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- 1. PHYSICAL EXAMINATION Ms. Neethu Mohanlal. V
- 2. Heart sounds – 5 points across the precordium A. Five points across the precordium 1. Aortic area - second intercostal space, right sternal border 2. Pulmonic area - second intercostal space, left sternal border 3. Erb's point - third intercostal space, left sternal border 4. Tricuspid area -fifth intercostal space, left sternal border 5. Mitral area - fifth intercostal space, left midclavicular line 7/3/2023 NEETHU MOHANLAL 2
- 5. Point of maximum impulse - area where pulse is felt the strongest Heaves or thrusts - sharp lifting of chest wall Thrills - vibration felt with palmar surface of hand. 7/3/2023 NEETHU MOHANLAL 5
- 6. • Heart murmurs are generated by turbulent flow of blood , it occur inside or outside the heart , may be physiological ( benign ) or pathological (abnormal) • It is caused by stenosis- Restricting the opening of a heart valve, resulting in turbulence as blood flows through it. 7/3/2023 NEETHU MOHANLAL 6
- 7. Pericardial friction rub Caused by the beating of the heart against an inflamed pericardium or lung pleura. • This sound is usually continuous and heard diffusely over the chest • If the rub completely disappears when the patient holds his breath it is more likely due to pleural , not pericardial , 7/3/2023 NEETHU MOHANLAL 7
- 9. Assessment of breasts Inspection Normal breast appears round and essentially symmetric ,although one breast is often slightly larger than the other, the skin should be smooth and intact with the areola darker in color , round and symmetric , the nipple should be everted 7/3/2023 NEETHU MOHANLAL 9
- 10. Contd… Palpation Palpation is done to determine if masses or lumps are present in the breast , Palpate each breast for tenderness, nodules or masses , during the palpation teach the women how to perform breast self palpation. 7/3/2023 NEETHU MOHANLAL 10
- 12. Abdomen – 9 regions 7/3/2023 NEETHU MOHANLAL 12
- 13. Anatomical landmarks of the abdomen 7/3/2023 NEETHU MOHANLAL 13
- 16. Inspection Normal findings: Colour :Uniform color, Silver –white striae( stretch marks) Shape :Flat, rounded( convex) or scaphoid (concave). No evidence of enlargement of liver or spleen Abdominal movements: 7/3/2023 NEETHU MOHANLAL 16
- 18. Abdomen – engorged veins 7/3/2023 NEETHU MOHANLAL 18
Editor's Notes
- Heart murmurs are sounds — such as whooshing or swishing — made by rapid, choppy (turbulent) blood flow through the heart. The sounds can be heard with a device called a stethoscope
- C- murphy’s point at the –intersecction of mid clvicular line used to assess liver. G- traube’s area, a space formed by the left costal margin, 7 th rib and Aal is used to assess spleen. E- Mc Burney’s point 3 cm medial to the antrior superior iliac spine used to asess apendix. Mc Burney’s line between anterior superior iliac spine to the umblics. F- anterior superior iliac spine
- Portal hypertension, cirrhosis, venecaval obstruction