pediatrics
Physical Examination of the Newborn
Head and Neck
In a vertex delivery, the head is commonly molded with overriding of the cranial bones at the sutures and some swelling and ecchymosis of the scalp ( Caput succedaneum ). In a A Cephalhematoma is a common finding; blood accumulates between the periosteum and the bone, producing a swelling that does not cross suture lines. It may occur over one or both parietal bones and occasionally over the occiput. Cephalohematomas usually are not evident until soft-tissue edema subsides; they gradually disappear over several months. Head size and shape are inspected to detect congenital Hydrocephalus . Numerous genetic syndromes cause Overview of Congenital Craniofacial Abnormalities . The face is inspected for symmetry and normal development, particularly of the mandible, palate, pinnae, and external auditory canals. The eyes may be easier to examine the day after birth because the birth process causes swelling around the eyelids. Eyes should be examined for the red reflex; its absence may indicate Primary Infantile Glaucoma , Low-set ears may indicate Overview of Chromosomal Abnormalities , including The clinician should inspect and palpate the palate to check for soft or hard palate defects. Cleft Lip and Cleft Palate are among the most common congenital defects. Some neonates are born with an epulis (a benign hamartoma of the gum), which, if large enough, can cause feeding difficulties and may obstruct the airway. These lesions can be removed; they do not recur. Some neonates are born with primary or natal teeth. Natal teeth do not have roots and may need to be removed to prevent them from falling out and being aspirated. Inclusion cysts called Epstein pearls may occur on the roof of the mouth. When examining the neck, the clinician must lift the chin to look for abnormalities such as Lymphatic Malformations , 