Newborn Exam Course - Image Sources and Attribution

This document tracks all clinical images used in the Newborn Pediatric Physical Exam course, their sources, licenses, and attribution requirements.

Image Sourcing Guidelines

All images used in this course must meet these criteria:

  1. Licensing: CC0 (Public Domain), CC-BY, or CC-BY-SA licenses only
  2. De-identification: No patient identifying information visible
  3. Quality: Clear, educational value, professional medical photography
  4. Appropriateness: Not graphic or disturbing; suitable for educational use
  5. Attribution: Proper credit given according to license requirements

Primary Image Sources

  1. Wikimedia Commons (https://commons.wikimedia.org)
    • License filter: Public Domain, CC-BY, CC-BY-SA
    • Search categories: “Neonatology”, “Newborn”, “Pediatric examination”
  2. CDC Public Health Image Library (PHIL) (https://phil.cdc.gov)
    • Most images are public domain (US Government work)
    • High quality medical photography
    • Search: neonatal, newborn, infant
  3. NIH Medical Arts (https://www.nih.gov)
    • US Government images (public domain)
    • Medical illustrations and photographs
  4. OpenPediatrics (https://www.openpediatrics.org)
    • Educational resources for global pediatric care
    • Check individual image licenses
  5. MedPix (https://medpix.nlm.nih.gov)
    • Medical image database from NIH
    • Verify licenses for each image

Module-by-Module Image Needs

Module 1: General Assessment & Vital Signs

Exercise 1.1: APGAR Scoring

  • Image needed: Diagram illustrating APGAR components
  • Type: Educational illustration
  • Status: ⚠️ TO BE SOURCED
  • Suggested search: “APGAR score diagram”, “newborn assessment illustration”
  • Alternative: Create custom educational diagram (public domain)

Exercise 1.2: Vital Signs

  • Image needed: None (text-based scenarios)
  • Status: ✅ No images required

Exercise 1.3: General Appearance

  • Image needed: Well-appearing term newborn in bassinet
  • Type: Clinical photograph
  • Status: ⚠️ TO BE SOURCED
  • Search terms:
    • “normal term newborn”
    • “healthy newborn infant”
    • “well baby”
  • License requirement: CC0 or CC-BY
  • Potential sources:
    • Wikimedia Commons: https://commons.wikimedia.org/wiki/Category:Newborn_humans
    • CDC PHIL

Module 2: Head, Eyes, Ears, Nose, Throat

Exercise 2.1: Cranial Findings

Image 1: Caput Succedaneum

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “caput succedaneum”, “newborn scalp swelling”
  • Requirements: Side view showing swelling crossing suture lines
  • Potential sources:
    • Wikimedia: Search “caput succedaneum”
    • Medical education textbooks with open licenses
  • Attribution template: “Image: [Title], by [Author], licensed under [License], via [Source]”

Image 2: Cephalohematoma

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “cephalohematoma”, “newborn head hematoma”
  • Requirements: Clear view of localized swelling not crossing suture lines
  • Potential sources: Same as above

Image 3: Normal Fontanelle

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “anterior fontanelle”, “newborn fontanelle examination”
  • Requirements: Photo or diagram showing fontanelle palpation technique

Exercise 2.2: Eye Examination

Image 1: Normal Red Reflex

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “red reflex”, “newborn eye examination”, “bilateral red reflex”
  • Requirements: Bilateral symmetric red-orange reflex visible
  • Potential source: Ophthalmology educational resources

Image 2: Subconjunctival Hemorrhage

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “subconjunctival hemorrhage newborn”, “birth trauma eye”
  • License: CC-BY or CC0
  • Alternative: Well-described scenario if image unavailable

Image 3: Leukocoria (Diagram/Educational)

  • Status: ⚠️ TO BE SOURCED
  • Note: Use comparison diagram showing normal vs absent red reflex
  • Sensitive content: If using real leukocoria image, ensure it’s appropriate for educational use

Exercise 2.3: Oral Cavity

Image 1: Ankyloglossia (Tongue-Tie)

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “tongue tie newborn”, “ankyloglossia infant”
  • Requirements: Clear view of lingual frenulum restriction

Image 2: Epstein Pearls

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “Epstein pearls”, “palatal cysts newborn”
  • Requirements: Clear view of palate showing white-yellow cysts

Image 3: Cleft Palate

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “cleft palate newborn”, “isolated posterior cleft”
  • Potential source: Craniofacial surgery educational materials
  • Sensitivity: Ensure appropriate for educational use

Module 3: Cardiovascular & Respiratory

Exercise 3.1: Heart Murmurs

  • Image needed: None (audio descriptions or text-based)
  • Status: ✅ No images required
  • Note: Could add heart diagram showing murmur locations (create custom)

Exercise 3.2: Respiratory Findings

Video/Image 1: Mild Tachypnea

  • Status: ⚠️ TO BE SOURCED
  • Type: Video clip or sequential photos showing breathing pattern
  • Alternative: Detailed text description

