Principles of Clinical Examination
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Principles of Clinical Examination
- 3. Adult General Physical Examination Dr. Seyed Morteza Mahmoudi, MBBS Gulf Medical University, Ajman 2013
- 5. Making use of all our senses, Except?
- 8. Initial Steps 2- Introduce yourself
- 9. Initial Steps 3- Make sure you have the right patient
- 11. Initial Steps 5- Make sure the environment is appropriate
- 13. Initial Steps 7- Wash hands, safety precautions
- 14. Initial Steps 8- Drape and adequately expose
- 15. Initial Steps 9- If necessary get a chaperon
- 16. Initial Steps 10- Ask about pain
- 17. Steps 1- Greet 2- Introduce yourself 3- Make sure you have the right patient 4- Explain 5- Make sure the environment is appropriate 6- Consent 7- Wash hands, safety precautions 8- Drape and adequately expose 9- Chaperon 10- Pain consideration
- 18. Start your physical examination as soon as you see the patient
- 19. Physical Examination Hand shake Body built Face Clothing Complexion Sounds Odors Posture and gait Movements Spot diagnosis
- 22. Useful Pneumonic Pallor Edema Nail changes/clubbing Cyanosis Icterus Lymph nodes Skin changes
- 26. CAUSES OF CLUBBING cyanotic congenital heart disease Sub acute bacterial endocarditis lung carcinoma bronchiectasis Emphysema lung abscess lung fibrosis Pulmonary Tuberculosis cirrhosis IBD Celiac disease Thyrotoxicosis Familial
- 28. CAUSES CENTRAL CYANOSIS Abnormal hemoglobin levels Congenital heart disease Hypoventilation Asthma Methmoglobinemia Valvular heart disease COPD Pulmonary embolism Arterial obstruction Heart failure Right to left venous arterial shunts High altitudes Polycythemia
- 30. PERIPHERAL CYANOSIS Exposure to cold Reduced cardiac output Arterial or venous obstruction
- 32. Skin Changes Dry & inelastic Moist Thickened and greasy Atrophied Colour Dupuytren's contracture Rashes Swellings Hemorrhages Hair
- 43. Lymph node Examination Cervical Sub mental Submandibular – Tonsillar (Jugulodigastric)Preauricular Postauricular Occipital Superficial (Anterior) Cervical Posterior cervical Supraclavicular Axillary Inguinal
Hinweis der Redaktion
- Greet the patient as he/she enters your room. Handshake Notice the gait. General body & built/physique Postural & spinal deformities Face (expressions/any swellings) Skin changes etc.
- Greet the patient as he/she enters your room. Handshake Notice the gait. General body & built/physique Postural & spinal deformities Face (expressions/any swellings) Skin changes etc.
- Greet the patient as he/she enters your room. Handshake Notice the gait. General body & built/physique Postural & spinal deformities Face (expressions/any swellings) Skin changes etc.
- Greet the patient as he/she enters your room. Handshake Notice the gait. General body & built/physique Postural & spinal deformities Face (expressions/any swellings) Skin changes etc.
- Greet the patient as he/she enters your room. Handshake Notice the gait. General body & built/physique Postural & spinal deformities Face (expressions/any swellings) Skin changes etc.
- Greet the patient as he/she enters your room. Handshake Notice the gait. General body & built/physique Postural & spinal deformities Face (expressions/any swellings) Skin changes etc.
- Greet the patient as he/she enters your room. Handshake Notice the gait. General body & built/physique Postural & spinal deformities Face (expressions/any swellings) Skin changes etc.
- Greet the patient as he/she enters your room. Handshake Notice the gait. General body & built/physique Postural & spinal deformities Face (expressions/any swellings) Skin changes etc.
- Greet the patient as he/she enters your room. Handshake Notice the gait. General body & built/physique Postural & spinal deformities Face (expressions/any swellings) Skin changes etc.
- Greet the patient as he/she enters your room. Handshake Notice the gait. General body & built/physique Postural & spinal deformities Face (expressions/any swellings) Skin changes etc.
- Certain disease process like thyrotoxicosis, hypothyroidism, Parkinson’s, acromegaly, 3rd & 7th nerve palsies (Diagnostic facies) Parotid swellings can be very obvious on the face. The cheeks can give a good idea about certain diseases pale in anemia and hypotpituitarism, pale & puffy in nephrotic syndrome, malar flush in mitral stenosis or a butterfly rash in cases of SLE.
- Dry & inelastic as in dehydration Moist Thickened and greasy as in acromegaly Atrophied as in old age or on glucocorticoid therapy It could be pale or cyanosed or yellow, any sort of pigmentation. Palmar erythema can also be noted as in cirrhosis, pregnancy or polycythemia. Dupuytren's contracture of palmar fascia seen in liver disease, trauma & epilepsy. There could be rashes or any swollen coin like lesions Hemorrhages or bleeding spots under the skin Hair can be examined for any loss on scalp or eyebrows or excessive growth of facial hair.
- Nails can be seen for : Koilonychias (spoon shaped ) in iron deficiency anemia or fungal nail infection Onycholysis (nail destruction ) in hyperthyroidism fungal infection and psoriasis Pitting is seen in psoriasis and alopecia areata Splinter hemorrhages (longitudinal hemorrhagic streaks) maybe seen in infective endocarditis
- size number consistency -firm or hard or rubbery tenderness matting mobility