General observation of the contour of the head is important, since casting occurs in almost all vaginal births. When delivering peaks, the head is usually flattened on the forehead, and the top rises and forms a point at the end of the parietal bones, while the hind skull or back of the head drops sharply. The usual more oval contour of the head is identical 1-2 days after birth. The change in shape is due to the fact that the bones of the skull are not merged, which allows overlapping the edges of these bones to adapt to the size of the birth canal during labor, such molding does not occur in babies born by cesarean section.
The main anatomy of the head bones
Six bones - frontal, occipital, two parietal and two temporal - contain the skull. Between the nodes of these bones are located strips of connective tissue, called sutures. At the junction of the seams are wider spaces of uninsulated membrane tissues, called native ones. The two most important fontanelles in infections are the anterior fontanelle, formed by the joining of the sagittal, coronal and frontal sutures, and the posterior fontanelle, which is formed by the joining of the sagittal and lyamoidal sutures. It is easy to remember the location of the seams, because the coronal suture “crowns” the head and the sagittal suture “separates” the head.
Two other fontanelles — splenoid and mastoid deposits are usually present, but usually not felt. An additional fontanelle, located between the anterior and posterior fontanelles along the sagittal suture, is found in some normal newborns, but also occurs in some babies with Down syndrome. The presence of this sagittal or parietal spring is always recorded.
Clinical evaluation
The doctor probes the skull for all patent seams and fontanels, not size, shape, molding, or abnormal closure. The seams are felt as cracks between the bones of the skull, and the fontanelles are felt as wider "soft spots" at the junction of the seams. They are palpable using the tip of the index finger and run along the ends of the bones.
The size of the front spring is estimated between the middle points of the opposite sides of the fontanel (between the frontal and parietal bones). The front fontanel has a diamond shape 2.5 cm (1 inch) by 3 cm (about 1.5 inches). The rear fontanelle has a triangular shape, measuring from 0% to 1 cm (less than 1/2 inch) in the widest part. It is easily located, following the sagittal suture in the direction of the occiput.
Parent fonts should feel flat, strong, and well demarcated with the bony edges of the skull. Frequent pulsations are visible in the front spring. Coughing, crying, or lying down may temporarily cause springings to bulge and become more taut. However, an extended, tense, bulging fontanelle is a sign of increased intracranial pressure. A noticeably sunken, depressive spring is an indicator of dehydration. Such data is recorded and reported to the doctor.
The doctor also palpates the skull for any unusual masses or protuberances, especially those resulting from trauma of labor, such as caput succedaneum or cephalus hematoma, due to the flexibility of the skull, accelerating pressure on the edge of the parietal and occipital pong This phenomenon is known as physiological craniotropic tissue and, although it is usually a normal discovery, may indicate hydrocephalus, syphilis and rickets.
The degree of control of the head in newborns is also evaluated. Although the lag of the head in a newborn is normal, one should recognize the degree of ability to control the head in certain positions. If the child on his back is thrown off his hands to the position of a semi-finisher, there is a noticeable lag in the head and hyperextension. However, when the person continues to raise the infant in a sitting position, the infant tries to control the head in an upright position. When the head falls on a chest, many babies try to reach a vertical position. If the infant is held in the abdominal suspension, i.e. It is held higher and parallel to the examining surface, the infant holds the head in a straight line of the column when lying on the stomach, the newborn can be removed by slightly tilting the head, turning it from side to side.
A noticeable lag in the head is observed in Down syndrome, hypoxic infections and newborns with brain damage, which are diagnosed using specific features of the head.
