what are the 9 broad parts of the general exam
initial assessment
intro, consent
examination of hands
examination of arms
examination of face
examination of lymph nodes
examination of front of chest
examination of lower limbs
closure
what are you looking for in your initial assessment
conciseness level
are they fit enough - DR ABC
is the patient in pain or distress
inspect immediate environment
what should you cover in the introduction
name status
name and dob of patient
consent
ask if they are in pain
height of trolley!!!
what are the board categories of things to be looked at on the hands (10)
colour
nails
capillary refill time
shape of joints
muscle wasting
palms
temperature
contractures
radial pulse
tremor
why are you looking at the colour of the hands
to check for tar staining
what are you looking for on the nails
pitting splinter haemorrhages leukonychia peripheral cyanosis koilonychia finger clubbing
what is leukonychia
where marks appear on the nails looking like white lines or milk spots
what is koilonychia
where the nails look like spoons and are indented - associated with anaemia
what are you looking for on the joints
and deformities or swollen areas
ask patient to open shut hands to see movement and if it is pain free
what are you looking for on the palms
stretching the palmer creases - should be red and flush
temperature
sweatiness
what are contractures
when the hands tighten (and look kind of like claws)
what are the 3 types of tremor to be looked for
fine
coarse
flapping
what is to be looked for on examination of the arms
joint deformity
bruises/ pigmentation/ rashes
spider naevi
scars/wounds
venous damage (track marks)
hydration status
what are spider naevi
red pinpoint blood vessels
originating out from a centre po like a web
how would you check hydration status
skin turgor
pull skin
severely dehydrated - elasticity is lost
what is to be examined when looking at the face
over all symmetry
ears
eyes
lips
buccal mucosa
fauces
gum margins
tounge
what is gout
the defective metabolism of uric acid causes arthritis and chalk stones
what are you looking for on they eyes
unequal pupils
yellow jaundiced sclerae
conjunctivae
what are you checking the ears for
shape, swelling and gout
what are you checking the lips for
the colour (should be pink/red)
what are you checking the buccal mucosa
what is the buccal mucosa
looking for any ulceration or pigmentation
the inside, side of your mouth
what are you examining in the fauces
the tonsils
what are you examining on the toungue
abnormal size, shape, surface texture
what are you looking for when examining the front of the chest
palpate any skin lesions - spider naevi should become flush?
check for gynaecomastia
what is gynaecomastia
males possibly developing breast tissue
what are things to be examined when looking at the lower limbs
skin
swelling
deformities
toes and feet - joints and ankles
soles and backs of heels for lesions/ ulcers
what thinks should be looked at on the skin of the legs
hair distribution, ulceration , varicose veins temperature down the legs, odema
what is the normal range for body temperature
36.0 to 37.5
