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A brief Presentation of Salient points to be considered while taking history and genaral examination.
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2. Personal History
3. Complaint: In the patients own words& duration 4. History of the present illness
5. Past history:
6. Example of a symptoms analysis Pain :ask about 1-Site:
3-Character of pain:aching, colicky, stabbing, burning. 2- Radiation : 7. Pain (cont .) 4-Severity of pain 5-Duration: e.g.- Trigemimdneuralgia( seconds) - Intestinalcolic(minutes) 6-Frequency &Periodicity 7-Time of occurence: e.g.
8. Pain (cont .) 8- Aggravating factors :e.g. swallowing in esophagitis 9- Relieving factors:e.g. stop walking in ischemic pain 10-Associated phenomena:e.g. marked swaeting in cardiac pain 9. General Examination 10. Routine Data or Vital Signs :
11. Radial Artery 12. Pulse Examination 13. Sphygmomanometer cuff 14. Length of the cuff 15. Stethoscope 16. Brachial Artery 17. BP measurement 18. Temperature Normal:36 .5 - 37.2 0 c -Diurnal variation -Age -Menstrual cyclevariation Fever: T>37.4 0 c -Infection-Tissue injury 19. Hyperpyrexia :T> 41.5 0 c
20.
Hypothermia: 21. Types of fever
22. Color changes
23. Pallor
24. Cyanosis
25. Cyanosis 26. Body Built 1 Body Built(weight & Hight)BMI = BW (kg) / Ht (m 2 ) >40 30-40 25-30 20-25 Morbid Obesity Obese Over weight Normal 27. Body Built 2
Body Built 28. Decubitus :
29. Tri Pod position Patient with emphysema bending over inTri-PodPosition 30. Examination of theHEAD & FACE 31. HEAD & FACE Head : Face :
32. Facial swelling causing asymmetry Facial swelling 33. Facial swelling:Rt periorbital 34. Normal Eye 35. Jaundice 36. Jaundice2 37. Eye Lids EdemaXanthelasmaDark ring Ptosis3rd nerve paralysis- Horners syndrome Myathenia gravisCongenital retractionThyrotoxicosis 38. Edema of the eye lids 39. Eye ball
40. Pupils
< 1mm( 1- 2.5 nm ) Unilateral Bilateral small pupils 41. Horner syndrome 42. Pupils 2 Large dilatedpupils anoxia Bilaterally dilated pupils (fixed): drugs (atropine - phenothiazine- tricyclicantidepressants) (Reactive) Unilaterally dilated pupil ( Fixed dilated) Oculomotor paralysis Temporal lobe herniation ---Mid brain .
43. Conjunctiva
Chemosis: edema 44. Conjunctivitis 45. Sclera
46. Scleritis 47. Nodular Episcleritis in a patient with CD 48. Cornea Nose Ear
49. Parotid glands
50. Unilaterally enlarged parotid 51. Mouth: Lips
52. Breath
53. Mouth :Dryness and increased salivation
54. Normal oral cavity 55. Left peritonsillar abscess 56. Teeth
xxxxx 57. Tooth abscess Tooth Abscess 58. Gums
59. Tongue 1
60. Tongue 2
61. Buccal mucosa 1
62. Buccal mucosa 2
63. Neck
64. Thyroid gland:anatomy Isthmus 65. Palpation of the thyroid gland:posterior approach 66. Palpation of the thyroid gland: anterior approach 67. Neckveins Jugular Vein Carotid Artery Nopulsations palpable. Palpable pulsations. Pulsations obliterated by pressure above the clavicle. Pulsationsnotobliterated by pressure above the clavicle. Level of pulse wave decreased on inspiration; increased on expiration. No effects of respiration on pulse. Usually two pulsations per systole (x and y descents). One pulsation per systole. Prominent descents. Descentsnotprominent. Pulsations sometimes more prominent with abnominal pressure.No effect of abdominal pressure on pulsations 68. Cervical lymph nodes 69. Examination of Axillae
70. Examination of the axilla 1 71. Axillary lymphadenopathy 72. Examination of the axilla 2 73. Examination of theBreast
74. Epitrochlear LN 75. Examination of the Upper Limbs:Edema 76. DVT of the right arm 77. Cellulitis of the upper limb Examination of upper limbs:Cellulitis 78. Cellulitis of the upper limb2 79. Examination of Hands
See also joint examination 80. Acromegaly 81. Peripheral Vascular Disease of the UL 82. Wasting of the thenar eminance 83. Nicotine staining 84. Wrist: Ganglion 85. Skin 1
86. Skin 2
Locaalized Generalized 87. Skin 3 2-Texture:
88. Skin 4 3.Elasticity: cutis loxa - old age - progeria 4.Thickness : -Acromegaly - Elephantiasis- Occupational 5.Striae:
89. Skin 5 6-Eruption:
90. Skin 6
91. Telangiectasia 92. Skin-Hair
93. Lymph nodes 1
94. Lymph nodes 2
95. Examination of the Lower Limbs 96. Peripheral pulsation :Dorsalis pedis 97. Peripheral puls ations:Dorsalis pedis2 98. Peripheral pulsations :post tibial artery 99. Peripheral pulsations : posterior tibial artery 2 100. Popliteal artery 101. Acute vascular insufficiency: mottled appearance 102. Chronic arterial insufficiency 103. Digital gangrene 104. Chronic Venous Insufficiency 105. Neuropathic ulcer in a diabetic patient 106. Lower limbs: edema 1
107. Lower limbs:Edema 2
108. LL edema 109. Pitting edema of the lower limb 110. Erythema nodosum 111. Onychomycosis 112. Genitalia and Joints Genitalia Joints:
113. Rheumatoid arthritis 114. RA: boutonniere finger 115. Rheumatoid arthritis 2 116. Heberdens nodes Heberdens nodes 117. Gout:MCP joints 118. Leprosy