Brief Presentation on clinical examination of Cardio Vascular System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
Brief Presentation on clinical examination of Cardio Vascular System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
Examination of Swelling in a patient is always a task for MBBS students. This PPT provides the students, how to elicit a history & also the easy way to examine a swelling.
Brief Presentation on clinical examination of Respiratory System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
R Alagappan - Manual of Practical Medicine, 4th Edition
Pulse Examination PPT -- By Prof.Dr.R.R.deshpande -- This is PPT abput Pulse Examination .Prof.Deshpande has explained how pulse should be examined for Rate,Rhythm,Volume ,Tension ,equality on both side ,Condition of vessel wall .He also explained about Sphygmograph .
Mobile – 922 68 10630
Also visit – www.ayurvedicfriend.com
This is a small booklet in an outline format to assist undergraduate medical students to aid in writing case write ups. This mainly contains how to elicit symptoms and signs.
Examination of Swelling in a patient is always a task for MBBS students. This PPT provides the students, how to elicit a history & also the easy way to examine a swelling.
Brief Presentation on clinical examination of Respiratory System with Report of Normal case
references:
macleod's clinical examination 13th edition
hutchinson clinical methods
R Alagappan - Manual of Practical Medicine, 4th Edition
Pulse Examination PPT -- By Prof.Dr.R.R.deshpande -- This is PPT abput Pulse Examination .Prof.Deshpande has explained how pulse should be examined for Rate,Rhythm,Volume ,Tension ,equality on both side ,Condition of vessel wall .He also explained about Sphygmograph .
Mobile – 922 68 10630
Also visit – www.ayurvedicfriend.com
This is a small booklet in an outline format to assist undergraduate medical students to aid in writing case write ups. This mainly contains how to elicit symptoms and signs.
This is an informative, illustrated presentation about the causes, symptoms, treatment and prevention of HIV AIDS. Gives relevant data, facts and statistics about the disease updated to the most recent 2010 data.
A physical examination is a routine test your primary care provider (PCP) performs to check your overall health. A PCP may be a doctor, a nurse practitioner, or a physician assistant. The exam is also known as a wellness check
History and physical assessment of integumentary systemSiva Nanda Reddy
this topic describes the assessment of integumentary system, history and physical examination in relation to integumatary system was described in detail
Taking History and Physical Examination in Hematology.pptxAskin Kaplan
Medical history taking
Assessment of symptoms
Reviewing previous records
Understanding the onset or progression of illness
Personal medical history for other disorders that can cause blood count abnormalities
Hematologic manifestations secondary to other diseases occur more frequently than primary hematologic diseases
Person’s ethnicity or race
Exposures; drugs, chemicals, toxins, radiation, alcohol
Family history
Lupus is a chronic autoimmune disease that occurs when a person's immune system attacks their own tissues and organs. Learn about the symptoms of lupus, how it is diagnosed and new treatment options to live well with lupus.
Basic introduction to Health screening in Malaysia.
Health screening refers to the process of testing or examining people who do not have symptoms of a particular disease or condition to identify if they are at risk of developing it. This type of screening can help detect diseases or conditions at an early stage, before symptoms develop, allowing for earlier treatment and a better chance of a positive outcome. Health screening can also identify risk factors that individuals may have for developing certain diseases, which can help guide preventive measures and lifestyle modifications to reduce the risk of developing the disease.
Health screening can take many different forms, depending on the disease or condition being screened for and the population being targeted.
Some common types of health screenings include:
Cancer screenings: Screening tests for cancer can help detect tumors or other abnormalities in the body before symptoms develop. Examples of cancer screenings include mammograms for breast cancer, colonoscopies for colon cancer, and Pap tests for cervical cancer.
Cardiovascular disease screenings: These screenings help identify risk factors for heart disease and stroke, such as high blood pressure, high cholesterol, and diabetes. Tests might include blood pressure checks, cholesterol tests, and glucose tests.
