Examinareastud Inter

7/29/2019 Examinareastud Inter

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Examinarea nou-nscutului


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Obiectivele prezentrii:

Examinarea iniial postnatal a nou-nscutului (primele 2 ore postnatal)

Primul examen neonatal de rutin (n primele72 ore de via)


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Examinarea primar a nou-nscutului are cascop:

Determinarea vrstei gestaionale a nou-

nscutuluii corespunderii acestei vrste

Detectarea strilor patologice ale nou-nscutului

Stabilirea prezenei anomaliilor congenitale de

dezvoltare.


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EVALUAREA I CONDUITA NOU-NSCUTULUI

Ev

aluarea

pentru

respiraie normal Neregulatsau absent

Normal normal

Frecvencardiac

FC>100bat/min

FC100bat/min

FC>100bat/min

Greutate/vrst degestaie

GN>2500

VG>37sapt

GN2500

VG37sapt

GN2500

VG37sapt

GN2500

VG37sapt

Defecte/traume la natere

Absente Absente Absente Present

clasificare copil sntos Asfixie Greutate

mic lanatere

Defect/traum

e la natere

conduit ngrijireacopiluluisntos

ngrijireacopiluluiasfixic

ngrijireacopilului cugreutate mic

la natere

ngrijireacopilului cutraume/defec

te la natere


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Variantele vrstei gestaionale:

a)nou-nscut matur(nscut ntre 37 i 42 sptmni)

b)nou-nscut prematur (nscutpn la 36 sptmni desarcin)

c)nou-nscut postmatur(nscutdup 42 sptmnidupsarcin).

Nou-nscut imaturcopil, nscut la termen, cu particularitimorfologice i funcionale caracteristice prematurului.


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Starea nou-nscutului n cadrul primuluiexamen clinic n sala de natere:

- scorul Apgar;

- criteriile antropometrice (greutatea, talia,perimetrul cranian i toracic);

- sexul;

- rezultatele primelorsimptome de depistajurgent.


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IPTUL NOU-NSCUTULUI (Strigtul copilului)

se apreciaz intensitatea (puternic, slbit, lipsete),durata (scurt, ndelungat), modularea (cefalic,afonic, nazonat, de frecven nalt),

emoionalitatea -strigtul emoional adecvat aparela aplicarea excitantului i se ntrerupe n scurttimpdup aciunea lui.


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Sistemul osos

Se ncepe cu examinarea extern: apreciereanumrului de degete, forma lor, micrile nele.

Examinarea feei.

Examinarea articulaiei coxo-femurale


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Examinarea tegumentelor i esutului adipos

subcutanat:

Pielea nou-nscutului e cald la palpare, fin,catifelat.

Particularitile pielei, sntoase:

- milia- milia cristalina

- hemoragii peteiale n cantiti mici

teleanghiectazii lanugo- pete mongolice

- nev pigmentar congenital


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Culoarea tegumentelor

n primele minute dup natere tegumentele pot ficianotice sau se observ cianoza perioral sau acrocianoz.Dup toaleta igienic a tegumentelor apare coloraiaroie-aprins a ei (eritemul fiziologic). Mai rar copilul se nate cu

tegumentele roze. Icterul fiziologic coloraia icteric a pielii (doar minile i

plantele, de asemenea sclerele i mucoasele pstreazculoarea obinuit) sentlnete la 60 70% nou-nscui.


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Examenul capului Forma - brahi-, dolicocefalic,asimetric, craniu n turn oxicefalic.

Configuraia - ca urmare aparcurgerii cilor de natere.

Perimetrul capului de obiceimsoar 34 37 cm i e cu 2 3 cm

mai mare dect perimetrul toracic. Palparea capuluideterminmintegritatea oaselor craniene,prezena bosei sero - sanguine saucefalohematomului, hemoragieisubaponeurotice, herniilor cerebrale,infiltratelor, abceselor.

Percutarea palpatorie

Aprecierea strii fontanelelor isuturilor craniene.


