儿科学英文课件:Pediatric History & Physical Exam.ppt

儿科学英文课件:Pediatric History & Physical Exam.ppt

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Vital signs Temperature. Heart Rate. Respiratory Rate. Blood Pressure: SP(mmHg)=AgeX2+80,DP=2/3SP O2 Saturation. CR time. Growth parameters Weigh- kilograms Height - centimeters Head circumference- centimeters Measure and plot on growth chart Skin Rashes: color, arrangement, distribution Color: mottling, cyanosis, jaundice Birth marker Turgor/Hydration Texture Thickness H E E N T Head Eyes Ears Nose Neck Throat Head Sutures, fontanelles anterior closed at 12-18 m posterior closed at 2-3 m fracture and swelling General shape Head Circumference Eyes Symmetry Swelling, lesions, discolouration Pupils Visual acuity Direct and consensual reflexes Visual fields and diplopia Ears Position of pinna EAC exam (otitis externa) TM exam (Clin Skills Lab) Landmarks ( malleus handle) Light reflex Colour (grey, opalescent, red, dull) Contour Middle ear contents (pus, clear fluid) Orophrynx Dentition - alignment, caries, eruption Mucous membranes Tongue Palate/Uvula - clefts, high arched Tonsils - size, exudate Posterior pharynx Neck Short in infancy Rashes/candidiasis Lymph nodes Nuchal rigidity in meningitis ROM - torticollis Clavicles - fracture Trachea Thyroid Masses Lymphadenopathy Carotid pulsations Carotid bruits Lymph nodes Enlargement Tenderness Erythematous Fluctuant Cervical, pre/post-auricular, axillary, inguinal, femoral Lungs Inspiration and Expiration Chest size and symmetry Bell or diaphragm Breath sounds harsher in infants and young children Tracheal, bronchial and adventitial Distinguish lower from transmitted upper airway sounds Abnormalities - decreased BS, crackles, wheeze, stridor, rate, retractions Cardiovascular Pulses Apical pulse - varies with age Rate and rhythm Sinus arrhythmia common S3 common Premature ventricular contractions common Functional murmur in 1/2 to 2/3 Abdomen and genitalia Warm hands, palpate gently Look at face not hands Kneel down Spleen t

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