Physical examination - Revision history

Michael at 18:12, 31 January 2022

2022-01-31T18:12:47Z

← Older revision		Revision as of 18:12, 31 January 2022
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	Peripheral:		Peripheral:
	*Clubbing (lung causes DDx: abscess, [[bronchiectasis]], [[cancer]], decreased O2, empyema, [[fibrosing alveolitis]]).		*[[Clubbing]] (lung causes DDx: abscess, [[bronchiectasis]], [[cancer]], decreased O2, empyema, [[fibrosing alveolitis]]).
	**Clubbing should be viewed with suspicion in patient with [[COPD]], as it should not be seen in the context of pure [[emphysema]].<ref>URL: [http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf]. Accessed on: 23 September 2010.</ref> Clubbing in COPD is relatively rare; thus, in the context of COPD and smoking it should prompt a search for an occult [[lung cancer]].<ref>URL: [http://www.merck.com/mmhe/sec04/ch045/ch045a.html http://www.merck.com/mmhe/sec04/ch045/ch045a.html]. Accessed on: 23 September 2010.</ref>		**Clubbing should be viewed with suspicion in patient with [[COPD]], as it should not be seen in the context of pure [[emphysema]].<ref>URL: [http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf]. Accessed on: 23 September 2010.</ref> Clubbing in COPD is relatively rare; thus, in the context of COPD and smoking it should prompt a search for an occult [[lung cancer]].<ref>URL: [http://www.merck.com/mmhe/sec04/ch045/ch045a.html http://www.merck.com/mmhe/sec04/ch045/ch045a.html]. Accessed on: 23 September 2010.</ref>
	*Cyanosis - fingernails.		*Cyanosis - fingernails.

Michael: +image

2020-06-07T19:43:49Z

+image

← Older revision		Revision as of 19:43, 7 June 2020
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			[[File:MMSA Checking Blood Pressure.JPG\|thumb\|A blood pressure check. (WC/Kilbosh)]]
	The '''physical examination''', also '''clinical examination''', in medicine is the art of acquiring information while looking fancy. The findings usually don't make the [[diagnosis]]. The [[clinical history\|history]] is often far more important.		The '''physical examination''', also '''clinical examination''', in medicine is the art of acquiring information while looking fancy. The findings usually don't make the [[diagnosis]]. The [[clinical history\|history]] is often far more important.

Michael at 04:01, 6 January 2017

2017-01-06T04:01:53Z

← Older revision		Revision as of 04:01, 6 January 2017
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	**Nasal flaring.		**Nasal flaring.
	**Cyanosis - lips, lingual frenulum.		**Cyanosis - lips, lingual frenulum.
	*Trachea midline?		*[[Trachea]] midline?
	*Accessory neck muscle use.		*Accessory neck muscle use.

Michael: /* Palpation */

2015-10-24T22:12:31Z

Palpation

← Older revision		Revision as of 22:12, 24 October 2015
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	===Palpation===		===Palpation===
	*Trachea midline (may be deviated in tension pneumothorax).		*Trachea midline (may be deviated in tension [[pneumothorax]]).

	*Tactile fremitus (boy-o-boy or 99).		*Tactile fremitus (boy-o-boy or 99).

Michael: /* Cranial nerves */

2014-06-18T18:12:23Z

Cranial nerves

← Older revision		Revision as of 18:12, 18 June 2014
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	*Finger flexors C8.		*Finger flexors C8.
	*Thumb abduction and adduction T1.		*Thumb abduction and adduction T1.

			==Peripheral vascular exam==
			Appearance:
			*Edema.
			*Erythema.
			*Hair loss.
			*Ulcers - bottom (more likely arterial).
			*Gangrene.
			*Scars.

			Feel:
			*Pulses:
			**Femoral artery pulse - femoral triangle.
			**Popliteal artery pulse - behind the knee.
			**Posterior tibial artery pulse - inferior and posterior to the medial malleolus.
			**Doralis pedis pulse - on dorsal surface of the foot.

	==See also==		==See also==

Michael: w

2013-01-16T12:10:55Z

← Older revision		Revision as of 12:10, 16 January 2013
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	The '''physical examination''', in ~~clinical~~ medicine, is the art of acquiring information while looking fancy. The findings usually don't make the [[diagnosis]]. The history is far more important.		The '''physical examination''', also '''clinical examination''', in medicine is the art of acquiring information while looking fancy. The findings usually don't make the [[diagnosis]]. The [[clinical history\|history]] is often far more important.

	The bit below is far from comprehensive and doesn't even think of pretending to be that.		The bit below is far from comprehensive and doesn't even think of pretending to be that.

Michael: tweak

2012-02-29T04:16:57Z

tweak

← Older revision		Revision as of 04:16, 29 February 2012
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	The '''physical examination''', in clinical medicine, is the art of acquiring ~~a small amount of~~ information while looking fancy. ~~It doesn~~'t ~~usually~~ make the diagnosis..~~. but can help you along that path.~~		The '''physical examination''', in clinical medicine, is the art of acquiring information while looking fancy. The findings usually don't make the [[diagnosis]]. The history is far more important.

