Physical Assessment 4. Palpate the temporomandibular joint (TMJ).

GENERAL SURVEY NECK

1. Observe for signs of distress in posture or facial 1. Inspect the neck.

expression. 2. Inspect movement of the neck structures
2. Observe for signs of distress in posture or facial 3. Inspect the cervical vertebrae.
expression health 4. Inspect range of motion.
3. Observe client’s posture and gait, standing, 5. Palpate the trachea.
sitting, and walking. 6. Palpate the thyroid gland.
4. Observe client’s overall hygiene and grooming. 7. Auscultate the thyroid only if you find an
5. Note body and breath odor. enlarged thyroid gland during inspection or
6. Note obvious signs of health or illness. palpation.
7. Assess the client’s attitude. 8. Palpate the lymph nodes.
8. Note the client’s affect/mood; assess the
EYES
appropriateness of the client’s responses.
9. Listen for quantity, quality, and organization of 1. Test distant visual acuity.
speech 2. Test near visual acuity.
3. Test visual fields for gross peripheral vision.
SKIN
4. Perform Corneal Light reflex test.
1. Inspect skin color. 5. Perform cover test.
2. Inspect uniformity of skin color. 6. Perform Positions Test.
3. Inspect, palpate, and describe skin lesions. 7. Inspect the eyelids and eyelashes.
4. Observe and palpate skin moisture. 8. Assess ability of eyelids to close.
5. Palpate skin temperature. 9. Note the position of the eyelids in comparison
6. Palpate to assess for presence of edema. with the eyeballs.
7. Palpate to assess for skin turgor. 10. Observe eyelids for redness, swelling, discharge
8. Remove and discard gloves and perform hand or lesions.
hygiene. 11. Observe eyelids for the position and alignment
of the eyeball in the eye socket.
HAIR
12. Inspect the bulbar conjunctiva and sclera.
1. Inspect the evenness of growth over the scalp. 13. Inspect the palpebral conjunctiva.
2. Inspect hair thickness or thinness. 14. Evert the upper eyelid.
3. Inspect hair texture and oiliness. 15. Inspect the lacrimal apparatus.
4. Note presence of infections or infestations. 16. Palpate the lacrimal apparatus.
5. Inspect amount of body hair. 17. Inspect the cornea and lens.
18. Inspect the iris and pupil.
NAILS 19. Test pupillary reaction to light (Pupillary Light
1. Inspect fingernail plate shape. Reflex).
2. Inspect fingernail and toenail bed color. 20. Assess Consensual Response
3. Inspect tissues surrounding nails. 21. Test accommodation of pupils.
4. Palpate fingernail and toenail texture. EARS
5. Palpate fingernail and toenail texture.
1. Inspect the auricle, tragus and lobule.
HEAD TO NECK 2. Palpate the auricle and mastoid process
HEAD AND FACE 3. Perform whisper test
4. Perform Weber’s Test
1. Inspect the head. 5. Perform the Rinne’s Test
2. Palpate the head 6. Perform the Romberg Test
3. Palpate the temporal artery
 MOUTH AND THROAT 8. Palpate for tenderness, sensation and surface
masses
1. Inspect the lips.
9. Palpate for tenderness at costochondral
2. Inspect the teeth and gums
junctions of ribs
3. Inspect the buccal mucosa.
10. Palpate for crepitus
4. Inspect and palpate the tongue.
11. Palpate for fremitus
5. Assess the ventral surface of the tongue
12. Palpate anterior chest expansion
6. Inspect for Wharton’s ducts
13. Percuss the tone
7. Observe the sides of the tongue.
14. Auscultate for breath sounds
8. Check the strength of the tongue.
9. Inspect the hard (anterior) and soft (posterior) BREAST AND LYMPHATIC SYSTEM
palates and uvula.
1. Inspect size and symmetry.
10. Note odor while the mouth is wide open
2. Inspect color and texture.
11. Assess the uvula
3. Inspect superficial venous pattern.
12. Inspect the tonsils
4. Inspect the areolas.
13. Inspect the posterior pharyngeal wall
5. Inspect the nipples.
NOSE 6. Inspect for retraction and dimpling.
7. Palpate texture and elasticity
1. Inspect and palpate the external nose
8. Palpate for tenderness and temperature.
2. Check patency of airflow through the nostrils.
9. Palpate for masses.
3. Inspect the internal nose
10. Palpate the nipples.
SINUSES 11. Inspect and palpate the axillae.
12. Demonstrate how to perform Breast Self-Exam
1. Palpate the sinuses
2. Percuss the sinuses HEART AND NECK VESSELS

