1 of 23

HOW TO DO A �NEWBORN EXAMINATION

DR SIDRA HAMAYOON

MBBS, FCPS (PAEDS)

NEONATAL FELLOW FMH.

2 of 23

Preparation

HISTORY

INFORMED CONSENT

EQUIPMENT

3 of 23

Approach and Principles of examination

Gentle

Systemic

Hygienic

Warm room

Good light

Adequate exposure

4 of 23

HISTORY

Demographic Data

Current pregnancy

    • Antenatal
    • Natal
    • Postnatal

Past obstetrics history

Maternal medical history

Family history

Socioeconomic history

5 of 23

HISTORY AND EXAMINATION PAPER

6 of 23

INFORMED CONSENT

مین اپنے بچے کے مکمل طبی معاءنے اور ویڈیو بنا نے کی اجاذت دیتا/دیتی ھوں. ضرورت پرنے یہ ویڈیو سوشل میڈیا پر بھی شیر کی جا سکتی ھے مجھے اس بارے میں مکمل آگاہ کر دیا گیا ہے اور میں اسکی اجازتِ دیتا/دیتی ھوں

​

7 of 23

EQUIPEMENT:

  • STHETOSCOPE
  • MEASURING TAPE
  • WEIGHT MACHINE
  • TORCH
  • HAND SANITIZER
  • THERMOMETER
  • STERILE GLOVES
  • OPHTHALMOSCOPE
  • BP CUFF

​

8 of 23

BP CUFFS

  • SITES:
    • RIGHT UPPER ARM
    • THIGHS
    • LEGS

​

  • SIZE:
    • BLADDER WIDTH SHOULD BE 50% OF MID ARM CIRCUMFERENCE

​

​

​

​

9 of 23

OBSERVATION:

Posture and Activity

Skin and Color

Respiratory rate and distress

Dysmorphism

GA assessment

Attached tubings/equipement

10 of 23

AUSCULTATION:

Heart rate

Heart Sounds (mitral, tricuspid, pulmonary, aortic, PDA site, back of chest)

Lungs (apical, middle, lateral - front and back)

Bowel sounds

11 of 23

HEAD TO TOE

  • SKULL SHAPE
  • FONTENELLE
  • SUTURES
  • HAIR COLOR
  • OCCIPITAL PROMINENCE

​

12 of 23

HEAD TO TOE

  • EAR : SIZE, APPEARANCE, POSITION
  • EYE : SYMMETRY, PALPEBRAL FISSURE, RED REFLEX
  • NOSE: SHAPE, PATENCY
  • MOUTH : TONGUE, PALATE, GUMS, ROOTING /SUCKING REFLEX
  • NECK: EXTRA SKIN, SWELLING
  • CLAVICLES: CREPITUS, NUMBER, SURFACE

​

13 of 23

HEAD TO TOE

Upper limbs: symmetry, tone, pulses, palms, palmar grasp, modified Moro

Chest: shape, movement

Abdomen: shape, movement, umbilical cord, palpable masses

Lower limbs: symmetry, tone, reflexes, plantar grasp

Hip examination

Genitalia( with gloves)

Anal patency

Back: spine, gallant reflex

14 of 23

EQUIPMENT USE

Check BP, pre and post ductal saturations, temperature

Head circumference, length, weight

Red reflex, oral cavity

15 of 23

QUICK GESTATIONAL AGE ASSESSMENT

16 of 23

EAR RECOIL

28 week

Flat pinna, no recoil

32 weeks

Some cartilage, readily recoil

38 weeks

Firm, curved with instant recoil

28-30 weeks

Flat to soft pinna, No recoil (folded) to slow recoil

​

32-34 weeks

Well curved, firm, instant recoil

​

>36 weeks

Thick cartilage, Stiff

​

17 of 23

PLANTAR CREASES

32 weeks

Fine lines only

​

36 weeks

Single transverse Crease on anterior 1/3rd

38 weeks

Creases over entire sole

28-30 weeks

No deep creases to faint red marks

​

32-34 weeks

Anterior transverse crease to creases over anterior 2/3rd

​

>36 weeks

Creases on entire sole

​

18 of 23

BREAST BUDS

28-30 weeks

Imperceptible to flat areola with no bud

​

32-34 weeks

Stippled to raised areola with bud 1-2 to 3-4 mm

​

>36 weeks

Full areola with 5-10 mm bud

​

19 of 23

SKIN AND LANUGO

28 WEEKS

​

36 WEEKS

38 WEEKS

28-30 weeks

Pink with visible veins,No to sparse hair

​

32-34 weeks

Pale areas, few veins, abundant to thining of hairs

​

>36 weeks

No veins, Leathery Skin,Bald areas mostly

​

20 of 23

MALE GENITALIA

28-30 weeks

Empty scrotum

Faint rugal folds

Testes in upper canal

​

32-34 weeks

Few rugal folds, testes descending

​

>36 weeks

Well developed scrotal sac with deep rugal folds, pendulous testes

​

21 of 23

FEMALE GENITALIA

28-30 weeks

Clitoris prominent, flat labia’s to enlarging minora

​

32-34 weeks

Majora and minora becomes equally prominent

​

>36 weeks

Majora covers clitorus and minora

​

22 of 23

DON’T MISS:

Red reflex

Nasal patency

Palate patency

Hips

Anal patency

23 of 23

THANK YOU