New Born Assessment

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2"><U>pearls pediatry 2</U></A>   |   <A HREF="id18.htm" TARGET="_top" TITLE="general"><U>general</U></A>   |   <A HREF="id34.htm" TARGET="_top" TITLE="appendiceal colic"><U>appendiceal colic</U></A>   |   <A HREF="id35.htm" TARGET="_top" TITLE="ATOPIC DERMATITIS"><U>ATOPIC DERMATITIS</U></A>   |   <A HREF="id19.htm" TARGET="_top" TITLE="Stuttering"><U>Stuttering</U></A>   |   <A HREF="id20.htm" TARGET="_top" TITLE="enuresis"><U>enuresis</U></A>   |   <A HREF="id21.htm" TARGET="_top" TITLE="Conduct Disorder in Children and Adolesc"><U>Conduct Disorder in Children and Adolescents </U></A>   |   <A HREF="id22.htm" TARGET="_top" TITLE="Specific Growth Curve Deviations "><U>Specific Growth Curve Deviations </U></A>   |   <A HREF="id23.htm" TARGET="_top" TITLE="Common Medical and Surgical Problems"><U>Common Medical and Surgical Problems</U></A>   |   <A HREF="id24.htm" TARGET="_top" TITLE="Chronic Abdominal Pain in Childhood: Dia"><U>Chronic Abdominal Pain in Childhood: Diagnosis and Management </U></A>   |   <A HREF="id25.htm" TARGET="_top" TITLE="child devlpt"><U>child devlpt</U></A>   |   <A HREF="id26.htm" TARGET="_top" TITLE="ACETAMINOPHEN OVERDOSE"><U>ACETAMINOPHEN OVERDOSE</U></A>   |   <A HREF="id27.htm" TARGET="_top" TITLE="SHAKEN BABY SYNDROME"><U>SHAKEN BABY SYNDROME</U></A>   |   <A HREF="id28.htm" TARGET="_top" TITLE="NEONATAL JAUNDICE (HYPERBILIRUBINEMIA)"><U>NEONATAL JAUNDICE (HYPERBILIRUBINEMIA)</U></A>   |   <A HREF="id29.htm" TARGET="_top" TITLE="Hyaline Membrane Disease (Respiratory Di"><U>Hyaline Membrane Disease (Respiratory Distress Syndrome) (HMD) (RDS</U></A>   |   <A HREF="id30.htm" TARGET="_top" TITLE="infectious disease"><U>infectious disease</U></A>   |   <A HREF="id32.htm" TARGET="_top" TITLE="HEMORRHAGIC DISEASE IN A NEW BORN"><U>HEMORRHAGIC DISEASE IN A NEW BORN</U></A>   |   <A HREF="id33.htm" TARGET="_top" TITLE="OPTIC NERVE GLIOMA"><U>OPTIC NERVE GLIOMA</U></A>   |   <B>New Born Assessment </B>   |   <A HREF="id38.htm" TARGET="_top" TITLE="laryngomalacia"><U>laryngomalacia</U></A>   |   <A HREF="id39.htm" TARGET="_top" TITLE="CRANIOSYNOSTOSIS "><U>CRANIOSYNOSTOSIS </U></A>   |   <A HREF="id40.htm" TARGET="_top" TITLE="DANDYWALKER MALFORMATION "><U>DANDY-WALKER MALFORMATION </U></A>   |   <A HREF="id41.htm" TARGET="_top" TITLE="DEJERINESOTTAS DISEASE "><U>DEJERINE-SOTTAS DISEASE </U></A>   |   <A HREF="id42.htm" TARGET="_top" TITLE="DOWN SYNDROME "><U>DOWN SYNDROME </U></A>   |   <A HREF="id43.htm" TARGET="_top" TITLE="Respiratory Syncytial Virus (RSV)"><U>Respiratory Syncytial Virus (RSV)</U></A>   |   <A HREF="id44.htm" TARGET="_top" TITLE="FABRY DISEASE "><U>FABRY DISEASE </U></A>   |   <A HREF="id45.htm" TARGET="_top" TITLE="PRADERWILLI SYNDROME "><U>PRADER-WILLI SYNDROME </U></A>   |   <A HREF="id37.htm" TARGET="_top" TITLE="new born fun"><U>new born fun</U></A>   |   <A HREF="id46.htm" TARGET="_top" TITLE="RETT SYNDROME "><U>RETT SYNDROME </U></A>   |   <A HREF="id47.htm" TARGET="_top" TITLE="Alexander Disease"><U>Alexander Disease</U></A>   |   <A HREF="id49.htm" TARGET="_top" TITLE="leukemia"><U>leukemia</U></A>   |   <A HREF="id17.htm" TARGET="_top" TITLE="Contact Me"><U>Contact Me</U></A></div> <div> </div> </td> </tr><tr> <td valign="top" width=190 BGCOLOR="#CCCCFF" TEXT="#080000" background="04411c00egdysm.gif"> <div> <A HREF="id31.htm" TARGET="_top" TITLE="PEDIATRIC PEARLS FOR THE USMLE"><U><B>PEDIATRIC PEARLS FOR THE USMLE</B></U></A></div> <div> <A HREF="id48.htm" TARGET="_top" TITLE="pearls pediatry 2"><U><B>pearls pediatry 2</B></U></A></div> <div> <A HREF="id18.htm" TARGET="_top" TITLE="general"><U><B>general</B></U></A></div> <div> <A HREF="id34.htm" TARGET="_top" TITLE="appendiceal colic"><U><B>appendiceal colic</B></U></A></div> <div> <A HREF="id35.htm" TARGET="_top" TITLE="ATOPIC DERMATITIS"><U><B>ATOPIC DERMATITIS</B></U></A></div> <div> <A HREF="id19.htm" TARGET="_top" TITLE="Stuttering"><U><B>Stuttering</B></U></A></div> <div> <A HREF="id20.htm" TARGET="_top" TITLE="enuresis"><U><B>enuresis</B></U></A></div> <div> <A HREF="id21.htm" TARGET="_top" TITLE="Conduct Disorder in Children and Adolesc"><U><B>Conduct Disorder in Children and Adolescents </B></U></A></div> <div> <A HREF="id22.htm" TARGET="_top" TITLE="Specific Growth Curve Deviations "><U><B>Specific