General Exam

Question 1

End of Bed:

Answer 1

• Conscious level
• Distressed, pain or breathing problems
• Bedside O2, vomit bowel, sputum pot or meds

Question 2

Hands

Answer 2

Tar Staining
Nails - Bed colour, pitting, splinter haemorrhages, leuconychia, koilonychia, cyanosis or anaemia
Clubbing
Capillary Refill
Joints: Deformed or Swollen
Movement - Make a fist and then straighten (look for pain)
Muscle Wasting
Palms - stretch palmar creases for colour
Temp & Sweat
Contractures (Dupuytren’s)
Tremors (Fine/Coarse/Flapping)

Question 3

Arms

Answer 3

Radial Pulse & Resp Rate
Joint Deformity
Tattoos/Bruising/Pigmentation/Rashes
Spider Naevi
Scars or Wounds
Venepuncture marks
Hydration

Question 4

Face

Answer 4

General - Symmetry, colour, hair distribution
Specific Facies - Acromegaly
Ears - shape of pinna + Swellings
Eyes - Pupils, Sclera (jaundice/redness), Conjunctivae, Symmetry
Lips - Colour (cyanosis), Angular Stomatitis
Buccal Mucosa - Pen torch to check for ulceration
Tonsils - Wooden spatula to depress tongue
Gum margins and dentition
Tongue - Size, shape, texture, movement, colour, moistness

Question 5

Lymph nodes

Answer 5

Supraclavicular
Anterior Cervical Chain
Submandibular
Submental
Pre-auricular
Post-auricular
Occipital 
Post-Cervical Chain

Question 6

Anterior Chest

Answer 6

Skin lesions e.g. Spider Naevi
Scars
Gynaecomastia (men)

Question 7

Lower Limb

Answer 7

Skin - colour, ulceration, hair distribution or varicose veins (soles of feet)
Temperature
Swelling (particularly pitting oedema)
Deformities
Swollen joints or skin thickening
Toe movement (curl toes)