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Newborn exam

Terms in this set (15)

Apgar Score
Subjective scoring system used to assess the need for resuscitation
Not a specific predictor of mortality or neurologic outcome
Scores range from 1-10
Any score lower than 7 is a sign that the baby needs medical attention. The lower the score, the more help the baby needs adjusting to life outside the mother's womb.
Check at 1 and 5 mins Check every 5 mins after if not at 7
HR
RR
Muscle tone
Reflex irritability
skin color

See chart...
Cephalohematoma
Subperiosteal blood collection caused by rupture of vessels beneath the periosteum so does NOT CROSS Suture lines
In 2.5% of newborns
Forceps and breech deliveries
Usually not treated
5% associated with underlying skull fractures
Can become infected leading to sepsis
Risk for jaundice
weight: regained, doubled tripled by?
2wks
6mo
1yr
scaphoid abdomen
caved in abdomen worry about absence of organ. Diaphragmatic hernia can cause lung hypoplasia
Caput Succedaneum
Serosanguinous fluid collection above the periosteum
Soft tissue swelling with purpura and ecchymosis over the presenting portion of the scalp
Extends across suture lines
Usually resolves over a few days without treatment

Crosses sutures lines since ABOVE periostum
Cutis Marmorata
Exposure to low environmental temperatures (Mottling)
Evanescent, lacy, reticulated red and/or blue cutaneous vascular pattern
Accentuated physiologic vasomotor response
Disappears with increasing age
Persistent and pronounced occurs in Menke disease, familial dysautonomia, and Cornelia de Lange, Down, and trisomy 18 syndromes
Vernix caseosa
Moist, greasy, gray-white coating composed of sebum, keratin, and hair
Becomes thicker with advancing gestational age
Provides protection in utero and perinatally
Staining by meconium may signal fetal distress
Harlequin Color Change
Rare, most common in the immediate newborn period
Transient imbalance in the autonomic vascular regulatory mechanism
With infant placed on the side, the body is bisected longitudinally into a pale upper half and a deep red dependent half
Lasts only a few minutes, affects only a portion of the trunk or face
Neonatal Transient Pustular Melanosis
More common in black infants
Transient, benign, self-limited dermatosis of unknown cause
Evanescent superficial pustules
Ruptured pustules with a collarette of fine scale
Hyperpigmented macules
Present at birth and may be profuse or sparse
Rarely lasts more than 2-3 days
Hyperpigmented macules may persist for as long as 3 months
Congenital Dermal Melanocytosis (Mongolian Spots)
Blue or slate-gray macular lesions with variably margins
Occur most commonly in the presacral area, also over the posterior thighs, legs, back, and shoulders
More than 80% of black, Asian, and East Indian infants have lesions
White infants- less than 10%
Dermal location of melanocytes arrests after migration from neural crest to epidermis
Usually fade in first few years
Larger and more numerous lesions tend not to resolve
Nevus Flammeus
Small, pale pink, ill-defined, vascular macules
Most commonly - glabella, eyelids, upper lip, and nuchal area
30-40% of normal newborns
Localized vascular ectasia (dilation)
More visible with crying or increased temperature
Most on the face eventually disappear
Those on posterior neck/occiput occasionally persist
Milia
Superficial epidermal inclusion cysts containing laminated keratinized material
Firm papules, each 1-2 mm in diameter, pearly, opalescent white
Most frequently scattered over the face
On gingiva and on the midline of the palate: Epstein pearls
Sebaceous Hyperplasia
More yellow than milia and are the result of maternal androgen exposure in utero
Sebaceous hyperplasia is a benign finding and spontaneously resolves with time
Capillary Hemangioma
Most common benign tumors of infancy
10% of term infants
Usually arise shortly after birth, grow rapidly during the first year
Growth slows in the next 5 years with involution by 10-15 years of age
More than half are located in the head and neck

More than one lesion increases the likelihood of visceral involvement - liver is the primary site
Majority are solitary lesions
Most require no therapy
10% cause significant impairment
1% are life threatening because of their location
Life modifying or threatening ones are usually treated

treated with beta blocker
Erythema Toxicum Neonatorum
Benign, self-limited eruption
About 50% of full-term infants
Firm, yellow-white, 1-2 mm papules on an erythematous macule
Usually flares with first bath in nursery
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