Thursday, July 8, 2010

General clinical assessment of eyes, ears, nose, mouth, throat and neck of a newborn

The knowledge of the peculiarities of some parts of the body to recognize the newborn to ensure a very accurate clinical assessment or be to distinguish between a healthy and a sick child.

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Usually the baby keeps his eyes closed. It is best, the study of the eyes by observing the lid edema, which is usually present for the first begin two days after delivery. A mongoloid slanted, the side slope of the eyes with an inner epicanthal fold. could be a signof Down syndrome, should be observed for symmetry and the eyes for hypertelorism. The average distance between the inner distance is 2cm, 3cm or more is as ocular hypertelorism.

Tears usually do not appear until the first or second month of life. mean Purulent discharge from the eyes shortly after birth may, by Ophthalmic neonatorum gonorrhea, chemical irritation or conjunctivitis can be caused, within 1 hours after instillation of silver nitrate should appear but only 24 hours.The doctor carefully notes and records, no relief.

To visualize the surface structures of the eyes, the doctor holds the child in the supine position and gently lower the head. The eyes are usually open, similar to the mechanism of the doll's eyes. The sclera was white and clear. The cornea is examined for the presence at birth, but usually not triggered when the brain or eye damage is feared. The student usually speaks of confining light. The absence of pupillary reflex.3 weeks old in particular, suggests blindness. A fixed, dilated or narrowed pupil can show anoxia or brain injury.

A user nystagmus is normal after birth. Strabismus is a normal finding in the absence of binocular. The color of the iris is noted. Most light-skinned babies have slate gray or dark blue eyes, while dark-skinned children have brown eyes. Absence of color is characteristic of albinism. While it is quite difficult to lead a FunduscopicExamination of the retina, a red reflex should be triggered. The absence of red reflex may indicate the presence of retinal heamorrhages or congenital cataracts.

Ears
The ears are for the position, structure investigated, and auditory function. The external ear is often flattened, A otoscopic examination is usually not carried out because the channels are filled with and mix in caseosa amnioti liquid. make visualization of the drum difficult. Auditory sbility can be assessed by asharp, loud noise near the infant's head. Normally the infant with silence as startle response or twitching of the eyelids. Since no behavioral response to a sudden noise can indicate congenital deafness, and should always be reported.

Nose
The nose is flattened, usually after birth, and bruising are not uncommon. Patency of the nasal channels can by holding his hand over the mouth of the infant and a channel and having regard to the unimpeded passage of air to be assessed byOpening. If nasal patency is questionable, it should have reported it, because newborns are obligatory nasal breathers.

Thin white mucus is very common in newborns, but an opinion, bloody nasal discharge without sneezing is very common in newborn babies. Flaring of the nasal cavity is always worth noting, because it is a serious sign of air hunger, shortness of breath.

Mouth and Throat
The doctor checks the mouth to identify the existing structures. The palate is usually high and archedsomewhat narrow, a common finding is Epstein-pearl small, white, epithelial cysts on both sides along the midline of the hard palate. They are minor and disappear in several weeks.

The frenulum of the upper lip is to imagine a band, pink tissue, which is below the inner surface of the upper lip and extends to the upper alveolar process. It usually disappears when the upper jaw grows. It is particularly clear when the child smiled or yawned. The sucking reflex is triggered byPlacement of a nipple or tongue blade into the mouth of the child. The infant should show a strong suck, strong. The rooting reflex is obtained by stroking the cheek of the child and the finding of the donation reaction of the stimulated side and suck.

It is difficult to check the back of the throat. If the doctor tries to push the tongue, the child objects with strong reflex protrusion of the tongue. Therefore, it is best to visualize the uvula, while the child is crying and the chindepressed. However, the suppositories are retracted upward and backward on crying. Tonsillar tissue is not generally seen in the newborn.

Neck
The newborns neck is short and fabric folds. Proper assessment of the neck allows the head requires gentle backward fall into hyper-extension, while the back in a slightly elevated position is supported. The doctor in the area of movement, shape and abnormal masses.

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