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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