This document outlines the purposes and procedures for a newborn examination. The goals are to identify any abnormalities, complications from delivery, or diseases in the newborn. The examination involves assessing vital signs, appearance, measurements, and examining each body system from head to toe. The APGAR score is also determined to evaluate the newborn's condition at 1 and 5 minutes after birth. A thorough physical exam is important for the health and survival of the newborn.
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 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
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 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
Kangaroo mother care is generally given to low birth weight babies. it is very essential for baby's health. there are many benefits of KMC as it provides warmth to he child, helps in breast feeding and helps in maintaining good attachment. please read this and get knowledge. this information will help young mothers more. stay tuned.
Normal newborn care, by Dr Amal Khalil, Dean of Nursing college, Port said University, Port said. Presented in the NICU nursing workshop, organized by Nursing syndicate in Suez canal & Sinai in cooperation with Port said university college of nursing & Port said neonatology society, December,2014 Port said
Immediate care of newborn, midwifery and obstetrical nursingNursing education
Having brief knowledge regarding immediate care of newborn The time of birth is one of transition from intrauterine life to an independent existence and call for many adjustment in the physiology of the baby. Normal infant are at low risk of developing problems in the new born period and therefore, require primary care only. That’s means the, new born care is comprehensive strategy designed to improve the health of newborn through intervention just soon after birth, in post natal ward and up to 28 days.
Essential care of the normal healthy neonates can be provided by the mothers under supervision of nursing personnel or basic or primary health care provider. About 80% of the newborn babies should be kept with their mothers rather than in separate nursery. The immediate care after birth is simple but very important. The baby has just come from warm quit uterus. So be gentle with the baby and keep the warm.
DEFINITION-
Newborn is the child of the first month of the life and transition of intrauterine life to extrauterine life.
Purposes-
1) To establish, maintain and support respiration
2) To prevent injury and infection
3) To provide warmth and prevent hypothermia
4) To identify actual or potential that may require immediate attention
Kangaroo mother care is generally given to low birth weight babies. it is very essential for baby's health. there are many benefits of KMC as it provides warmth to he child, helps in breast feeding and helps in maintaining good attachment. please read this and get knowledge. this information will help young mothers more. stay tuned.
Normal newborn care, by Dr Amal Khalil, Dean of Nursing college, Port said University, Port said. Presented in the NICU nursing workshop, organized by Nursing syndicate in Suez canal & Sinai in cooperation with Port said university college of nursing & Port said neonatology society, December,2014 Port said
Immediate care of newborn, midwifery and obstetrical nursingNursing education
Having brief knowledge regarding immediate care of newborn The time of birth is one of transition from intrauterine life to an independent existence and call for many adjustment in the physiology of the baby. Normal infant are at low risk of developing problems in the new born period and therefore, require primary care only. That’s means the, new born care is comprehensive strategy designed to improve the health of newborn through intervention just soon after birth, in post natal ward and up to 28 days.
Essential care of the normal healthy neonates can be provided by the mothers under supervision of nursing personnel or basic or primary health care provider. About 80% of the newborn babies should be kept with their mothers rather than in separate nursery. The immediate care after birth is simple but very important. The baby has just come from warm quit uterus. So be gentle with the baby and keep the warm.
DEFINITION-
Newborn is the child of the first month of the life and transition of intrauterine life to extrauterine life.
Purposes-
1) To establish, maintain and support respiration
2) To prevent injury and infection
3) To provide warmth and prevent hypothermia
4) To identify actual or potential that may require immediate attention
Health Assessment of the Newborn
The newborn requires thorough skilled observation to ensure a satisfactory adjustment to extra uterine life.
Health assessment of newborn after delivery can be divided into:
1. Initial Assessment
2. Transitional Assessment
3. Assessment of gestational age
4. Behavioural asessment
5. Systemic physical examination
Initial Assessment:
Initial assessment is done by using the APGAR scoring system.
APGAR score: It is method use to assess the newborn’s immediate adjustment to extra uterine life.
