Neck: Goiter.Lymph nodes & other lymph node groups. Vascular pulsation. Short with webs(Turner syndrome). Breasts: Female breasts:Normal.Mass or thickenings or nodularity. Male breasts: Normal.Mass. Gynecomastia:Liver cirrhosis.Drugs as spirinolactone,oestrogen. Puberty.Old age.Hypogonadism.Thyrotoxicosis. Tumours (testicular,adrenals,lung)
Nails: Nails clubbing(lung,liver,cyanotic heart,intestinal &inflammatory bowel diseases). what degree? 1.increased base flactuation. 2.loss of nail angle. 3.increased curvature. 4.drum stick. Confirm clubbing by Shamruth sign: Absence of rectangular space on coinsiding corresponding nails of both hands). Cholenychia or spoon nails(flat or concave in iron dificiency). Splinter sunangual hemorrhage(SBE,trauma,valculitis,trichinliasis). White nails:Hypoalbuminemia.Severe chronic illness. Nail pitting in psoriasis. Transverse depression in nails(Beaus lines):Acute severe illness. Onycolysis(elevation of nail end):Thyrotoxicosis.Chronic nail disorders.
Hands: Scleroderma hand. Acromegaly. Short metacarpals(hypoparathyroid) Tetany:Hypocalcemia.Hyperventilation.
Legs: Wasting Pseudohypertrophy(Hereditary Dushein muscular dystroohy). Swolen&tender(DVT). Ulcers. Erythema nodosum(tender red painful nodules): TB.Streptococcal infections.Sarcoidosis.IBD.Behcet disease. Varicose veins. Coldness in ischemia(compare with other side). Ankle edema: Pitting: Heart failure.Renal failure.Nephrotic syndrome.Liver cirrhosis.Malnutrition. Non-pitting:Lyphedema.
Legs: Rashes:Petichae or echemosis, vasculitic rash. Hair changes. Feet: Edema.Swelling.Flat foot.Pes cavus(friedricks ataxia). Rheumatoid foot. Swollen big toe(gout). Ulcers. Gangrene. Achilis tendonitis(sero –ve arthritis). Cold in ischemia(compare with other side). Diabetic foot ulcers or gangrene. Clubbing of toe nails.