Nose

The examination of the nose is essentially the same as in adults. Mouth and Pharynx

The teeth should be examined with regard to their condition and spacing. Have the child bite down, and observe the bite. (See Table 24-5 at the end of this chapter, which summarizes the ages at which shedding of the primary teeth occurs, as well as the ages of secondary tooth eruption.)

Inspect the tongue for dryness, size, and lesions. Deep furrows are common and have no clinical significance.

Inspect the palate for petechiae.

Inspect the tonsils for enlargement, injection, and exudation. Neck

Palpate the thyroid for nodules. The thyroid is rarely palpable in normal children in this age group.

Palpate for lymphadenopathy. Anterior cervical nodes are seen in association with upper respiratory infections and dental infections. Posterior adenopathy is seen with infections of the middle ear and scalp. Generalized adenopathy is seen in viral diseases such as infectious mononucleosis, measles, and rubella. Is the trachea midline?

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