• The score based on five signs
1. Appearance (colour)
2. Pulse (Heart rate)
3. Grimace (Reflex irritability )
4. Activity (Muscle tone)
5. Respiratory rate
• Each item is given a score 0, 1, or 2
• 0-3 severe distress
• 4-6 moderate difficulty
• 7-10 no difficulty adjusting to life
• Evaluations of all five categories are made on 1-5 min after birth.
APGAR score:
Sign 0 1 2
Appearance (colour) Blue or pale Body pink, Extrimities Blue Completely Pink
Pulse (Heart rate) Absent Slow (<100 /> 100/m
Grimace (Reflex irritability ) No response Grimace Cough Or Sneeze
Activity(Muscle tone Limp Some flexion Active movement
Respiratory rate Absent Slow, Irregular Good, Crying
Other initial assessment are-
• Stabilization
• Measuring weight.
Transitional Assessment during the period of reactivity
First period of reactivity (6- 8 hours after birth):
During the first 30 minutes the newborn is very alert, cries vigorously, may suck a first greedily, and appears very interested in the environment. Physiologically the respiratory rate can be as high as 80 breaths/ min, crackles may be heard, heart rate may reach 180 beats/min, bowel sound are active, mucus secretions are increased and temperature may decrease slightly.
Second period of reactivity:
Began when the newborn awake from the deep sleep, it lasts about 2-5 hours. The newborn is alert and responsive, heart and respiratory rate are increased, gastric and respiratory secretions are increased, and passage of meconium commonly occurs.
Following this stage is a period of stabilization of physiologic systems & vacillating patern of sleep & activity.
Topic 03: Health Assessment of the Newborn
The newborn requires thorough skilled observation to ensure a satisfactory adjustment to extra uterine life.
Health assessment of newborn after delivery can be divided into:
1. Initial Assessment
2. Transitional Assessment
3. Assessment of gestational age
4. Behavioural asessment
5. Systemic physical examination
Initial Assessment:
Initial assessment is done by using the APGAR scoring system.
APGAR score: It is method use to assess the newborn’s immediate adjustment to extra uterine life.
• The score based on five signs
1. Appearance (colour)
2. Pulse (Heart rate)
3. Grimace (Reflex irritability )
4. Activity (Muscle tone)
5. Respiratory rate
• Each item is given a score 0, 1, or 2
• 0-3 severe distress
• 4-6 moderate difficulty
• 7-10 no difficulty adjusting to life
• Evaluations of all five categories are made on 1-5 min after birth.
APGAR score:
Sign 0 1 2
Appearance (colour) Blue or pale Body pink, Extrimities Blue Completely Pink
Pulse (Heart rate) Absent Slow (<100 /> 100/m
Grimace (Reflex irritability ) No response Grimace Cough Or Sneeze
Activity(Muscle tone Limp Some flexion Active movement
Respiratory rate Absent Slow, Irregular Good, Crying
Other initial assessment are-
• Stabilization
• Measuring weight.
Transitional Assessment during the period of reactivity
First period of reactivity (6- 8 hours after birth):
During the first 30 minutes the newborn is very alert, cries vigorously, may suck a first greedily, and appears very interested in the environment. Physiologically the respiratory rate can be as high as 80 breaths/ min, crackles may be heard, heart rate may reach 180 beats/min, bowel sound are active, mucus secretions are increased and temperature may decrease slightly.
Second period of reactivity:
Began when the newborn awake from the deep sleep, it lasts about 2-5 hours. The newborn is alert and responsive, heart and respiratory rate are increased, gastric and respiratory secretions are increased, and passage of meconium commonly occurs.
Following this stage is a period of stabilization of physiologic systems & vacillating patern of sleep & activity.
Gestational Age Assessment
An accurate assessment of age is important for 2 reasons
• Age and growth patterns appropriate to that age aid in identifying neonatal risks
• Help in developing management plans
Gestational age can measure by weight for gestational age chart.
Gestational Age Number of weeks that have elapsed since the first day of the last menstrual period to the time of birth. This is usually retrieved from mother’s Antenatal History.
