儿科体格检查
儿科体格检查表
姓名:_____________________________性别:_____________________________
年龄:_____________________________出生日期:_____________________________
体检日期:_____________________________检查医生:_____________________________
一、一般情况
1.体重:___________________kg2.身高:___________________cm
3.体质指数(BMI):________________4.健康评价:___________________________
二、生长发育
1.出生体重:________________kg2.出生身长:________________cm
3.正常喂养情况:__________________________4.目前喂养情况:__________________________
5.牙齿生长情况:__________________________6.舌苔情况:_____________________________
三、头部检查
1.头围:___________________cm2.头皮情况:____________________________
3.头部畸形情况:__________________________4.颅缝闭合情况:__________________________
四、眼部检查
1.裸眼视力:___________________2.眼球运动情况:__________________________
3.眼底检查:__________________________4.眼球震颤情况:__________________________
5.眼周红晕情况:__________________________6.眉毛、睫毛生长情况:_____________________
五、耳鼻喉检查
1.听力状况(右耳):___________________2.听力状况(左耳):___________________
3.耳朵外形情况:__________________________4.鼻腔通气情况:__________________________
5.鼻腔分泌物情况:__________________________6.扁桃体情况:____________________________
7.舌苔情况:____________________________
六、心肺检查
1.心率:___________________次/分钟2.心音:______________________________
3.心律:______________________________4.心界:______________________________
5.肺呼吸音:__________________________6.呼吸频率:__________________________
7.肺力:______________________________
七、腹部检查
1.腹壁肌张力:__________________________2.腹部包块:____________________________
3.腹部肝脾大小:__________________________4.腹部压痛:____________________________
5.肠鸣音:______________________________6.脐部情况:____________________________
7.会阴情况:____________________________
八、四肢检查
1.肢体活动度:__________________________2.肌力:______________________________
3.关节活动度:__________________________4.手/足趾呈现曲张情况:______________