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Examinarea analizorului vizual

Reacia la excitanii vizuali.Pentru nou-nscutulsntos sunt caracteristice:

simetria fantelor palpebrale

corneea transparent, vie reacie vie la lumin

poate fi strabism convergent i nistagmus orizontal nestabil

exoftalmie nepronunat la prematuri

conjunctiva neted,roz,strlucitoare

fixeaz privirea la a doua sptmn de via


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Examinarea simului olfactiv

pe rnd se apropie spre nasul sugaruluisubstane mirositoare (picturi de mint,tinctur de valerian).

Nou-nscuii i sugarii la aciunea mirosurilorreacioneaz nemulumii prin: nchidereapleoapelor, grimas a feii,ipt, se intensific

pulsul irespiraia.


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Examinarea cavitii bucale

Atragem atenie la prezena anomaliilor dedezvoltare:

micro-, macroglosia

macroglosia relativ n sindromul Pierre-Robin (areloc subdezvoltarea mandibulei micrognatie)

heiloschizis (dehiscena buzei superioare, buz de

iepure) palatoschizis (dehiscena palatului dur, gur de lup)


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Examinarea analizorului auditiv

Reacia la excitani auditivi. Normal de la 27 28 sptmni de gestaie copilul la aciuneaexcitantului auditiv rspunde prin reflexul

cohleopalpebral, tresrire, micri n membre,ncetinirea respiraiei i btilor cardiace.


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Examinarea gtului

poziia capului i palparea muchilui

sterno-cleido-mastoidian (excluderea

torticolisului)determinarea integritii claviculelor

prezena chisturilor i fistulelor

gt pterigoidian n sindromul

Shershevski-Turner


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Examinarea cutiei toracice

Normal cutia toracic a nou-nscutului e de formconic,simetric.

Stri patologice sunt considerate: asimetria cutiei

toracice, cutia toraciccuneiform sau n form deplnie, prezena ghibusului cardiac.

Palparea cutiei toracice

Percuia


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Aprecierea strii sistemului respirator

Respiraiediminuat.

Raluri

Respiraiezgomotoas

Tahipnee

Bradipnee

Dereglarea ritmului respirator

Apnee ndelungat fr bradicardie e consideratca echivalentul convulsiilor (predominant laprematuri).


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Aprecierea sistemului cardio

vascular

Referitor la suflurile cardiace la nou-nscui, trebuie atrasatenie la urmtoarele:

n primele 24-48 ore de via 60-80 % din toi nou-nscuii ausuflu cardiac. De obicei el e la mijloc de sistol

Suflu diastolic izolat la nou-nscui e depistat destul de rar,adic e suflu sistolic sau sistolic n combinare cu diastolic.

La majoritatea absolut a nou-nscuilor (mai mult de 95%)suflurile nu sunt legate de afeciuni cardiace sau suntcondiionate de defecte

Muli copii cu vicii congenitale cardiace n primele zile dupnatere nu au suflu cardiac

La nou-nscutul sntos zgomotele cardiace sunt clare, ritmice


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Examenul sistemului digestiv

Anomaliile de dezvoltare ale pereteluiabdominal, herniile.

Balonarea abdomenului

Excavarea abdomenului Asimetria abdomenului

Palparea abdomenului

Ficatul Splina


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Sistemul uro-genital

Rinichiinormal se palpeaz numai rinichiul drept.

Examinarea organelor genitale externe.

La fetie cercetarea fantei vaginale

La este necesar de examinat: hipo-, epispadie, deformareapenisului, hernie inghinal, criptorhism, hidrocele.


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. Examinarea regiunii lombare ifeselor:

hipertrihoz n reglarea formrii coloanei vertebrale

asimetrie n cazul hemoragiei suprarenalelor

simptomul mingiiperforate la afectarea regiunii lombare a mduveispinrii.

vicii de dezvoltare grave (lipsa membrelor, degetelor, etc.) articulaiile coxo-femurale normal abducia nu e limitati marginea

lateral a genunchilor nu atinge msua de examinare

Limitarea abduciei

Motilitatea patologic


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Examinarea neurologic a nounscutului

Comunicabilitatea nou-nscutului

Reacia la lumin

Reacia la excitani sonori

Activitatea motorie spontan

Mimica nou-nscutului


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Aprecierea simptomaticii neurologice

Dereglri vegetative

Aprecierea simptomaticii patologice oculare

Aprecierea simptomaticii plcii nazo-labiale

Lipsa reaciei la sunet

Lipsa suptului

Diagnosticul parezelor


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MODALITATEA APRECIERII REFLEXELOR

Se recomand cercetarea tripl a fiecrui reflex.

