Neural Exam - Newborn tone - scarf sign

From Embryology
<html5media height="400" width="500">File:Newborn n 07.mp4</html5media> This 5-day-old infant is in the alert, quiet state.
  • The tone of the shoulder girdle is assessed by taking the baby’s hand and pulling the hand to the opposite shoulder like a scarf.
  • The hand should not go past the shoulder and the elbow should not cross the midline of the chest.

Scarf sign assessment 01.jpg

See also Scarf Sign Assessment below.

Neural Exam Movies: normal behaviour | cranial nerves | Newborn Tone - resting posture | upper extremity‎ | arm traction | arm recoil | scarf sign | hand position | lower extremity | leg traction‎ | leg recoil‎‎ | popliteal angle‎ | heel to ear | neck tone | head lag‎ | head control | Newborn Positions - prone | ventral suspension | vertical suspension | Newborn Reflexes - deep tendon reflexes | plantar reflex‎ | suck, root | Moro | Galant | stepping‎ | grasp | Newborn Head - head shape and sutures‎ | head circumference‎ | Neonatal Diagnosis
Scarf Sign Assessment
This Scarf Sign assessment based upon 1970 study criteria.[1]

With the baby supine, take the infant's hand and try to put it around the neck and as far posteriorly as possible around the opposite shoulder. Assist this maneuver by lifting the elbow across the body. See how far the elbow will go across and grade.

  • 0 - Elbow reaches opposite axillary line
  • 1 - Elbow between midline and opposite axillary line
  • 2 - Elbow reaches midline
  • 3 - Elbow will not reach midline.
  1. <pubmed>5430794</pubmed>
Movie Source - Paul D. Larsen  
Movies from the PediNeuroLogic Exam website are used by permission of Paul D. Larsen, M.D., University of Nebraska Medical Center and Suzanne S. Stensaas, Ph.D., University of Utah School of Medicine. Additional materials were drawn from resources provided by Alejandro Stern, Stern Foundation, Buenos Aires, Argentina; Kathleen Digre, M.D., University of Utah; and Daniel Jacobson, M.D., Marshfield Clinic, Wisconsin. The movies are licensed under a Creative Commons Attribution-NonCommerical-ShareAlike 2.5 License.
Links: Neural Exam Movies | Movies

Cite this page: Hill, M.A. (2024, May 18) Embryology Neural Exam - Newborn tone - scarf sign. Retrieved from

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