Infectious disease screenings: Testing for infectious diseases like HIV, hepatitis, and sexually transmitted infections can help identify people who are infected and in need of treatment, as well as prevent the spread of these diseases to others.
Genetic screenings: Some health screenings are designed to identify genetic mutations that increase the risk of certain conditions, such as breast cancer or cystic fibrosis.
The benefits of health screening can be significant, as detecting diseases or risk factors early can lead to better outcomes and quality of life for individuals. However, health screening also has some potential downsides, including the possibility of false-positive or false-negative results, anxiety or distress related to the screening process, and overdiagnosis and overtreatment of conditions that may never have caused harm. To maximize the benefits of health screening while minimizing the potential risks, it is important to carefully consider which screening tests are appropriate for each individual based on their age, sex, medical history, and other risk factors. Health screening should also be part of a broader approach to preventive care that includes healthy lifestyle choices, regular check-ups with a healthcare provider, and appropriate immunizations.
In conclusion, health screening is an important tool for identifying diseases and risk factors early, but it is important to approach it with caution and careful consideration of individual needs and risk factors. With proper use, health screening can be an effective tool for promoting health and preventing disease.
Objective and Study Design: This was a cross-sectional study purposed to observe the effects of led bulbs and artificial lights on human health and its physiological considerations on sleep.
Our study addressed two goals. Our first goal was to determine the extent to which light pollution was perceived as a problem by the people. Our second goal was to recommend
applicable lighting ordinances for reducing light pollution. Material and Methods: This study was conducted at All India Institute of Medical Sciences hospital, Bhopal and Narayana medical college, Nellore during the period between May 2014 and August 2015. Three hundred human volunteers, 123 female and 177 male, ages of 18 and 55 were studied in a two-part experiment, which included one Sleep questionnaire regarding light pollution to study each individual's
normal body conditions, and an Assay of melatonin in saliva. Results: The results showed that many participants have a long history of sleeping problems. They usually take at least an hour to fall asleep and tend to wake up frequently throughout the night and feel poorly rested in the morning. The salivary melatonin levels also declined at night due to progressive exposure to artificial light. Conclusion: Through our research, we have obtained data that strongly suggest that light pollution is adversely affecting public health, causing them to experience sleep loss, visual fatigue, weariness, anxiety, and depression.
Objective and Study Design: Stress is considered as physiological response to the mental, emotional, or physical challenges. Most of the times mental stress provokes body’s “fght or flight” response called as acute stress
response. But prolonged or chronic stress can affect numerous physiological functions, such as growth, immune system, metabolism, reproduction and circulation. The Autonomic regulation of the cardiovascular system is most commonly affected by stress and is assessed
by means of heart rate variability (HRV)
Material and Methods: The aim of this study is to establish mental stress and cardiovascular autonomic Nervous System response to mental stress assessed by combining different physiological parameters using HRV and Stroop test as tool. We compared the mean RR interval, Blood pressure and indices of HRV during the Stroop Color Word Test (SCWT).A total of 50 normal healthy subjects were participated in this study. Results: Statistically signifcant change in heart rate, RR interval and BP was observed during the stress as compared to resting condition. All the components of HRV (SDNN, RMSSD, NN50, PNN50, LF, HF, LF/HF) were sensitive to stress in all the healthy individuals. Males were more prone to stress when compared to females.
Conclusion: The results suggest that there was increased sympathetic activity and reduced parasympathetic activity in HRV performed
during the Stroop test and showed statistically signifcant difference among the genders. Both physical and mental stress influence risk factors that may increase risk for cardiovascular diseases and autonomic imbalance
Aim: The aim of the present study was to perform the set of standard autonomic function
tests in children with a family history of hypertension and compare the results with
children of normotensive parents.
Background: Hypertension is considered one of the highest causes of morbidity
worldwide and it becomes one of the leading causes of death due to cardiovascular and
renal failure. Hypertension can be especially hard to manage when combined with other
disorders, such as diabetes or obesity. Most of the children with a family history of
hypertension forms the risk factor for being hypertensive in future life.
