under five

1. PHYSICAL
EXAMINATION OF
UNDER-FIVE
CHILDRENS
MS. KALYANI R. SAUDAGAR

2. INTRODUCTION
Under five assessment in necessary for decision concerning
provision of appropriate health services to the children.
Children are susceptible to get many health problems. Most of
the disease are easily preventable. Children under year of age
require special health care.
PURPOSE
 To assess the health status of children
 To know the existing health problem among children
 To assess the growth and development of children
 To provide health education to their parents
 To treat the diseases if any

3. ARTICLES REQUIRED
• WEIGHING MACHINE:- To record weight
• INCH TAPE :- To measure height
• SNELLENS CHART
• SHAKIR TAPE :- To measure MAUC, bangle 4 cm
radius
• INFANT METER :- To measure the length of infant
• NUTRITION CUPS
• FLASH CARDS AND POSTERS

4. STEPS IN UNDER FIVE
ASSESSMENT
1. Take hand washing articles from the bag
2. Wash hand thoroughly with soap and water
3. Allow hands to dry in the air
4. Get the paper bag ready
5. Take out the articles from the bag such as inch tape, shakir
tape, nutrition cup, bangles 4cm radius
6. Explain the procedure the parent or the group
7. Weight the infant using the weight balance or Barscale
weighing machine or path weighing machine
8. Remove the shirt of the child
9. Weight the individual and record

5. For height and length:-
1. Place the scale and measuring rod in a well lighted or well
ventilated area
2. Hold the head and heal form and read the measure
3. Check the scale for accuracy
4. Remove extra clothing or shoes otherwise weight will vary
5. Record it accurately
6. Use infant meter if childs age is below 2 yrs
7. Place the infant on the board, hold head and feet in a straight
line and record the measurement where the tape is fixed on
the board
8. If the child is more than 2 years instruct the child to stand
with his feet together with his back to measure, arms and
hand down, head erect and eyes straight
9. Tell the height and weight of the child to the parents
10. Chest and head circumference can be measured
11. Anthro-pometry should be entered in health card

6. CLINICAL EXAMINATION OF
THE CHHILD
1. Screen the child from head to foot
2. Screen the child in the following order(and find out the
abnormalities if any)
VITAL SIGNS
Temperature :
Heart rate :
Respiratory rate :
Blood pressure :
Weight :
height/weight :

7. • General appearance of the
child:
 Body position:
 Posture:
 Evidence of pain:
 Crying:
 Hygiene:
 Nutritional status:
 Mental alertness:
 Behaviour:

8. • Head and neck: examine head for shape and size, fontanelle, sutures, hair color and
texture, presence of infection or any lesion, dandruff, webbing of neck, enlarged of thyroid
or neck swelling etc.
• Face: examine the face for expression ,asymmetry, paralysis, nose bride, size of maxillla
and mandible, tenderness over sinus.
• Eyes: observe eyes for infection, periorbital edema, photophobia, distance between the
eye, distribution of eyebrows, xeropthalmia and vision.
• Ears: examine the ear for the shape size position discharge hearing ability.
• Nose: examine the nose for patency, discharge, bleeding, deviated septum, foreign body
• Mouth and throat: examine the color of lips, lesion, cleft lip or palate, number of teeth,
evidence of dental caries, gum bleeding, swelling and lesion of baccal mucosa, tongue
and pharynx tonsilitis.
• Chest: observe the size, shape and symmetry of chest, pigeon chest, condition of breast
and nipple, breath sound, heart sound etc.
• Abdomen: examine for size and shape, distension, scar, condition of umbilical cord in
neonate, hernia.
• Limbs: examine for any deformity, asymmetry, bow legs, knock-knees, edema, limitation
of the joints, paralysis, clubbing of finger, number of fingers.
• Spine and back: sign of abdominal spine, curvature, hair, spine-bifida, neck stiffness.
• Genitalia: male genitalia assess for urethral opening and its abnormalities hypospadias,
epispadias, phimosis, hydrocele, hernia, underscended testes, size of penis.
• Anus and rectum: observe for patency of anus, presence of fistula, perianal erythema.
• Behaviour pattern: irritable, depressed, apathetic, excited, aggressive.
• Abdominal signs and symptoms: examine for presence of cough and cold, bleeding,
vomiting, loose motion, lack of hygiene, oliguria, anaemia, edema, wound, ulcer etc.
3. Inform the parent about the condition of the child.
4. Record the finding in the individual health card
5. Refer the child if needed
6. Give health talks according to the felt heads of the child