,CONTENTS
UNITd I 15 MaledGenitalia,d213
dAngeldK.dChen
PEDIATRICdGENERALd
ASSESSmENT 16 MaledanddFemaledBreast,d232
1 ApproachdtodCaredanddAssessmentdof EricadBisgyerdMonasterio;dNaomidA.dSchapir
dChildrendanddAdolescents,d1
o
KarendG.dDuderstadt 17 Femaled Genitalia,d 242
2 AssessmentdParameters,d9 EricadBisgyerdMonasterio;dNaomidA.dSchapir
dKarendG.dDuderstadt
o
3 DevelopmentaldSurveillancedand 18 MusculoskeletaldSystem,d259d
dScreening,d24
KarendG.dDuderstadt;dNaomidA.
dSchapiro
AbbeydAlkon
4 ComprehensivedInformation 19 NeurologicaldSystem,d288
dKarendG.dDuderstadt
Gathering,d 36
KarendG.dDuderstadt;dNaomidA.dSha
piro UNITd III ChARTINg
d
5 EnvironmentaldHealthdHistory,d55 PEDIATRICdHEALThd
dKarendG.dDuderstadt CAREdVISITS
20 ChartingdPediatricdComprehensive
UNITd II SYSTEm-SPECIFIC danddSymptom-
ASSESSmENT FocuseddHealthdCaredVisits,d311
KarendG.dDuderstadt
6 Skin,d64
ReneedP.dMcLeod
APPENDICES
7 HeartdanddVasculardSystem,d83d
ElizabethdTong;dPatriciadO’Brien A Gender-danddAge-
SpecificdGrowthdChartsdanddPret
8 ChestdanddRespiratorydSystem,d102
ermdGrowthdChart,d324
dConcettinad(Tina)dTolomeo
B BodydMassdIndex–for–
9 HeaddanddNeck,d118
AgedGrowthdCharts,d331
dKarendG.dDuderstad
t C ModifieddChecklistdfordAutismdin
dToddlersd(M-CHAT),d333
10 LymphaticdSystem,d130
dKarendG.dDuderstad
D Pediatricd Symptomd Checklist,d 335
t E ChildrendwithdSpecialdHealthdCare
dNeedsd(CSHCN)dScreener,d336
11 Eyes,d140
KarendG.dDuderstadt F PediatricdEnvironmentaldHistory,d338
12 Ears,d157 G SportsdConcussiondAssessmentdToold2
PatriciadJacksondAllen d(SCATd2),d342
13 Nose,dMouth,danddThroat,d178
dPatriciadJacksondAllen
14 AbdomendanddRectum,d19
8dVictoriadF.dKeeton
,KARENdG.dDUDERSTADT,dPHD,dRN,dCPNP,dPCNS
ClinicaldProfessor
DepartmentdofdFamilydHealthdCaredNursingdS
chooldofdNursing
UniversitydofdCalifornia,dSandFrancisc
odSandFrancisco,dCalifornia;
Children’sdHealthdCenter
SandFranciscodGeneraldHospitaldSa
ndFrancisco,dCalifornia
, 3251dRiverportdLane
St.d Louis,d Missourid 63043
PEDIATRICd PHYSICALd EXAMINATION:
ANd ILLUSTRATEDd HANDBOOK,d SECONDd EDITION ISBN:d 978-0-323-10006-9
Copyrightd©d2014dbydMosby,dandimprintdofdElsevierdInc.d Copy
rightd©d2006dbydMosbydInc.
Nodpartdofdthisdpublicationdmaydbedreproduceddordtransmitteddindanydformdordbydanydmeans,delectronicdordmechani
cal,d includingdphotocopying,drecording,dordanydinformationdstoragedanddretrievaldsystem,dwithoutdpermissiondindwriting
dfromd thedpublisher. dDetailsdondhow dtodseekdpermission, dfurtherdinformation daboutdthedPublisher’s dpermissionsdpolicie
sdanddourd arrangementsdwithdorganizationsdsuchdasdthedCopyrightdClearancedCenterdanddthedCopyrightdLicensingdAg
ency,dcandbed founddatdourdwebsite:dwww.elsevier.com/permissions.
ThisdbookdanddthedindividualdcontributionsdcontaineddinditdaredprotecteddunderdcopyrightdbydthedPublisherd(otherdthand
asd maydbednoteddherein).
Notices
Knowledgedanddbestdpracticedindthisdfielddaredconstantlydchanging.dAsdnewdresearchdanddexperiencedbroadendour
d understanding,dchangesdindresearchdmethods, dprofessionaldpractices, dor dmedicaldtreatmentdmaydbecome dnecessary
.
Practitionersdanddresearchersdmustdalwaysdrelydondtheirdowndexperiencedanddknowledgedindevaluatingdanddusin
gd anydinformation,dmethods,dcompounds,dordexperimentsddescribeddherein.dIndusingdsuchdinformationdordmetho
ds,d theydshoulddbedmindfuldofdtheirdowndsafetydanddthedsafetydofdothers,dincludingdpartiesdfordwhomdtheydhavedad
profes-d sionaldresponsibility.
