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RESPIRATORY SYSTEM & ALIMENTARY SYSTEM
RESPIRATORY SYSTEM
INSPECTION
1) Type of respiration. Thoracic ( )
Abdominal ( ) Abdominothoracic ( )
2) Shape of the chest Normal (
) Barrel ( ) Other ...........
3) Deformity
Pectus carinatum ( )
Pectus excavatum ( )
Harrison's sulcus ( )
Thoracic kyphoscoliosis ( )
Local bulging ( )
Flattening
( ) of the chest.
4) Prominent veins ( )
Pulsations ( )
Scar
( )
5) Examination of Nose
Shape...........
Movement of ala nasi ( )
Condition of nasal mucosa
........................
Condition of nasal septum
........................
Position of nasal septum
........................
Hypertrohpic turbinates ( )
Any foreign bodies ( )
Talengiectasis ( )
PALPATION
1) Position of trachea ........................
2) Chest movements ........................
3) Chest expansion ........................
4) Vocal fremitus ........................
5) Tenderness ( )
6) Crepitations ( ) ........................
7) Palpable sounds ( ) ........................
PERCUSSION
1) Upper border of liver
........................
2) Comparison of percussion note on both sides
........................
3) Tidal percussion ........................
AUSCULTATION
1) Breath sounds ........................
Intensity ........................ Character ........................
2) Added sounds , Ronchi
........................ Crepitations ........................
Pleural rub ........................ Vocal
resonance ........................
Whispering pectoriloquy
........................
Forced expiratory time ........................
ALIMENTARY SYSTEM
Oral cavity
Lips
Color ........................ Fissures ( ) Ulcers ( )
Vesicles ( ) Talengiectasis ( )
Gums
Lead line ( ) Gingival hyperplasia ( )
Bleeding ( ) Swollen gums ( )
Teeth
Tartar deposits ( ) Abnormal Pigmentation ( )
Ill fitting dentures ( )
Loss of enamel ( ) Crowding of teeth ( )
Hutchison's teeth
( )
Tongue
Size ........................ Mucosal growth ( ) Red & Swollen
( )
Geographical tongue ( ) Coating ( )
Atrophic papillae ( )
Ulcers ( )
Mucosa
Ulcers ( )
Koplick's spots (
)
Uvula
Congested ( ) Pulled to one side ( )/ Normal ( )
Soft palate
Ulcers ( )
Congestion ( )
Moving equally on 'aah!!' ( )
Fauces & palatine tonsils
Breath foul ( )
Posterior pharyngeal wall
Congested ( )
Sublingual salivery gland's duct ........................
Parotid duct/Submendibular gland (bimanual examination-- if needed!)
ABDOMINAL EXAMINATION
INSPECTION
Anterior abdominal wall
1) Shape of abdomen
Normal(scaphoid) ( )
Distended ( )
2) Symmetry symmetrical ( )\ asymmetrical ( )
(localized buldge )
3) Scar ( )
4) Striae ( )
5) Prominent veins ( ) Site ( ) Direction of
flow ( )
6) Umbilicus -- Position
........................ Shape: Normal ( ) / Everted ( )
7) Movements of abdomen with respiration ( )
Peristalsis ( )
Pulsations ( ) Site ........................
Transmitted ( ) / Expansile ( )
8) Pubic hair Normal ( ) Thick ( )
Distribution- Male ( ) Female ( )
9) Hernial orifices Epigastric
........................ Umbilical ........................
Paraumbilical ........................
Incisional ........................ Inguinal ........................
Femoral ........................
PALPATION
Superficial
Rigidity ( )/Guarding ( )
Tenderness ( )
Deep
Tenderness
( ) Rebound tenderness ( )
Mass ( )
Palpation for viscera (Complete description)
..........................................................................................................
..........................................................................................................
..........................................................................................................
Liver ........................ Size ...... cm.
Surface ........................ Consistency ........................
Borders ........................ Tenderness
.......................
Spleen ........................Size ...... cm
Consistency ........................ Notch ........................
Tenderness ........................
Gall bladder- Murphy's sign ( )
Urinary bladder ........................
Kidneys ........................
Thickened coils of intestine
........................
Palpation for hernial orifices
........................
Scrotum ........................
Dipping palpation (in ascities)
........................
PERCUSSION FOR VISCERA
Liver ........................
Spleen ........................
Urinary bladder ........................
Other masses ........................
For ascities, Shifting Dullness ( ) Fluid thrill ( )
Ovarian cyst ........................
AUSCULTATION
1) Bowel sounds ........................
Intensity ........................ No. /min ........................
2) Bruits, Hepatic ( ) Renal ( ) Arterial, sup.
mesenteric artries ( )
3) Venous hum, Epigastric ( ) Umbilicus ( )
4) Rubs, Hepatic ( ) Splenic ( )
5) Succussion splash (if needed) ( )
DIGITAL RECTAL EXAMINATION
1) Appearance of perianal area tags ( ) Pigmentation ( )
2) Tone of anal sphinctor ........................
3) Porstate ........................
4) Rectal mucosa (Ant,Post,Lat,Walls) ........................
5) Fecal impaction ( )
6) Finger staining ( )
POSTERIOR ABDOMINAL WALL
Symmetry/bulging in renal area ( ) Flanks ( ) Deformity scoliosis ( )
Gibinis ( )
Movement with respiration ( )
Murphy's renal punch ( )
Any tenderness at spinal percussion ( )