C:\Documents And Settings\Bkkqf\Desktop\Physical Examination
Upcoming SlideShare
Loading in...5
×
 

C:\Documents And Settings\Bkkqf\Desktop\Physical Examination

on

  • 2,186 views

 

Statistics

Views

Total Views
2,186
Views on SlideShare
2,177
Embed Views
9

Actions

Likes
0
Downloads
69
Comments
0

2 Embeds 9

http://www.slideshare.net 8
http://translate.googleusercontent.com 1

Accessibility

Categories

Upload Details

Uploaded via as Apple Keynote

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

C:\Documents And Settings\Bkkqf\Desktop\Physical Examination C:\Documents And Settings\Bkkqf\Desktop\Physical Examination Presentation Transcript

  • PHYSICAL EXAMINATION IN HEMATOLOGY Pensri Pootrakul MD. Thalassemia Research Center Institute of Molecular Bioscience Mahidol University,Salaya Campus
  • DIAGNOSIS
  • DIAGNOSIS Chief complaint
  • DIAGNOSIS Chief complaint History : Present history Past history
  • DIAGNOSIS Chief complaint History : Present history Past history Physical examination
  • DIAGNOSIS Chief complaint History : Present history Past history Physical examination Lab. tests: Rountine tests Special tests
  • PHYSICAL EXAMINATION
  • PHYSICAL EXAMINATION Inspection
  • PHYSICAL EXAMINATION Inspection Palpation
  • PHYSICAL EXAMINATION Inspection Palpation Percussion
  • PHYSICAL EXAMINATION Inspection Palpation Percussion Auscultation
  • GENERAL APPEARANCE
  • GENERAL APPEARANCE Figure,malformation
  • GENERAL APPEARANCE Figure,malformation Dressing
  • GENERAL APPEARANCE Figure,malformation Dressing Severity of symptoms and signs
  • GENERAL APPEARANCE Figure,malformation Dressing Severity of symptoms and signs Growth : body weight and hight
  • GENERAL APPEARANCE Figure,malformation Dressing Severity of symptoms and signs Growth : body weight and hight Development
  • GENERAL APPEARANCE Figure,malformation Dressing Severity of symptoms and signs Growth : body weight and hight Development Level of conciousness,mood,IQ,
  • GENERAL APPEARANCE Figure,malformation Dressing Severity of symptoms and signs Growth : body weight and hight Development Level of conciousness,mood,IQ, Speaking,voice
  • GENERAL APPEARANCE Figure,malformation Dressing Severity of symptoms and signs Growth : body weight and hight Development Level of conciousness,mood,IQ, Speaking,voice Co-operative
  • Vital Signs
  • Vital Signs Temperature
  • Vital Signs Temperature Pulse
  • Vital Signs Temperature Pulse Respiratory rate,rhythm
  • Vital Signs Temperature Pulse Respiratory rate,rhythm Blood pressure
  • Problems in Hematology
  • Problems in Hematology Anemia
  • Problems in Hematology Anemia Gum hypertrophy
  • Problems in Hematology Anemia Gum hypertrophy Jaundice
  • Problems in Hematology Anemia Gum hypertrophy Jaundice Hepato-splenomegaly
  • Problems in Hematology Anemia Gum hypertrophy Jaundice Hepato-splenomegaly Cyanosis
  • Problems in Hematology Anemia Gum hypertrophy Jaundice Hepato-splenomegaly Cyanosis Clubbing finger
  • Problems in Hematology Anemia Gum hypertrophy Jaundice Hepato-splenomegaly Cyanosis Clubbing finger Growth retardation
  • Problems in Hematology Anemia Gum hypertrophy Jaundice Hepato-splenomegaly Cyanosis Clubbing finger Growth retardation Mongoioid face
  • Problems in Hematology Anemia Gum hypertrophy Jaundice Hepato-splenomegaly Cyanosis Clubbing finger Growth retardation Mongoioid face Lymphadenopathy
  • Problems in Hematology Anemia Gum hypertrophy Jaundice Hepato-splenomegaly Cyanosis Clubbing finger Growth retardation Mongoioid face Lymphadenopathy Bleeding
  • Problems in Hematology Anemia Gum hypertrophy Jaundice Hepato-splenomegaly Cyanosis Clubbing finger Growth retardation Mongoioid face Lymphadenopathy Bleeding Skin : bruise,echymosis, hematoma,pethichiae
