This document provides guidance on newborn examinations. It outlines the objectives, precautions, and systematic approach for the exam. Key components include assessing growth parameters, vital signs, skin appearance, tone/movements, and examining the head/face, chest, abdomen, genitals, extremities, and neurological reflexes. Common normal variants like erythema toxicum and mongolian spots are described. The goals are to detect any deviations from normal, establish a baseline, and provide parental reassurance through counseling.
An important condition that is usually misdiagnosed. It's therefore important that healthcare practitioners understand this condition and this is what this presentation will help them with.
Neonatal jaundice (hyperbilirubinemia) by Rajiv MavachiRajiv Mavachi
Jaundice is the most common condition that requires medical attention in newborns. The yellow coloration of the skin and sclera in newborns with jaundice is the result of accumulation of unconjugated bilirubin.
Neural tube defects (myelomeningocele) | spina bifida NEHA MALIK
NTDs occur when the neural tube does not close properly. The neural tube forms the early brain and spine. These types of birth defects develop very early during pregnancy, often before a woman knows she is pregnant. The two most common NTDs are spina bifida (a spinal cord defect) and anencephaly (a brain defect).
follow me on my YouTube channel :- medic o mania
it contains information about the important measurements , the vital signs, head, eyes, ears, nose , mouth and throat, neck, chest, breast and abdomen of a newborn. You'll find the normal and the abnormal findings on each category.
An important condition that is usually misdiagnosed. It's therefore important that healthcare practitioners understand this condition and this is what this presentation will help them with.
Neonatal jaundice (hyperbilirubinemia) by Rajiv MavachiRajiv Mavachi
Jaundice is the most common condition that requires medical attention in newborns. The yellow coloration of the skin and sclera in newborns with jaundice is the result of accumulation of unconjugated bilirubin.
Neural tube defects (myelomeningocele) | spina bifida NEHA MALIK
NTDs occur when the neural tube does not close properly. The neural tube forms the early brain and spine. These types of birth defects develop very early during pregnancy, often before a woman knows she is pregnant. The two most common NTDs are spina bifida (a spinal cord defect) and anencephaly (a brain defect).
follow me on my YouTube channel :- medic o mania
it contains information about the important measurements , the vital signs, head, eyes, ears, nose , mouth and throat, neck, chest, breast and abdomen of a newborn. You'll find the normal and the abnormal findings on each category.
Basic examination of a newborn. A primer for postgraduate medical students to understand how to examine a just-born baby. Taken from a standard book, this presentation is a summary of the entire book.
newborn infant is a very important topic for pg entrance.....so all about it has been discussed in detail as required for pg entrance....do make use of it...
Newborn Care: Skills workshop Neonatal resuscitationSaide OER Africa
Newborn Care was written for healthcare workers providing special care for newborn infants in level 2 hospitals. It covers: resuscitation at birth, assessing infant size and gestational age, routine care and feeding of both normal and high-risk infants, the prevention, diagnosis and management of hypothermia, hypoglycaemia, jaundice, respiratory distress, infection, trauma, bleeding and congenital abnormalities, communication with parents
Newborn Care: Skills workshop Clinical history and examinationSaide OER Africa
Newborn Care was written for healthcare workers providing special care for newborn infants in level 2 hospitals. It covers: resuscitation at birth, assessing infant size and gestational age, routine care and feeding of both normal and high-risk infants, the prevention, diagnosis and management of hypothermia, hypoglycaemia, jaundice, respiratory distress, infection, trauma, bleeding and congenital abnormalities, communication with parents
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
1. Newborn Examination
Dr. Mahr Shoblack , Dr. Hussam KhodairDr. Mahr Shoblack , Dr. Hussam Khodair
and Dr. Zuhair Aldajaniand Dr. Zuhair Aldajani
2.
3. Newborn examination objectives
Indication and importanceIndication and importance
Precautions prior to exam !Precautions prior to exam !
Systematic approachSystematic approach
Neonatal reflexesNeonatal reflexes
Normal variantsNormal variants
4. Indications
Earliest possible detectionEarliest possible detection of deviations.of deviations.