Results: The study included 60 young and healthy children. Out of them, 30 children were
selected based on their family history of hypertension while the remaining were the
children of normotensive parents. Thesubjects were selected based on exclusion-inclusion
criteria. All the children underwent for a set of autonomic function tests which are noninvasive, simple and comfortable. Results showed that children with a family history of
hypertension have abnormal values on autonomicfunction testing, when compared with
children of normotensive parents. The results were obtained using ANOVA and student‘t’
–test, to study the significance of autonomic parameters.
Conclusion: This study stated that the children with family history of hypertension
experienced mild to moderate autonomic fluctuations in early age which may make them
more susceptible to hypertension in their future life
Aim: This study investigated the eff ect of video games on Critical fl ickering fusion frequency rate
(CFFFR).
Background: CFFFR is the rate of successive light fl ashes from a stationary light source at which the
sensation of fl icker disappears and the light becomes steady. CFFFR with higher values suggested that
greater perceptual accuracy. The eye and brain act together to perceive fl ickering light. The activities
in the retina and brain are synchronized as a part of the visual process. If the modulation i.e. fl icker
frequency is high enough, the visual system will perceive fl ickering light as a continuous steady light.
This CFFFR has been used in the studies on physiology of vision, Stress, drug research.
Results: In the present study CFFFR was measured in two age-matched groups of healthy volunteers
whose ages ranged from 18 – 45 years with 75 subjects in each group. Test group consists of Media
players who were played video games since their childhood. Control group consists of Non-Media
players who did not know how to play the video games. The scope of the present study is to know
the eff ect of video games on CFFFR. The results in our study showed that CFFFR threshold increases
signif cantly in media players when compared to non – media players (p<0.001).This study also
showed that CFFFR signif cantly decreases as the age increases and high CFFFR threshold were
recorded in media players who played puzzle and brain games than the action adventure and sports
games. The gender eff ect on CFFFR was not signif cant but higher CFFR values were recorded for men
than women.
Conclusion: This study proved that playing video games can develop cognitive skills, high level
thinking skills, problem solving complex, concentration, logical thinking, imagination and creativity
but on the other side teenagers who spend an ample amount of time playing games experience eff ects
which are not so benef cial at all.
To study the variations of autonomic nervous system in hypertensive patients using a set of autonomic
function tests. The study included 50 hypertensive patients and set of autonomic function tests were done to assess
the autonomic functions. These results were compared with age and sex matched controls (normotensives). The
subjects were selected based on exclusion-inclusion criteria. Hypertensives show abnormal values on autonomic
function testing, when compared with normotensives. The statistically significant differences were found between
hypertensives and normotensives in some autonomic function tests. The results were obtained using ANOVA and
student‘t’ –test, to study the significance of autonomic parameters. Results showed that there was significant
increase in the Heart rate response to standing. Valsalva ratio & Heart rate response to deep breathing test values
were decreased in Hypertensives as compared to Normotensives (p<0.05).><0.05).><0.05). From this study, it is evident that Hypertension can alter the normal
autonomic functions of the body and predisposes to autonomic neuropathy. Early and regular screening of these
individuals is necessary to prevent any future complications.
To study the variations of autonomic nervous system in hypertensive patients using a set of autonomic function tests
and to correlate cardiac autonomic function with Heart rate variability in hypertensives. Background: The pathophysiological mechanism for the development of hypertension is the lack of balance between sympathetic and parasympathetic nervous system. Both Heart rate variability (HRV) and Autonomic function tests provide a tool to know the concept of autonomic modulation of heart. They also forms an index of cardiac autonomic regulation. Methods: The study included 50 hypertensive patients and 50 normotensive
subjects. All the subjects underwent for the analysis of heart rate variability in time domain (TD) and frequency domain and a set of autonomic function tests were done to assess the autonomic functions. These results were compared with age and sex matched controls (normotensives). The subjects were selected based on exclusion-inclusion criteria. Results: Results showed that S: L ratio, Valsalva ratio & Heart rate response to deep breathing test values were decreased in Hypertensives as compared to Normotensives (p<0.05).><0.05). Both the time domain and frequency domain values of HRV reduced significantly in hypertensives indicated that there is increased sympathetic activity and decreased parasympathetic activity. Conclusion: From this study, it is evident that Hypertension can alter the normal autonomic functions of the body and predisposes to autonomic neuropathy. Early and regular screening of these individuals is necessary to prevent any future complications.
