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Neonate Examination and Disorders


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toxoplasmosis, other (gonorrhea, rubella), CMV, Herpes, HIV, Histoplasmosis, Syphillis
What is a term delivery defined as?
A baby born after 37 weeks
What does a breech delivery suggest?
decreased fetal movement
What all goes into the APGAR score?
cry, breathing, color, tone, and heart rate
What is the most important measurement when examing a neonate?
head circumference
How can you tell the difference between brief placental insufficiency and long term insufficiency?
If baby has been sick or w/o nutrients for a long time BOTH brain and body will be smaller.
Babinski response should be positive until?
6 months
Drop baby on back while supporting the head and baby should symmetrically throw their arms and legs up in response.
Moro reflex
Put a finger in each of the baby's palms and they should grasp tightly.
Palmar grasp
Stroke the baby's face and they will turn their head to the side being stroked.
Rooting reflex
Turn the baby's head one way and they will extend their arm on that side and flex the opposite arm.
Tonic neck (fencing response)
Hold a baby upright in a standing position and they will make stepping movement.
Place-stepping reflex
Focus on face
2 weeks
Track w/ eyes
1 month
Hold up head
1-2 months
Reach out w/ hands.
3-4 months
Roll over.
3-5 months
Sitting independently.
6-8 months, 9 months at the lastest. Important milestone.
7-11 months
8-16 months.
1-2 months
5-8 months
Purposeful words (ma-ma, da-da)
1 year
Identify objects
15-18 months
Put two words together.
24 months
Why is head ultrasound easier on baby? What is US good for looking for?
still have open fontanel; good for looking at bleeds or cystic/water lesions
What is a CT good for?
spotting bleeds and calcifications
What are MRIs good for?
development malformations and hypoxia/ischemia
What is used as mandatory screening for hearing problems?
Brainstem evoked potentials
When is white matter more susceptible to injury?
2nd half of pregnancy (20-32 weeks)
Early neuromigration problems with failure of neural tube fusion at top of brain.
Occipital encephalomeningocele
Baby has only 4 layers of cortex. "Smooth brain"
Asymmetrical brain, little bumps or nodules of brain matter that got stuck in migration. Can cause seizures.
Periventricular heterotopias
"Half a big head"
Believed to be a vascular problem caused by a stroke in the MCA. Extra grey matter accumulating in a cleft.
Grade I IVH
small amount of blood in ventricle
Grade II IVH
blood fills ventricle
Blood dilates ventricle
Grade IV IVH
Blood spreads to brain
Complication of IVH
Hydrocephalus -- head enlargement, cranky, smiling, sleepy, irritable, fussy, "sundowning"
Death of white matter due to hypoxia or ischemia in neonates.
Periventricular leukomalacia
When is the grey matter susceptible to injury?
After 32 weeks
High bilirubin that can result in brain damage particularly to deep gray structures.
What are some symptoms of kernicterus?
lethary, high pitched cry, irritability w/ arched back
How is a neonatal stroke usually identified?
when child shows hand preference b/f 12 months
Most common cause of neonatal meningitis.
Group B strep.
Combined abnormalties that involve the nervous system, skin, and other organs as well.
Skin lesions on the face seen in tuberous sclerosis
adenoma sebaceum
Multiple hemangiomas, typically in kidney and cerebellum
Van Hippel-Lindau Disease
Vascular malformation that involves the face and brain
Struge-Weber Syndrome
A herniation of the cerbellar vermis through the formaen magnum. Secondary features include hydrocephalus and myelomeningocele.
Arnold-Chiari Malformation (Chiari Type 2 malformation)
Fourth ventricle is enlarged due to a cyst in the cerebellum associated w/ poor development of inferior cerebellar vermis
Dandy-Walker Malformatio
Syringomyelia is lined by _____
Hydromyelia is lined by ____
ependymal cells (swelling of cenral canal in the spinal cord)
Most common lesion seen in premature babies w/ respiratory distress syndrome
Interventricular hemorrhage
Common location of IVH
subependymal blastema (germinal matrix)
Swelling beneath skin that occurs during birth.
caput succedaneum
Between the galeal aponeurosis and the periosteum.
subgaleal hematoma
Between the periosteum and the skull

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