Reflex normal - amplitudinea reflexului n toate 3 cazuri esteidentic sau puin sczut la a 3-a apreciere.

Reflexul sczut amplitudinea iniial este sczut i se menine

n 3 cazuri de testare sau dac se micoreaz n testrileulterioare.

Istovirea reflexului - amplitudinea normal a reflexului la prima testare cumicorarea lui n urmtoarele testri sau dispariiei reflexului. Din contra,amplitudinea nalt a reflexului sau creterea ei pe msura testriidovedete creterea reflexului.


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Ce trebuie s cunoatemnainte de a examina nou-

nscutul?


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RASPUNS:

1. Evaluare familial:

etnia, condiiile socio-economice, vrsta prinilor;

toate afectrile ereditare din familie, a procreaturilor; expunerea mamei la diferii factori toxici; grupa sanguin a mamei, i dac este posibil - a tatlui; afeciunile somatice la mam; antecedente obstetrico-ginecologice la mam.


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Care sunt condiiile pentru

examinarea nou-nscutului ?


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RASPUNS:

copilul se examineaz n primele ore dup natere

temperatura ncperii unde se afl nou-nscutul vafi 24 26 C

examenul se efectueaz n incubator sau pemsu cu surs de nclzire, nou-nscutul trebuie

s fie uscat copilul se examineaz la lumina zilei sau la lumina

lmpilor de zi

minile examinatorului trebuie s fie uscate i

calde timpul binevenit pentru examinarentre hrniri

(de obicei dup 30 min dup hrnire).


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CE momente de bazeste necesar de evideniat inexaminarea nou-nscuilor ?


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s

a

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n

u

s

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RASPUNS

Copilul are cianoz?Copilul are icter?

Sunt sau nu semne de dereglare a

microcirculaiei,?

Destul de perfect e pronunatculoarea roz a Sunt tegumentelor;

paliditatea nu indic oc, anemie sau

acidoz?

Nu sunt erupii pe tegumente? Sunturme de meconiu?

E normal poza copilului? Nu sunt

tremurturi sau convulsii?

Nu sunt schimbri caracteristice pe fa sau exist vre


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Nu sunt schimbri caracteristice pe fa sau exist vre-un sindrom, de exemplu, Daunism? Respiraia eregulat? E normal frecvena ei (40) i caracterul?

Dac se petrece ventilaia artificial, e concordatdup faza respiraiei copilului cu regimulventilatorului?

Sunt edeme, focare de inflamaie, nu tinde copilul s

ia o poziie anumit (nu trebuie de schimbat)? Dac abdomenul e balonat, sunt sectoare cu

peristaltism sau fr, cu regiuni cu hiperemie?

Examinai scutecele, n care a fost nfat copilul, fiiateni dac nu sunt urme de vome, urin, snge,fecale, care ar putea indica schimbri patologice.


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Ce schimbri patologice aleculorii tegumentelor n/n

sunt ?


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Raspuns:Cianoza generalde caractercentralCianoza periferic.AcrocianozaSimptomul arlechinPaliditatea tegumentelorTen suriu (pmntiu)Icterul patologicAspect marmoratMacerarea pielii


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Ce poziii patologice ale

minii cunoasteti?

Ce poziie patologic a

plantei cunoasteti ?


