Newborn Assessment

Reference for physical norms & abnormalities in the newborn

49 cards   |   Total Attempts: 188
  

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Cards In This Set

Front Back
SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Posture SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Posture SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Posture SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Posture SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Posture SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Posture
The preterm infant primarily exhibits unopposed passive extensor tone, while the infant approaching term shows progressively less opposed passive flexor tone.
SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Square Window SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Square Window SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Square Window SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Square Window SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Square Window SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Square Window SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Square Window
From extremely pre-term to post-term, the resulting angle between the palm of the infant's hand and forearm is estimated at >90°, 90°, 60°, 45°, 30°, and 0°.
SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Arm Recoil SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Arm Recoil SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Arm Recoil SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Arm Recoil SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Arm Recoil SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Arm Recoil
Taking the infant's hand, the examiner briefly sets the elbow in flexion, then momentarily extends the arm before releasing the hand. The angle of recoil to which the forearm springs back into flexion is noted, and the appropriate square is selected on the score sheet. The extremely pre-term infant will not exhibit any arm recoil. Square #4 is selected only if there is contact between the infant's fist and face. This is seen in term and post term infants.
SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Popliteal Angle SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Popliteal Angle SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Popliteal Angle SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Popliteal Angle SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Popliteal Angle SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Popliteal Angle SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Popliteal Angle SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Popliteal Angle
The angle formed at the knee by the upper and lower leg is measured; premature infants may have a popliteal angle > 100o
SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Scarf Sign SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Scarf Sign SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Scarf Sign SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Scarf Sign SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Scarf Sign SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Scarf Sign SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Scarf Sign
Landmarks noted in order of increasing maturity are: full scarf at the level of the neck (-1); contralateral axillary line (0); contralateral nipple line (1); xyphoid process (2); ipsilateral nipple line (3); and ipsilateral axillary line (4). - term infants' elbow position should not cross midline
SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Heel To Ear SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Heel To Ear SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Heel To Ear SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Heel To Ear SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Heel To Ear SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Heel To Ear SIGN NEURO-MUSCULAR MATURITY SCORE SIGN SCORE -1 0 1 2 3 4 5 Heel To Ear
Landmarks noted in order of increasing maturity include resistance felt when the heel is at or near the: ear (-1); nose (0); chin level (1); nipple line (2); umbilical area (3); and femoral crease (4).
How does the newborn's skin indicate gestational age?
Maturation of fetal skin involves the development of its intrinsic structures concurrent with the gradual loss of its protective coating, the vernix caseosa. Hence, it thickens, dries and becomes wrinkled and/or peels, and may develop a rash as fetal maturation progresses. These phenomena may occur at varying paces in individual fetuses depending in part upon the maternal condition and the intrauterine environment.
How does lanugo indicate gestational age?
In extreme immaturity, the skin lacks any lanugo. It begins to appear at approximately the 24th to 25th week and is usually abundant, especially across the shoulders and upper back, by the 28th week of gestation. Thinning occurs first over the lower back, wearing away as the fetal body curves forward into its mature, flexed position.
How does the plantar surface indicate gestational age?
The first appearance of a crease appears on the anterior sole at the ball of the foot. Very premature and extremely immature infants have no detectable foot creases.
How does the infant breast indicate gestational age?
The breast bud consists of breast tissue that is stimulated to grow by maternal estrogens and fatty tissue which is dependent upon fetal nutritional status. the examiner notes the size of the areola and the presence or absence of stippling (created by the developing papillae of Montgomery).
How does the ear indicate gestational age?
The pinna of the fetal ear changes it configuration and increases in cartilage content as maturation progresses. In very premature infants, the pinnae may remain folded when released. In such infants, the examiner notes the state of eyelid development as an additional indicator of fetal maturation
How do the genitals indicate gestational age?
Testicles found inside the rugated zone are considered descended. In extreme prematurity the scrotum is flat, smooth and appears sexually undifferentiated. At term to post-term, the scrotum may become pendulous and may actually touch the mattress when the infant lies supine.

In extreme prematurity, the labia are flat and the clitoris is very prominent and may resemble the male phallus. As maturation progresses, the clitoris becomes less prominent and labia minora become more prominent. Nearing term, both clitoris and labia minora recede and are eventually enveloped by the enlarging labia majora.
Normal weight range
2500-4000 g (avg wt = 3400 g)
<2500 premature; >4300 diabetes, post-term
ABNORMAL = loss of 3% in 1st 24 hr, >6% in 1st 2 wks
Normal length range
45-55 cm (avg = 49.6 cm)
18-22 in
long: Marfan's, LGA, diabetes
short: dwarfism, OI, SGA
Axillary Temperature
97.7o - 99.1oF (36.5-37.3oC)
ABNORMAL: environment, infection, CNS injury