The HEENT, or Head, Eye, Ear, Nose and Throat Exam is usually the initial part of a general physical exam, after the vital signs. Like other parts of the physical exam, it begins with inspection, and then proceeds to palpation. It requires the use of several special instruments in order to inspect the eyes and ears, and special techniques to assess their special sensory function. This module reviews some of the relevant surface anatomy and describes the basic HEENT exam. The module includes an introduction to use of the ophthalmoscope.

Pediatric musculoskeletal examination

If your body makes too little melanin, your skin gets lighter. Vitiligo is a condition that causes patches of light skin. Albinism is a genetic condition affecting a person's skin. A person with albinism may have no color, lighter than normal skin color, or patchy missing skin color.

Meningitis is a common life-threatening medical emergency caused by infectious and non-infectious agents. Rapid and accurate evaluation by history and clinical examination is helpful to guide further specific investigation and treatment. Kernig's sign, Brudzinski's sign, and nuchal rigidity are bedside diagnostic signs used to evaluate suspected cases of meningitis. The presence of meningeal irritation, however, is not pathognomonic for meningitis.

In a normal person, when a muscle tendon is tapped briskly, the muscle immediately contracts due to a two-neuron reflex arc involving the spinal or brainstem segment that innervates the muscle. The afferent neuron whose cell body lies in a dorsal root ganglion innervates the muscle or Golgi tendon organ associated with the muscles; the efferent neuron is an alpha motoneuron in the anterior horn of the cord. The cerebral cortex and a number of brainstem nuclei exert influence over the sensory input of the muscle spindles by means of the gamma motoneurons that are located in the anterior horn; these neurons supply a set of muscle fibers that control the length of the muscle spindle itself. Hyporeflexia is an absent or diminished response to tapping. It usually indicates a disease that involves one or more of the components of the two-neuron reflex arc itself. Hyperreflexia refers to hyperactive or repeating (clonic) reflexes. These usually indicate an interruption of corticospinal and other descending pathways that influence the reflex arc due to a suprasegmental lesion, that is, a lesion above the level of the spinal reflex pathways.

Pediatrics abdominal examination

examination of the lungs and respiration of newborn and children

Primitive reflexes are reflex actions originating in the central nervous system that are exhibited by normal infants, but not neurologically intact adults, in response to particular stimuli. These reflexes are absent due to the development of the frontal lobes as a child transitions normally into child development.

Pediatric examination of muscle strength and muscle tone

Examination of pulse, blood pressure and capillary refilling time

full examination of the heart

Level of consciousness, cranial nerves, muscle strength and tone, reflexes, cerebellar functions, gait, sensations...

Psychomotor learning is demonstrated by physical skills such as movement, coordination, manipulation, dexterity, grace, strength, speed; actions which demonstrate the fine motor skills such as use of precision instruments or tools. Psychomotor ability refers to a wide range of actions involving physical movement related to conscious cognitive processing. Psychomotor ability may be measured by accuracy or speed (reaction time)

This shows how to observe the movement pattern of a baby for motor abnormalities

Pediatric measurements: length, body weight...etc.

Pediatric Medical History

For open hernia repair surgery, a single long incision is made in the groin. If the hernia is bulging out of the abdominal wall (a direct hernia), the bulge is pushed back into place. If the hernia is going down the inguinal canal (indirect), the hernia sac is either pushed back or tied off and removed.

When a ventral hernia occurs, it usually arises in the abdominal wall where a previous surgical incision was made. In this area the abdominal muscles have weakened; this results in a bulge or a tear. In the same way that an inner tube pushes through a damaged tire, the inner lining of the abdomen pushes through the weakened area of the abdominal wall to form a balloon-like sac. This can allow a loop of intestines or other abdominal contents to push into the sac. If the abdominal contents get stuck within the sac, they can become trapped or “incarcerated.” This could lead to potentially serious problems that might require emergency surgery.

Laparoscopic ventral hernia repair is a technique to fix tears or openings in the abdominal wall using small incisions, laparoscopes (small telescopes inserted into the abdomen) and a patch (screen or mesh) to reinforce the abdominal wall.

The words “laparoscopic” and “open” appendectomy describes the techniques a surgeon uses to gain access to the internal surgery site. Most laparoscopic appendectomies start the same way. Using a cannula (a narrow tube-like instrument), the surgeon enters the abdomen. A laparoscope (a tiny telescope connected to a video camera) is inserted through a cannula, giving the surgeon a magnified view of the patient’s internal organs on a television monitor. Several other cannulas are inserted to allow the surgeon to work inside and remove the appendix. The entire procedure may be completed through the cannulas or by lengthening one of the small cannula incisions. A drain may be placed during the procedure. This will be removed later by your surgeon.