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Raspuns:

1.Mna n form de ghear afectarea SNC2.Mn balan afectarea segmentelor cervicale inferioare ale mduveispinrii (Dejerin-Cliumpche)3.Mn de maimu (Aran-Duchenne, atrofic) afectarea perinatal a SNCde diferit genez4.Poziie patologic ale degetelor minii II- IV n sindromul Patau, IIIIV nsindromul Edwards

RASPUNS

1.Varusdevierea medial a planteide la axa piciorului2.Valgus - devierea lateral a planteide la axa piciorului

3.Picior calcanean flexia dorsala plantei

4.Picior balantafectarea mduveispinrii la nivelul segmentelorlombare sau afectarea trunchiurilor

nervoase ce pleac din acestesegmente

Ce patologie a tegumentelor


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Ce patologie a tegumentelorEste prezentata ?


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Ce patologie este in acest

slaid.


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RAspuns1.Cefalohamatom osusui parietal drept

2.Hidrocefalie


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Numiti patologia prezentata


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Enumerati dinamica reflexelor

necondiionate ale sugarului ?


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RASPUNS:


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Cum se apreciaza Reflexulde cercetare (Cussmaul

Henler)


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Cum se apreciaza Reflexul Babkin


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Cum se apreciaza Reflexul de

prehensiune ?


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.

C i R fl l


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Cum se apreciaza ReflexulMoro ?


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Cum se apreciazaReflexul de sprijin i

mers automat


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Cum se apreciaza Reflexul de


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Cum se apreciaza Reflexul deaprare


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Cum se apreciaza Reflexul Galant


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Cum se apreciaza Reflexul Bauer


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Examenul fizic al nou-nscutului la 72 ore

Examinarea iniialpostnatal a nou-nscutului


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p(primele 2 ore dupnatere):

Aceast examinarea are ca scop detectareaunormalformaii majorei acordareaajutorului de urgen n aceste patologii.

O scurt examinare de screening ar trebui s

includ: examinarea feei, ochilor, cavitiibucale, toracelui, abdomenului, coloaneivertebrale i a membrelor pentru a excludeanomalii majore.

Un ipt puternic i o coloraie roz ategumentelor rspndit pe fai pe corp suntsemne bune i ne vorbesc despre un copilviguros la natere.

Unii copii pot fi nscuicu nediscifrarea,


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p p ,nedeterminarea organelor genitale. n astfel decazuri, este important snu se ghiceasc genul

copilului, deoarece situaia este incerti suntnecesare mai multe teste.

Dacaveisuficientexperienclinicisuntei

capabil de a efectua o sondare orogastric acesta artrebui s fie aplicat n cazul n care avem onatere cu: polihidramnios, pentru a excludeatresia deesofag.

Primul examen neonatal de rutin (n primele
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( p72 ore de via):

Acest examen trebuie s fie efectuat de unmembru al echipei n cazul n care copilul seafl nc n maternitate/spital (medicul

neonatolog sau medical rezident ninstituiile de nivel II i III), n cele de nivel Ide ctre medicul primar de ngrijire (mediculneonatolog sau medicul pediatru).


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Obiectivele acestei examinri sunt ndreptate pe deplin

a explica mamei nainte de a fi efectuate, rezultatele artrebui s fie comunicate mamei (prinilor) inregistrate n planul de ngrijire postnatalifia deexaminare.

Se recomand ca examinarea s fie efectuat nprimele 72 de ore de la natereiinclude:

O revizuire privind starea de nutriie a copilului ianamnesticul familial, matern antenatal a mamei, peperioada de sarcininatere

Despre sarcinele, naterele anterioare, inclusiv orice sarcin,naterefinalizat cu deces, de a identifica greutatea icircumferina capului n naterile precedente.

Dac copilul a avut meconium iurin.


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Se recomand ca examenul s fie efectuatntr-un loc bine iluminat i cald.

!!! n primul rnd splai-vminile riguros pentru a reduce

riscul de infecie.


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Apoi:Ascult i respect

Evaluarea n aspect general.Evaluarea generalinclude tonusul, starea de veghe a copiluluiicoloraia tegumentelor.

Observarea general include proporiile i maturitateacopilului.

Uitai-vcu atenie pentru a exclude icterul (depreferin la lumina natural).

Dac exist birthmarks, rashes sau alte anomalii alepielii?

