History and Physical Examination

You really only need to print the slides with the stars on them, to remind you

how to perform each part of the examination.

History and Physical

• Have the patient fill out a form that asks about their complete medical history.

• Take their vital signs• Do a physical exam

Vital Signs

• Blood Pressure• Heart Rate• Respirations• Temperature• Height, Weight

HEENT

• Head• Eyes• Ears• Nose • Throat

Head Exam

Head Exam

• Head• Shape• Size• Tenderness• Deformities• Trauma• Other abnormalities

Eye Exam

Snellen Eye Chart

Tests acuity and CN II

Test for Colorblindness

Deviated Nasal Septum

Deviated Nasal Septum

Nasal Polyps

Throat Exam

• Lymph Nodes• Pharynx Exam

Lymph Nodes

• submental area• submandibular nodes• Supraclavicular nodes• Anterior cervical (Sternocleidomastoid

area)• posterior cervical chain is along the back

of the neck (often positive in infectious mononucleosis and HIV+ patients)

• Axillary nodes• Inguinal nodes

Lymph Nodes

Axillary Lymph Nodes

Swollen Cervical Nodes

Swollen Inguinal Lymph Nodes

Throat Exam

Throats with tonsillitis

Abdomen• Shape• Symmetry• Girth• Scars• Tenderness• Masses• Organomegaly – Hepatomegaly (liver)– Splenomegaly (spleen)

• bowel sounds• hernias

Abdominal Exam

• Listen with the diaphragm of the stethoscope for the presence of bowel sounds in the lower abdominal quadrants.

• Measure the girth of the abdomen around the umbilicus. Excess girth is a risk factor for cardiovascular disease:– FEMALES: waist size more than 35 inches – MALES: waist size more than 40 inches

Abdominal Exam• Have patient lie down.• Place your fingertips on the upper

right quadrant (URQ), below the costal margin. Have them exhale.

As they exhale, press firmly into the abdomen and try to feel the border of the liver. It should be difficult to feel much. If it is easy to palpate, the liver is enlarged (hepatomegaly).

Repeat this procedure on the left upper quadrant (LUQ) to check for an enlarged spleen (spenomegaly).

Palpate the two lower quadrants for tenderness and masses.

Hepatomegaly

Hepatomegaly

Splenomegaly

Splenomegaly

Hernias

Umbilical Hernia

Inguinal Hernia

Inguinal Hernia

Back Exam

ABNORMALITIES OF THE SPINE• SCOLIOSIS is a lateral curve in the spine• KYPHOSIS is a hunchback curve• LORDOSIS is a swayback in the lower region.

Scoliosis

KYPHOSIS

LORDOSIS