  • Problems in Hematology Anemia Gum hypertrophy Jaundice Hepato-splenomegaly Cyanosis Clubbing finger Growth retardation Mongoioid face Lymphadenopathy Bleeding Skin : bruise,echymosis, hematoma,pethichiae Organs bleeding : GI,cerebral,gum
  • ANEMIA
  • ANEMIA Symptom, not disease and found in many diseases
  • ANEMIA Symptom, not disease and found in many diseases Fatique,weakness,dizzy,easily tired
  • ANEMIA Symptom, not disease and found in many diseases Fatique,weakness,dizzy,easily tired Signs : color of conjunctiva,lip,tongue,nail,palm,skin
  • JAUNDICE Sclera, mucosa, skin
  • CYANOSIS
  • CYANOSIS Lip, tounge, mucosa, nail, skin
  • CYANOSIS Lip, tounge, mucosa, nail, skin Clubling of finger
  • Clubling of finger
  • EDEMA
  • EDEMA Dorsum of foot, ankle,medial side of tibia
  • EDEMA Dorsum of foot, ankle,medial side of tibia Pitting edema
  • EDEMA Dorsum of foot, ankle,medial side of tibia Pitting edema Non-pitting edema : local ,thick & rough skin
  • EDEMA Dorsum of foot, ankle,medial side of tibia Pitting edema Non-pitting edema : local ,thick & rough skin Severe edema - sex organ swelling
  • EDEMA
  • EDEMA Severe edema
  • HEAD, FACE, NECK
  • HEAD, FACE, NECK Head : Start from up to down, skull, hair, Scalp,
  • HEAD, FACE, NECK Head : Start from up to down, skull, hair, Scalp, Face : eyes,ears,nose,sinus,mouth,face appearance
  • HEAD, FACE, NECK Head : Start from up to down, skull, hair, Scalp, Face : eyes,ears,nose,sinus,mouth,face appearance Pharynx : lip,teeth,gum,mucosa,tounge,tonsils
  • HEAD, FACE, NECK Head : Start from up to down, skull, hair, Scalp, Face : eyes,ears,nose,sinus,mouth,face appearance Pharynx : lip,teeth,gum,mucosa,tounge,tonsils Neck : Scar?, Mass - thyroid, lymph node ,trachea,
  • HEAD, FACE, NECK Head : Start from up to down, skull, hair, Scalp, Face : eyes,ears,nose,sinus,mouth,face appearance Pharynx : lip,teeth,gum,mucosa,tounge,tonsils Neck : Scar?, Mass - thyroid, lymph node ,trachea, jugular vein and pressure , carotid artery,
  • HEAD, FACE, NECK Head : Start from up to down, skull, hair, Scalp, Face : eyes,ears,nose,sinus,mouth,face appearance Pharynx : lip,teeth,gum,mucosa,tounge,tonsils Neck : Scar?, Mass - thyroid, lymph node ,trachea, jugular vein and pressure , carotid artery, superior vena cava syndrome
  • Angular stomatitis
  • Hypotrophy of tongue
  • Tongue ulcer
  • Tongue ulcer
  • Hereditary hemorrhagic telangectasia Tongue ulcer
  • Gum hypertrophy
  • Gum hypertrophy
  • Gum hypertrophy Gum hypertrophy with poor mouth hygene
  • Ulcer at base of tongue
  • Ulcer at base of tongue Ulcer at sublingual
  • Inflammation
  • Inflammation Infection
  • Koilonychia
  • LYMPH NODES
  • LYMPH NODES Which group of lymph nodes enlargement single or multiple nodes,multiple groups
  • LYMPH NODES Which group of lymph nodes enlargement single or multiple nodes,multiple groups Signs of inflamation, tenderness, consistency, fix or movable
  • LYMPH NODES Which group of lymph nodes enlargement single or multiple nodes,multiple groups Signs of inflamation, tenderness, consistency, fix or movable Location of infection or inflammation - coresponding the enlarged nodes:
  • LYMPH NODES
  • LYMPH NODES Group of lymph nodes :
  • LYMPH NODES Group of lymph nodes : Preauricular,postauricular,occipital,submandibular,
  • LYMPH NODES Group of lymph nodes : Preauricular,postauricular,occipital,submandibular, submentle, cervical
  • LYMPH NODES Group of lymph nodes : Preauricular,postauricular,occipital,submandibular, submentle, cervical Cervical: anterior, posterior,supraclavicular