Gestational Age:
• SGA- small for gestational age-weight below 10th percentile •
• AGA-weight between 10 and 90th percentiles
• LGA-weight above 90th percentile
Behavioural Assessment
While babies may not speak their first word for a year, they are born
This slide contain detail description of basic terminologies, neonatal (head to toe examination) assessment, neonatal reflexes, minor physiological handicaps of newborn
how to examine sick baby , approach to child medical examination , diagnosis of sick child , evaluation of sick baby , medical examination of children , child medical history and examination , care of children
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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
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
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
2. INTRODUCTION
• Head to toe physical examination of a
newborn to look for any abnormalities or
pathology.
3. PURPOSES
• Gives detailed information regarding the
problems of babies during the 1st four
weeks of life.
• To identify the abnormalities of the
newborn.
• To improve neonatal care and it leads to
better and intact infant survival.
4. PURPOSES
• To detect any complication occurs during
delivery.
• To identify and record evidence of birth
injury , congenital malformation and
diseases.
7. APGAR Scoring
• The APGAR score is determined by
evaluating the newborn baby on five simple
criteria on a scale from zero to two and
summing up the five values. The resulting
APGAR score ranges from zero to 10.
13. TEMPERATURE
• It can be recorded at three sites: rectal, oral
or axillary. Most common site is axilla.
– After birth the baby should be kept in skin to
skin contact with the mother immediately.
– Hands and feet should be checked for warmth
with back of the hand to see if the baby is in
cold stress.
14. –If the baby feet and hand are cold but the baby
is warm when seen over the chest, it means that
the baby is in cold stress.
– Each time use a fresh clean thermometer. The
temperature of a baby is seen with the
thermometer held vertically in the axilla for 3
minutes.
• Normal temperature is 36.5 ° C – 37.5 ° C.
If it is between 36° C- 36.5 ° C , the baby is
in cold stress.
15. RESPIRATION
• Observe the chest rise and fall in full 60
seconds. Most often, the breathing of a
newborn is diaphragmatic, so during
inspiration the anterior thorax usually
draws inward while the abdomen protudes.
• Newborn respiratory rate is 30 to 60/ min.
• Grunting or labored breathing usually
suggests respiratory distress syndrome.
16. PULSE
• The heart rate is taken apically with a
stethoscope and the brachial, femoral
arteries are palpated for equality of
strength. Both are counted for a full 60
seconds.
• Normal heart rate 100-160 bpm
• Absence of femoral pulses or brachial
femoral delay is suggestive of left sided
heart lesions and coarctation of the aorta.
17. BLOOD PRESSURE
• Blood pressure measurement can be
difficult to perform on the neonate and
normal values vary depending on
gestational age and weight.
• Blood pressure should always be measured
with the infant in a quiet state and with the
correct sized blood pressure cuff.
18. • The preffered site for BP is right arm;
however other sites such as the forearm,
calf or thigh may be used as long as the cuff
width is 40 % of the circumference of the
limb on which the cuff is placed.
• Newborn BP (systolic) 60-80 mmHg.
20. WEIGHT
• The scale should be taken to the baby. Then
the pan of the weighing scale is covered
with a fresh cloth.
• After this, the baby is placed naked over
the weighing scale.
• Normal weight is 2500- 4000 gm (2.5 to 4.5
kg)
22. LENGTH
• Length is most accurately recorded using a
neonatal measurement board in which the
baby’s crown is placed at one end and the
examiner deflexes the hip and knees and
measures a maximum length to the sole of
the feet.
• Infant lies on back with legs extended;
measure the distance from vertex to heel of
right foot.
24. HEAD CIRCUMFERENCE
• The occipito frontal head circumference is
measured by placing a tape measure around
the head to encircle the occiput, the parietal
bones and the forehead (1cm above the
nasal bridge)
• Newborn head circumference is 32-37cm
(12.5- 14.5 inches)
26. CHEST CIRCUMFERENCE
• An assistant is required to assure that the
infant is in the correct position.
