Although some of the principles of examining children are similar to adult examination, there are important differences in both outline and detail. Children are not just small adults, and the pattern of disease, the approach to the examination and content of the examination are quite different in children. To complicate things further, the examination changes as children develop and get older. Eventually it is similar to examination in adults. The following outline aims to highlight the important differences, give some general principles and provide an outline of the examination in different age groups.
Aims and purposes of paediatric examination
- It is important to distinguish between:
- The routine examination of well babies (to screen largely for abnormalities of growth and development).
- The examination of ill babies (to establish the nature and cause and extent of any illness or injury).
- The examination of children for other specific purposes such as:
- To establish fitness for education or certain activities.
- To examine for signs of sexual abuse in child protection cases.
- However, this is not an absolute distinction. Whether ill or well, the examining doctor should have a good working knowledge of routine examination and normal findings in children at different ages.
- Problems with development, behaviour and growth may thus be identified opportunistically whilst examining an ill child.
- Doctors working with children should have a good knowledge of normal developmental milestones, as well as routine physical development and findings at different ages.
Umbilical Hernia (the navel)
- This is one of the most common paediatric surgical conditions affecting 1 in 5 of all children.
- Umbilical hernias are more common in premature babies and children with Down’s Syndrome and there is a slight familial tendency.
- They appear as a bulge at the umbilicus (the navel), which can vary from the size of a pea up to the size of a small plum. They are not usually painful and are much more obvious when the child cries or strains.
Undesended testes
- Cryptorchidism is the absence of one or bothtestes from thescrotum. The word is from the Greekkryptos, meaning hidden orchids, meaning testicle. It is the most common birth defect of the male genital. About 3% of full-term and 30% of premature infant boys are born with at least one undescended testis. However, about 80% of crypt orchid testes descend by the first year of life (the majority within three months), making the true incidence of cryptorchidism around 1% overall. Cryptorchidism may develop after infancy, sometimes as late as young adulthood, but that is exceptional.
- Cryptorchidism is distinct from monorchism, the condition of having only one testicle. The condition may occur on one or both sides; it more commonly affects the right testis.
Neural tube defect
- Neural tube defects (NTDs) are a group of birth defects in which an opening in the spinal cord or brain remains from early in human development. In the 3rd week of pregnancy called gastrulation, specialized cells on the dorsal side of the embryo begin to change shape and form the neural tube. When the neural tube does not close completely, an NTD develops.
Specific types include: spina bifida which affects the spine, anencephaly which results in little to no brain, encephalocele which affects the skull, and iniencephaly which results in severe neck problems. - Dr. Amar Shah was the speaker for all disease condition which can be examine by the nurses also and this are the common condition which we found in pediatric patients.