more common in males and no treatment is needed.

Answer 22

Neonatal acne

Question 23

This is normal when found on presenting parts of the infant.

Answer 23

Petechiae

Question 24

Petechiae anywhere other than the presenting parts of the infant may indicate what?

Answer 24

Infection

Question 25

These are hyperpigmented lesions, usually macules that are irregular in shape and light brown in color.

Answer 25

Cafe-au-lait spots

Question 26

A newborn with 6 or more cafe-au-lait spots bigger than 1cm must be worked up for:

Answer 26

Neurofibromatosis

Question 27

This occurs in health infants, appears the same, and improves as skin is warmed?

Answer 27

Cutis marmorata

Question 28

Mottling May be due to:

Answer 28

Hypothermia or infection

Question 29

Pallor or paleness of the skin may be caused by:

Answer 29

Anemia or infection

Question 30

Anterior fontanel is ___ shapes and closes by ____.

Answer 30

Diamond shaped | Closes by 18 months

Question 31

Posterior fontanel is ___ shaped and closes by___.

Answer 31

Triangle shaped | Closes by 4months

Question 32

How many sutures total?

Answer 32

5 total

Question 33

This is a collection of blood under the periosteum caused by pressure during labor or operative measures. Do NOT cross suture lines.

Answer 33

Cephalohematoma

Question 34

Cephalohematomas typically resolve in:

Answer 34

6-8 weeks without intervention

Question 35

This is localized swelling of the soft tissues of the scalp caused by pressure during labor and birth. These DO cross suture lines.

Answer 35

Caput succedaneum

Question 36

Caput succedaneum typically resolves in:

Answer 36

24-48 hours after birth spontaneously

Question 37

Newborns can fix and focus on an object how far from face?

Answer 37

8-10 inches

Question 38

Permanent eye color by:

Answer 38

3-6 months

Question 39

Hypertelorism is:

Answer 39

Eyes too far apart

Question 40

Hypotelorism is:

Answer 40

Eyes too close together

Question 41

Cornea haziness could indicate:

Answer 41

Glaucoma

Question 42

Absent red reflex can indicate:

Answer 42

Infection or cataracts

Question 43

Grey or white pupil could indicate:

Answer 43

Retinoblastoma

Question 44

This is eye openings too small and could indicate chromosomal anomaly or syndrome.

Answer 44

Palpebral fissures

Question 45

This is slanting of the eyes:

Answer 45

Epicanthal folds

Question 46

Ankyloglossia can cause:

Answer 46

Difficulty feeding and latching. Some tissue is anatomically normal and not all tongue ties require repair.

Question 47

Cysts on top of the mouth:

Answer 47

Ebstein pearls and normally resolve by 1m of age.

Question 48

Average newborn chest circ:

Answer 48

33cm or 2cm less than head circ

Question 49

CN1 assessment in infants:

Answer 49

Olfactory- alcohol wipe under nose should elicit a grimace

Question 50

CN II, III, IV, and VI assessment in newborns:

Answer 50

``` II- optic III- oculomotor IV- trochlear VI- abducens Light in eye causes rapid closure Baby’s head should follow your face 8-10 inches away ```

Question 51

CN V, IX, and XII assessment:

Answer 51

``` V- trigeminal IX- glossopharyngeal XII- hypoglossal Rooting and sucking reflexes Swallowing assessed by observing latch ```

Question 52

CN VII assessment:

Answer 52

Facial- glabella rap for blinking

Question 53

CN VIII assessment

Answer 53

Auditory- assess infant in a quiet room to observe their reaction to sound