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Age Groups:. Neonatal 1st 4 weeks Infant 1 st year Childhood 1 to 15 Years Preschool 2 to 4 years School 5 to 15 years - PowerPoint PPT Presentation
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Age Groups:Neonatal 1st 4 weeks Infant 1 st yearChildhood 1 to 15 Years
Preschool 2 to 4 years School 5 to 15 years Adolescent 13 to 19 Years
History&Physical ExaminationChief Complaint
History
Physical Examination
History :
History of Present IllnessPrevious HistoryFamily HistoryDevelopmental HistorySocial & Environmental History
History of Present Illness:
Age &SexExplain CCFeeding&AppetiteVomitingThirstAbdominal painBowel habitWeight gain or loss
Discharge from eyes ,ears,nose
Sore throatCoughBreathlessnessMouth breathingLocalized pain or
swelling
History of Present IllnesSkin Lesions or
rashJaundiceCyanosisPallorMusculatureWalkingCoordinationSpeech
HeadacheVisionHearingDysuria
&FrequencyBed WettingCharacter of urineMood……….
Previous History
Pregnancy HxDelivery HxNeonatal HxNutritional HxVaccination HxPrevious infection Dis.….
Family History
ParentsAbortionOther brothers &SistersHx of SIDS….
Developmental HistorySmilingSittingStandingWalkingSpeech….
gross motor milestones
fine motor milestones
Social & Environmental HistoryDivorceAddictionDisabilitiesDeathEconomy…..
Physical Examination:
General Inspection Physical Measurements Head &Neck Chest & Lung Cardiovascular System Abdomen Perineum &Genitalia Nervous System Locomotion System
General Inspection:General Inspection:
• Consciousness• Nutrition• cry• Speech• Dehydration• Skin• Deformity
• Nail• Breathing• Posture• Movements• Relationship with
parents• Abnormal smells
Physical signs of allergy The allergic salute Eczema lesions
Cholinergic urticaria Angioedema
Physical Measurements: Weight
15% weight loss during first 7-10 days
1st 4 mo. : BW + (Age in mo. * 0.8)2nd 4 mo. : BW + (Age in mo. * 0.7)3rd 4 mo. : BW + (Age in mo. * 0.6) Infants birth weight double by 5 mo. Infants birth weight triple by 1 year
Physical Measurements: Weight
1-9 years add 4 to the age in years and multiply by 2
9-12 triple the age in year
Physical Measurements:length
At birth 50 cm6 mo. 68 cm1year 75 cm2 years 85 cm3 years 95 cm4 years 100 cmOver the next 8 years 5.5 cm each year
This 5.5-year-old boy with growth hormone deficiency (left) was significantly smaller
than his twin sister (right).
Physical MeasurementsHead circumference
At birth 35cm6 mo. 43.5 cm1 year 46.5 cm2 years 49 cm2-7 years 0.5 cm annually
microcephaly
Physical MeasurementsTemperature
Low reading thermometers(29-43 c)
Diurnal variation
Rectal 37.5 c (>38 c) Groin &Auxiliary 37 c (>37.3 c)
oral 37-37.5 (>37.6 c)
Physical Measurements Blood pressure
Right armNewborn(Flush method) 70/35
Infancy(Systolic/Diastolic) 80/55
Preschool child (Systolic/Diastolic) 85/60School child (Systolic/Diastolic) 90/60
Head &NeckCranium
Ant. Fontanel: 2.5 * 2.5 cm and closed until 18 mo.
Post. Fontanel:0.5 cm and closed shortly after birth.
Sutures
Cranium
Head &Neck
Facial appearance
Large tongue
Marked nasolabial line
Nasal bridge(Low,Wide)
Facial palsy
Low hair line
Hypertelorism
Microganetia
Russell-Silver dwarfism
Vitiligo Pityriasis alba
Alopecia areata Tinea capitis
Head &NeckEar
AnomaliesLow set earCanal(Wax,Forign body,Discharge…)Tympanic membrane(Color,Perforation ,Buldging or Retraction)Cone of light