• The infant lies on back. With an automated
tape device, measure the circumference of
the chest at the level of the nipples during
normal breathing.
28. WAIST CIRCUMFERENCE
• An assistant is required to assure that the
infant is in the correct position.
• The infant lies on back with legs fully
extended. With an automated tape device,
measure the circumference just below the
level of the iliac crest and above the level of
the greater trochanter in a plane
perpendicular to the torso.
31. POSTURE
• In the full term neonate, the posture is one
of complete flexion. Infant’s behavior is
carefully noted.
• Normal flexion of the extremities indicates
good muscle tone. Lack of flexion is
associated with hypotonicity, whereas
excessive flexion usually suggests
hypertonicity.
32. SKIN
• Color: Most babies are pink, although
some babies exhibit ACROCYANOSIS
(cyanosis of the peripheries) without
significance.
• Fingers and toes appear bluish is normal
for a new born infant. If there is generalized
cyanosis, observe the response to oxygen
administration as well as cry.
33.
34. • VERNIX : This is a white substance
often present on the skin at birth. Its role in
the fetus is to prevent overhydration of fetal
skin
35. • LANUGO : Fine downy hair covers the
skin of the shoulder, upper arms and
thigh.
36. • PETECHIA: The presences of the small
hemorrhagic skin lesions may be begin and
occur on the face due to birth injuries or
trauma
37. • MILIA : They occur particularly over the
nose and are small sebaceous cyst.
38. • MONGOLIAN SPOT : Acres of bluish
colored pigmentation may occur extensively
on the back especially over the sacro
coccygeal region.
39. SCALP
• The scalp is most commonly the presenting
part at delivery. It is relatively easily
traumatised and swelling with or without
bruising in relatively common. A cranial
meningocele (neural tube defect that
develops due to inadequate development of
upper end of neural tube)or encephalocele
may also poduce a swelling.
40. HEAD
• FONTANELLES:
Fontanelles are areas where at least three
bony plates of the skull meet. They can be
felt as soft spots on the head. The posterior
fontanelle normally measures less than
0.5cm at birth and closes shortly after it.
41. • The anterior fontanelle normally measures
1-5cm in diameter at birth and doesnot
close until 18months of age.
• The anterior fontanelle at rest should
neither bulge nor be sunken. It will bulge as
the baby cries.
42.
43. SUTURES
• Sutures are the gaps between two bony
plates of the skull. At birth the sutures may
be easily palpable, but the bone edges are
not widely separated.
• Premature fusion of a suture may be
palpable as a prominent edge, but beware
because over riding sutures can often be felt
following delivery, but they will resolve with
time.
44.
45. • Examine head for:
– Asymmetry/ abonrmal shape
– Size
– Premature closing of suture and fontanelles.
– Large fontanel is associated with
hypothyroidism, osteogenesis, chromosomal
abnormalities.
– Bulging fonatenelles due to increased ICP,
meningitis or hydrocephalus.
– Decreased fonatenelles are seen with
dehydration.
– Small fonatenelle may be due to hyper
thyroidism, microcephaly.
46. • CAPUT SUCCEDANEUM: It is formation
of swelling due to stagnation of fluid in the
layers of scalp.
• MOLDING: Over riding of parietal bones.
• CEPHALOHEMATOMA: It is the
collection of blood in between the
periosteum usually unilaterally over the
parietal bone.
47.
48.
49. FACE
• The skin of the face should be uniformly
pink in color and free from swellings,
abrasions and lesions to detect asymmetry;
hemihypertrophy, cleft clip.
• Look at the symmetry of the face.
Asymmetry may result from abnormalities
of development of individual components,
postural deformities or syndromes.
50. EYES
• Examination of the eyes by observing the lids for
edema.
• Eyes are observed to find out asymmetry,
corneal opacity, coloboma (hole in one of the
structures of the eye) and to asses for jaundice.
• Sclera should be white and clear. The iris of a
baby is normally blue. It should be perfectly
circular with a round opening (pupil) in the
center.