Video/Image 2: Respiratory Distress

  • Status: ⚠️ TO BE SOURCED
  • Requirements: Clear view of retractions, nasal flaring
  • Search terms: “respiratory distress newborn”, “intercostal retractions”

Exercise 3.3: Cyanosis

Image 1: Acrocyanosis

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “acrocyanosis newborn”, “peripheral cyanosis infant”
  • Requirements: Blue hands/feet, pink trunk visible

Image 2: Central Cyanosis

  • Status: ⚠️ TO BE SOURCED
  • Note: Use with caution; ensure educational appropriateness
  • Alternative: Diagram or detailed description

Module 4: Abdomen, GU, & Musculoskeletal

Exercise 4.1: Abdominal Findings

Image 1: Umbilical Granuloma

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “umbilical granuloma”, “newborn umbilicus”

Image 2: Umbilical Hernia

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “umbilical hernia infant”, “infantile umbilical hernia”

Exercise 4.2: Hip Examination

Images/Diagrams: Ortolani and Barlow Maneuvers

  • Status: ⚠️ TO BE SOURCED
  • Type: Educational diagrams showing technique
  • Potential source: Orthopedic educational resources
  • Alternative: Create custom diagrams

Exercise 4.3: Extremity and Spine

Image 1: Sacral Dimple

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “sacral dimple newborn”, “spinal exam infant”

Image 2: Polydactyly

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “polydactyly newborn”, “extra digit infant”

Image 3: Clubfoot

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “talipes equinovarus”, “clubfoot newborn”

Module 5: Skin & Neurological

Exercise 5.1: Skin Findings

Image 1: Milia

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “milia newborn face”, “neonatal milia”

Image 2: Erythema Toxicum

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “erythema toxicum neonatorum”, “newborn rash”

Image 3: Mongolian Spots

  • Status: ⚠️ TO BE SOURCED
  • Search terms: “Mongolian spots”, “congenital dermal melanocytosis”
  • Cultural sensitivity: Ensure respectful presentation

Image 4: Neonatal HSV (if used)

  • Status: ⚠️ CONSIDER DESCRIPTION ONLY
  • Note: May be too graphic; consider detailed text description instead

Exercise 5.2: Primitive Reflexes

Videos: Reflex Testing

  • Status: ⚠️ TO BE SOURCED
  • Type: Short video clips demonstrating:
    • Moro reflex
    • Rooting reflex
    • Grasp reflex
  • Alternative: Sequential photos or detailed descriptions

Exercise 5.3: Neurological Exam

Video/Images: Tone Assessment

  • Status: ⚠️ TO BE SOURCED
  • Type: Photos or video showing:
    • Normal tone/posture
    • Hypotonic posture
  • Search terms: “infant neurological exam”, “newborn tone assessment”

Image Processing Guidelines

When sourcing images:

  1. Resolution: Minimum 800x600px for clarity
  2. File size: Optimize to <500KB for web performance
  3. Format: JPEG or PNG
  4. Watermarking: Do not remove existing watermarks
  5. Cropping: Crop only to improve educational focus, not to remove attribution

Attribution Template

For each image, include:

**Image**: [Descriptive title]
**Source**: [URL or repository name]
**Author/Creator**: [Name if available]
**License**: [CC0, CC-BY, CC-BY-SA, Public Domain]
**Modifications**: [None / Cropped / Resized]
**Attribution**: [Required attribution text per license]

Fallback Strategies

If suitable images cannot be found for a finding:

  1. Detailed Text Descriptions: Provide comprehensive written descriptions
  2. Educational Diagrams: Create custom illustrations (ensure accuracy)
  3. Link to External Resources: Reference reputable medical sites (with disclaimer)
  4. Placeholder Notice: Clearly mark as “Image to be added” with full text description

Image Verification Checklist

Before adding any image to the course:

  • License verified (CC0, CC-BY, or Public Domain)
  • Source URL documented
  • Attribution prepared according to license
  • Image is de-identified (no PHI visible)
  • Image quality is adequate for educational purposes
  • Content is appropriate (not graphic or disturbing)
  • File optimized for web (<500KB)
  • Alt text written for accessibility

Contact for Image Contributions

If you have properly licensed newborn exam images suitable for this course, please contact the project maintainers.

Current Status Summary

Total Images Needed: ~30-40 Images Sourced: 0 Status: ⚠️ Image sourcing in progress

Priority: High priority to source images for Module 1 and Module 2 first, as these are beginner modules.

Next Steps:

  1. Systematically search Wikimedia Commons for each needed finding
  2. Review CDC PHIL for public domain medical photographs
  3. Create custom diagrams for anatomy/technique illustrations
  4. Write detailed text descriptions as fallback for hard-to-find images

Last Updated: 2025-11-18 Maintained By: Physician Prompt Engineering Project