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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:Age Groups:Neonatal 1st 4 weeks Neonatal 1st 4 weeks Infant 1 st yearInfant 1 st yearChildhood 1 to 15 Years Childhood 1 to 15 Years
Preschool 2 to 4 yearsPreschool 2 to 4 years School 5 to 15 years School 5 to 15 years Adolescent 13 to 19 YearsAdolescent 13 to 19 Years
History&Physical ExaminationHistory&Physical ExaminationChief ComplaintChief Complaint
HistoryHistory
Physical ExaminationPhysical Examination
History :History :
History of Present IllnessHistory of Present IllnessPrevious HistoryPrevious HistoryFamily HistoryFamily HistoryDevelopmental HistoryDevelopmental HistorySocial & Environmental History Social & Environmental History
History of Present Illness:History of Present Illness:
Age &SexAge &Sex Explain CCExplain CC Feeding&AppetiteFeeding&Appetite VomitingVomiting ThirstThirst Abdominal painAbdominal pain Bowel habitBowel habit Weight gain or lossWeight gain or loss
Discharge from Discharge from eyes ,ears,noseeyes ,ears,nose
Sore throatSore throat CoughCough BreathlessnessBreathlessness Mouth breathingMouth breathing Localized pain or Localized pain or
swellingswelling
History of Present IllnesHistory of Present Illnes Skin Lesions or rashSkin Lesions or rash JaundiceJaundice CyanosisCyanosis PallorPallor MusculatureMusculature WalkingWalking CoordinationCoordination SpeechSpeech
HeadacheHeadache VisionVision HearingHearing Dysuria &FrequencyDysuria &Frequency Bed WettingBed Wetting Character of urineCharacter of urine MoodMood ………………..
Previous HistoryPrevious History
Pregnancy HxPregnancy HxDelivery HxDelivery HxNeonatal HxNeonatal HxNutritional HxNutritional HxVaccination HxVaccination HxPrevious infection Dis.Previous infection Dis.……..
Family HistoryFamily History
ParentsParentsAbortionAbortionOther brothers &SistersOther brothers &SistersHx of SIDSHx of SIDS……..
Developmental HistoryDevelopmental HistorySmilingSmilingSittingSittingStandingStandingWalkingWalkingSpeechSpeech……..
gross motor milestones gross motor milestones
fine motor milestones fine motor milestones
Social & Environmental HistorySocial & Environmental HistoryDivorceDivorceAddictionAddictionDisabilitiesDisabilitiesDeathDeathEconomyEconomy……....
Physical Examination:Physical Examination:
General InspectionGeneral Inspection Physical MeasurementsPhysical Measurements Head &NeckHead &Neck Chest & LungChest & Lung Cardiovascular SystemCardiovascular System AbdomenAbdomen Perineum &GenitaliaPerineum &Genitalia Nervous SystemNervous System Locomotion SystemLocomotion 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 Physical signs of allergy The allergic saluteThe allergic salute Eczema lesions
Cholinergic urticaria Angioedema
Physical Measurements:Physical Measurements: Weight Weight
15% weight loss during first 7-10 days 15% weight loss during first 7-10 days
1st 4 mo. : BW + (Age in mo. * 0.8)1st 4 mo. : BW + (Age in mo. * 0.8)2nd 4 mo. : BW + (Age in mo. * 0.7)2nd 4 mo. : BW + (Age in mo. * 0.7)3rd 4 mo. : BW + (Age in mo. * 0.6)3rd 4 mo. : BW + (Age in mo. * 0.6) Infants birth weight double by 5 mo.Infants birth weight double by 5 mo. Infants birth weight triple by 1 yearInfants birth weight triple by 1 year
Physical Measurements:Physical Measurements: Weight Weight
1-9 years add 4 to the age in years and 1-9 years add 4 to the age in years and multiply by 2multiply by 2
9-12 triple the age in year9-12 triple the age in year
Physical Measurements:Physical Measurements:lengthlength
At birth 50 cmAt birth 50 cm6 mo. 68 cm6 mo. 68 cm1year 75 cm1year 75 cm2 years 85 cm2 years 85 cm3 years 95 cm3 years 95 cm4 years 100 cm4 years 100 cmOver the next 8 years 5.5 cm each yearOver the next 8 years 5.5 cm each year
This 5.5-year-old boy with growth hormone This 5.5-year-old boy with growth hormone deficiency (deficiency (leftleft) was significantly smaller ) was significantly smaller
than his twin sister (than his twin sister (rightright).).
Physical MeasurementsPhysical MeasurementsHead circumferenceHead circumference
At birth 35cmAt birth 35cm6 mo. 43.5 cm6 mo. 43.5 cm1 year 46.5 cm1 year 46.5 cm2 years 49 cm2 years 49 cm2-7 years 0.5 cm annually2-7 years 0.5 cm annually
microcephalymicrocephaly
Physical MeasurementsPhysical MeasurementsTemperatureTemperature
Low reading Low reading thermometers(29-43 c)thermometers(29-43 c)
Diurnal variationDiurnal variation
Rectal 37.5 c (>38 c)Rectal 37.5 c (>38 c) Groin &Auxiliary 37 c Groin &Auxiliary 37 c (>37.3 c)(>37.3 c)
oral 37-37.5 (>37.6 oral 37-37.5 (>37.6 c) c)
Physical Measurements Blood pressure
Right armRight armNewborn(Flush method) Newborn(Flush method) 70/3570/35
Infancy(Systolic/Diastolic) Infancy(Systolic/Diastolic) 80/5580/55
Preschool child Preschool child (Systolic/Diastolic) 85/60(Systolic/Diastolic) 85/60School child School child (Systolic/Diastolic) 90/60(Systolic/Diastolic) 90/60
Head &NeckHead &NeckCraniumCranium
Ant. Fontanel: 2.5 * 2.5 cm and closed until 18 Ant. Fontanel: 2.5 * 2.5 cm and closed until 18 mo.mo.
Post. Fontanel:0.5 cm and closed shortly after Post. Fontanel:0.5 cm and closed shortly after birth.birth.
SuturesSutures
CraniumCranium
Head &NeckHead &Neck
Facial appearanceFacial appearance
Large tongueLarge tongue
Marked nasolabial lineMarked nasolabial line
Nasal bridge(Low,Wide)Nasal bridge(Low,Wide)
Facial palsyFacial palsy
Low hair lineLow hair line
HypertelorismHypertelorism
MicroganetiaMicroganetia
Russell-Silver dwarfismRussell-Silver dwarfism
Vitiligo Vitiligo Pityriasis albaPityriasis alba
Alopecia areata Tinea capitis Alopecia areata Tinea capitis
Head &NeckHead &NeckEarEar
AnomaliesAnomaliesLow set earLow set earCanal(Wax,Forign body,Discharge…)Canal(Wax,Forign body,Discharge…)Tympanic membrane(Color,PerforationTympanic membrane(Color,Perforation ,Buldging or Retraction),Buldging or Retraction)Cone of lightCone of light
Preauricular skin tag
Eyes:Eyes:
Telecantus:Apert,Telecantus:Apert, Hypertelorism,CrouzonHypertelorism,Crouzon PtosisPtosis Sunset signSunset sign ExophtalmusExophtalmus Enophtalmus(Horner)Enophtalmus(Horner) BuphtalmusBuphtalmus Pupils(Myosis,Myderiasis)Pupils(Myosis,Myderiasis)
ConjunctivitisConjunctivitis Icterus(Hepatitis)Icterus(Hepatitis) Ctaract(Rubella)Ctaract(Rubella) Opacity of corneaOpacity of cornea
Enophtalmus
Exophtalmus