Establishes aEstablishes a baselinebaseline for subsequentfor subsequent
examinationsexaminations
Parents assurance and counselingParents assurance and counseling
5. Newborn examination
Immediately after birthImmediately after birth
Before discharge from maternity unitBefore discharge from maternity unit
Whenever there is any concern about theWhenever there is any concern about the
infant's progressinfant's progress
6. Newborn first exam
Apgar scoreApgar score
– Heart rate
– Respiratory effort
– Color
– Tone
– Reflex irritability
7. Examination precaution
Hand washing,hand washing ,handHand washing,hand washing ,hand
washingwashing
Thermal environmentThermal environment
Light and noiseLight and noise
Brief examination timeBrief examination time
11. General
Well, Distress or not?Well, Distress or not?
skinskin
– Pink is normal
– Acro cyanosis is normal
– Cyanosis
– Bruised part look blue
– Jaundice
– Common variants skin rash
• Erythema toxicum, mongolian spot, Benign Pustular
Melanosis
12. Erythema Toxicum
Erythematous macules and firm 1-3 mmErythematous macules and firm 1-3 mm
yellow or white papules or pustulesyellow or white papules or pustules
Etiology obscureEtiology obscure
Pustules contain eosinophils and arePustules contain eosinophils and are
sterilesterile
Appear in the first 3-4 days of lifeAppear in the first 3-4 days of life
– Range: Birth to 14 days
Benign and self limitedBenign and self limited
15. DD: Impetigo Neonatorum
Vesicular, pustular, or bullous lesionsVesicular, pustular, or bullous lesions
developing as early as day of life 2-3 up todeveloping as early as day of life 2-3 up to
2 weeks of life2 weeks of life
Lesions occur in moist or opposingLesions occur in moist or opposing
surfaces of skinsurfaces of skin
Unroofed lesions do not form crustsUnroofed lesions do not form crusts
Treat with antibioticsTreat with antibiotics
17. Mongolian Spots
90% of African infants, 81% of Asian, and90% of African infants, 81% of Asian, and
9.6% of Caucasian infants9.6% of Caucasian infants
Slate-gray to blue-black lesionsSlate-gray to blue-black lesions
Usually over lumbosacral area andUsually over lumbosacral area and
buttocksbuttocks
Accumulation of melanocytes within theAccumulation of melanocytes within the
dermisdermis
Generally fade by age 7 yearsGenerally fade by age 7 years
21. General
Obvious Dimorphism or malformationsObvious Dimorphism or malformations
E:g(Down syndrome ear tag neural tubeE:g(Down syndrome ear tag neural tube
defect )defect )
Tone & Movements:Tone & Movements:
Flexion of upper and lower extremitiesFlexion of upper and lower extremities
-Asymmetric movement-Asymmetric movement
– Brachial plexus and fractured clavicle
-Ventral, vertical suspension and head-Ventral, vertical suspension and head
control for tone assessmentcontrol for tone assessment
22. General inspection
Vigorous cry is assuringVigorous cry is assuring
Weak cryWeak cry
– sepsis, asphyxia, metabolic, narcotic use
HoarsenessHoarseness
– Hypocalcemia, airway injury
High pitch cryHigh pitch cry
– CNS causes, kernicterus
23. Head and Face
Shape of the headShape of the head
Fontanels?Fontanels?
Sutures?Sutures?
Eyes?Eyes?
Nose?Nose?
Mouth,lips,palate?Mouth,lips,palate?
Ears?Ears?
Neck?Neck?
24. Head
Forceps and vacuum marksForceps and vacuum marks
Caput succedaneumCaput succedaneum
– Boggy edema in presenting part of head
– Cross suture lines
– Disappear in few days
CephalhematomaCephalhematoma
– Subperiosteal
– Weeks to resolve
– Dose not cross sutures
30. Craniosynostosis
Definition: premature closure of one orDefinition: premature closure of one or
more cranial suture.more cranial suture.
Growth of the skull occurs parallel to theGrowth of the skull occurs parallel to the
suture(s) involvedsuture(s) involved
Early correction optimizes cosmeticEarly correction optimizes cosmetic
appearanceappearance
Can be part of syndromes:Can be part of syndromes:Crouzon's ,Crouzon's ,
Apert's syndromeApert's syndrome
31. Craniosynostosis
Types:Types:
– Sagittal synostosis results in
scaphocephaly
– coronal synostosis results in
brachycephaly
– coronal, sagittal, and
lambdoid synostosis results
in acrocephaly
– single suture on one side of
head can result in
plagiocephaly
www.uscneurolosurgery.com
39. Epicanthal folds
Many variations exist. The boy on the left
does not have folds. On the right image, the
effect of the epicanthal fold extending above
the inner canthus is illustrated.
