-
anterior fontanelle molding
- overriding of parietal bones as head passes through birth canal
- resolves on its own
-
caput succedanum
- scalp swelling
- collection of fluid under scalp, looks like a crown
- can also block posterior fontanelle
- resolves on its own in several days
-
cephalohematoma
- bleeding between periosteum and skull from pressure during birth
- limited to one cranial bone, doesnt cross suture line
- resolves on its own in about 1 month
-
normal head circumference at birth
- 32-38 cm
- 1/4 of newborns length
- 1/3 of their weight
-
macrocephaly
- large head size
- can be WNL, familial
- due to increased ICP before sutures close
-
craniosynstosis
- asymmetrical head shape due to premature closure of sutures
- need surgery to correct
-
dacrocystitis
blocked tear duct: will see redness, discharge, swelling
-
parachute reflex
- around 8-9 months
- if you drop the baby, they put their hands out in a parachute in front of them
-
grasp reflex
place finger in the babies hand and want them to hold your finger
-
head lag
- with baby laying down, hold their hand and slowly pull them into a sitting position
- the head will lag behind the body until you get into a sitting position and it should straighten up
-
hypotonia, hypertonia
- both occur during the head lag reflex
- hypo: baby will be floppy, muscles not flexed at all
- hyper: muscles will be flexed, baby may look scrunched up
-
doll's eye test
you want the eyes to move as you move their head
-
rooting reflex
tests the trigeminal nerve, touch the side of their face and they should turn their head in that direction
-
tonic neck reflex
- turn head to the side, and their arm should straighten out in the direction the head is facing
- will go away by the first year
-
moro reflex
- as you lower the child, hands are opened and C shaped, and their hands move in above them
- damage to shoulder during birth may affect one arm
-
startle reflex
hit basinet/crib or make a noise and they will clench fists and bring them in front of their body
-
Pediatric growth monitoring
- birth-3yrs: length for age and weight for age
- or head circumference for age and weight for length
- at 2 yrs, head size is 2/3 adult size
-
birth weight
- doubles by 6 monhts
- triples by 1 year
-
newborn vitals
- HR: 110-160
- BP: 65-85/ 45-55
- RR: 40-60
- count HR and RR for a full minute
-
innocent heart murmur
- can resolve on its own
- non-pathological
- wont find any other symptoms
-
PMI in peds
- 4th intercostal space in children 7 or younger
- 5th intercostal space
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