Tanner staging sexual maturity score

Pubic hair (both male and female)

1. Tanner I -- no pubic hair at all [10 and under] (prepubertal state)
2. Tanner II -- small amount of long, downy hair with slight pigmentation at the base of the penis and scrotum (males) or on the labia majora [10-11](female)
3. Tanner III -- hair becomes more coarse and curly, and begins to extend laterally [12-14]
4. Tanner IV -- adult-like hair quality, extending across pubis but sparing medial thighs [13-15]
5. Tanner V -- hair extends to medial surface of the thighs [16+]

Genitals (male)

1. Tanner I -- prepubertal (testicular volume less than 1.5 ml; small penis of 3 cm or less)
2. Tanner II -- testicular volume between 1.6 and 6 ml; skin on scrotum thins, reddens and enlarges; penis length unchanged
3. Tanner III -- testicular volume between 6 and 12 ml; scrotum enlarges further; penis begins to lengthen to about 6 cm
4. Tanner IV -- testicular volume between 12 and 20 ml; scrotum enlarges further and darkens; penis increases in length to 10cm and circumference
5. Tanner V -- testicular volume greater than 20 ml; adult scrotum and penis of 15 cm in length

Breasts (female)

1. Tanner I -- no glandular tissue; areola follows the skin contours of the chest (prepubertal)
2. Tanner II -- breast bud forms, with small area of surrounding glandular tissue; areola begins to widen
3. Tanner III -- breast begins to become more elevated, and extends beyond the borders of the areola, which continues to widen but remains in contour with surrounding breast
4. Tanner IV -- increased breast size and elevation; areola and papilla form a secondary mound projecting from the contour of the surrounding breast
5. Tanner V -- breast reaches final adult size; areola returns to contour of the surrounding breast, with a projecting central papilla.

clinical manifestations of childhood tuberculosis

how to measure palpable spleen length or spleenomegaly?

Measuring length of spleen has been confusing medical students since years, many examiners giving subjective opinions and guidelines that may not serve purpose all the time. the misunderstanding which is taught most often is that spleen is to be measured as a perpendicular length from tip to costal margin or at midclavicular line. but that is wrong.

The correct way to measure palpable spleen length is the length from the tip of the spleen along the long axis, at the midpoint of green line C, the line that joins the points c1 and c2, that are the points where spleen gets retrocostal. Refer the image on right side, there are 3 spleens A B C. The yellow lines drawn give correct measurements of respective spleens even though the lines are not perpendicular to costal margin nor they are ending in midclavicular line.

Spleen length may be falsely small at times if perpendicular length or length upto midclavicular line on costal margin is taken, Just because the apex of spleen doesnt always lie along the line towards umbilicus and umbilicus doesnt always lie in center.

learning basics of pediatric medicine

learning basics of pediatric medicine

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