General examination Flashcards
What should you do when you walk into the room?
Clean your hands
Inspect environment
Before examination say the patient seems fit for examination and make sure they are not in any pain
What could be present in the environment that you should point out?
Oxygen mask
Tubing
Vomit bowl
Sputum pot
Bedside medication
Before the examination what should you always do?
Ask the patient if in pain
Obtain consent
Position the patient at 45 degrees
Make sure the bed height is correct
Examination of the hands
Colour of hands e.g. Tar staining
Temperature and sweatiness of palms
Muscle wasting
Capillary refill time
Nails - splinter haemorrhages, peripheral cyanosis, anaemia, finger clubbing
Palpate joints
Contractures
Radial pulse & Respiratory rate
Tremor - fine & flapping
Examination of the arms
Bruising/rashes
Track marks
Spider naevi
Scars or wounds
Joint deformity
Assess skin turgor to assess hydration
Examination of the face
Appearance - symmetry, colour and hair distribution
Specific facies
Eyes - unequal pupils and jaundice, examine both conjunctivae, note eyelid position and symmetry
Lips - colour and presence of angular stomatitis
Use a wooden spatula for tonsils
Gum margins - note swelling
Tongue - shape, size moistness
Examination of the lymph nodes
Get patient to swing to one side of the bed
Start with supraclavicular node including scalene nodes
Then the anterior cervical chain (including tonsillar nodes)
Submandibular
Submental
Pre & post auricular
Occipital
Posterior cervical lymph nodes
Examination of the anterior chest area
Inspect and palpate skin lesions e.g spider naevi
Check for gynaecomastia (man boobs)
Examination of the lower limbs
Skin - colour, hair distribution, evidence of ulceration or varicose veins
Palpate temperature
Swelling - Pitting oedema
Deformities
Joint swelling, skin thickening
Inspect the movement of the toes
What do you do after an examination?
Let them know you have finished
Thank your patient
Clean your hands
Give them privacy to redress
