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Physical examination in children

on May 16 at 01:27 PM
Physical examination
The history taking is followed by a detailed head-to￾foot physical examination of the child. Components 
of the physical examination are as follows: 
1. General examination 
• Level of consciousness 
• Nutritional status 
• Posture or attitude 
• Dysmorphic features 
• Signs of respiratory distre.u 
• Anaemia 
• Cyanosis 
• Jaundice 
• Clubbing 
• Significant lymphadenopathy 
2. Vital signs 
• Pulse 
• Respiratory rate 
• Blood pressure 
• Temperature 
3. Anthropometry 
e Weight 
e Height 
• Head circumference 
• Midarm circumference 
4. Systemic examination-the system suspected 
to be affected should be examined first. For 
eu.mple, if the child presents with palpitations 
and cymosis, the cardiovascular system should 
be examined 6rst, followed by examination of 
other systems. Systemic examination includes 
examination of the following: 
• Cardiovucular system 
• Respiratory system 
• Gastrointestinal system 
• Central nervous system 
• Genitourinary system 
• Musculoskdetal system 
• Lymphoreticular system 
Head-to-foot examination should be done for 
patients with diseases such as chromosomal disorders 
and protein energy malnutrition. 
Following features should be carefully checked 
in children, as they may be associated with other 
conditions such as congenital heart defects. neurological 
defects, delayed milestones. and so on: 
• Features of Down's syndrome 
• Features of infective endocarditi.s 
• Features of hypothyroidism 
• Features of nutritional disorders/vitamin defi￾ciencies 
• Skin and hair changes rdated to protein energy 
malnutrition 
• Neurocutaneous markers

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