Neonatology Book

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Newborn Cardiopulmonary ExamAka: Newborn Chest Exam

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  1. See Also
    1. Newborn Resuscitation
    2. Pediatric Murmur
    3. Congenital Heart Disease
    4. Neonatal Cyanosis
    5. Fetal Tachycardia
    6. Fetal Bradycardia
  2. Breast and Xiphisternum Exam
    1. Palpate for abnormality
    2. Inspection
      1. Unilateral absence or hypoplasia of pectoralis major
        1. Poland's Syndrome (Poland's Sequence)
      2. Chest Deformity
        1. Pectus Carinatum
        2. Pectus Excavatum
      3. Widely spaced nipples
        1. Turner's Syndrome
        2. Noonan Syndrome
  3. Respiratory Exam
    1. Breathing with diaphragm
    2. Brief periods apnea are normal in transition
  4. Cardiovascular Exam
    1. Vitals (Normal Newborn)
      1. See Pediatric Vital Signs
    2. Diminished Pulses
      1. Pulses diminished in all extremities
        1. Diminished cardiac output
        2. Peripheral vasoconstriction
      2. Diminished femoral pulses
        1. Heart lesion dependent on ductus arteriosus
        2. Example: Aortic Coarctation
    3. Hypertension (See normal Blood Pressure above)
      1. See Hypertension in Infants
    4. Murmurs
      1. See Pediatric Murmur
      2. Newborn murmurs are often transient
        1. Tricuspid regurgitation
        2. Patent Ductus Arteriosus
    5. Altered position of precordial heart sounds
      1. Shifted right: Dextrocardia
    6. Gallup Rhythms
      1. Split S2 is Normal
      2. Split S2 absent
        1. Aortic or pulmonic valvular atresia or stenosis
        2. Results in high pulmonary vascular resistance

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