General Examination Flashcards
What should be done upon walking into the room?
Introduction and check correct patient
Explanation and Consent
Ask if in any pain
What should be done after introduction?
End of bed examination:
Check charts - make sure it belongs to correct patient
Drowsey or Conscious
Cooperative or confused
Comfortable or in distress
Obese or healthy
Environment - O2 masks, nasal tubes, IV cannulas, sputum/vomit pots, medication
Emotional state
Skin - sweating, pallor, jaundice, pigmentation and rashes
What is looked at in nails?
Inter-digitate your own nails
Tar staining Clubbing Splinter hemorrhages Koilonychia - spooning Leuciychia - white Nail pitting Peripheral cyanosis
Then do capillary refill
What is looked at in hand joints?
Hand joint swelling/pain - ask to make a fist then move joints
Look at joint below nail for heberdens nodes
What is looked for in palms?
Palmer erythema Palmer creases Temperature Sweating Muscle wasting
What should be done after hands have been inspected?
Tremors - fine and flapping
What should be done after checking for tremors?
Radial pulse rate
rate, character, volume, rhythm
What should be looked for in arms?
Track marks
Self harm scars
Bruising
Skin turgor for hydration status
What should be examined in the face?
Face - facial symmetry, mallar flush, xantheasma
What should be examined in the ears?
Gouty tophy, hearing aid
Temperature if there
What should be examined in the eyes?
Unequal pupils
Corneal arcus
Pink conjunctivi and white sclera’s
What should be examined in the mouth?
Cracks in side of mouth Lips and under tongue for central cyanosis Tongue for moisture Side of mouth for thrush, pigmintation Tonsils Dentures and fillings and teeth State of gum margins
Name of lymph nodes and order they are examined?
Supraclavicular Anterior cervical chain Sub mandibular Submental Post and pre auricular Posteriour cervical chain Occupital
What is looked at on inspection of the chest?
Even chest rising Gynacomastia - one breast bigger than other in males Skin lesions - blanching Spider naevi Campbell de-morgan spots
What is looked at on the legs?
Skin temp, colour
Palpate both legs - look for ischaemic issues (cold skin, smooth hairless skin)
Varicose veins
Oedema - press on skin above ankles for 10-15 seconds