48. Supernumerary Nipples
Found in males and femalesFound in males and females
Pink or brown papules along the milk line,Pink or brown papules along the milk line,
most commonly on the chest or abdomenmost commonly on the chest or abdomen
May contain breast tissue and in womenMay contain breast tissue and in women
carry the same relative neoplasia riskscarry the same relative neoplasia risks
Not considered a marker for otherNot considered a marker for other
anomaliesanomalies
64. Hip and Extremities
Erb’s palsy: extended arm and internalErb’s palsy: extended arm and internal
rotation with limited movementrotation with limited movement
Humerous fractureHumerous fracture
Digital abnormalityDigital abnormality
– Syndactaly, brachdactaly, polydactaly
Single palmar creaseSingle palmar crease
Hip dislocationHip dislocation
– Female, breach
77. CNS
Awakenes and alertnessAwakenes and alertness
moving extremitiesmoving extremities
Flexed body postureFlexed body posture
Minimal Head lagMinimal Head lag
Ventral suspensionVentral suspension
Vertical suspensionVertical suspension
79. Neonatal reflexes
Also known as developmental, primary,Also known as developmental, primary,
or primitive reflexes.or primitive reflexes.
They consist of autonomic behaviorsThey consist of autonomic behaviors
that do not require higher level brainthat do not require higher level brain
functioning. They can providefunctioning. They can provide
information aboutinformation about lower motor neuronslower motor neurons
and muscle tone.and muscle tone.
They are often protective and disappearThey are often protective and disappear
as higher level motor functions emerge.as higher level motor functions emerge.
80. Suck
Onset: ~28weeks GAOnset: ~28weeks GA
Well-established: 32-34 weeks GAWell-established: 32-34 weeks GA
Disappears: aroundDisappears: around 12 months12 months
Elicited by the examiner stroking the lipsElicited by the examiner stroking the lips
of the infant; the infant’s mouth opens andof the infant; the infant’s mouth opens and
the examiner introduces their gloved fingerthe examiner introduces their gloved finger
and sucking starts.and sucking starts.
81. Rooting
Onset: 28 weeks GAOnset: 28 weeks GA
Well-established: 32-34 weeksWell-established: 32-34 weeks
GAGA
Disappears:Disappears: 3-4 months3-4 months
Elicited by the examinerElicited by the examiner
stroking the cheek or corner ofstroking the cheek or corner of
the infant’s mouth. The infant’sthe infant’s mouth. The infant’s
head turns toward thehead turns toward the
stimulus and opens its mouth.stimulus and opens its mouth.
82. Palmar grasp
Onset: 28 weeks GAOnset: 28 weeks GA
Well-established: 32 weeks GAWell-established: 32 weeks GA
Disappears:Disappears: 2 months2 months
Elicited by the examiner placingElicited by the examiner placing
his finger on the palmar surfacehis finger on the palmar surface
of the infant’s hand and theof the infant’s hand and the
infant’s hand grasps the finger.infant’s hand grasps the finger.
Attempts to remove the fingerAttempts to remove the finger
result in the infant tightening theresult in the infant tightening the
grasp.grasp.
83. Tonic neck (Fencing posture(
Onset: 35 weeks GAOnset: 35 weeks GA
Well-established: 4 weeks PCAWell-established: 4 weeks PCA
Disappearance:Disappearance: 7 months7 months
Elicited by rotating the infantsElicited by rotating the infants
head from midline to one side.head from midline to one side.
The infant should respond byThe infant should respond by
extending the arm on the side toextending the arm on the side to
which the head is turned andwhich the head is turned and
flexing the opposite arm. Theflexing the opposite arm. The
lower extremities respondlower extremities respond
similarly.similarly.
84. Moro
Onset: 28-32 weeks GAOnset: 28-32 weeks GA
Well-established: 37 weeks GAWell-established: 37 weeks GA
Disappearance:Disappearance: 6 months6 months
The examiner holds the infant so that one handThe examiner holds the infant so that one hand
supports the head and the other supports the buttocks.supports the head and the other supports the buttocks.
The reflex is elicited by the sudden dropping of theThe reflex is elicited by the sudden dropping of the
head in her hand. The response is a series ofhead in her hand. The response is a series of
movements: the infant’s hands open and there ismovements: the infant’s hands open and there is
extension and abduction of the upper extremities. Thisextension and abduction of the upper extremities. This
is followed by anterior flexion of the upper extremitiesis followed by anterior flexion of the upper extremities
and and audible cry.and and audible cry.
