Date post: | 26-Dec-2015 |
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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
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
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.
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.