Down syndrome :

1.Head and neck :

-brachycephaly ;

-epicanthic folds ;

-flat nasal bridge ;

-folded or dysplastic ears ;

-small ears ;

-open mouth ;

-protruding tongue ;

-narrow palate ;

-abnormal teeth ;

-short neck ;

-excessive skin at nape of the neck ;

2.Extremities:

-short broad hands;

-hypoplastic middle phalanx of fifth finger ;

-incurved fifth finger ;

-sandal gap deformity ;

-hyperflexibility of joints ;

3.Heart defects:

-atrioventricular septal defect (endocardial cushion defect);

-ventricular septal defect with or without other lesions ;

-isolated secundum atrial septal defect ;

-isolated persistent patent defectus arteriosus ;

-isolated tetralody of Fallot ;

4.Gastroontestinal defects :

-duodenal atresia/stenosis ;

-annular pancreas ;

-imperforate anus ;

-esophageal atresia ;

-hirschpung’s disease ;

5.Neonatal features ;

-flat facial profile ;

-poor Moro reflex ;

-excessive skin at nape of the neck ;

-slanted palpebral fissures ;

-hypotonia ;

-hyperflexibility of joints ;

-dysplasia of pelvis ;

-anomalous ears ;

-dysplasia of midphalanx of fifth finger ;

-transverse palmar (Simian) crease .

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