Ascultiptul copilului i nota sa de sunet. Cntretecopilul i completeaz aceast dat pe

curba de cretere. Apoi fectuai o examinare sistemic de la cap spre

picioare"

EXAMINAREA NOU NSCUTULUI (SCREENING NEONATAL)
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EXAMINAREA NOU-NSCUTULUI (SCREENING NEONATAL)1.PREGTIREA EXAMINRII

Consimmntul prinilorPregtirea mediului (confort, temperatur, iluminare)Identificarea nou-nscutuluiTemperatura nou-nscutului

6. ABDOMEN/UMBILICForma abdomenului

Mase abdominal

Bontul ombilical

Numrul de vase ombilicale

2. STAREA GENERAL/TEGUMENTELECuloarea i integritatea tegumentelor i mucoaselorActivitatea

Caracteristici dismorfice

Asimetrie

Caracteristici distinctive

Vrst gestaionalPigmentaii, decolorarea pielii, etc.

7. ORGANELE GENITALE/ANUSULPasajul de urin (miciunea)

Bieei:

o Penisulo Meatul uretrei

o TesticuleleFetie:

o Vaginul i orificiul utetrei

o Anusul

o Pasajul meconiumuluiOrificiul anal

3. CAP/FASimetria feei, craniuluiFontanelele id suturileCircumferina craniuluiPrulEchimoze / abraziuni

Faa: ochi,i nasul, gur, urechi le

8.MUSCOCHELETALClaviculele

Brae, mini, degete

Coapse, picioare, degete

Gt

old (ine de competena practicianului)

Spate4. SISTEMUL RESPIRATOR

Culoarea tegumentelor

Frecvea respiraieiRespiraia nazalRetracie sternal sau tiraj intercostalGrunting

9. SISTEMUL NERVOSiptul

Reflexele

5. SISTEMUL CARDIOVASCULARFrecvena cardiac i suflurilePunctul maxim de auscultare

Pulsul brachial i femoral

Simptomul depatalb

10. DOCUMENTAIE/COMPLETAREnregistra-i greutatea i lungimea copilului

Consiliai prinii la constatarea unor patologii

Documentai n fi constatrile i concluziile

Capul:


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Capul:

Forma, prezena fontanelei i dimensiunele ei,dac este normal, excavat sau bombat

Dimensiunele circumferinei craniului, apoi elevor fi nregistrate n curba de cretere

Msoar i nregistreaz circumferina craniuluipe curba de cretere n diagram

Evaluarea aspectului facial i poziia ochilor

Verificai orice asimetrie sau anomalie de formfaciale


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Ochii

Forma i aspectul normal?Verificai prezena reflexuluirou

Examinai i depistai

cataracta congenitalevident sau oricare altesemne de infecieoftalmic

Urechile:
http://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DRED%2520REFLEX%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhi7NiaySwQY6JGoH3SbnTRkKTF0lwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DEYE%2520INFECTIONS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjmYXh262xuFMkK7arka3gRmcil5ghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DEYE%2520INFECTIONS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjmYXh262xuFMkK7arka3gRmcil5ghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DEYE%2520INFECTIONS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjmYXh262xuFMkK7arka3gRmcil5ghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DEYE%2520INFECTIONS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjmYXh262xuFMkK7arka3gRmcil5ghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DRED%2520REFLEX%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhi7NiaySwQY6JGoH3SbnTRkKTF0lw


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Forma i mrimea

Inseria lor la nivelul normal sau "jos"?

Verificai pavilionul urechii, ductul auditiv extern Gura:

Culoarea mucoasei bucale, se observ boltapalatin

Verificai reflexul de sugere prin introducereaunui deget curatpuinuor n interiorul guriicopilului

Braele i cu minile:


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Braele i cu minile:

Sunt de forma normal i se deplaseaz n mod normal? Uita-te pentru o dovad de traum natal (de exemplu, de

paralizie Diushen-Erb)prin verificarea gtului, umerilor i aclaviculelor

Numrul degetelor, forma lor nu exist nici o dovad debrahidactilie, clinodactilie, sindactilie (rudimente, degetesuplimentare)?

