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Figure 1.182. In this stillborn infant with ectopia cordis, the heart lies outside the thoracoab-dominal wall. The heart typically has severe defects, such as in this case, with tetralogy of Fallot, secundum atrial septal defect, persistent left superior vena cava, and absent ductus arteriosus. Figure 1.181. In the same infant as in Figure 1.180, the diagnosis of diverticulum of the left ventricle was confirmed by angiogram. Figure 1.182. In this stillborn infant with ectopia cordis, the heart...
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Figure 1.164. Reticuloendothelioses or histiocytosis X represents a variety of conditions which show clinical and pathologic overlap. There is a spectrum of widely disseminated monoblastic leukemia formerly called Letterer-Siwe disease. The lung is involved in only 2 of all cases. In this chest radiograph, note the bilateral lung nodules. Figure 1.163. Congenital generalized fibromatosis can involve the skin, subcutaneous tissue, muscle, bone and visceral organs. The radiograph on die left...
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Figure 1.61. Congenital lobar emphysema most commonly involves the left upper lobe of the lung 47 . In general, the distribution is slightly greater in the right lung than in the left. The left upper lobe in this infant is hyperinflated and displaces the mediastinum to the right. The left hemithorax is larger than the right, but the absence of increased pulmonary vascular markings on the left and respiratory distress suggests the diagnosis of congenital lobar emphysema. Singleton, E., Wagner,...
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Figure 1.86. The same infant as in Figure 1.84 and 1.85 later required a second thoracentesis at the age of 48 hours. In diis chest radiograph following aspiration of the chylodiorax, a subcutaneous collection of air and a small residual pneumothorax persisted. Figure 1.85. Radiograph of the same infant as in Figure 1.84 at the age of eight hours, following thoracentesis at the age of 4 hours. Note marked improvement, although some fluid is still present. Figure 1.86. The same infant as in...
Bilateral Pulmonary Hyperaeration
Figure 1.128. Bilateral pulmonary interstitial emphysema in another infant in which the radiograph shows the typical findings of hyperinflation and diffuse hyperlucencies within the lung parenchyma. This complication of hyaline membrane disease occurs most commonly as a complication of mechanically assisted ventilation and rarely occurs spontaneously. There is widespread rupture of alveoli resulting in accumulation of air in the interstitial lung tissue. Figure 1.128. Bilateral pulmonary...
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Figure 1.110. The sequelae of meconium aspiration syndrome are noted in this radiograph. There are areas of infiltrate and blebs seen in the right lung field. Pneumothorax and pneumomediastinum are common complications. Figure 1.109. Meconium pneumonitis can occur when aspirated contents cause chemical inflammation of portions of the lung, resulting not only in hyperinflation from obstruction of airways but in patchy interstitial infiltrates extending out to the periphery. In meconium...
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Figure 1.79. In this infant with a unilateral paralysis of the right diaphragm, note the elevation of the ribs on the affected side of the chest. The chest is asymmetrical and, with inspiration, chest expansion occurred only on the normal side. In general, this condition is functional and may resolve spontaneously. Figure 1.79. In this infant with a unilateral paralysis of the right diaphragm, note the elevation of the ribs on the affected side of the chest. The chest is asymmetrical and, with...
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Figure 1.102. This photomicrograph shows hyaline membrane formation and edema fluid within the alveolus. The surrounding alveoli are thickened and atelectatic. Hyaline membranes are proteinaceous exudate from injured type I alveolar cells not lined with surfactant. The lack of surfactant represents immaturity of the type II alveolar cell. Figure 1.103. Transient tachypnea of the newborn wet lung syndrome may occur at all gestational ages most common in term infants and must be differentiated...
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Figure 1.121. A radiograph of the chest of an infant with congenital syphilis demonstrates the typical interstitial pneumonia pneumonia alba and the osseous changes of growth arrest lines at the proximal ends of the humeri and periostitis of the clavicles Higoumenakis' sign . Figure 1.121. A radiograph of the chest of an infant with congenital syphilis demonstrates the typical interstitial pneumonia pneumonia alba and the osseous changes of growth arrest lines at the proximal ends of the humeri...
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Figure 1.117. This radiograph is another example of group B streptococcal pneumonia indistinguishable from hyaline membrane disease. Only 50 of blood cultures are positive with congenital pneumonia. The diagnosis of group B streptococcal pneumonia was suggested by a positive tracheal aspirate and urine counterimmune electrophoresis CIE . Figure 1.115. Neonatal pneumonia is most commonly caused by group B Streptococcus, but can be due to Escherichia coli, Staphylococcus aureus, or Listeria...
Scaphoid Abdomen
Figure 1.67. Radiograph of another infant with congenital cystic adenomatoid malformation of the lung on the left side. This infant developed increasingly severe respiratory distress within 18 hours of birth as a result of progressive air trapping and hyperinflation. In these infants, surgical removal of the malformation is essential. Congenital cystic adenomatoid malformation may present initially as an intrapulmonary mass which appears solid or has a few scattered translucent areas, but this...
Preface
I first became attracted to the idea of producing a color atlas of neonatology many years ago. However, the impetus to synthesize my experience and compile this current collection was inspired by the frequent requests from medical students, pediatric house staff, nurses and others to provide them with a color atlas of the clinical material provided in my slide shows. For the past few decades I have used the medium of color slides and radiographs as a teaching tool. In these weekly slide shows...
Metabolic Disorders
Figure 1.21. The same infant showing the Pierre Robin sequence micrognathia, macroglossia, a protruding tongue, and a cleft palate which is often posterior. Cyanosis is often due to the tongue falling back and obstructing the posterior oropharynx. The infant should be managed in a prone position to avoid breathing problems. Micrognathia improves significantly over time. Figure 1.20. Mandibular hypoplasia, a small underdeveloped mandible, can be an isolated finding or part of a sequence such as...
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Figure 1.43. In the extremely rare condition of tracheal agenesis, the trachea and esophagus arise from the endoderm of the laryngotracheal tube. Note the communication that abnormally persists between these two structures. Figure 1.44. This radiograph depicts a swallowed cuffed endotracheal tube in the stomach. Attempts to resuscitate this infant by endotracheal intubation by the physician in attendance at delivery were unsuccessful. Leaving the tube in place, he called for assistance and the...
Introduction
Although several texts provide extensive descriptions of the newborn infant, the senses of touch, hearing, and especially sight, create the most lasting impressions. Over a period of almost five decades, my brother Jack Rudolph diligently recorded, in pictorial form, his vast experiences in physical examination of the newborn infant. Atlas of the Newborn reflects his selection from the thousands of color slides in his collection. It truly represents the art of medicine as applied to...
Cardiorespiratory System
Following birth, the function of gas exchange is transferred from the placenta to the lungs. Oxygen supply to the newborn infant depends upon the establishment of rhythmic breathing, expansion of the lungs with air, adequate pulmonary blood flow to pick up oxygen from the lungs, and systemic blood flow to transport oxygen to the tissues. Normal respiration requires that the central and peripheral nervous systems involved in breathing are appropriately developed, that respiratory muscle...