52. EARS
• Examine for position, structure and
auditory function to identify skin creases,
deformity, perauricular skin tags.
• The top of the pinna should lie in a
horizontal plane to the outer canthus of the
eye.
53. NOSE
• Babies are nasal breathers.
• The nose is usually flattened after birth.
• Patency of the nasal canal is assessed by
holding a handover the infants mouth and
one canal and noting the passage of air
through the unobstructed opening.
54. MOUTH AND THROAT
• Assures for cleft lip and palate.
• Epstein pearl small white epithelial cyst
both sides of the hard palate.
55.
56. NECK
• Observe for range of motion, shape and any
abnormal masses and palpate each clavicle
for possible fractures especially if there us
any history of shoulder dystocia or any
suggestion of an Erb’s palsy (paralysis of
arm)
57. CHEST
• Chest is examined for asymmetry.
• Moving down to the chest look for any
asymmetry of the rib cage.
• The newborn’s breast may be enlarged due
to maternal estrogen.
• The white discharge from nipple is
commonly known as “Witch’s milk”
58. HEART
• One of the most difficult and important
systems to examine is the heart, so the baby
must be calm and content. It is the ideal to
examine the heart first before examining
other parts.
• Check heart rate, rhythm and also
presence of any abnormal heart sound.
59. ABDOMEN
• The examiner’s fingertips must be gently
placed and held on the abdomen without
exerting any downward pressure. Deep
palpation should then proceed gradually.
• Examine for distention, shape, tenderness
and organomegaly, hepatomegaly,
spleenomegaly.
60. UMBILICUS
• Umbilical cord is inspected for determining
for 2 arteries and one vein, any discharge,
color and redness.
• The normal umbilicus is bluish white in
color on first day. Later over the next few
days, it begins to dry and shrink and falls
off after 7-10 days
61. GENITALIA
FEMALE:
• The labia majora are not well developed
and therefore the clitoris and labia minora
are prominent.
• Vaginal discharge and some vaginal
bleeding may be present during 1st week is
pseudo menstruation. It is due to
withdrawal of maternal hormones.
62. MALE:
• Examine for testis within the stratum and
hydrocele, hypospadias etc.
• Check for testis, size and shape of penis,
position of meatus, urine stream.
64. EYES
• BLINKING OR CORNEAL REFLEX:
Infant blinks at sudden appearance of a
bright light or at approach of an object
toward the cornea, persist throughout the
life.
65. PUPILLARY:
Pupil constrict when a bright light shines
towards it persists throughout the life.
DOLL’s EYE:
As head is moved slowly to right or left, eyes
tag behind and donot immediately adjust
to new position of head.
66.
67. NOSE
SNEEZE:
Spontaneous response of nasal passages to
irritation or obstruction.
GLABELLA:
Tapping briskly on glabella causes eyes to
close tighly.
68. MOUTH, THROAT & NECK
• ROOTING: Touching or striking the cheek
along the side and begin to suck.
• SUCKING: Infant begins strong sucking
movements of circumoral areas in response
to stimulation.
• SWALLOWING: Movement of throat
muscle to push food from mouth to
esophagus.
69.
70. • EXTRUSION: When tongue is touched or
depressed infants respond to by forcing it
outward.
• YAWN: Spontaneous response to decreased
oxygen by increasing amount of inspired
air.
71. • COUGH: Irritation of mucus membrane of
larynx or trachea bronchial tree carries
coughing.
• TONIC AND NECK REFELX: When
head is turned to one side, arm and leg of
same side are extended in a fencing posture.
72.
73. EXTREMITIES
• GRASP: Touching palms of hands or soles
of feet near base of digits causes flexion of
hands and toes.
• BABINSKI: Stroking outer sole of foot
outward from head and across ball of foot
causes the big toes to dorsi flex and the
other toes to hyperextend or fanning of
finger occurs.
74.
75. • MORO: When startled, arms and legs
swing quickly out, then immediately back
and neonate curls up into a ball.