Autonomic neuropathy is the most common complication of diabetes. Various studies showed that cardiac autonomic
neuropathy (CAN) in diabetes is strongly associated with microvascular complications. Cardiac autonomic neuropathy in Type 2 diabetics is detected by various autonomic function tests. The scope of the present study is to compare the sensitivity of sympathetic and parasympathetic function tests in the early detection of autonomic dysfunction in Type 2 diabetics. The Autonomic function tests which
are used to test the parasympathetic activity are deep breathing i.e., E: I ratio, valsalva ratio and Heart rate response to standing. The Sympathetic activity can be tested by using simple tests like blood pressure responses to standing, isometric handgrip test and cold pressure test. All the tests are capable for early detection of cardiovascular autonomic dysfunction. Results in our study showed that both Parasympathetic and sympathetic neuropathy was found in diabetics but parasympathetic cardiac autonomic function tests are more sensitive for the detection of cardiac autonomic neuropathy in type 2 diabetics than sympathetic cardiac autonomic function tests. Ultimately this study indicates that autonomic dysfunction occurs in diabetes Mellitus and Parasympathetic functional tests are highly sensitive in the early detection of Autonomic neuropathy.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
3. Vital Data
• Name Of The Institution :
• Name Of The Doctor:
• Ward No:
• Cot No :
• Case No :
• Date:
• Name Of The Patient :
• Age :
• Sex :
• Religion :
• Caste :
• Married Or Single :
• Children :
• Occupation :
• Income
• Address
4. General History
• The general history is organized into the following
sections:
• Identifying data (ID)
• Chief complaint (CC)
• History of the present illness (HPI)
• Past medical history (PMHx)
• Family history (FHx)
• Medications (MEDS) and Allergies (ALL)
• Social history (SHx)
• Review of systems or functional inquiry (ROS/FI)
5. History of Present Illness
• Symptom characterization:
• 0 =Onset and duration
• P = Provoking and alleviating factors
• Q = Quality of pain (e.g. sharp, dull, throbbing)
• R = Does the pain radiate?
• S = Severity of pain ("on a scale from 1 to 10, 10 being the
most severe")
• T =Timing and progression ("Is the pain constant or
intermittent? Worse in the morning or at nighttime?")
• U = "How does it affect 'U' in your daily life?“
• V = Deja vu ("Has this happened before?")
• W ='What do you think it is?
6. General examination
• General examination is actually the first step of physical
examination and Key component of diagnostic approach.
• Inspection is the major method during general
examination, combining with palpation, auscultation,
and smelling.
• Aims to
– Assess patient's general condition
– Detect manifestations of internal & systemic diseases
• 3 components:
– History taking – Clues are the symptoms
– Physical exam - Clues are the signs
– Investigations - Clues are test results
7. Instruments And Equipment :
• Stethoscope
• Sphygmomanometer
• Thermometer
• Torch
• Wooden tongue depressors
• Measuring tape
• Note:-
• Exam begins the minute you first see the patient
• Exam continues throughout your patient interaction
8. Prerequisites:
• Examination environment
• Hand Washing
• Proper light
• Privacy & Confidentiality
• Presence of a chaperon when examining female
patients
• Correct position of Doctor & Patient - Ideally examiner
should be on right side of patient
• Proper Exposure
• Ensure your hands are warm
9. General examination
– General Appearance
– Hands and arms
– Skin
– Face
– Eyes
– Mouth
– Neck
– Oedema
– Lymph nodes
–Vital Signs
• Temperature
• Pulse
• Respiration Rate
• Blood Pressure
10. General Appearance
• General state of health: Healthy/ill/comfortable/Distressed
• Body Built and Nutritional status
– Height
– Weight
– BMI
– Obese/lean
– Tall/short
– Muscular/Asthenic/Cachexic
• State of awareness or level of consciousness
• Facial feature/expression/ Mood/Attitude
• Speech(tone/voice)
• Position/posture and Gait
• Personal Hygiene
• Breath/Odor
11. • General state of health:
Healthy/ill/comfortable/Distressed
13. I. Sheldon's Anthropometric Types.
• ENDOMORPHIC - in whom viscera and abdomen tend to
dominate the body.
• MESOMORPHIC - in whom the muscular tissue dominates the
body
• ECTOMORPHIC - in whom the skin, bones and the head
dominate the body..
II. Clinical types.
• Asthenic or hyposthenic has a slender or a weak figure.
• Sthenic or Hypersthenic has a broad and muscular figure.
• Normosthenic or Orthosthenic is midway between the above
two.
28. Acromegaly
The enlargement of the
frontal and maxillary
sinuses results in an
prominent brow and long
face
Growth of
mandible leads to a
jutting jaw
(prognathism).
Alveolar bone
growth causes the
teeth to separate
29. Acromegaly
Macroglossia. There is
also generalized visceral
enlargement
Broadening and enlargement
of the hands and feet due to
increased periosteal growth as
well as thickening of the skin
30. Graves’ disease
Ocular involvement is mediated by
one or more distinct but still poorly
characterised orbital-stimulating
immunoglobulins:Proptosis, due to
increased volume and edema of
retrobulbar fat. Shortened
extraocular muscles, because of the
muscle infiltration and fibrosis result
in upper lid retraction. Conjunctival
erythema, and periorbital edema are
evident.
Facial expression
The stare in hyperthyroidism
31. Hypothyroidism
• The most common cause is
the Hashimoto’s thyroiditis,
affects appr. 1% of adult
population
This woman demonstrates
the typical hypothyroid facies.
She also had a slow, hoarse,
deep voice and lassitude
(state of feeling very tired in
mind or body).
• Dull, puffy facies. Edema does
not pit with pressure. The
lateral eyebrows are thin.
35. Position & Posture
• It refers to patient’s body status and the general way of
holding the body
• Divided into:
• Active
• Passive
• Compulsive
• Active position
The patient can move his/her body freely, without any
restriction
It can be seen in normal adult, patients with mild diseases
or at earlier stage of the diseases
• Passive position
The patient can’t adjust or move his/her body
It occurs in extremely sick or patients with unconsciousness
36. • Compulsive supine position
The patient lie down on the beck, with two legs bending.
Acute peritonitis
38. Compulsive side down position
in patients with one sided pleurisy or pleurorrhea
39. Orthopnea
An abnormal condition in which a person must keep the head
elevated (sit or stand) to breathe deeply or comfortably (orthopnea) or
wakes up suddenly in the middle of the night short of breath. It can be
seen in patients with lung or heart disease
41. • Compulsive rest position
When patient suffers an angina attack it will force them to rest.
The heart is then able to return to it’s normal working level
• Toss & turn position (alternative position)
• Opisthotonos
It is an abnormal posturing condition characterized by
rigidity and severe aching of the back, with head thrown
backwards
42. The typical position of COPD patients
An elderly patient who looks chronically ill. He is unable to speak more than two or
three words at a time due to shortness of breath. He has intercostal muscle
retraction when breathing and sits upright. Hi is thin with diffuse muscle wasting.
43. Gait : a way or manner of walking
Gait abnormalities describe unusual and uncontrollable
problem with walking
51. Nicotine Staining Onycholysis: Separation of Nail
from Underlying Bed
Onychomycosis: Fungal
Infection of the Nail
Paronychia: Infection of skin adjacent
to nail of middle finger
69. NECK AND CHEST
• Cervical lymphadenopathy
• Left supraclavicular fossa (Virchov’s node)
• Gynaecomastia
• Symmetry of the chest
70.
