A neonate, or newborn, is defined as a child less than 28 days old. A thorough physical examination should be performed within the first 24 hours of life to identify abnormalities and improve outcomes by offering timely treatment. Physical examination of the newborn is typically performed sequentially from head to toe, keeping in mind common neonatal pathologies based on family and prenatal history, risk factors, and geographic region.
Last updated: Jun 8, 2023
Before examining the infant, a thorough chart review should be performed.
|Sign||0 points||1 point||2 points|
|A||Appearance||Cyanotic or mottled||Cyanotic extremities, pink body||Pink extremities and body|
|P||Pulse||Absent||< 100/min||> 100/min|
|G||Grimace||No response to stimulation||Grimace with suction or aggressive stimulation||Cry on stimulation|
|A||Activity||None||Some flexion Flexion Examination of the Upper Limbs of arms and legs||Active flexion Flexion Examination of the Upper Limbs against resistance Resistance Physiologically, the opposition to flow of air caused by the forces of friction. As a part of pulmonary function testing, it is the ratio of driving pressure to the rate of air flow. Ventilation: Mechanics of Breathing|
|R||Respirations||Absent||Weak, irregular, and slow||Strong cry|
The normal range for neonatal vital signs is unique.
Physical exam findings can help confirm the gestational date (Ballard score):
The infant’s reaction to the examination is useful in assessing:
Palpate the anterior (3–6 cm in diameter) and posterior (1–1.5 cm) fontanelles:
Palpate for symmetry:
Auscultate the lung fields bilaterally.
Inspect and palpate for any congenital Congenital Chorioretinitis defects of the spine Spine The human spine, or vertebral column, is the most important anatomical and functional axis of the human body. It consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae and is limited cranially by the skull and caudally by the sacrum. Vertebral Column: Anatomy.
|Palmar grasp Palmar Grasp Primitive Reflexes||Rooting||Moro||Tonic neck Neck The part of a human or animal body connecting the head to the rest of the body. Peritonsillar Abscess|
|Onset (gestation)||28 weeks||32 weeks||28–32 weeks||35 weeks|
|Fully developed||32 weeks of gestation||36 weeks of gestation||37 weeks of gestation||1 month after birth|
|Duration||2–3 months after birth||Less prominent 1 month after birth||5–6 months after birth||6–7 months after birth|
The following conditions can be identified or suspected through physical examination of the newborn:
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