CHEST, BREAST, AND HEART 1. Observe the jugular venous pulse.

2. Evaluate jugular venous pressure.
POSTERIOR THORAX 3. Auscultate the carotid arteries
1. Inspect Configuration 4. Palpate the carotid arteries.
2. Observe use of accessory muscles 5. Inspect pulsations.
3. Inspect the client’s positioning 6. Palpate the apical impulse.
4. Palpate for tenderness, sensation and crepitus 7. Palpate for abnormal pulsations.
5. Palpate surface characteristics 8. Auscultate heart rate and rhythm.
6. Palpate for fremitus 9. Auscultate to identify S1 and S2.
7. Assess chest expansion 10. Auscultate for extra heart sounds.
8. Observe use of accessory muscles 11. Auscultate for murmurs.
9. Percuss the tone ABDOMEN
10. Percuss for diaphragmatic excursion
11. Auscultate for breath sounds 1. Observe the coloration of the skin.
12. Auscultate for voice sounds 2. Note the vascularity of the abdominal skin.
3. Note any striae
ANTERIOR THORAX 4. Inspect for scars.
1. Inspect for shape and configuration 5. Assess for lesions and rashes.
2. Inspect position of the sternum 6. Inspect the umbilicus.
3. Watch for sternal retractions 7. Inspect abdominal contour.
4. Inspect slope of the ribs 8. Assess abdominal symmetry.
5. Observe quality and pattern of respirations 9. Inspect abdominal movement when the client
6. Inspect intercostal spaces breathes
7. Observe for use of accessory muscles 10. Observe aortic pulsations.
 11. Observe for peristaltic waves.
12. Auscultate for bowel sounds.
13. Auscultate for vascular sounds.
14. Listen for venous hum.
15. Auscultate for a friction rub over the liver and
spleen.
16. Percuss for tone.
17. Percuss the span or height of the liver by
determining its lower and upper borders.
18. Perform blunt percussion on the liver and the
kidneys.
19. Perform light palpation.
20. Deeply palpate all quadrants to delineate
abdominal organs and detect subtle masses.
21. Palpate the liver.
22. Palpate the urinary bladder.
23. Assess for rebound tenderness.

MUSCULOSKELETAL

MUSCLE, BONES AND SKELETAL

1. Inspect the muscles for size. Compare each

muscle on one side of the body to the same
muscle on the other side.
2. Inspect the muscles and tendons for
contractures.
3. Inspect the muscles for tremors.
4. Palpate muscles at rest to determine muscle
tonicity.
5. Palpate muscles while the client is active and
passive for flaccidity, spasticity, and
smoothness of movement.
6. Test muscle strength of the head & shoulders
7. Test muscle strength of upper extremities
8. Test muscle strength of lower extremities
9. Inspect the skeleton for normal structure and
deformities.
10. Palpate the bones to locate any areas of edema
or tenderness.
11. Inspect the joint for swelling.
12. Palpate each joint for tenderness, smoothness
of movement, swelling, crepitation, and
presence of nodules.
13. Assess joint range of motion of the head
14. Assess joint range of motion of body trunk
15. Assess joint range of motion of upper
extremities
16. Assess joint range of motion of lower
extremities.