systematic examination
Last reviewed 04/2021
Systematic examination may proceed as follows:
- look at both hands; look at the palms
- feel both brachial pulses
- feel the anterior and posterior fontanelles
- look at the ears
- look in the eyes with an opthalmoscope. Assess the red reflex and check that the iris is complete.
- double check for cyanosis by looking at the lips and tongue
- look in the mouth. After asking permission from the parents, gently feel the top of the mouth for a membranous cleft.
- look at the praecordium; count the heart rate and then auscultate
- listen to the chest; count the respiratory rate
- palpate the abdomen
- feel for the femoral pulses
- check hip stability with Barlow's and Ortalani's tests
- examine the genitalia. Check that the testes are descended in boys; also check for hypospadias. Enquire whether the baby has passed urine.
- look at the anus; assess patency. Enquire whether meconium has been passed - often this is all too obvious
- check the legs for any abnormality
- replace the nappy and ventrally suspend the baby, assessing the tone
- whilst in ventral suspension inspect and run a hand down the length of the spine as far as the sacrum. Note any dimples.
- suspend the baby facing you, with held by your thumbs under the arms. Babies with decreased tone tend to slip through the hands
- check for a moro reflex