1503 201

18 2560 .
:
(Professionalism)

1. 50
2. 10
3. 1
4. 1

1. power point
2.

1.
2.
3.



Eagles eye, Lions heart, Ladys hand

", ,

(Physical examination)

2






1.
2.

3.
3
4.

5.
(Complete and comprehensive) (Focused and concise)


1. (Inspection)
2. (Vital signs measurement)
3. (Palpation)
4. (Percussion)
5. (Auscultation)
6. (Special test)
:
(Bowel sound)

(Right side
approach)

(General physical examination)

( )
(HEENT)



/ / ____( )____
___(// )___
___()___ /
/ ()
( ) /

(General appearance)



(First impression)
: Gigantism
( 1.1, 1.2), Dwarfism , Obesity , Cachexia
 ( 1.3), Kyphosis , Scoliosis ( 1.4), Febrile ,
Frail , (Cushingoid apperance) ( 1.5)
(Gait) : Fascinating gait
(Parkinsonism), Hemiplegic gait
, Ataxic gait , Spastic gait
(Level of consciousness)
(Fully consciousness) :

(Confusion) :
Clouding of consciousness
(Lethargy) : (Drowsiness)
Obtundation
(Stupor) :
(deep pain)
(Coma) :
(Body build) : (Cachexia), (Thin), (Normal), (Obese)
(Behavior) : (Cooperative) , (Nervous), (Agitated),
(Withdrawal), (Aggressive)
(Suffering) : Dyspnea , Orthopnea

, Air hunger , Pain

: (Radial 2.1
artery) radial artery
(Bates Guide to physical
examination and history
taking Edition 10th)

1. (Rate) 2. (Rhythm) 3. (Pulse intensity)

15
1
, (Coarctation of aorta)
(Aortic dissection)
:
(Accessory
muscle use)

 :
Sphygmomanometer

(Resting blood
pressure) 5
30


(Arteriovenous fistular)
(Cuff/Bladder) 2.2
2 3 (Sphygmomanometer)
(Bates Guide to physical examination and history
taking Edition 10th)
(Cubital fossa)

(radial artery)
radial artery

(Systolic blood pressure)
Korokovs sound (Stethoscope)
(Diaphragm) ( Bell)
(Brachial artery)
Systolic blood pressure 20-30
2-3 ( )
systolic blood pressure
(Diastolic blood pressure)

" 120/80 "

2.3
(Medical Thermometer)

: 2



2
0.5 (Core temperature)
core temperature, (rectum)
0.3

(Head), (Eye), (Ear),
(Nose) (Throat)

(Anemia) (Jaundice)
(Cyanosis)

3.1 (anemia) (Central cyanosis) (Jaundice)

(Wikipedia and stockphoto internet)
:
(Hair line)

(abnormal mass)


(Hyperpigmentation) (Central cyanosis)
(Cyanosis)
(Bluish/Purplish discoloration) (Central cyanosis)
(Peripheral cyanosis)
Central cyanosis :

(Polycythemia)
Peripheral cyanosis :
Central cyanosis
,
 (Ptosis) ( 3.2)
(Exopthalmos) ( 3.3)
(Myasthenia Gravis) (Lambert-Eaton Myasthenic Syndrome)
(Horner's syndrome)
(Puffy eyelids) ( 3.4)
(Xanthelasma) ( 3.5)
(Conjuctivae)
Palpable conjuctivae
Palpable
conjuctivae (Anemia)
Bulbar conjuctivae

(Sclera)
3.6 (Conjuctiva)
(Human-anatomy101.com ;Conjuctiva) (Jaundice)
(Hyperbilirubinemia)
(Iris) (Pupil)
(Light reflex)

2

(Lid eversion)


(Ophthalmoscope)

3.7
(Lid eversion) (ADAM) (Low set ear)


(Otitis externa)

(Otoscope)
(Tuning fork)
(Audiometer)

(Patency of
anterior nare) 3.8
(American Rhinology Society)
 (Nasal discharge)
(Nasal mucosa)

( 3.8)

(Sinusitis)
(Oral cavity)

(Crack) (Dryness) (Angioedema)
( 3.15) (Abnormal pigmentation)
3.9
(Oral mucosa) (Buccal), (Bates Guide to physical examination and history
taking Edition 10th)
lower lip
2 (hard palate) (Uvula)

uvula

3.10 (Dental nomenclature)

(Atropic Glossitis) ( 3.11) hairy leukoplekia (
3.12) (Oral candidiasis) (
3.2)

(Thyroid gland)
surface anatomy thyroid
2
anterior boarder Sternocleidomastoid
lateral boarder thyroid gland
Ischmus

4.1
 (Size), (Consistency), (Abnormal mass)
,
15
5 (75 ), 3 (45 )
2 (25-
30 ) ( 4.2)
(thyroid bruit) Bell
(Thyrotoxicosis) Graves disease




1. Occipital
2. Posterior auricular
3. Pre auricular
4. Submaxillary
5. Submental
6. Posterior cervical
7. Anterior (Superficial) cervical
8. Supraclavivular
Virchow node

4.3
9. Internal jugular (Deep cervical) (Bates Guide to physical examination and history
taking Edition 10th)


3 1.Parotid gland 2. Submaxillary gland 3. Sublingual gland

4.4

(Bates Guide to physical examination
and history taking Edition 10th)

4.5 (Saliva gland)

(Mayo foundation for medical education/research)


. . 2. :
; 2551.
. . 2. :
; 2557
. . 3. :
; 2558.
. . 1. :
Lynn Bickley et al. Bates Guide to Physical Examination and History taking. Edition 11 th .
Lippincott Wiliams & Wilkins; 1999.
Mark Dennis, William Talbot Bowen, Lucy Cho. Mechanisms of clinical signs. 1 st edition.
Elsevier Australia; 2012.
Multiple free internet resources
 :

1.1 Giantism 1.2 Acromegaly

Pituitary (Robert F. Gagel, M.D., and Ian E. Growth hormone
McCutcheon, M.D. ; New england Journal of medicine) (Philippe Chanson and Sylvie Salenave - Acromegaly. Orphanet
Journal of Rare Diseases 2008)

1.3 Cachexia
(Addressing Cachexia for
Cancer Patients; Medscape)

1.4 Kyphosis Lordosis Scoliosis abnormal curvature

(The spine 3rd Edition ; Abnormal curvation)

3.2 Ptosis

st
(Mechanism of clinical signs 1 edition) 3.3 Exophthalmos / Staring eyes
Graves disease (Mechanism
of clinical signs 1st edition)
 3.4 Puffy eyelids
2
4.2 Goiter 3.11 Angular stomatitis Atropic glossitis
(Nursing signs ; General apperance)
(Mechanism of clinical signs 1st 1
edition) (Mechanism of clinical signs 1st edition)

3.13 Herpes simplex labialis

(Mechanism of clinical signs 1st edition)

3.12 Hairy leukoplakia Oral candidiasis (HelloMrDordor.com)

3.15 Angioedema



(Stock photo)

3.14 Aphthous ulcer

(HelloMrDordor.com)
 1.5 Cushingoid apperance

(Buffalo hump)
(Mechanism of clinical signs 1st edition)

3.5 Xanthelasmas

(Mechanism of clinical signs 1st edition)

4.6 Hypothyroidism


(Mechanism of clinical signs 1st edition)