DEFINITION• Health examination• Health examination is the systematic assessment of human body which involves the use of one’s senses to determine the general physical and mental conditions of the body
Physical examination• Physical examination is defined as a complete assessment of a patient’s physical and mental status.• A physical assessment is the systematic collection of objective information that is directly observed or is elicited through examination techniques
Indication of health examination• On admission• On discharge• On follow up• Health camps• Before and after diagnostic and therapeutic procedure.
PRINCIPLES OF PALPATION• You should have short fingernails.• You should warm your hands prior to placing them on the patient.• Encourage the patient to continue to breathe normally throughout the palpation.• If pain is experienced during the palpation. discontinue the palpation immediately.• Inform the patient where, when, and how the touch will occur, especially when the patient cannot see what you are doing.
FOUR CHARACTERISTICS OF SOUND• 1.Pitch (ranging from high and low):frequency or number of oscillations generated per second by vibrating object• 2. Loudness (ranging from soft to loud): amplitude of sound• 3. Quality (gurgling or swishing)• 4. Duration (short, medium or long)
ARTICLES FOR NEUROLOGICAL• Powder, soap EXAMINATION• Snellan’s chart• Pencil or pen• Cotton wicks• Torch• Tuning fork• Salt, sugar
ARTICLES FOR NEUROLOGICAL EXAMINATION• Tongue depressor• 2 test tubes one with hot water and other with cold water• Safety pins• Some thing solid for grasping• Sharp object like key• Reading material to assess eyes and language of person• Knee harmer
GENERAL SURVEY• Identification data• Gender and race• Age• Signs of distress• Body type• Posture• Gait
GENERAL SURVEY• Body movements• Hygiene and grooming• Body odour• Affect and mood• Speech• Substance abuse:
ASSESSING NAILS• Shape; convex• Angle : between nail and its base is 160 degrees• Texture: smooth, nail base should be firm and non tender• Color: pinkish nail bed with translucent white tips• Capillary refill
ABNORMALITIES OF NAIL• Koilonychias (spoon nail)• clubbing• Paranychia• indentations called (beau’s line)
ASSESSING HAIR AND SCALP• color,• texture and distribution.• Thickness and lubrication of hair
INSPECT THE MOUTH PHARYNX AND NECK• LIPS: lesions ,pallor (anemia), cyanosis(respiratory cardiovascular problems), cherry colored• BUCCAL MUCOSA , GUMS AND TEETH: teeth look for alignment , dental caries.buccal mucosa is a good site to visualize jaundice and pallor.leukoplakia (thick white patches ) is a precancerous lesion.• TONGUE• FLOOR OF MOUTH• PHARYNX:
ABNORMAL FINDINGS• pallor, cyanosis or redness• lesions, swollen lips red tonsils, swollen red bleeding gums,• white coating of tongue fissured tongue from dehydration.• bright red tongue seen in deficiency of iron b12 or niacin,• black tongue
ASSESS THE THORAX AND LUNGS• INSPECT THE THORAX• Abnormal findings :increase in chest size and contour , abnormal breathing pattern with the use of accessory muscles, unequal chest expansion, and abnormal breath sounds, barrel chest, pigeon chest
AUSCULATE BREATH SOUND• Bronchial sounds heard over the trachea are high – pitched, harsh sounds with expiration longer than inspiration .• Bronchovesicular sounds: heard over the main stem bronchus and is moderate (blowing) sound with inspiration equal to expiration.• Vesicular sounds are soft , low pitched and heard best in base of lungs during inspiration longer than expiration.