General Examination What will I examine General appearance

General Examination

What will I examine? General appearance. Vital signs. Head examination. Neck examination. Upper limb examination. Lower limb examination. Lymph node examination.

1. General appearance: . Conscious and orientation (GCS). Cooperation. Mentality. Memory. Mood. Decubtus

Glasgow coma scale (GCS): Eye Opening Best verbal response Best motor response 4 - Spontaneous eye opening 5 - Oriented 6 - Follow commands 3 - Eye opening on command 4 - Gives confused answers 5 - Localizes painful stimulus 2 - Eye opens to painful stimulus 3 - Inappropriate response 4 - Non localizing movement to pain 1 - No eye opening 2 - Makes unintelligible noises 3 - Abnormal flexion to pain 1 - Makes no verbal responses 2 - Abnormal extension to pain 1 - Gives no motor response

Body Mass Index: Weight/height² BMI Underweight <18, 5 Normal 18, 5 -24, 9 Over weight 25 -29, 9 obese 30 -39, 9 Morbidly obese >40

2. Vital signs: . Pulse. Blood pressure. Respiratory Rate ( Normal = 16 -22). Temperature ( 36, 5 -37, 2)

Pulse: . Rate ( Normal = 60 – 100). tachycardia. . . . >100 bradycardia. . . <60 regular) . Equality on both sides. Peripheral Pulsation. State of arterial wall

Blood Pressure: Blood Pressure Normal Systolic mm hg (upper) Diastolic mm hg (lower) Less than 120 Less than 80 Prehypertension 120 -139 80 -89 Hypertension stage 1 140 -159 90 -99 Hypertension stage 2 160 or higher 100 or higher Higher than 180 Higher than 110 Hypertension crisis

Head Examination: . Facies (Down syndrom , Thalasemia). . Hair( Alopecia). Eye ( jaundice, Exophthalmous). Nose and cheeks (Malar rash). Mouth: odor, lips, tongue, teeth, Gums, oral cavity, Palate. . Ear. parotid

Neck Examination: . Trachea: central or shifted Mobile or fixed heal tug (A. A, Campbell's sign). Thyroid gland: Inspection palpation percaussion Auscultation

JVP Carotid pulastion Medial to sternomastoid muscle Lateral to sternomatoid muscle One peak Wavy pulastion Unaffected by posture Prominent on lying down Un affected by respiration Decrease by inspiration Better felt than seen Seen and not felt

. Lymph nodes: Circular ……. . Retropharyngeal tonsils submental submandibular preauricular postauricular occipital Vertical ………Superficial and deep groups

Upper Limbs: . Hand Examination S ( shape , sweating) T ( tremors , temperature) N ( nail, nodule) P ( pallor , palmer erythema). skin 4 s ( stria, scratch marks , scar, spider navi) purpra Ecchomosis. Axillary lymph nodes

Lower Limbs Examination. Oedema. Dorsalis Pedis. Post tibial. Lax calf muscles. Varicosities. Skin + ulcers. Pretibial Myxedema. Erythema nodsum