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Case history and physical examination

During the case history, the doctor or nursing specialist asks different questions to obtain a good impression of how your child is doing. You will be asked about any particularities that may arise. The physical examination follows the case history. The case history and physical examination will both take place during the admission to the clinic and visits to the outpatient clinic. An example, to make it more concrete: your child comes to the outpatient clinic due to stomach pain. Next, you will be asked how often your child defecates, what the stools look like and whether they contain blood or mucus.

The case history and physical examination will both take place during the admission to the clinic and visits to the outpatient clinic. An example, to make it more concrete: your child comes to the outpatient clinic due to stomach pain. Next, you'll be asked questions such as how often your child defecates, what the stools look like and so forth.

Preparations

In fact, the case history itself is a preparation for the physical examination. No specific preparation is required for a case history. This means that your child does not have to refrain from eating or drinking or to wear certain clothing. However, it may be sensible to write down and clearly state matters that are important for you or your child. If you would like to discuss certain issues concerning your child's physical health, you can raise them while the medical history is being taken.

In the beginning, your child may be stressed about the examination. In that case, a clear and honest explanation will be extremely helpful. Young children often begin playing with a doctor's kit at home. If your child is anxious about being examined, it can help if you stand next to your child or, after consulting the researcher, you hold your child on your lap. The medical pedagogical employees can also help if your child is scared and/or anxious about the examination.

The examination

The doctor or nursing specialist will physically examine your child after the case history has been taken. The following are the various components of the examination:

Lungs
When a doctor listens to lungs with a stethoscope, he/she can hear whether a child has a problem with them, such as constriction or a lung infection.

Heart
A stethoscope is used to listen to the heart beat (rate and rhythm).

Abdomen
We use a stethoscope and hands to examine your child's abdomen.

Blood pressure
A certain pressure is required for blood to flow through the blood vessels. We refer to this as 'blood pressure'. There is systolic (high) and diastolic (low) blood pressure. The blood pressure is too high in some illness and in too low in others. In the latter case, you will suffer from dizziness. Blood pressure is measured with a device that has band which encircles the upper arm and is automatically inflated until it is tight. After this band slowly deflates, the blood pressure level become clear.

Ears
The ears are examined with a small light (otoscope) to detect potential abnormalities.

Throat/mouth
The pediatrician examines the throat and mouth, among other reasons, to determine if there are any signs of an infection. It's important that your child keeps his/her mouth open wide with the tongue sticking out. We sometimes facilitate this by pushing the child's tongue down with a small piece of wood (a tongue depressor).

Movement
The pediatrician or nursing specialist will see how your child walks and moves. To determine this, certain exercises will be performed such as standing on one leg for older children or crawling for babies. 

Neurological examination
During a neurological examination, the doctor examines how well your child can talk and what he/she understands. The doctor will examine your child's vision, hearing, sense of touch and, sometimes, his/her sense of smell. In addition, the doctor will examine the muscle strength and muscular control of your child's body. He/she will look at whether the child can properly feel touch and examines his/her reflexes. To accomplish this, the doctor will lightly strike your child's elbow, knees and ankles with a hammer and scratch the bottom of the feet. This does not cause any pain. At the end of the examination, the doctor will ask your child to walk a bit, to hop, and to stand with his/her eyes closed.