71. Skin
• The skin is the largest organ of the body
• One of the best indicators of general health
• The examination of the skin is dependent on inspection, but
palpation of a skin lesion must also be performed
• The color changes include
– Pallor
– Cyanosis
– Yellow skin (Icterus)
– Redness
– Pigmentation
– Discoloration
77. Discoloration
Vitiligo
• It is a skin condition in which there is loss of pigment
from areas of skin resulting in irregular white patches
with normal skin texture
• Associated with pernicious anemia, hyperthyroidism,
Addison’s disease
78. Discoloration
Leukoplakia
• A precancerous lesion that develops on the tongue or
the inside of the cheek as a response to chronic
irritation
• Occasionaly, leukoplakia patches develop on the female
external genitalia
79. Rashes
• Skin rashes are frequently one of the manifestation of systemic
diseases, and hence, they are important for the diagnosis of
some special diseases
• The different rashes may occur in infectious disease,
dermentological disease, drug or other allergic materials
• The rashes have some special regular patterns and sharps
• Types of rashes
– Macule
– Roseola
– Papules
– Maculopapulae
– Urticaria
80. Macule
• A macule is small, flat, distinct colored area of skin
• Does not include a change in skin texture or thickness
81. Rosela
• Rosela is a skin lesion that is small, solid, and
raised. It may be seen in measles, drug rashes,
eczema
82. Papule
• A papule is defined as a small (5 millimeters or
less), solid lesion slightly elevated above the
surface of the skin.
83. Maculopapulae
• It is plate lesion with redness around the
papules
• It can be seen in scarlet fever and drug-
induced rashes
84. Urticaria
• Urticaria (hive) are raised red welts of variuos
size on the surface of the skin, often itchy, which
come and go. It is associated with allergic
reaction
86. Subcutaneous hemorrhage
• Bleeding into the skin & subcutaneous tissues
• According to the size of bleeding, it may be subdivided
as follows:
petechia <2mm
purpura 3~5 mm
ecchymosis >5mm
• A hematoma is a large collection that forms a lump
87. Spider angioma
• Spider angioma is a group of abnormal blood vessel that
produces the appearance of a spider-web on the surface
of the skin
• A spider angioma lesion typically has a red dot in the
center with reddish extensions radiating out for some
distance around it
• Liver palms
88. Spider angioma
From very small to 2 cm; pulsatility is often demonstrable, when pressure
with a glass slide is applied. Distribution: upper trunk, face, arms.
89. Edema
• Excessive build up of fluid in the tissues
• Either occurs throughout the body (generalized swelling)
or limited to a specific part of the body (localized swelling)
• It can be either pitting edema or non-pitting edema
• Mild : facial edema, peripheral edema
• Moderate: generalized edema
• Severe: generalized severe edema
110. • Clinical Examination
• Personal information
• Name: Age: Sex: Address:
• 1. General Findings
• • General appearance - Normal/ Healthy
• • Mental state/ intelligence/ consciousness–Patient conscious, co-operative, well
oriented in time, place and person
• • Body Build
• o Height -
• o Weight -
• o BMI -
• o Nutritional Status– Normal or average
• • Gait - Normal
• • Pallor - Absent
• • Icterus - Absent
• • Cyanosis - Absent
• • Clubbing - Absent
• • Edema(foot)- Absent
• • Lymph nodes – Not palpable
• • JVP– Not visible
• • Vitals
• o Temperature– ….measured/febrile/afebrile
• o Pulse -
• o Respiration -
• o BP -
111. The systemic examination
• The various systems to be examined are :
• 1. Cardio - vascular system.
• 2. Respiratory system.
• 3. Digestive system .
• 4. Hemopoietic system .
• 5. Excretory system.
• 6. Reproductive system .
• 7. Endocrine system .
• 8. Nervous system .
• 9. Special senses.