87. Moro significance
An absent or inadequate Moro responseAn absent or inadequate Moro response
on one side : hemiplegia, brachial plexuson one side : hemiplegia, brachial plexus
palsy, or a fractured claviclepalsy, or a fractured clavicle
Persistence beyond 5 months of age is :Persistence beyond 5 months of age is :
indicate severe neurological defects.indicate severe neurological defects.
88. Stepping
Onset: 35-36 weeks GAOnset: 35-36 weeks GA
Well-established: 37 weeks GAWell-established: 37 weeks GA
Disappearance:Disappearance: 3-4 months3-4 months
PCAPCA
Elicited by touching the top ofElicited by touching the top of
the infant’s foot to the edge of athe infant’s foot to the edge of a
table while the infant is heldtable while the infant is held
upright. The infant makesupright. The infant makes
movementsmovements that resemblethat resemble
stepping.stepping.
89. Galant (Trunk incurvation(
Onset: 28 weeks GAOnset: 28 weeks GA
Well-established: 40 weeks GAWell-established: 40 weeks GA
Disappearance:Disappearance: 3-4 months3-4 months
The infant is held in ventralThe infant is held in ventral
suspension with the chest in the palmsuspension with the chest in the palm
of the examiner’s hand. Firmof the examiner’s hand. Firm
pressure is applied to the infant’spressure is applied to the infant’s
side parallel to the spine in theside parallel to the spine in the
thoracic area. The response consiststhoracic area. The response consists
of flexion of the pelvis toward the sideof flexion of the pelvis toward the side
of the stimulus.of the stimulus.
90. Babinski
Onset: 34-36 weeks GAOnset: 34-36 weeks GA
Well-established: 38 weeksWell-established: 38 weeks
Disappearance:Disappearance: 12 months12 months
PCAPCA
Elicited by stimulus appliedElicited by stimulus applied
to the outer edge of the soleto the outer edge of the sole
of the foot. The infantof the foot. The infant
responds by plantar flexionresponds by plantar flexion
and either flexion orand either flexion or
extensionextension of the toes.of the toes.
91. Postnatal assessment of gestational
age
Ballard ScoreBallard Score
Accuracy within 1-2 weeksAccuracy within 1-2 weeks
2 parts2 parts
– Neurologic characteristic
– Physical characteristic
Part of general examinationPart of general examination
92. Physical Maturity
Skin: thicker , less translucent, dry, peelingSkin: thicker , less translucent, dry, peeling
Lanugo:Lanugo:
– fine non pigmented hair all over 27-28 wks
– disappears gradually
Plantar surface: presence or absence of creasesPlantar surface: presence or absence of creases
Breast: areola developmentBreast: areola development
Ear cartilageEar cartilage
Eyelid openingEyelid opening
External genitaliaExternal genitalia
– Rugation, desend
– Prominent labia majora
93. Neuromuscular Maturity
PosturePosture
Square windowSquare window
Arm recoilArm recoil
Poplitteal anglePoplitteal angle
Scarf signScarf sign
Heel to earHeel to ear
94. Remember
Wash your hand prior to examinationWash your hand prior to examination
Inspect,Inspect,Inspect,then Touch.Inspect,Inspect,Inspect,then Touch.
Neonatal reflexes implicatonsNeonatal reflexes implicatons
Normal variationsNormal variations
Editor's Notes
Etiology is unknown
Smears from the pustules reveal polymorphonuclear leukocytes with absence of organisms .
DD: Erythema Toxicum
Pigment fade in 3w-3m
Low set ears?,Preauricular pits, External meatus tie
Natal teath
Choanal atresia
Epstein pearls
Cleft, submucosal
Crouzon,s: brachycephalic craniosynostosis, significant hypertelorism, proptosis, maxillary hypoplasia, beaked nose and possibly, cleft palate. Intracranial anomalies include hydrocephalus, Chiari 1 malformation, and hindbrain herniation (70
Apert syndrome;Craniosynostosis and symmetric syndactyly of the extremities are hallmarks of this syndrome. The clinical features include misshapen skull caused by coronal suture synostosis, wide-set eyes, midface hypoplasia, choanal stenosis, and shallow orbitspercent).