Verificai palma, pliurile palmare - sunt multiple sau doarunul singur? Un singur pliu palmar poate fi normal, darpoate fi un semn de sindrom Down.
http://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DERB%2520S%2520PALSY%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhbRxEGfhl1MT30DcqV1hgPRuKxOwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DERB%2520S%2520PALSY%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhbRxEGfhl1MT30DcqV1hgPRuKxOwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DERB%2520S%2520PALSY%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhbRxEGfhl1MT30DcqV1hgPRuKxOwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DERB%2520S%2520PALSY%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhbRxEGfhl1MT30DcqV1hgPRuKxOwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DCLINODACTYLY%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhgJbEpSydSkJFy-B60D1YModxmHeQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DCLINODACTYLY%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhgJbEpSydSkJFy-B60D1YModxmHeQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DDOWN%27S%2520SYNDROME%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhimpK3LXOnsBuWlGPFaBKeEP_nwCQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DDOWN%27S%2520SYNDROME%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhimpK3LXOnsBuWlGPFaBKeEP_nwCQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DDOWN%27S%2520SYNDROME%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhimpK3LXOnsBuWlGPFaBKeEP_nwCQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DCLINODACTYLY%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhgJbEpSydSkJFy-B60D1YModxmHeQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DERB%2520S%2520PALSY%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhbRxEGfhl1MT30DcqV1hgPRuKxOwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DERB%2520S%2520PALSY%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhbRxEGfhl1MT30DcqV1hgPRuKxOwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DERB%2520S%2520PALSY%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhbRxEGfhl1MT30DcqV1hgPRuKxOwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DERB%2520S%2520PALSY%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhbRxEGfhl1MT30DcqV1hgPRuKxOwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DPERIPHERAL%2520PULSES%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhihtl1MSJqgpmtHXLFpeEpbcqNKghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DPERIPHERAL%2520PULSES%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhihtl1MSJqgpmtHXLFpeEpbcqNKg


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Pulsul

Verificai pulsul brachial, radial i femoral,amplitudinea, ritm i volumul

Un puls hiperdinamic poate sugera opersisten a

ductului arterial(DAP) Un puls slab poate s apar n o anomalie

congenital cardiac (afecteaz debitul cardiac)

Verificai pentru o posibil ntrziere radio-

femural (poate fi suspectat o coarctaie deaort)

Inima:
http://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DPERIPHERAL%2520PULSES%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhihtl1MSJqgpmtHXLFpeEpbcqNKghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DPATENT%2520DUCTUS%2520ARTERIOSUS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhil-Ezb-gMrrQpGtW-UGyqJuSR2JQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DPATENT%2520DUCTUS%2520ARTERIOSUS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhil-Ezb-gMrrQpGtW-UGyqJuSR2JQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DAORTIC%2520COARCTATION%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhiz_A7aZdMiyt0dGKh4cXGo7U5XzQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DAORTIC%2520COARCTATION%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhiz_A7aZdMiyt0dGKh4cXGo7U5XzQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DAORTIC%2520COARCTATION%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhiz_A7aZdMiyt0dGKh4cXGo7U5XzQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DAORTIC%2520COARCTATION%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhiz_A7aZdMiyt0dGKh4cXGo7U5XzQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DPATENT%2520DUCTUS%2520ARTERIOSUS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhil-Ezb-gMrrQpGtW-UGyqJuSR2JQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DPATENT%2520DUCTUS%2520ARTERIOSUS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhil-Ezb-gMrrQpGtW-UGyqJuSR2JQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DPERIPHERAL%2520PULSES%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhihtl1MSJqgpmtHXLFpeEpbcqNKg


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Inima:

Verificai poziia cordului la palpare i orice

depresiune sau proieminen Ascultai zgomotele inimii cu atenie, pentru a

depista orice sunet sau murmur suplimentar

Suspectarea anomalilor necesit o examinare

suplimentar (i, adesea, sunt necesare mai multeopinii i investigaii)
http://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DHEART%2520MURMUR%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjpYmObum3Krj86U3Aho_nFvkE_oQhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DHEART%2520MURMUR%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjpYmObum3Krj86U3Aho_nFvkE_oQ


