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PHYSICAL EXAMINATION: Overview

The physical examination consists of preparing the child/adolescent for the examination, a general physical examination, a genital examination, and when appropriate, the collection of physical evidence. Laboratory and radiographic evaluations may also be necessary. The separate parts of the evaluation are conducted simultaneously; however, they are presented separately for clarity.

The goals of the examination are:

  • To minimize further emotional trauma to the child/adolescent by using appropriate preparation and examination techniques
  • To identify injuries that must be treated, including signs of abuse or neglect, such as failure to thrive, bruises, burns, lacerations, and fractures
  • To identify medical conditions that should be treated, such as sexually transmitted diseases (STDs) or pregnancy
  • To collect medical-legal evidence, when appropriate
  • To reassure the child/adolescent and parent/caregiver that the child/adolescent will recover, that any acute injuries present will be treated, or that old injuries have healed


Key Concepts
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Considerations

  • Consent
  • Personnel during the examination
  • Preparing the child/adolescent for the examination
  • Sedation and anesthesia

The General Physical Examination

  • General examination outline

The Genital Examination

  • Using a colposcope
  • Alternatives to a colposcope
  • Positioning
  • Inspection/palpation of the genitalia
  • Female genital examination
  • Male genital examination
  • Anal/rectal examination

Evidence Collection

  • Preparation
  • Consent
  • Preserving the integrity of evidence
  • Swabs and smears
  • Bite mark evidence collection
  • Evaluating for drug facilitated sexual assault
  • Release of evidence

Reassuring the Child/Adolescent and Parent/Caregiver

Additional Resources
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Physical Examination: Overview  Physical Examination: Considerations  Physical Examination: General Physical Examination  Physical Examination: Genital Examination  Physical Examination: Evidence Collection  Physical Examination: Reassuring the Child/Adolescent and Parent/Caregiver  Physical Examination: Additional Resources 

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