PHYYSICAL EXAMINATION OF THE NEWBORN

1. General inspection

-If the infant is hypotonic, cyanotic, abnormal respiratory rate, rash, cry

a. Vitals:

- Temperature (oral, auxillary, Rectal(core temperature))

- Respiration (40-60bpm)
- Pulse

b. Estimate infant weight / check infant chart

2. Examination by system

a. Head

Inspect: Size (in proportion with the body) and shape (frontal bossing, caput,
hematoma)

Measure fetal head circumference (35 +/- 2cm)

Palpate: Sutures (if closed, normal spaced, too wide or if bones overlapping) and
fontanelles (too large, sunken or bulging). What are the ages of closures of these
orifices?

b. Ears

Inspect: Pinna, periauricular tags and sinuses, fistulas, position of the ear (How do
you do this? And what would the result indicate?)

c. Face

Inspect:

- Symmetry of facial features

- Eyebrows (Joined- Dysmorphic features)
- Eyes
o Fissure should be straight when the eyes are closed, epicantal folds
o Sclera for any discharge or colour change
o Spacing of the eyes
 o Assess for cataracts or glaucoma
- Nose (Bridge of nose is saddle shaped or flat, patent nostrils or nasal flaring)
- Mouth (Presence of the pitulum and if the upper lip is thin and smooth)
- Tongue (fissures, large/small, tie tongue, teeth(true/false)

Palate :if it is intact and check suck reflex

- Jaw (Position, if larger/smaller than normal)

d. Neck

Inspect: Length, webbing, masses, tracheal tugging or the use of accessory muscles
during respiration

Palpate: Masses/ enlargements, clavicular fractures

e. Chest

Inspect: Chest wall deformities, intercostal and/ or chest wall deformities

Ascultate:

o Heart - Rate, S1S2 murmurs (grade? where it is heard the loudest,

radiation, thrills or heaves)
o Lungs Airflow, adventitious sounds

f. Abdomen

Inspect: Colour, rashes, distended (round, stiff, shiny)

Ascultate: Bowel sounds, bruit and vessels

Palpate: Superficial- masses

Deep- Organomegaly

Percuss?

g. Genital area

Inspect: Gender (male/female/ambiguous) and size

Palpate: Femoral pulse, stretched penile length, distended testes, abnormal orifices
h. Posterior aspect of neonate

Inspect (Deformities, depressions, elevations, sacral dimpling, tuff of hair) and

palpate the spine noting any deformities.

Inspect for patent anus

i.Extremities

Inspect and palpate: deformities , symmetry, fractures, count digits, capillary refill,
Barlow and Ortalani

Reflexes- Grasp(palmer and plantar), Babinski, moro, rooting