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