Table of contents
Neonatal Exam
- General Appearance: (Alertness, Vitals, weight/length/HC, Apgar Score)
- HEENT
- Appearance (Dysmorphic Features)
- Head (shape, size, fontanelles) Caput succedaneum (cone head), Cephalohematoma?
- Eyes (red reflex, pupils, no conjunctivitis [Ophthalmia neonatorum])
- Ears & Nose (Shape/size/position)
- Throat/mouth (cleft lip and/or palate) (can check root reflex, and also exam palate for clefts) [Ankyloglossia - cleft tongue]
- Neck (Midline/lateral masses) {Thyroglossal duct cyst, cystic hygroma, brachial cleft cyst}
- Appearance (Dysmorphic Features)
- CVS/Resp
- Resp: Chest deformity, cyanosis, accessory muscle use, resp rate
- CV: HR, S1, S2 (no S3/4), no murmurs.
- Abdomen
- Inspection (Size, shape, masses, herniations, anus [patent?])
- Gastroschisis (lateral to umbilicus, herniated intestine no sac)
- Omphalocele (herniated bowel or other organs, peritoneum present).
- Umbilical Hernia
- Inspection (Size, shape, masses, herniations, anus [patent?])
- Genito-Urinary
- Male: Genital anatomy, bilat descended testes, hernia, hydrocele
- Female: Genital anatomy, swollen labia, dischrage (maternal estrogen withdrawal).
- MSK
- Barlow (adduct hip, attempt to dislocate posteriourly)
- Ortolani (abduct hip, attempt to dislocate anteriourly) [looking for "clunk"]
- Birth injuries: clavicle intact, Erb palsy (C5, C6 - extended, pronated forearm), Klumpke's paralysis (C8, T1, forearm supinated, fingers hyperextended).
- Neuro/Spine
- Primitive Reflexes
- Rooting (suck)
- Galant (stroke abdo side)
- Palmer/Plantar grasp (finters/toes curl)
Pick up baby - Placing (upright, simulate walking)
- Moro (parachute)
- ATNR (fencing)
- Spine
- Spina bifida occulta (10% of pop'n, incidental on x-ray, sometimes dark or hair growing)
- Meningocele (Herniated meninges, spinal cord ok)
- Myelomeningocele (Herniated meninges + spinal cord)
- Primitive Reflexes
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