2016-06-15

Physical Exam
Inspection
Toxic vs Non- toxic
Cool Extremities
A=Activity
P=Pulse
G=Grimace
A=Appearance
R=Respiration
LOC
Nutritional Status
Developmental status
Dysmorphic features
Vital Signs
Growth Chart:
Head Circumference
Height
Weight
BMI
Hydration Status:
Mucous membranes, tears, skin
turgor, sunken eyes,
Abdomen:
Peritoneal signs
Inspection: scaphoid, or protuberant,
umbilical hernieas,
Ausuclatate: bowel sounds
Percussoin: ascites, liver span,
traubes space
Palpation: hepatosplenomegaly:
tenderness, guarding, masses.
Stigmata of liver disease

HEENT:
Head: dysmorphic, shape of skull, head circumference, fontanels in infants
Eyes: strabismus, pupillary response, red reflex, conjunctivitis
Ears and Pharynx: exam in any child with a fever
Nose: deviated septum, presence of polyps
Mouth: lips, hard palate,soft palate
Neck: lymphadenopathy, thyroid, webbing
CV:
HR,BP, heaves/thrills
S1/S2 +S3/S4
Murmors:
Timing, location, pitch, loudness
Perfusion
pulses, cap refill, skin color
Respiratory:
Audible stridor
Wheeze
Grunting
RR, O2 sat. level of distress, Able to speak
Depth and rhythm of respiration
Signs of distress: nasal flaring, tracheal tug, indrawing
Chest wall deformities
Finger clubbing
GU:
Anal position, external inspection, Testes descended, inguinal hernias
Labia majora/minora/ vaginal discharge, Erythema/excoriation
MSK:
Gait, flat feet, toe walking, normal foot, Standing,Joints
Neurological:
Overall development
LOC.New borns: primitive reflexes
CN;Motor: strength, tone, deep reflexe, Sensory
Derm:
Jaundice, mottling, petechial,purpura
Rashes, birthmarks, hemangiomas, stigmata