Age Groups:

1. 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 • Adolescent 13 to 19 Years

2. History&Physical Examination • Chief Complaint • History • Physical Examination

3. History : • History of Present Illness • Previous History • Family History • Developmental History • Social & Environmental History

4. Age &Sex Explain CC Feeding&Appetite Vomiting Thirst Abdominal pain Bowel habit Weight gain or loss Discharge from eyes ,ears,nose Sore throat Cough Breathlessness Mouth breathing Localized pain or swelling History of Present Illness:

5. Skin Lesions or rash Jaundice Cyanosis Pallor Musculature Walking Coordination Speech Headache Vision Hearing Dysuria &Frequency Bed Wetting Character of urine Mood ………. History of Present Illnes

6. Previous History Pregnancy Hx Delivery Hx Neonatal Hx Nutritional Hx Vaccination Hx Previous infection Dis. ….

7. Family History • Parents • Abortion • Other brothers &Sisters • Hx of SIDS • ….

8. Developmental History • Smiling • Sitting • Standing • Walking • Speech • ….

9. gross motor milestones

10. fine motor milestones

11. Social & Environmental History • Divorce • Addiction • Disabilities • Death • Economy • …..

12. General Inspection Physical Measurements Head &Neck Chest & Lung Cardiovascular System Abdomen Perineum &Genitalia Nervous System Locomotion System Physical Examination:

14. Physical signs of allergy The allergic salute Eczema lesions Cholinergic urticaria Angioedema

15. 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

16. Physical Measurements: Weight • 1-9 years add 4 to the age in years and multiply by 2 • 9-12 triple the age in year

17. Physical Measurements:length • At birth 50 cm • 6 mo. 68 cm • 1year 75 cm • 2 years 85 cm • 3 years 95 cm • 4 years 100 cm • Over the next 8 years 5.5 cm each year

18. This 5.5-year-old boy with growth hormone deficiency (left) was significantly smaller than his twin sister (right).

19. Physical MeasurementsHead circumference • At birth 35cm • 6 mo. 43.5 cm • 1 year 46.5 cm • 2 years 49 cm • 2-7 years 0.5 cm annually

20. microcephaly

21. 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)

22. 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

23. 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

24. Head &Neck Facial appearance Large tongue Marked nasolabial line Nasal bridge(Low,Wide) Facial palsy

25. Low hair line Hypertelorism Microganetia

26. Russell-Silver dwarfism

28. Vitiligo Pityriasis alba

29. Alopecia areata Tinea capitis

30. Head &Neck • Ear • Anomalies • Low set ear • Canal(Wax,Forignbody,Discharge…) • Tympanic membrane(Color,Perforation • ,Buldging or Retraction) • Cone of light