	~~The history is far more important. The radiology is more informative and the labs and pathology often more definitive.~~		The bit below is far from comprehensive and doesn't even think of pretending to be that.

	The bit below is far from comprehensive and doesn't even think of pretending to be that~~. It was written from the perspective of someone that sorta knows the stuff. It is useful perhaps only as a review~~.

	This was written to review the physical exam and serve as a template for the examination at [[autopsy]]... where one sees a lot more 'cause the subject doesn't have to be in one piece after one is done.		This was written to review the physical exam and serve as a template for the examination at [[autopsy]]... where one sees a lot more 'cause the subject doesn't have to be in one piece after one is done.
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	===Extras===		===Extras===
	*Calf tenderness - think about DVT/PE.		*Calf tenderness - think about [[DVT]]/PE.
	*Homans' sign - calf pain on dorsiflexion (suggestive of DVT).		*Homans' sign - calf pain on dorsiflexion (suggestive of DVT).
	*Vitals - may help figure-out tumour vs. infection.		*Vitals - may help figure-out tumour vs. infection.
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	One should palpate the painful area last (for practical and psychological reasons).		One should palpate the painful area last (for practical and psychological reasons).
	===~~Inspec.~~===		===Inspection===
	*Masses, scars, lesions, signs of trauma & previous surgery.		*Masses, scars, lesions, signs of trauma & previous surgery.
	*Distension.		*Distension.
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	==Spleen==		==Spleen==
	===~~Inspec.~~===		===Inspection===
	*Masses etc.		*Masses etc.
	*Stigmata of liver disease, lymphadenopathy.		*Stigmata of [[liver]] disease, [[lymphadenopathy]].
	===Percussion===		===Percussion===
	*Castell's sign - most sensitive.		*Castell's sign - most sensitive.
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	*Adnexal masses.		*Adnexal masses.
	*Tenderness - adnexal.		*Tenderness - adnexal.
	*Cervical motion tenderness (think PID, [[appendicitis]]~~...~~).		*Cervical motion tenderness (think PID, [[appendicitis]]).

	==Neurologic==		==Neurologic==

Michael: /* Respiratory */ w

2012-02-21T14:56:37Z

Respiratory: w

← Older revision		Revision as of 14:56, 21 February 2012
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	Peripheral:		Peripheral:
	*Clubbing (lung causes DDx: abscess, bronchiectasis, cancer, ~~decr.~~ O2, empyema, ~~fibrosis~~ alveolitis).		*Clubbing (lung causes DDx: abscess, [[bronchiectasis]], [[cancer]], decreased O2, empyema, [[fibrosing alveolitis]]).
	**Clubbing should be viewed with suspicion in patient with [[COPD]], as it should not be seen in the context of pure [[emphysema]].<ref>URL: [http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf]. Accessed on: 23 September 2010.</ref> Clubbing in COPD is relatively rare; thus, in the context of COPD and smoking it should prompt a search for an occult [[lung cancer]].<ref>URL: [http://www.merck.com/mmhe/sec04/ch045/ch045a.html http://www.merck.com/mmhe/sec04/ch045/ch045a.html]. Accessed on: 23 September 2010.</ref>		**Clubbing should be viewed with suspicion in patient with [[COPD]], as it should not be seen in the context of pure [[emphysema]].<ref>URL: [http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf http://medicine.ucsf.edu/education/resed/Chiefs_cover_sheets/Clubbing.pdf]. Accessed on: 23 September 2010.</ref> Clubbing in COPD is relatively rare; thus, in the context of COPD and smoking it should prompt a search for an occult [[lung cancer]].<ref>URL: [http://www.merck.com/mmhe/sec04/ch045/ch045a.html http://www.merck.com/mmhe/sec04/ch045/ch045a.html]. Accessed on: 23 September 2010.</ref>
	*Cyanosis - fingernails.		*Cyanosis - fingernails.

Michael: /* Integrated quick exam */ w

2011-10-08T15:50:24Z

Integrated quick exam: w

← Older revision		Revision as of 15:50, 8 October 2011
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	*CN IX, X: "Ah" - palate symmetry.		*CN IX, X: "Ah" - palate symmetry.
	*CN XI: sternomastoid - strength.		*CN XI: sternomastoid - strength.
	*CN XII: stick-out tongue.		*CN XII: stick-out [[tongue]].

	Skipped:		Skipped:
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	*CN VII: skip taste ant. 2/3, parotid gl., lacrimal gl., stapedius m.		*CN VII: skip taste ant. 2/3, parotid gl., lacrimal gl., stapedius m.
	*Skip CN VIII entirely.		*Skip CN VIII entirely.


	===Screening neurologic exam===		===Screening neurologic exam===

Michael: /* Liver */

2011-09-14T18:34:50Z

Liver

← Older revision		Revision as of 18:34, 14 September 2011
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	*Clubbing.		*Clubbing.
	*Palmer erythema.		*Palmer erythema.
	*Dupuytren's contracture.		*[[Dupuytren's contracture]].

	Body:		Body: