NEWBORN OR NEONATAL CLINICAL EXAMINATION.pptx

Brief illustration on how neonatal examination is done after birth of a child

1. PREP CLASS 2026 NEONATAL EXAMINATION 10/17/2025 PREP CLASS 2026 1

2. CONCEPT OF NEONATAL EXAMINATION To assess the general health of the baby. To identify any congenital abnormalities. To identify conditions requiring urgent treatments. 10/17/2025 PREP CLASS 2026 2

3. CONT’D Neonatal examination does follow any specific pattern It uses the IPPA processes. Inspection Palpation Percussion Auscultation It is usually advisable to start your examination is a cranio-cordial way. 10/17/2025 PREP CLASS 2026 3

4. BEFORE EXAMINATION? Wash your hands Introduce your to the parent Explain your role to the parent Explain procedure to the parent Seek consent from the parent and the patient Put the patient in a comfortable supine position Expose the patient adequately. Offer to check the weight, height and plot them against the appropriate growth chart for age. 10/17/2025 PREP CLASS 2026 4

5. SURROUNDINGS? Patient’s environment (oxygen, nasal prongs, incubator etc.) Cannula in situ Child’s cry (normal or abnormal) Dysmorphic features ( one limb, asymmetrical limbs, one eye etc) Generalized appearance (well, ill, flexed, extended, small for age, small for age) Cyanosis or discoloration(jaundiced) Grunting or laboured breathing Count respiratory rate (always rate and effort) 10/17/2025 PREP CLASS 2026 5

6. SKIN Vernix Milia or milium cyst Birthmarks 10/17/2025 PREP CLASS 2026 6 Vernix caseosa Milia Birthmarks

7. HEAD Inspection Shape Size Birth injuries (caput, cephalohematoma, subgaleal bleed etc.) Hair (colour, distribution, hairline, texture, pluckable) Palpation Anterior and posterior fontanelles (shape & size) Sutural lines (coronal, sagittal, frontal, lambdoidal) Measure head circumference (measure three times and take average) 10/17/2025 PREP CLASS 2026 7

8. FACE Touch forehead for temperature Eyes Number of eyes Size Shape Positioning Sclera Jaundice Conjunctiva Pallor Red reflexes Conjunctivitis 10/17/2025 PREP CLASS 2026 8

9. EARS Number of ears Size of the ears (microtia) Positioning of the ears (low set ears) 10/17/2025 PREP CLASS 2026 9

10. JAW Absence of Jaw(agnathia) Small Jaw (micrognathia) 10/17/2025 PREP CLASS 2026 10

11. CONT’D Nose Nasal bridge (normal or flat) Patency of the nostrils (choanal atresia) Philtrum (smooth points to foetal alcohol syndrome) Flaring of ala nasae Blanch the tip of nose to check for jaundice 10/17/2025 PREP CLASS 2026 11

12. CONT’D Mouth Patency Size Positioning Palate both hard and soft (cleft lip and palate) Central cyanosis Neonatal tooth Suckling reflex 10/17/2025 PREP CLASS 2026 12

13. NECK Inspection Cystic hygroma Short neck Webbed necked Palpation Palpate for clavicle for fractures PREP CLASS 2026 10/17/2025 13

14. CHEST Inspection Symmetry Scars Deformities Chest recession (effort in breathing) Nipples ( number, symmetry, positioning) Visible vein 10/17/2025 PREP CLASS 2026 14

15. CONT’D Palpation Breast enlargement Nipple bud Apex beat Heaves and thrill 10/17/2025 PREP CLASS 2026 15

16. CONT’D Auscultation Air entry Breath sounds Added sounds Heart sounds Murmurs 10/17/2025 PREP CLASS 2026 16

17. ABDOMEN Inspection Obvious deformities Distention Umbilical cord (still attached, well clamped, bleeding site, reddening around the base, discharge around the base, offensive smelling cord) Obvious bulging (hernia) Symmetry 10/17/2025 PREP CLASS 2026 17

18. CONT’D Palpation Light palpation for tenderness and masses Organ specific palpation Hernia orifices Auscultation Bowel sounds 10/17/2025 PREP CLASS 2026 18

19. GENITAL Inspection Male or female or ambiguous genitalia, Female: fused labia, clitoris & vulvar enlargement, vaginal discharges Male: circumcised or not, retractable foreskin, scrotal reggae, pigmentation, scrotal swellings Palpation Presence of testes in both scrotum Centrality of penial meatus Femoral pulses and check for inguinal lymph nodes. Check for brachio -femoral delays 10/17/2025 PREP CLASS 2026 19

20. ANUS 20 Open the anus to check for patency Fistula Fissures Haemorrhoids Masses PREP CLASS 2026 10/17/2025

21. LIMBS 21 Lower limbs Barlow and Ortolani reflexes Limb abnormalities such as clubfoot Feet (creases, polydactyly, syndactyly, number of digits) Upper limbs Capillary refill time, Palmar creases, polydactyly, syndactyly, number of digits. PREP CLASS 2026 10/17/2025

22. NEUROLOGIC Generally flexed attitude Level of alertness Tone Suckling Fencing or tonic neck Plantar Stepping Reflexes Grasp Rooting Morro (complete and symmetrical, incomplete, asymmetrical 10/17/2025 PREP CLASS 2026 22

23. BACK (turn the baby onto its side) Inspection Spina bifida Swelling Abnormalities (scoliosis, kyphosis etc.) Mongolian spot Palpation Palpate the spine Sacral oedema Auscultation Lung fields for air entry, breath sounds, and added sounds. Lung Bases. 10/17/2025 PREP CLASS 2026 23

24. 10/17/2025 PREP CLASS 2026 24 THANK THE MOTHER PRESENT YOUR FINDINGS

25. 10/17/2025 PREP CLASS 2026 25