This maneuver measures passive flexor tone about the pelvic girdle by testing for passive flexion or resistance to extension of posterior hip flexor muscles.
The infant is placed supine and the flexed lower extremity is brought to rest on the mattress alongside the infant's trunk. With preterm newborns, you’ll come close to touching the heel to the ear, while you’ll meet resistance almost immediately with term newborns.
How to Review Heal to Ear of the Infant
The examiner supports the infant's thigh laterally alongside the body with the palm of one hand. The other hand is used to grasp the infant's foot at the sides and to pull it toward the ipsilateral ear.
The examiner fells for resistance to extension of the posterior pelvic girdle flexors and notes the location of the heel where significant resistance is appreciated. Landmarks noted in order of increasing maturity include resistance felt when the heel is at or near the: ear (-1); nose (0); chin level (1); nipple line (2); umbilical area (3); and femoral crease (4).
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SIGN
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NEURO-MUSCULAR MATURITY SCORE
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SIGN SCORE
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-1
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0
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1
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2
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3
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4
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5
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Heel To Ear
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