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Pulmonii:

Verifica-i respiraia, frecvena, profunzimeapentru cteva secunde

Uita-te pentru orice dovad de recesiune

intercostal Ascult pentru a exclude stridorul

Auscultarea pulmonilor pentru a exclude sunetesuplimentare

Abdomenul:
http://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DINTERCOSTAL%2520RIB%2520RECESSION%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjr3Ldq4js68q1oo-QrkSDQ0EVJ2ghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DSTRIDOR%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhiRMNU-p0MwXP2NPk2zQWgOZ-jjfghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DSTRIDOR%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhiRMNU-p0MwXP2NPk2zQWgOZ-jjfghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DINTERCOSTAL%2520RIB%2520RECESSION%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjr3Ldq4js68q1oo-QrkSDQ0EVJ2g


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Abdomenul:

Msuraicircumferinabdominali forma lui Verificai cu atenie pentru a exclude hernia

umbilical, semne de infecie sau alte formaiuni

Palpaiuor organelle interne, pentru a exclude

formaiuni sau alte hernii, este necesar pentru a ficapabil de a se simi ficat i / sau splina la nou-nscuiisntoi

Verificai cu atenie organele genitale externe (a se

vedea ambiguitatea genital) alpai testicule la biei

Cercetai anusul (a fost evacuat meconiumul?)

Partea dorsal(spatele):
http://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/showdoc/40000421/&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhMwrZ-ZQM4vNnw6B6yLLIqHgM47ghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/showdoc/40000421/&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhMwrZ-ZQM4vNnw6B6yLLIqHgM47ghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/showdoc/40000421/&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhMwrZ-ZQM4vNnw6B6yLLIqHgM47ghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/showdoc/40000421/&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhMwrZ-ZQM4vNnw6B6yLLIqHgM47ghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/showdoc/40000421/&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhMwrZ-ZQM4vNnw6B6yLLIqHgM47ghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/showdoc/40000421/&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhMwrZ-ZQM4vNnw6B6yLLIqHgM47ghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/showdoc/40000421/&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhhMwrZ-ZQM4vNnw6B6yLLIqHgM47g


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Partea dorsal(spatele):

Uita-te cu atenie la tegumentele n regiuneaspatelui i la curbura spatelui / simetrie

Exist vreo dovad de spina bifida occult sau sinuspilonidal ?

Palpeaz coloana vertebral uor
http://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DSPINA%2520BIFIDA%2520OCCULTA%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhgQiTfPTFuAnMBlM2bad5QpHNbBWghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DSPINA%2520BIFIDA%2520OCCULTA%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhgQiTfPTFuAnMBlM2bad5QpHNbBWghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DPILONIDAL%2520SINUS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhiOJd8UNssLXe46LM-lPwFglQG_vwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DPILONIDAL%2520SINUS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhiOJd8UNssLXe46LM-lPwFglQG_vwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DPILONIDAL%2520SINUS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhiOJd8UNssLXe46LM-lPwFglQG_vwhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DSPINA%2520BIFIDA%2520OCCULTA%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhgQiTfPTFuAnMBlM2bad5QpHNbBWghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DSPINA%2520BIFIDA%2520OCCULTA%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhgQiTfPTFuAnMBlM2bad5QpHNbBWghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DSPINA%2520BIFIDA%2520OCCULTA%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhgQiTfPTFuAnMBlM2bad5QpHNbBWghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DSPINA%2520BIFIDA%2520OCCULTA%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhgQiTfPTFuAnMBlM2bad5QpHNbBWg


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oldurile:

n mod specific este o manver pentrudepistarea displazia congenital de old,utiliznd combinaia manevrelor Barlow i

Ortolani


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Membrele inferioare:

Verificai i depistai equinovarus talipes Verificai numrul degetelor de la picioare i

verificai forma lor .

