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 Examination

Chief 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 Illnes

Skin Lesions or rash

JaundiceCyanosisPallorMusculatureWalkingCoordinationSpeech

HeadacheVisionHearingDysuria

&FrequencyBed WettingCharacter of urineMood……….

Previous History

Pregnancy Hx

Delivery Hx

Neonatal Hx

Nutritional Hx

Vaccination Hx

Previous infection Dis.

….

Family History

ParentsAbortionOther brothers &SistersHx of SIDS….

Developmental History

SmilingSittingStandingWalkingSpeech….

gross motor milestones

fine motor milestones

Social & Environmental History

DivorceAddictionDisabilitiesDeathEconomy…..

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 arm

Newborn(Flush method) 70/35

Infancy(Systolic/Diastolic) 80/55

Preschool child (Systolic/Diastolic) 85/60

School 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