Growth Curve Deviations </B></U></A></div> <div> <A HREF="id23.htm" TARGET="_top" TITLE="Common Medical and Surgical Problems"><U><B>Common Medical and Surgical Problems</B></U></A></div> <div> <A HREF="id24.htm" TARGET="_top" TITLE="Chronic Abdominal Pain in Childhood: Dia"><U><B>Chronic Abdominal Pain in Childhood: Diagnosis and Management </B></U></A></div> <div> <A HREF="id25.htm" TARGET="_top" TITLE="child devlpt"><U><B>child devlpt</B></U></A></div> <div> <A HREF="id26.htm" TARGET="_top" TITLE="ACETAMINOPHEN OVERDOSE"><U><B>ACETAMINOPHEN OVERDOSE</B></U></A></div> <div> <A HREF="id27.htm" TARGET="_top" TITLE="SHAKEN BABY SYNDROME"><U><B>SHAKEN BABY SYNDROME</B></U></A></div> <div> <A HREF="id28.htm" TARGET="_top" TITLE="NEONATAL JAUNDICE (HYPERBILIRUBINEMIA)"><U><B>NEONATAL JAUNDICE (HYPERBILIRUBINEMIA)</B></U></A></div> <div> <A HREF="id29.htm" TARGET="_top" TITLE="Hyaline Membrane Disease (Respiratory Di"><U><B>Hyaline Membrane Disease (Respiratory Distress Syndrome) (HMD) (RDS</B></U></A></div> <div> <A HREF="id30.htm" TARGET="_top" TITLE="infectious disease"><U><B>infectious disease</B></U></A></div> <div> <A HREF="id32.htm" TARGET="_top" TITLE="HEMORRHAGIC DISEASE IN A NEW BORN"><U><B>HEMORRHAGIC DISEASE IN A NEW BORN</B></U></A></div> <div> <A HREF="id33.htm" TARGET="_top" TITLE="OPTIC NERVE GLIOMA"><U><B>OPTIC NERVE GLIOMA</B></U></A></div> <div> <B>New Born Assessment </B></div> <div> <A HREF="id38.htm" TARGET="_top" TITLE="laryngomalacia"><U><B>laryngomalacia</B></U></A></div> <div> <A HREF="id39.htm" TARGET="_top" TITLE="CRANIOSYNOSTOSIS "><U><B>CRANIOSYNOSTOSIS </B></U></A></div> <div> <A HREF="id40.htm" TARGET="_top" TITLE="DANDYWALKER MALFORMATION "><U><B>DANDY-WALKER MALFORMATION </B></U></A></div> <div> <A HREF="id41.htm" TARGET="_top" TITLE="DEJERINESOTTAS DISEASE "><U><B>DEJERINE-SOTTAS DISEASE </B></U></A></div> <div> <A HREF="id42.htm" TARGET="_top" TITLE="DOWN SYNDROME "><U><B>DOWN SYNDROME </B></U></A></div> <div> <A HREF="id43.htm" TARGET="_top" TITLE="Respiratory Syncytial Virus (RSV)"><U><B>Respiratory Syncytial Virus (RSV)</B></U></A></div> <div> <A HREF="id44.htm" TARGET="_top" TITLE="FABRY DISEASE "><U><B>FABRY DISEASE </B></U></A></div> <div> <A HREF="id45.htm" TARGET="_top" TITLE="PRADERWILLI SYNDROME "><U><B>PRADER-WILLI SYNDROME </B></U></A></div> <div> <A HREF="id37.htm" TARGET="_top" TITLE="new born fun"><U><B>new born fun</B></U></A></div> <div> <A HREF="id46.htm" TARGET="_top" TITLE="RETT SYNDROME "><U><B>RETT SYNDROME </B></U></A></div> <div> <A HREF="id47.htm" TARGET="_top" TITLE="Alexander Disease"><U><B>Alexander Disease</B></U></A></div> <div> <A HREF="id49.htm" TARGET="_top" TITLE="leukemia"><U><B>leukemia</B></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="Contact Me"><U><B>Contact Me</B></U></A></div> </td> <td valign="top" height=370 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> New Born Assessment </div> <div> General Appearance</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Body Posture: flexion. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Respirations: unlabored, rise and fall symmetrically, slight irregularity, clear. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Color: acrocyanosis (bluish hands and feet).</div> <div> Head</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Hair Strands </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Lacerations/bruises: from trauma of birth. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Cephalhematoma: a mass composed of clotted blood, located between the periosteum and the skull of a <FONT SIZE="3" COLOR="#800000" FACE="Arial" >newborn</FONT>; the swelling is confined between suture lines and usually is unilateral. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Caput Succedaneum: diffuse edema of the fetal scalp that crosses the suture lines; head compression against the cervix impedes venous return, forcing serum into the interstitial tissues; swelling reabsorbs within 1-3 days. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Fontanel: <I>Anterior fontanel</I><FONT SIZE="3" COLOR="#000000" FACE="Wingdings" ><I>à</I></FONT><I> </I>diamond shaped, depressed = dehydration, bulging = increased intercranial pressure, closes in 12-18 months. <I>Posterior fontanel</I><FONT SIZE="3" COLOR="#000000" FACE="Wingdings" ><I>à</I></FONT><I> </I>triagnle shaped, 2-3 months closes. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Molding: cone shaped cranium after vaginal birth. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Head circumference: 31-38cm, done at birth and every office visit.</div> <div> Ears: developed same time as kidney. If ther is a problem with ears, then there is a problem with the kidneys.</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Cartilage in Pinna: firm. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Placement of Ears: low set could indicate chromosomal abnormalities.</div> <div> Eyes</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Spacing of Eyes: the distance between the inner canthus of each eye is = to the width of the eye itself. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Conjunctival Hemorrhage: occur from pressure during birth. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Opacity of pupils </div> <div> Nose:</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Milia: white pinhead-size, keratin-filled cyst; in <FONT SIZE="3" COLOR="#800000" FACE="Arial" >newborn</FONT>, milia occur on the face and, less frequently, on the trunk, and usually disappear within several weeks. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Choanal Atresia: A congenital occlusion of the passage between the nose and pharynx by a bony or membranous structure.</div> <div> Mouth:</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Thrush plaques </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Suck Reflex: well developed. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Hard Palate: palpate with gloved finger; should be intact. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Epstein’s Pearls: whitish-yellow accumulation of epithelial cells, or retention cysts, on the hard palate; they are harmless and disappear within a few week. If they are loose, they are removed because they pose a risk for aspiration. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Frenulum: a small fold that attaches the lower side of the tongue to the floor of the buccual cavity. In neonates, it may be tight.</div> <div> 7. Facial Symmetry: is there any drooping.</div> <div> 8. Neck: symmetrical with full ROM.</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Clavicle: should be symmetrical; if has crepitation, this indicates a clavicle fracture.</div> <div> Skin:</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Vernix caseosa: whitish-yellow, greasy textured, cheese like substance that covers the fetus in utero. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Lanugo: soft, down like growth of hair commonly seen on the shoulders and back of the normal <FONT SIZE="3" COLOR="#800000" FACE="Arial" >newborn</FONT>. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Erythema toxicum: "<FONT SIZE="3" COLOR="#800000" FACE="Arial" >newborn</FONT> rash", appears as firm white or whitish-yellow papules or pustules varying in size from 1-3mm; widespread over the body but does not appear on the palms of the hands or the soles of the feet. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Icterus Neonatorum: physiologic <FONT SIZE="3" COLOR="#800000" FACE="Arial" >jaundice</FONT>, appears in many <FONT SIZE="3" COLOR="#800000" FACE="Arial" >newborn</FONT>s on the second or third day after birth. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Mongolian spots: slate-gray discolorations present at birth and most frequently noted on the buttocks or lower portion of the back of the <FONT SIZE="3" COLOR="#800000" FACE="Arial" >newborn</FONT>. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Nevus Flammeus: type of hemangioma, also known at "port wine stain"; these birthmarks are not elevated, are red to purple, and generally appear on the face. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Telangiectatic nevi: commonly referred to as "stork bites: are temporary, superficial vascular lesions formed by dilation of a group of small blood vessels; may appear as fine red lines and are sometimes seen at the nape of the neck, upper eyelid or upper lip.</div> <div> Extremities:</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Arms: movement and flexion. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Hands: number of digits present; finger grasp; Simian crease (commonly seen in Down syndrome), normally the palm of the hand at birth contains several flexion creases. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Legs: signs of congenital hip dislocation. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Capillary refill</div> <div> Chest: measure at level of nipples; should be 3cm less than head.</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Symmetry of chest </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Breast: areolae are stippled, 1cm diameter. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Heart sounds: between 4<FONT SIZE="1" COLOR="#000000" FACE="Arial" >th</FONT> and 5<FONT SIZE="1" COLOR="#000000" FACE="Arial" >th</FONT> intercostal space for 1 full minute; rate, rhythm, abnormal sounds. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">"Witches Milk": white discharge when palpated. Caused by influence of maternal estrogen.</div> <div> Abdomen:</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Contour of Abdomen: slightly protrudes and symmetrical. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Bowel sounds: may be heard 15minutes to 2 hours after birth; assess after heart and lungs have been auscultated. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Diastasis Recti: a separation of the two halves of the rectus abdominis muscles in the midline at the linea alba. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Vessels on skin of Abdomen </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Umbilical Cord: look for drainage or foul odor; falls off within 10-14 days.</div> <div> Femoral Pulses: should be equal. </div> <div> Genitalia:</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Male: scrotum<FONT SIZE="3" COLOR="#000000" FACE="Wingdings" >à</FONT> look for rugae; testes<FONT SIZE="3" COLOR="#000000" FACE="Wingdings" >à</FONT> make sure descended; meatus opening<FONT SIZE="3" COLOR="#000000" FACE="Wingdings" >à</FONT> <I>epispadias </I>(congenital opening of the urethra on the dorsum of the penis) or <I>hypospadias </I>(congenital opening of the urethra upon the undersurface of the penis). <I>Smegma</I> <FONT SIZE="3" COLOR="#000000" FACE="Wingdings" >à</FONT> collection of cheesy like secretions found under the foreskin of the penis in an uncercumcised neonate. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Female: labia minora and majora; look for vaginal and urethral opening; <I>pseudomenstruation</I> <FONT SIZE="3" COLOR="#000000" FACE="Wingdings" >à</FONT> whitish or bloody discharge caused by influence of maternal estrogen. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Anus should be patent.</div> <div> Spinal Canal: should be straight and midline.</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Sacral dimple </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Hair tuft </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Occult spinal bifida</div> <div> Reflexes: indicate normal CNS.</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Hand grasp: hand around finger. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Rooting reflex: stroke side of cheek and neonate turns head. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Sucking reflex: well developed. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Stepping reflex: steps like trying to walk. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Tonic neck/fencing reflex: head to side, leg and arm extend of that side and leg and arm flex on other side. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Moro relfex: abduction and extension of arms and legs in response to being startled. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Babinski: should fan.</div> <div> Neurologic Considerations:</div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Recoil of arms and legs: bring arms and legs down and observe how they recoil back. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Angles of wrist, feet, popliteal, heel to ear. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Scarf sign: note where the elbow is in relation to midline. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Head lag. </div> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.gif" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Ventral suspension.</div> <bR> <bR> </td> </tr></table></body>