Introduction General examination carried out in following headings. General appearance History Mental state and intelligence Consciousness and cooperation Build Muscle power, Tone. Development Height , weight and secondary sexual development . State of nutrition. Pallor ( anemia). Jaundice. Cyanosis. Clubbing. Edema. Lymphadenopathy Skin condition and Vital signs Temp, Pulse ,Resiration, Blood Pressure.

1. Pandian M
Dept of Physiology
DYPMCKOP

2. • Reasons why people visit doctors
• They have reached their limits of tolerance
• They have reached their limits of anxiety
• They have problems of living presenting as
symptoms
• For prevention
• For administrative reasons

3. • If your hands are visibly soiled, wash
thoroughly with soap and water
• If your hands are not obviously dirty, wash
with soap and water or use an alcohol-based
rub or gel
• Always wear surgical gloves when contact with
blood, mucous membranes or non-intact skin
could occur.
• Your hand should be in warm condition.

5. Objectives
• Introduction
– General examination carried out in following
headings.
» General appearance
» History
• Mental state and intelligence
• Consciousness and cooperation
» Build
• Muscle power, Tone.
» Development
• Height , weight and secondary sexual
development .

6. Cont….
»State of nutrition.
»Pallor ( anemia).
»Jaundice.
» Cyanosis.
»Clubbing.
»Edema.
»Lymphadenopathy
»Skin condition and
»Vital signs
• Temp, Pulse ,Resiration, Blood
Pressure.

8. General appearance

14. bedshore

19. Mental state & Intelligence
• Qtn’s about :-
–Educational
– Occupational
–history and finally
–General
Knowledge.

20. Consciousness &Cooperation
• Impt one ascertain the level of consciousness of the
patient.
– Clear sensorium, drowsiness, stupor, semicoma and coma.
– If he/she is fully conscious, assess whether he is Cooperative
enough to give all Info.

22. Build
• Skeletal structure of a
person, according to
age, sex of the
individual as compared
to a normal person.
• Which means tall or
short , lean or fat, and
muscular or asthenic.

23. Development

24. Nutrition
• Its very impt part of general examination
• It is done by taking dietary history and by
performing physical examination.
• Measurements of bulk of muscles and body
fats ( skin fold thickness).
• Here include recording of height and weight of
the patient.

25. Pallor
• Pallor is paleness of the skin.
• Depends on the thickness and quality of the
skin, and amt & quality of the blood in
capillaries.
• It seen in thick or opaque skin.
• Mainly detected by examining the LOWER
PALPEBRAL CONJUCTIVA, TIP AND DORSUM
OF THE TONGUE, SOFT PALATE, PALM, NAILS.

29. Jaundice

31. Cyanosis

32. • Cyanosis
• SKIN and MUCOUS MEMBRANE of the
body due to the presence of reduced Hb
in more than 5g % in the blood.
• Types
– Peripheral
– Central &
– Mixed.
–Spl category of cyanosis called
Differential cyanosis.

33. Clubbing

37. Edema

40. • Cardiac edema
– Its usually seen in the dependent parts of body .
– Dyspnea at rest is one of the associated features.
• Hepatic edema
– Edema is prominent on the abdomen & ascites is one
of the associated features.
• Renal edema
– 1st appears in the face, especially puffiness of the
lower eyelid.
• Anemia & hypoproteinemia
– Severe pallor is one of the associated features.

46. • Neck, axilla, inguinal region and
supratrochlear areas of both the sides should
be examined & have to check enlargement of
lymph nodes.

48. • Skin should examined carefully, preferably in
daylight & the maximum surface of body
should be exposed.
• Colour of the skin
• Pigmentation
• Eruption
• Secondary lesions.

49. nickel dermatitis from earring

50. Grouped (zosteriform)
herpes zoster

51. Type of lesion
Primary lesion
• Macule - Non-palpable lesion with distinct borders, less than 1 cm in diameter
• Patch - Non-palpable lesion with distinct borders, greater than 1 cm in diameter
• Papule – Palpable, solid lesion less than 1 cm in diameter
• Plaque – Palpable, solid lesion greater than 1 cm in diameter
• Nodule – Palpable, lesion more than 1 cm in diameter which is taller than it is
wide
• Vesicle – Fluid-containing, superficial, thin-walled cavity less than 1 cm
• Bulla – Fluid-containing ,superficial, thin-walled cavity greater than 1 cm
• Erosion – A skin defect where there has been loss of the epidermis only
• Ulcer – A skin defect where there has been loss of the epidermis and dermis
• Pustule – Pus containing, superficial, thin-walled cavity
• Abscess – Thick-walled cavity containing pus

52. Vital signs
• There are 4 vital sign must always be
examined in general examination.
• These are
– Temp
– Pulse
– Respiration
– Bp

53. Temperature

55. Palpaltion

62. Percussion

63. • To percuss the upper posterior chest ask patients
to fold their arms across the
• front of their chest, thereby moving the scapulae
laterally.
• Do not percuss near the midline, as this produces
a dull note from the solid
• structures of the thoracic spine and paravertebral
musculature. Map out abnormal
• areas by percussing from resonant to dull.

65.  Place the palm of your left hand on the chest, with your
fingers slightly separated .
 Press the middle finger of your left hand firmly against the
chest, aligned with the underlying ribs over the area to be
percussed.
 Strike the centre of the middle phalanx of your left middle
finger with the tip of your right middle finger, using a loose
swinging movement of the wrist and not the forearm.
 Remove the percussing finger quickly so the note generated is
not dampened.
 Percuss the lung apices by placing the palmar surface of your
left middle finger across the anterior border of the trapezius
muscle, overlapping the supraclavicular fossa and percussing
downwards.
 Percuss the clavicle directly over the medial third, as
percussing laterally is dull over the shoulder muscles.

68. Type Detected over
Resonant Normal lung
Hyper-resonant Pneumothorax
Dull Pulmonary consolidation
Pulmonary collapse
Severe pulmonary fibrosis
Stony dull Pleural effusion
Haemothorax
Percussing normal lung produces a
resonant note (Box 7.21); a
pneumothorax produces a hyper-
resonant

70. Auscultation

79. References
• Text book of Medical
Physiology
– Guyton & Hall
• Hutchinson Clinical Methods
• Practical Physiology
Manual
– A.K. Jain, C.L. Ghai, G.K. Pal
• Net source for pictures

80. THANK YOU . . .