Neurological Assessment of a Newborn
A newborn neurological assessment is performed during a complete physical exam. The nervous system consists of the brain, spinal cord, 12 cranial nerves that come from the brain and other various nerves that arise from the spinal column (University of Rochester Medical Center [URMC], 2014). A thorough neurological examination is important to detect underlying problems that can cause delay or deficit in the normal development and functioning of an infant (URMC, 2014). This paper will discuss the proper examination of behavior, cranial nerves, tone, positioning, reflexes, head sutures and head circumference of a newborn and how they relate to a neurological examination (University of Utah Medical Center …show more content…
Thigh is flexed to abdomen and leg is then straightened by raising at the ankle: should be no more than approximately 90 degrees
Heal to ear Attempt to bring foot to ear; should stop at chest or shoulder, otherwise this indicates hypotonia
Neck tone Perform passive ROM by turning head side to side. The chin should not go past the shoulder
Head lag This can be performed while pulling the baby by the arms to the sitting position. The head should lag behind, partially (not fully) flexed backward and the infant should be able to raise the head upright for a few seconds
Head control The infant should momentarily be able to raise head from chest from a flexed position as well as bring head upright from an extended position while sitting up
(UUMC, 2013a)
Positions
To assess newborn positions, the baby is draped over the hand in a prone position (UUMC, 2013a). The head and back should remain in the same plane and there should be flexion maintained in the extremities (UUMC, 2013a). Vertical suspension is performed by holding the baby under the arms and around the chest in a vertical position (UUMC, 2013a). The infant should be easily held upright without slipping through the hands; which would indicate poor muscle tone of the shoulder girdle (UUMC, …show more content…
It is not uncommon to have molding (over-riding cranial bones) of the head due to childbirth, but this should resolve within the first five days of life (Moses, 2014). Fontanelles should be soft and neither bulging or sunken which could indicate increased intracranial pressure or dehydration, respectively (Moses, 2014). It is important to measure the occipital-frontal circumference (OFC) of the head which should be 33-38 cm (Moses, 2014). A large or small OFC can indicate serious congenital issues (Moses, 2014) and should be
A newborn neurological assessment is performed during a complete physical exam. The nervous system consists of the brain, spinal cord, 12 cranial nerves that come from the brain and other various nerves that arise from the spinal column (University of Rochester Medical Center [URMC], 2014). A thorough neurological examination is important to detect underlying problems that can cause delay or deficit in the normal development and functioning of an infant (URMC, 2014). This paper will discuss the proper examination of behavior, cranial nerves, tone, positioning, reflexes, head sutures and head circumference of a newborn and how they relate to a neurological examination (University of Utah Medical Center …show more content…
Thigh is flexed to abdomen and leg is then straightened by raising at the ankle: should be no more than approximately 90 degrees
Heal to ear Attempt to bring foot to ear; should stop at chest or shoulder, otherwise this indicates hypotonia
Neck tone Perform passive ROM by turning head side to side. The chin should not go past the shoulder
Head lag This can be performed while pulling the baby by the arms to the sitting position. The head should lag behind, partially (not fully) flexed backward and the infant should be able to raise the head upright for a few seconds
Head control The infant should momentarily be able to raise head from chest from a flexed position as well as bring head upright from an extended position while sitting up
(UUMC, 2013a)
Positions
To assess newborn positions, the baby is draped over the hand in a prone position (UUMC, 2013a). The head and back should remain in the same plane and there should be flexion maintained in the extremities (UUMC, 2013a). Vertical suspension is performed by holding the baby under the arms and around the chest in a vertical position (UUMC, 2013a). The infant should be easily held upright without slipping through the hands; which would indicate poor muscle tone of the shoulder girdle (UUMC, …show more content…
It is not uncommon to have molding (over-riding cranial bones) of the head due to childbirth, but this should resolve within the first five days of life (Moses, 2014). Fontanelles should be soft and neither bulging or sunken which could indicate increased intracranial pressure or dehydration, respectively (Moses, 2014). It is important to measure the occipital-frontal circumference (OFC) of the head which should be 33-38 cm (Moses, 2014). A large or small OFC can indicate serious congenital issues (Moses, 2014) and should be