For hands, mouth, tongue, abdomen, and eyes see b Respiratory system, Cardiovascular system, and Gastrointestinal system. The external genitalia are examined for any evidence of ambiguity, congenital abnormality, and size. For this examination you should have a chaperone present for both sexes. In the older child you must ensure privacy and preserve the child’s dignity with the appropriate use of covers and gowns. Examine once only.
· In boys: development of the penis, testes, scrotum, and pubic hair can be staged using a standardized system (Tanner scale). Look at the state of the foreskin. Is there evidence of infection or discharge. Locate the position of the penile meatus. Have both testes descended?
· In girls: Tanner stage the pubic hair. Is there evidence of fused labia, enlarged clitoris, or infection with discharge or bleeding?