Join a discussion about growth and development by Dr. Hands, who presents all that any parent would like to know about any health concern during the first few years of child's life. This video shows what happens in a physical exam for an 8 year ol...
Read the full transcript »

What to Expect from a Child's Physical Exam We have three children of different age. We have an eight-year old, a six-year old and we also have an 18-month old. We’re going to demonstrate some of the physical exam. It’s a physical exam characteristic that we try to list each different age group. First, what we’re going to do is the standard height and weight exam. We’re going to have Carl step up in the scale. He can take his shoes off. And my nurse will get height and weight. Now as we talk about height and weight has more meaning today when we relate them to what we call a body mass ratio. So what he would be is entered on a chart which will include body mass ratios which would be followed each year. So the height and weight are done in the usual manner that they are interpreted in a little bit different manner than we used to. What I'm going to have you do is step over here. Let’s get a blood pressure and a pulse on her. In physical examinations, they are after the height and weight is obtained. Vital signs are next. They usually consist of pulse, blood pressure and respiration if necessary. The six-year old and Casey is having her blood pressure taken, important this cap sized and the physician will use the right cap size for the child. We have larger caps for older kids and we have smaller caps to younger. This is important and as parents you find that you're getting some abnormal blood pressure at school and other places, it may be they are not using a proper cap size. Another thing is the pulse can be taken. Now the pulse is still important because it’s a hint of arrhythmias and it’s a hint of cardiac problems. It can also be a hint in disease related to different types of pulses whether it is tachycardia or bradycardia means slow pulse. Tachycardia being a rapid pulse and it’s still an important measurement. Respirations we really do in the office. We do them only if the patient has abnormal respiratory signs or complains of respiratory symptoms. Now there are some other things that we do. On the young man here, if we’re doing an evaluation for nutrition and for weight, we often do a mid-circumference of the arm which helps a lot in assessing nutrition. More significant however, is what we call skin fold measurements. And these are often done with calipers and they can be done in four locations. We do them here, in the biceps. We do it here, triceps. And we do two more, one in the back, one above his hip. These can tell us the body fat content and they are very important especially in our youngster who are heavy or are very thin in assessing their nutrition and how they are doing. Head circumference is very important. Head shape is very important. More important though in the younger kids and we've talked about general appearance. We've talked about skin. We will look at nails. Dermatoglyphics is important where we look at the hands and we look at the pattern of the skin folds and the ridging in the hands. Abnormal patterns have seen in certain inherited diseases, the one that’s best known is what we call Simian crease which is across the palm which is seen in Down syndrome and can be helpful. Again, in children you come in and have complaints and we’re trying to see if there's some underlying neurologic or neurogenetic type of problem. The rest of the exam on the bigger kids is the same as adult exam. We ask the youngster to usually get undress, but in this case for the purpose of the DVD and this young lady will just demonstrate superficially. Abdominal exam is best on trying to get the patient to relax. We always put the legs up and get them relax this way. And sometimes if we’re having trouble, we have the youngster actually palpate or on top of us. We do the abdominal exam. We check they’re get examine both boys and girls. We listen to the heart, the lung. We do ear checks, throat checks and we look in the eyes as part of the exam. What also important are other aspects of th

Advertisement
Advertisement
Advertisement