  • LYMPH NODES Group of lymph nodes : Preauricular,postauricular,occipital,submandibular, submentle, cervical Cervical: anterior, posterior,supraclavicular Axillary,epitrochlear,mediasternal,hilar
  • LYMPH NODES Group of lymph nodes : Preauricular,postauricular,occipital,submandibular, submentle, cervical Cervical: anterior, posterior,supraclavicular Axillary,epitrochlear,mediasternal,hilar Inguinal,abdominal
  • Lymph nodes at the neck
  • Lymph nodes at the neck
  • Lymphadenopathy
  • Thyroid examination from the front
  • Thyroid examination from the front
  • Thyroid examination from the front Thyroid examination from the back
  • CHEST
  • CHEST Chest appearance :
  • CHEST Chest appearance : abnormal shapes -
  • CHEST Chest appearance : abnormal shapes - barrel,cobbler,flat, funnel,pigion
  • CHEST Chest appearance : abnormal shapes - barrel,cobbler,flat, funnel,pigion Spine - kyphosis,scoliosis
  • CHEST Chest appearance : abnormal shapes - barrel,cobbler,flat, funnel,pigion Spine - kyphosis,scoliosis Palpation :
  • CHEST Chest appearance : abnormal shapes - barrel,cobbler,flat, funnel,pigion Spine - kyphosis,scoliosis Palpation : apex beat , chest movement
  • CHEST Chest appearance : abnormal shapes - barrel,cobbler,flat, funnel,pigion Spine - kyphosis,scoliosis Palpation : apex beat , chest movement Percussion :
  • CHEST Chest appearance : abnormal shapes - barrel,cobbler,flat, funnel,pigion Spine - kyphosis,scoliosis Palpation : apex beat , chest movement Percussion : cardiac dullness , chest dullness
  • CHEST Chest appearance : abnormal shapes - barrel,cobbler,flat, funnel,pigion Spine - kyphosis,scoliosis Palpation : apex beat , chest movement Percussion : cardiac dullness , chest dullness Auscultation :
  • CHEST Chest appearance : abnormal shapes - barrel,cobbler,flat, funnel,pigion Spine - kyphosis,scoliosis Palpation : apex beat , chest movement Percussion : cardiac dullness , chest dullness Auscultation : breath sound,heart sound
  • Spleen palpation
  • SPLEEN
  • SPLEEN
  • SPLEEN
  • SPLEEN
  • Auscultation
  • Growth retardation
  • Thalassemic face - Mongoloid face
  • Thalassemic face - Mongoloid face
  • Tower skull
  • Tower skull
  • Tower skull Radiography - Hair on end
  • Tower skull
  • Tower skull
  • Tower skull Radiography - Hair on end
  • Knock knee
  • Bone deformity
  • Hyperpigmentation of skin
  • Hyperpigmentation of skin
  • Abdominal enlargement
  • Bone deformity
  • Gynecomastia
  • Gangrene
  • Skin bleeding
  • Skin bleeding Petichiae
  • Purpura over the lower limbs in acute leukemia
  • MASSIVE BLEEDING
  • MASSIVE BLEEDING HEMOPHILIA A
  • Early urticarial lesion
  • Early urticarial lesion
  • Early urticarial lesion Bleeding with bleb formation
  • HENOCH-SCHÖNLEIN PURPURA Early urticarial lesion Bleeding with bleb formation
  • Senile purpura
  • MYCOSIS FUNGOIDES
  • Herpes Zoster infection
  • Indurated and confluent purpura of the arm Disseminated intravascular coagulation ( DIC )
  • Peripheral gangrene with swelling and discoloration of the skin of the feet in fulminant disease
  • Massive subcutaneous hemorrhage in thrombocytopenia
  • Severe bleeding
  • Acute hemarthrosis of Rt. knee joint wasting of the quadriceps muscles on the left
  • Acute hemarthrosis of Rt. knee joint wasting of the quadriceps muscles on the left
  • Acute hemarthrosis of Rt. knee joint Severe disability wasting of the quadriceps muscles on the left
  • Hemophilia A Acute hemarthrosis of Rt. knee joint Severe disability wasting of the quadriceps muscles on the left
  • Midline grannuloma
  • Kaposiʼs sarcoma
  • Kaposiʼs sarcoma in acquired immune deficiency syndrome ( AIDS )
  • Urine color