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Head and Facial Structure
People with Down syndrome can have Microgenia or a smaller than average chin, overall broadened and flattened facial features and possibly a shortened neck. One of the most recognizable features of Down syndrome are upturned almond shaped eyes with epicanthic folds. A flattened nasal bridge is also common, as well as macroglossia or an "enlarged" protruding tongue (due to both size of the tongue and a smaller oral cavity) and Brushfield spots (white or grey spots on the iris). The ears are often smaller in size and low set. Teeth can be irregularly formed, sized and placed in the skull incorrectly.
For more complications of the eye arising from Down syndrome, please consult Eye Problems Frequently Experienced with Down Syndrome. For more complications of the ear arising from Down Syndrome, please consult Hearing Complications with Down Syndrome.
Most people with Down Syndrome have an overall shorter height and tend towards being more overweight than their peers. Commonly, there is a shortening of the femurs or humerus bones or both, causing the legs or arms to be smaller than normal. Often there is brachycephaly or a flattened skull. Hypotonia or poor muscle tone is common, as is hypermobility or the ability to flex certain joints beyond their normal range (this may not affect all joints). Related to this is a potentially dangerous condition known as Atlanto-axial Instability where there is a looseness between the fist and second vertebrae. It is also not uncommon for people with Down syndrome to have diastasis recti or a separation in the abdominal muscles. Umbilical hernias are also frequently seen.
Hands and Feet
A single palmar crease or simian crease is very common, as is "sandal foot" or the presence of a larger than normal space between the great and second toe. Short fingers, an increased amount of ulnar loops in the fingerprints and a kink or bend of the little finger towards the hand (known as clinodactyly) are also common.
Many people with Down syndrome also have congenital heart issues as well as problems with the digestive and other organ systems. Although considered a "visual disability" by some, Down syndrome can many aspects of the body that may not be readily noticeable. Many of these traits are best viewed as quirks and have little to no impact on quality of life at all.