SNC:
http://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DTALIPES%2520EQUINOVARUS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjhFb8Cnut-73jmiFuGrIG43uTZaAhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DTALIPES%2520EQUINOVARUS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjhFb8Cnut-73jmiFuGrIG43uTZaAhttp://images.google.md/imgres?imgurl=http://forums.naturalparenting.com.au/attachments/health-issues/4243d1170111781-club-foot-talipes-equinovarus-question-new-image.jpg&imgrefurl=http://forums.naturalparenting.com.au/health-issues/22294-club-foot-talipes-equinovarus-question.html&usg=__yVbOjsm0oA_BR0gAk9dlrr6lpG8=&h=280&w=268&sz=24&hl=ro&start=1&um=1&itbs=1&tbnid=HZJM5yZ_ibH_uM:&tbnh=114&tbnw=109&prev=/images%3Fq%3Dequinovarus%2Btalipes%26um%3D1%26hl%3Dro%26lr%3D%26sa%3DN%26rlz%3D1R2ADBS_ruMD357%26tbs%3Disch:1http://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DTALIPES%2520EQUINOVARUS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjhFb8Cnut-73jmiFuGrIG43uTZaAhttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DTALIPES%2520EQUINOVARUS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhjhFb8Cnut-73jmiFuGrIG43uTZaA


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SNC:

Observai tonusul, comportamentul, micrile ipostura copilului

Verificai reflexele nou-nscutului

Toate constatrile se vor nregistra n fia deexaminare a nou-nscutului.

Frecvente anomalii depistate la nou-


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Frecvente anomalii depistate la nounscut n timul examenului-screening:

Capilare sau maculare haemangioame: De asemenea, sunt cunoscute i ca pata congenitalse depisteaz n jurul ochilor i a gtului, n

regiunea cefei la 30-50% copii Cele din jurul ochilor dispar n mod normal, n primul an de via, de obicei, dac persist pe ceaf i

gt .

Zona pigmentar blue-negru: De asemenea, sunt cunoscute ca pete mongoloide albastre; vzute n regiunea lombar i pe fese.

Acestea sunt comune la copiii din prini de ras neagr, dar poate s apar i la sugarii de originecaucazian.

n mod normal, ele dispar dup primul an de via

Nevus congenital

pate mongoloide albastre

hi i b l
http://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DHAEMANGIOMAS%2520AND%2520HAEMANGIOBLASTOMAS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhg9RCfuaKINFGKrroMJJB6sSfjvqghttp://74.125.79.132/translate_c?hl=ro&sl=en&u=http://www.patient.co.uk/DisplayConcepts.asp%3FWordId%3DHAEMANGIOMAS%2520AND%2520HAEMANGIOBLASTOMAS%26MaxResults%3D50&prev=/search%3Fq%3DExamination%2Bof%2Bthe%2BNeonate%26hl%3Dro%26lr%3D%26sa%3DG&usg=ALkJrhg9RCfuaKINFGKrroMJJB6sSfjvqg


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Chist n cavitatea bucal:

Acestea sunt gsite n apropiereapalatului i pe gingii (cunoscut isub numele de perle Epstein)

Ele pot fi mai mari i pe planeulbucal

De obicei, ele se rezolv spontan

Dinii pot fi prezeni la natere(nu este necesar nici o aciune,doar cu excepia cazului n care

acestea sunt n anormali, caz ncare acestea ar putea s fiextrai).

Anomaliile care pot indica o cauza a


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Anomaliile care pot indica o cauza aunei alte maladii:

Orice fontanel cu dimesiuni largi, cu prezena unor insuledin os (oase Wormian) pot indica anomalii craniene fiindcauzate de o serie de sindroame congenitale.

O a treiafontanel,ntre anterioarnormali ceaposterioar poate indica sindromul Down.

Forma urechilor anormal sau plasate anormal ne pot indicaSindromul alcoolic fetal, anomalii craniofaciale sau altestri, cum ar fi sindromul Edward's (trisomia 18) sauanomalii congenitale renale.

Pliu palmar unic pot indica sindromul Down, dar poate figsit la copii care nu sufer de aceastafeciune.

Anomalii ale feei, maxilarului i urechilor sunt adeseaasociate cu disfuncii de auz; deaceea sunt indicate examenulspecialistului ORL i testele auditive.
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