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Differences from adult in physical examination

Discover the differences in physical examinations between babies and adults. From comfort to anomalies and developmental assessments, explore the varying tools and assessments used with pediatric patients. Learn insightful memory aids for estimating weight, length, and head circumference in infants and young children.

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Differences from adult in physical examination

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  1. Differences from adult in physical examination • Comfort, confidence of the baby FIRST • OBSERVATION! • Unstructured • Intimidating examinations last • Variation from 1 Kg to 45, HR from 140 to 72 • Tools of the trade vary from toys to measuring tapes to different sizes of stethescope & BP cuffs. • Congenital malformations, dysmorphic features • Anthropometry:weight, height,HC, MAC, (span, US:LS ratio) • Developomental assessment • Nutritional status

  2. Physiological variations • Ant. Fontanel • Tonsils • Dentition • Apex beat; functional murmers • Respiratory: puerile breath sounds • Abdomen:palpable liver & spleen • Genitalia:hydrocoel in NB, phimosis in infant • umbilical hernia • Bow legs & flat feet up to 2 years • Upgoing plantars up to 2 years

  3. SOME MEMORY-AIDS INPAED.PHYSICAL EXAMINATION

  4. A ROUGH ESTIMATE OF WEIGHT • After initial wt. loss, wt.gain starts at about 10 days of age, at approx. 30 gms./day for first 3 months. • 5 months of age=BWx2 (3x2 =6Kg) • 12 months BW x3 (3x3=9Kg) • 2 yrs. BWx4 (3x4=12kg) • 3yrs. BWx5 (3x5=15Kg) • 10 yrs. Bwx10 (3x10=30kg)

  5. A rough estimate of length • (recumbent) length upto 2 yrs.of age • (standing) height after 2 yrs.of age • At birth: 50cm. • 1 year : 75cm (50% increase) • 2 years: 87.5cm ) • 4years; 100cm. • Then 5cm. /year till 10 years • (2 to 12 years…age in yrs. X6 +77cm)

  6. Head circumference • At birth: ~ 35cms. • At 12 months 47cm. (ie 12cm. increase in 12 months, but not at the rate of 1 cm./ month,but: • 2cm/mth.x3months, • 1cm/mth.xnext 3months • 0.5 cm/month x next 6 months!) • HC is approx. 3cm.> CC at birth. • HC = CC at 1 year, after which CC is > HC

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