physical examnation

1. PHYSICAL EXAMINATION
DR.Pyuza, MD

2. Definitions
• Physical Examination or Clinical
Examination: The process by which a
healthcare provider investigates the
body of a patient for signs of disease.
It generally follows the taking of the
medical history

3. preparations for physical
examination
Reflect your approach to the patient,
 Try to be calm, organized and
compliment
Prepare the environment
 Make the environment comfortable to
your patient, should be clean, prepare
beds for examination, make sure that
room have enough light, Make the room
quiet and maintain privacy.
Prepare and check your equipment.
Make the patient comfortable

4. equipment for physical
examination
 A stethoscopes for auscultation
 Sphygmomanometer for measuring blood pressure
 A thermometer for measuring body temperature
 Cotton for testing the sense of light touch
 Gloves and lubricant for oral, vaginal and rectal
examinations
 A penlight for inspection of hidden body parts like in the
ears
 Safety pins for testing two point discrimination
 Watch with second hand for evaluation of pulse
 Ophthalmoscope, otoscope for examination of eyes and
ears o Patella hammer for examining reflex
 Tape measures for evaluation of lengths o Tongue
depressor for examination of throat o Vaginal specula
for vaginal examinatio

8. cardinal techniques of physical
examination
 Inspection
 Palpation
 Percussion
 Auscultation

9. Inspection
• Close observation of the details of the
patient’s:
 Appearance
 Behaviour
 Movement such as facial expression, mood,
body habitus, and conditioning
 Skin conditions such as petechiae, or
ecchymosis
 Eye movement
 Pharyngeal colour
 Symmetry of thorax o
 Height of jugular venous pulsation o
Abdominal contour
 Lower extremity oedema and gait

10. Palpation
• Tactile pressure from the palm, fingers
or finger pads to assess:
Areas of skin elevation , depression,
warmth, or tenderness
Lymph nodes, pulses
Contours, and sizes of organs and
masses

11. Percussion
 Use the striking or plexor finger, usually
the third, to deliver a rapid tap or blow
against the distal pleximeter finger;
usually the distal third finger of the left
hand is laid against the surface of the
chest or abdomen, to evoke the sound
wave such as resonance or dullness
from the underlying tissue or organs
 • This sound wave also generates a
tactile vibration against the pleximeter
finger


12. Auscultation
• Use the diaphragm and bell of the
stethoscope to detect:
The characteristics of the heart, lung,
and bowel sounds, including location,
timing, duration, pitch and intensity o
For the heart, this involves sounds
from closing of the four valves and
flow into the ventricle as well as
murmurs o Auscultation also permits
detection of bruits or turbulence over
arterial vessels

13. sequence of physical
examination
 It include general examination and
systemic examination
 Start with general examination then
systemic examination

14. General examination
 From the head to the toe
 General survey
Alert , consciousness , illilooking

18. Hair
 Color and texture and distribution

19. face

20. EYES
 Exphthalmos/ enophthalmos
 Eye lid
 Conjunctiva pallor- sign of anaemia
 Sclera: jaundice

22. Mouth
 Cyanosis
 Pallor
 Any mass or lesion
 Gum and teeth (if there is any
bleeding)
 Tongue
 Lips
 Angular stomatitis

25. neck
 Any swelling
 Lympnode

26. skin
 Cyanosis
 Pigmentation
 Redness
 Discoloration
 Rashes

27. Hands

29.  Hand tremours

30. Lymph node examination

31.  Axillary lympnode (5 groups )
 Inguinal lympnode

32. LOWER LIMB
ASSESSIMENT

33. Vital signs

41. Normal rate
 16-22bpm in adult

42. Temperature

43.  NORMAL RANGES
 36.5 TO 37.4 C

44. End
 thank you