The skull is made up of many bones, 8 in the skull itself and 14 in the face area. They join together to form a solid, bony cavity that protects and supports the brain. The areas where the bones join together are called the sutures. The bones are not joined together firmly at birth. This allows the head to change shape to help it pass through the birth canal. The sutures get minerals added to them over time and harden, firmly joining the skull bones together. In an infant, the space where 2 sutures join forms a membrane-covered "soft spot" called a fontanelle (fontanel). The fontanelles allow for growth of the brain and skull during an infant's first year. There are normally several fontanelles on a newborn's skull. They are located mainly at the top, back, and sides of the head. Like the sutures, fontanelles harden over time and become closed, solid bony areas.
The fontanelles should feel firm and very slightly curved inward to the touch. A tense or bulging fontanelle occurs when fluid builds up in the brain or the brain swells, causing increased pressure inside the skull. When the infant is crying, lying down, or vomiting, the fontanelles may look like they are bulging. However, they should return to normal when the infant is in a calm, head-up position. Page 2Leggett JE. Approach to fever or suspected infection in the normal host. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 264. Nield LS, Kamat D. Fever. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 201. Page 3Chernecky CC, Berger BJ. Urinalysis (UA) - urine. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures. 6th ed. St Louis, MO: Elsevier Saunders; 2013:1146-1148. Riley RS, McPherson RA. Basic examination of urine. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 29. Sobel JD, Brown P. Urinary tract infections. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 72. Page 4Dean AJ, Lee DC. Bedside laboratory and microbiologic procedures. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 67. Korenblat KM, Berk PD. Approach to the patient with jaundice or abnormal liver test results. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 138. Riley RS, McPherson RA. Basic examination of urine. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 29. Page 5Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Full TranscriptHi, I'm Meris with Level Up RN, and in this video, I'm going to be talking to you about expected and abnormal findings in the newborn following birth. I'm going to be following along using our maternity flashcards, which are available on our website, leveluprn.com, if you want to get a set for yourself. And if you already have a set, I would invite you to follow along with me. Okay. Let's get started.
Comments will be approved before showing up. |