Uploaded byMr. Mata Deen
Physical Examination
The document outlines the comprehensive procedures and techniques involved in conducting a physical examination, including inspection, palpation, percussion, auscultation, and various assessments of the body's systems. It details the necessary equipment, patient preparation, and the systematic evaluation of different body parts, emphasizing factors such as vital signs, skin conditions, and neurological assessment. Additionally, it provides guidelines for aftercare and documentation following the examination.
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Physical Examination
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- 2. Physical examination •Physical examinationis 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
- 3. Indication of physicalexamination • On admission • On discharge • On follow up • Health camps • Before and after diagnostic and therapeutic procedure.
- 4. TECHNIQUE OF PHYSICALEXAMINATION
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- 6. GENERAL INSPECTION OFA CLIENT FOCUSES ON • Overall appearance of health or illness • Signs of distress • Facial expression and mood • Body size • Grooming and personal hygiene
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- 8. PRINCIPLES OF PALPATION •Examiner should have short fingernails. • Examiner 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 examiner is doing.
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- 12. TYPE OF PERCUSSION •DIRECT PERCUSSION
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- 15. FOUR CHARACTERISTICS OFSOUND • 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)
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- 34. PREPARING THE PATIENT •PSYCHOLOGICAL PREPERATION
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- 36. ARTICLES REQUIRED • Screento provide privacy • Bowl for antiseptic lotion • Kidney tray and paper bag • Weighing machine and height scale • Patient gown
- 37. ARTICLES REQUIRED • Bathblanket to cover the patient • Draw sheet to cover patient’s chest • Square drum containing test tube, gauze piece, cotton swab, specimen bottle, swabsticks • Gloves • lubricant
- 38. ARTICLES REQUIRED • Torch •Ophthalmoscope • Snellen’s chart • Book for colour blindness • Pen • Flash card • Autoscope with speculum of different sizes • Percussion Hammer • Tuning fork
- 39. ARTICLES REQUIRED • Nasalspeculum • Mouth gag • Laryngeal mirror • Tongue depressor • Stethoscope • Inch tape
- 40. ARTICLES REQUIRED • Steriletray for vaginal examination • Proctoscope • Vitals Tray
- 41. ARTICLES FOR NEUROLOGICAL EXAMINATION •Powder, soap • Snellen’s chart • Pencil or pen • Cotton wicks • Torch • Tuning fork • Salt, sugar
- 42. ARTICLES FOR NEUROLOGICAL EXAMINATION •Tonguedepressor •2 test tubes one with hot water and other with cold water •Safety pins •Sharp object like key •Reading material to assess eyes and language of person •Knee harmer
- 43. GENERAL SURVEY • Identificationdata • Gender • Age • Signs of distress • Body type • Posture • Gait
- 44. GENERAL SURVEY • Bodymovements • Hygiene and grooming • Body odour • Affect and mood • Speech • Substance abuse:
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- 47. ASSESSING INTEGUMENT SYSTEM •Assessing skin • Skin color Erythema
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- 51. Inspect skin vascularity •Ecchymosis
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- 54. Palpate skin temperature,texture, moisture and turgor
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- 57. 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
- 58. ABNORMALITIES OF NAIL •Koilonychias (spoon nail) • clubbing • Paranychia
- 59. ASSESSING HAIR ANDSCALP • color, • texture and distribution. • Thickness and lubrication of hair
- 60. INSPECT THE SCALP •Cleanliness, color, dryness, • Lump, lesions, • Lice (pediculus humanus capitus) • Dandruff etc
- 61. HEAD AND NECK ASSESSINGTHE SKULL • for size, symmetry • any nodules or masses
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- 63. ASSESS THE EYE •Inspect external eye structure • Position and alignment • Exophthalmoses
- 64. ASSESS THE EYE •Eye brows • Eye lid : • ectropion(eversion ,lid margin turn out) • entropion(inversion, lid margin turns inwards) • ptosis( abnormal drooping of lid over pupil
- 65. ASSESS THE EYE •Eye lashes : sty. • Eye balls • Conjunctiva and sclera{ Paleness, redness or purulent,jaundice}
- 66. ASSESS THE EYE •Cornea and iris :arcus senilis
- 67. PUPILLARY REFLEX TOLIGHT
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- 69. INSPECT INTERNAL EYESTRUCTURES
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- 72. EARS AURICLES • EAR CANALAND TYMPANIC MEMBRANE
- 73. HEARING • WEBER’S TEST: •RINNE, S TEST:
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- 75. INSPECT THE MOUTHPHARYNX 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:
- 76. 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
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- 78. PALPATE TRACHEA ANDLYMPH NODES
- 79. PALPATE THE THYROIDGLAND
- 80. ASSESS THE THORAXAND 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
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- 83. 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.
- 84. ABNORMAL BREATH SOUNDS •WHEEZE • RHONCHI • CRAKLES • FRICTION RUB
- 85. CARDIO VASCULAR SYSTEM •INSPECT NECK AND PRECORDIUM • PALPATE THE PRECORDIUM • AUSCULATATE HEART SOUND
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- 87. ASSESSING THE BREASTAND AXILLA • INSPECT BREAST AND AXILLA • PALPATION OF BREAST AND AXILLA
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- 94. ASSESS MUSCULO SKELTALSYSTEM • INSPECT AND PALPATE MUSCLE
- 95. MUSCULO SKELTAL SYSTEM •PALPATE THE BONES • INSPECT AND PALPATE THE JOINTS • INSPECT SPINAL CURVES • kyphosis
- 96. AFTER CARE • Makethe patient comfortable • Recording and reporting • Replace all articles