Foundations of Clinical Medicine Physical Examination, Slides of Clinical Medicine

Download Foundations of Clinical Medicine Physical Examination and more Slides Clinical Medicine in PDF only on Docsity! UW School of Medicine: Foundations of Clinical Medicine Physical Examination Checklist Medical students will be required to perform a comprehensive physical examination. The Checklist below provides an overview of the physical examination tasks. Student: Examiner: Steps Yes/No Notes General appearance, skin, & vital signs General appearance Observe general appearance Skin Perform an integrated skin exam during entire exam Vital Signs Pulse: measure radial pulse for 15 seconds Measure systolic and diastolic blood pressure by auscultation Respiratory rate: count the respirations for 30 seconds HEENT General Impression Inspect size and shape of the head and the scalp Inspect for symmetry, masses, and signs of trauma Inspect the skin as you perform the HEENT exam Note any difficulty with breathing or speech Eyes Measure visual acuity Inspect the eyelids, lashes, bulbar & palpebral conjunctiva, sclera, cornea, anterior chamber, and iris Assess pupils Perform ophthalmoscopy* Ears Inspect auricle and mastoid Examine auditory canals, TMs, and middle ear structures* Assess hearing with finger rubbing Nose Examine the external nose, nares, septum, and nasal cavities* Mouth Inspect the lips, buccal mucosa, tongue, floor of mouth, palate, palatine tonsils, and posterior pharyngeal wall Inspect the teeth and gums Palpate parotid glands Palpate temporomandibular joints (TMJ) Neck Inspect the neck Palpate the neck, including lymph nodes (anterior cervical, posterior cervical, and supraclavicular) Palpate thyroid Chest Inspection Observe respiratory effort and note any signs of respiratory distress Inspect the skin of the posterior chest Palpation Assess symmetry of respiratory excursion Steps Yes/No Notes Assess tactile fremitus Percussion Percuss the chest posteriorly Percuss the spine and the costovertebral angles Auscultation Auscultate the chest using the diaphragm of the stethoscope posteriorly, laterally, and anteriorly Cardiovascular Inspection Inspect and measure JVP Inspect the precordium Inspect the skin of the anterior chest and neck as you perform the CV exam Palpation Palpate the apical impulse Palpate LLSB for lifts Palpate the carotid arteries Auscultation Listen at each location with the diaphragm: RUSB, LUSB, LLSB, apex Listen with the bell at the cardiac apex Listen for bruits over each carotid artery Peripheral Circulation Palpate each of the following pulses on each side: radial, femoral, DP, PT Edema Inspect for pedal edema Abdomen Inspection Observe the patient for discomfort Inspect the abdominal contour Inspect skin as you examine the abdomen Auscultation Listen in one place with the diaphragm of the stethoscope Percussion & Palpation Percuss all four quadrants Palpate all 4 quadrants Percuss the liver Palpate the lower liver edge Palpate for an enlarged spleen Palpate for inguinal LAD Neurologic Mental Status Observe the level of consciousness Observe speech and language Assess orientation to person, place, and time Assess short term memory Cranial Nerves If not done in the HEENT exam, test visual acuity & visual fields for each eye (CN II) If not done in the HEENT exam, test pupillary reaction (CN II and III) Test eyelid opening (CN III) Test extra-ocular movements (CN III, IV, VI), observing for nystagmus (CN VIII) Test facial sensation & muscles of mastication (CN V) Test muscles of facial expression (CN VII) Test hearing (CN VIII) Test palatal rise to phonation (CN IX and X)