This document provides guidance on performing an adult general physical examination. It outlines the initial steps, which include greeting the patient, introducing yourself, confirming patient identity, explaining the exam, ensuring a proper environment, obtaining consent, hand washing, draping the patient, and considering pain. It then describes aspects to examine such as handshake, body build, face, clothing, complexion, sounds, odors, posture, gait, and movements. Specific examination techniques are also mentioned, including examining the pallor, edema, nails, cyanosis, icterus, lymph nodes, and skin. Causes and characteristics of various physical findings are listed.

3. Adult General Physical
Examination
Dr. Seyed Morteza Mahmoudi, MBBS
Gulf Medical University, Ajman
2013

5. Making use of all our
senses, Except?

7. Initial Steps
1- Greet

8. Initial Steps
2- Introduce yourself

9. Initial Steps
3- Make sure you have the
right patient

10. Initial Steps
4- Explain

11. Initial Steps
5- Make sure the
environment is appropriate

12. Initial Steps
6- Consent

13. Initial Steps
7- Wash hands, safety
precautions

14. Initial Steps
8- Drape and adequately
expose

15. Initial Steps
9- If necessary get a
chaperon

16. Initial Steps
10- Ask about pain

17. Steps
1- Greet
2- Introduce yourself
3- Make sure you have the right patient
4- Explain
5- Make sure the environment is appropriate
6- Consent
7- Wash hands, safety precautions
8- Drape and adequately expose
9- Chaperon
10- Pain consideration

18. Start your physical
examination as soon as
you see the patient

19. Physical Examination
Hand shake
Body built
Face
Clothing
Complexion
Sounds
Odors
Posture and gait
Movements
Spot diagnosis

22. Useful Pneumonic
Pallor
Edema
Nail changes/clubbing
Cyanosis
Icterus
Lymph nodes
Skin changes

25. SCHAMROTH’S WINDOW TEST

26. CAUSES OF CLUBBING
cyanotic congenital heart disease
Sub acute bacterial endocarditis
lung carcinoma
bronchiectasis
Emphysema
lung abscess
lung fibrosis
Pulmonary Tuberculosis
cirrhosis
IBD
Celiac disease
Thyrotoxicosis
Familial

28. CAUSES
CENTRAL CYANOSIS
Abnormal hemoglobin
levels
Congenital heart disease
Hypoventilation
Asthma
Methmoglobinemia
Valvular heart disease
COPD
Pulmonary embolism
Arterial obstruction
Heart failure
Right to left venous
arterial shunts
High altitudes
Polycythemia

30. PERIPHERAL CYANOSIS
Exposure to cold
Reduced cardiac output
Arterial or venous obstruction

32. Skin Changes
Dry & inelastic
Moist
Thickened and greasy
Atrophied
Colour
Dupuytren's contracture
Rashes
Swellings
Hemorrhages
Hair

37. Nail Changes
Koilonychias
Onycholysis
Pitting
Splinter hemorrhages

43. Lymph node Examination
Cervical
Sub mental Submandibular –
Tonsillar (Jugulodigastric)Preauricular
Postauricular
Occipital
Superficial (Anterior) Cervical
Posterior cervical
Supraclavicular
Axillary
Inguinal

44. Massive
lymphadenopathy

45. Tuberculosis
Lymphadenopathy