other symptoms associated with it?
•Provocative &Palliative- what makes it better or worse?
•Quality - what's it like? Is it sharp, dull, piercing, throbbing?
•Radiation - where is it? Does it move to other parts of the body?
•Severity - how bad is it (on a scale of 1 to 10)?
•Timing - does it usually start at a certain time of day? How long does it last? Is it constant
• How was your health as achild? Any major childhood illnesses?
• How has your health been as anadult? Any major adult illnesses? Hospitalizations?
• Whatmedications are you currently taking?
• Do you have anyallergies to foods, medicines, or anything else?
• Tell me about what you do for a living.
• How far did you go in school?
• Do you live with anyone? Are you married, or have you ever been? Do you have children?
• Inspect sclera / conjunctiva
•Snellen card eye test (cover one eye)
•Opthalmoscope -lower lights first; find fundus; switch hands with opthalmoscope
• Palpate sternal notch - trachea midline?
• Palpate lymph nodes
• Palpate thyroid gland (tilt head & swallow, then palpate)
◦ Name 3 objects
◦ Repeat "The sky is blue in Baltimore"
◦ Point to ceiling, point way out of room
•CN III / IV / IV: Extra-ocular movements (cross)
•CN V: touch face
•CN VII (2)
•CN VIII: hearing (rub fingers, same on both sides?)
•CN IX: elevation of palatte (penlight, open mouth, say "ah")
•CN XI: shoulder shrug (bilateral)
•CN XII: stick out tongue
• Proximal leg: hip flexor (instruct patient to brace with hands first)
• Distal leg: dorsiflex foot
• Pronator drift:eyes closed, hold hands out like tray for 10 seconds
2, thigh x 2, distal big toe x 2)
• Vibration (tuning fork on PIP of great toe x 2 - hit tuing fork hard)
• Proprioception (shield vision, move great toe up x 5 and down x 5 for each great toe)
• Biceps x 2 (palpate first)
• Patella x 2 (palpate, then slightly lateral to midline)
• Babinski x 2 (warn of discomfort)
• Finger - nose x 2 (full reach)
• Hand tapping (or flipping)
• Walk across room (full length)
• Romberg (stand with eyes closed, feet together: against wall, provide contact guard)
• Tandem walk (drunk walk)
• Stand on heels, then toes
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