Withdrespectdtodanyddrugdordpharmaceuticaldproductsdidentified,dreadersdaredadviseddtodcheckdthedmostdcurren
td informationdprovidedd(i)dondproceduresdfeatureddord(ii)dbydthedmanufacturerdofdeachdproductdtodbedadministered,
dtod verifydthedrecommendedddose dor dformula,dthedmethoddandddurationdofdadministration,danddcontraindications.dI
tdisdthed responsibilitydofdpractitioners,drelyingdondtheirdowndexperiencedanddknowledgedofdtheirdpatients,dtodmakeddi
agnoses,dtod determineddosagesdanddthedbestdtreatmentdfordeachdindividualdpatient,danddtodtakedalldappropriatedsafe
tydprecautions.
Todthedfullestdextentdofdthedlaw,dneitherdthedPublisherdnordthedauthors,dcontributors,dordeditorsdassumedanydliab
ilityd fordanydinjurydand/orddamagedtodpersonsdordpropertydasdadmatterdofdproductsdliability,dnegligencedordother
wise,dord fromdanydusedordoperationdofdanydmethods,dproducts,dinstructions,dordideasdcontaineddindthedmateriald
herein.
Library dofdCongressdCataloging-in-PublicationdData
Duderstadt,dKaren.
Pediatricdphysicaldexaminationd:dandillustrateddhandbookd/dKarendG.dDuderstadt.—2ndded.
p.d;dcm.
Includesdbibliographicaldreferencesdanddindex.d IS
BNd978-0-323-10006-9d(pbk.d:dalk.dpaper)
I. Title.
[DNLM:d1.d PhysicaldExamination—
Handbooks.d2.d Child.d WSd39]d RJ50
618.92’0075--dc23
2013012810
ExecutivedContentdStrategist:dLeedHendersond
ContentdDevelopmentdSpecialist:dJackiedTwomeyd
PublishingdServicesdManager:dJeffdPattersond P
rojectdManager:dTraceydSchriefer
Designd Direction:dJessicadWilliams
Topdcoverdphoto:dNursedPractitionerdPatdClintondperformingdandeardassessment.d(PhotodbydTimdScho
on.d Copyrightd©dUniversitydofdIowa,d2002.)
Rightdcoverdphoto:dNursedPractitionerdJuliedTsirambidisdassessing
andinfantdindHaiti.d(PhotodbydTeddStevens.dCopyrightd©dTeddStevens,d2011.)
PrinteddindChina
Lastddigitdisdthedprintdnumber:d d 9d d 8d d 7d d 6d d 5d d 4d d 3d d 2d d 1
UNITd I 15 MaledGenitalia,d213
dAngeldK.dChen
PEDIATRICdGENERALd
ASSESSmENT 16 MaledanddFemaledBreast,d232
1 ApproachdtodCaredanddAssessmentdof EricadBisgyerdMonasterio;dNaomidA.dSchapir
dChildrendanddAdolescents,d1
o
KarendG.dDuderstadt 17 Femaled Genitalia,d 242
2 AssessmentdParameters,d9 EricadBisgyerdMonasterio;dNaomidA.dSchapir
dKarendG.dDuderstadt
o
3 DevelopmentaldSurveillancedand 18 MusculoskeletaldSystem,d259d
dScreening,d24
KarendG.dDuderstadt;dNaomidA.
dSchapiro
AbbeydAlkon
4 ComprehensivedInformation 19 NeurologicaldSystem,d288
dKarendG.dDuderstadt
Gathering,d 36
KarendG.dDuderstadt;dNaomidA.dSha
piro UNITd III ChARTINg
d
5 EnvironmentaldHealthdHistory,d55 PEDIATRICdHEALThd
dKarendG.dDuderstadt CAREdVISITS
20 ChartingdPediatricdComprehensive
UNITd II SYSTEm-SPECIFIC danddSymptom-
ASSESSmENT FocuseddHealthdCaredVisits,d311
KarendG.dDuderstadt
6 Skin,d64
ReneedP.dMcLeod
APPENDICES
7 HeartdanddVasculardSystem,d83d
ElizabethdTong;dPatriciadO’Brien A Gender-danddAge-
SpecificdGrowthdChartsdanddPret
8 ChestdanddRespiratorydSystem,d102
ermdGrowthdChart,d324
dConcettinad(Tina)dTolomeo
B BodydMassdIndex–for–
9 HeaddanddNeck,d118
AgedGrowthdCharts,d331
dKarendG.dDuderstad
t C ModifieddChecklistdfordAutismdin
dToddlersd(M-CHAT),d333
10 LymphaticdSystem,d130
dKarendG.dDuderstad
D Pediatricd Symptomd Checklist,d 335
t E ChildrendwithdSpecialdHealthdCare
dNeedsd(CSHCN)dScreener,d336
11 Eyes,d140
KarendG.dDuderstadt F PediatricdEnvironmentaldHistory,d338
12 Ears,d157 G SportsdConcussiondAssessmentdToold2
PatriciadJacksondAllen d(SCATd2),d342
13 Nose,dMouth,danddThroat,d178
dPatriciadJacksondAllen
14 AbdomendanddRectum,d19
8dVictoriadF.dKeeton
,KARENdG.dDUDERSTADT,dPHD,dRN,dCPNP,dPCNS
ClinicaldProfessor
DepartmentdofdFamilydHealthdCaredNursingdS
chooldofdNursing
UniversitydofdCalifornia,dSandFrancisc
odSandFrancisco,dCalifornia;
Children’sdHealthdCenter
SandFranciscodGeneraldHospitaldSa
ndFrancisco,dCalifornia
, 3251dRiverportdLane
St.d Louis,d Missourid 63043
PEDIATRICd PHYSICALd EXAMINATION:
ANd ILLUSTRATEDd HANDBOOK,d SECONDd EDITION ISBN:d 978-0-323-10006-9
Copyrightd©d2014dbydMosby,dandimprintdofdElsevierdInc.d Copy
rightd©d2006dbydMosbydInc.
Nodpartdofdthisdpublicationdmaydbedreproduceddordtransmitteddindanydformdordbydanydmeans,delectronicdordmechani
cal,d includingdphotocopying,drecording,dordanydinformationdstoragedanddretrievaldsystem,dwithoutdpermissiondindwriting
dfromd thedpublisher. dDetailsdondhow dtodseekdpermission, dfurtherdinformation daboutdthedPublisher’s dpermissionsdpolicie
sdanddourd arrangementsdwithdorganizationsdsuchdasdthedCopyrightdClearancedCenterdanddthedCopyrightdLicensingdAg
ency,dcandbed founddatdourdwebsite:dwww.elsevier.com/permissions.
ThisdbookdanddthedindividualdcontributionsdcontaineddinditdaredprotecteddunderdcopyrightdbydthedPublisherd(otherdthand
asd maydbednoteddherein).
Notices
Knowledgedanddbestdpracticedindthisdfielddaredconstantlydchanging.dAsdnewdresearchdanddexperiencedbroadendour
d understanding,dchangesdindresearchdmethods, dprofessionaldpractices, dor dmedicaldtreatmentdmaydbecome dnecessary
.
Practitionersdanddresearchersdmustdalwaysdrelydondtheirdowndexperiencedanddknowledgedindevaluatingdanddusin
gd anydinformation,dmethods,dcompounds,dordexperimentsddescribeddherein.dIndusingdsuchdinformationdordmetho
ds,d theydshoulddbedmindfuldofdtheirdowndsafetydanddthedsafetydofdothers,dincludingdpartiesdfordwhomdtheydhavedad
profes-d sionaldresponsibility.
Withdrespectdtodanyddrugdordpharmaceuticaldproductsdidentified,dreadersdaredadviseddtodcheckdthedmostdcurren
td informationdprovidedd(i)dondproceduresdfeatureddord(ii)dbydthedmanufacturerdofdeachdproductdtodbedadministered,
dtod verifydthedrecommendedddose dor dformula,dthedmethoddandddurationdofdadministration,danddcontraindications.dI
tdisdthed responsibilitydofdpractitioners,drelyingdondtheirdowndexperiencedanddknowledgedofdtheirdpatients,dtodmakeddi
agnoses,dtod determineddosagesdanddthedbestdtreatmentdfordeachdindividualdpatient,danddtodtakedalldappropriatedsafe
tydprecautions.
Todthedfullestdextentdofdthedlaw,dneitherdthedPublisherdnordthedauthors,dcontributors,dordeditorsdassumedanydliab
ilityd fordanydinjurydand/orddamagedtodpersonsdordpropertydasdadmatterdofdproductsdliability,dnegligencedordother
wise,dord fromdanydusedordoperationdofdanydmethods,dproducts,dinstructions,dordideasdcontaineddindthedmateriald
herein.
Library dofdCongressdCataloging-in-PublicationdData
Duderstadt,dKaren.
Pediatricdphysicaldexaminationd:dandillustrateddhandbookd/dKarendG.dDuderstadt.—2ndded.
p.d;dcm.
Includesdbibliographicaldreferencesdanddindex.d IS
BNd978-0-323-10006-9d(pbk.d:dalk.dpaper)
I. Title.
[DNLM:d1.d PhysicaldExamination—
Handbooks.d2.d Child.d WSd39]d RJ50
618.92’0075--dc23
2013012810
ExecutivedContentdStrategist:dLeedHendersond
ContentdDevelopmentdSpecialist:dJackiedTwomeyd
PublishingdServicesdManager:dJeffdPattersond P
rojectdManager:dTraceydSchriefer
Designd Direction:dJessicadWilliams
Topdcoverdphoto:dNursedPractitionerdPatdClintondperformingdandeardassessment.d(PhotodbydTimdScho
on.d Copyrightd©dUniversitydofdIowa,d2002.)
Rightdcoverdphoto:dNursedPractitionerdJuliedTsirambidisdassessing
andinfantdindHaiti.d(PhotodbydTeddStevens.dCopyrightd©dTeddStevens,d2011.)
PrinteddindChina
Lastddigitdisdthedprintdnumber:d d 9d d 8d d 7d d 6d d 5d d 4d d 3d d 2d d 1
