During the systematic examination, each system is examined separately by inspection (looking), palpation (feeling), percussion (tapping) and auscultation (listening with a stethoscope):

1. Respiratory system:
   • Count the respiratory rate.
   • Listen for cough, wheezing or stridor.
   • Look for signs of respiratory distress (recession, grunting).
   • Percuss for dullness over both lungs, front and back.
   • Auscultate both lungs, front and back.
2. Cardiovascular system:
   • Count the pulse and note the nature of the pulse (easy or difficult to feel?)
   • Take the blood pressure (not always needed in infants).
   • Look at the shape of chest.
   • Palpate (feel) for the position of the apex beat.
   • Auscultate the heart for heart sounds and murmurs.
3. Gastrointestinal system:
   • Look for abdominal distension.
   • Look and feel for hernias.
   • Feel for abdominal tenderness.
   • Feel for enlarged organs (liver, spleen, kidneys) or other masses.
   • Listen for bowel sounds.
4. Genitourinary system:
   • Is the child obviously a boy or girl?
   • If a boy, are the testes descended?
5. Central nervous system:
   • Assess whether the child is alert and fully conscious. Any convulsions (fits)?
   • Determine the developmental milestones.
   • Can the child see and hear normally?
   • Can the child smile and close eyes tightly?
   • Assess for neck stiffness (meningism).
   • Asses whether the child is able to move all limbs normally.
   • Observe whether the child walks normally (if old enough).
6. Muscular skeletal system:
   • Look whether the back is straight.
7. Ears, nose and throat:
   • Examine mouth and throat.
   • Examine ears.

The order of the examination is flexible. Usually the examination of the mouth, throat and ears is done last as it is unpleasant for a young child. Sometimes the heart is examined first so that the heart sounds can be heard before the child becomes upset and cries.