STUDENT NAME:

ENCOUNTER ELEMENT 04 – INSTRUCTOR ASSESSMENT OF PHYSICAL EXAM (20 POINTS)( (ENCOUNTER Element 4 -
Instructor’s assessment of the student’s ability to carry out a focused, but sufficiently thorough, physical examination)

PHYSICAL EXAM

General Skills Components by which to determine the score (scores are given only in case
of correct technique)

Heent  Inspect and palpate the scalp

 Inspection of the sclera 
 Sinus palpation (maxillary and frontal)

● Examination for cervical lymphadenopathy

Neck Exam
● Examination of neck for thyromegaly

● Tactile fremitus ( posterior)

● Percussion of both lung fields (posterior)

Lung Exam
● Auscultation of both lung fields ( posterior)

GU ● Costovertebral angle tenderness

ENDO ● Peripheral tremor

● Inspection of the hands and nails

● Clubbing

● Inspection of neck veins (right JVD)

● Auscultation of Carotids

● Complete auscultation of all four points of the precordium

Cardiovascular
Exam ● Auscultations of bruits on abdominal aorta

● Auscultation of bruits on renal arteries

● Posterior tibial pulses

● Examination of dorsalis pedis

● Examination of the ankles for pitting edema

Abdominal Exam ● Auscultation (bowel movements)

● General percussion in 4 quadrants

● Light palpation 4 quadrants

● Deep palpation 4 quadrants

● Liver percussion

● Liver palpation
 STUDENT NAME:
● Spleen palpation

● Spleen percussion

Extremities movement and strength

● Ask the patient to fully extension the elbow and then flex
them as far as possible
● Passive full flexion and extension of the elbow
● Active full flexion of the knees and hips: ask the patient to
bend the knees and bring them towards the chest  
● Passive full flexion and extension of the knees:

● Patella tap test (minor)

● Check strength in 4 extremity

Spine flexion
SBMJ
● Assess lateral flexion of cervical spine, by asking the patient to
bring ear to shoulder (without moving the shoulder)

● Assess forward flexion, by asking the patient to bend to touch the

toes while keeping knees extended (normal: finger-floor distance
<15 cm)

Range of motion of the fingers:

● Ask the patient to make a fist

● Grip strength: ask the patient to squeeze your fingers;

● Finger opposition: ask the patient to touch the thumb with each
finger

Neuro exam ● Level of Consciousness: Orientation in time, place and person

● Test memory: Recent / long-term memory /

● Pupillary exam

● II- nerve

● III, IV, VI nerve - visual fields, eye movement

● Check V nerve - motor and sensor portions

● Check VII nerve 

● Check VIII  nerve - whispered test,

● Rinne test, Weber test

● Check the IX; X; XII nerve 

● Check the XI

● Check the sensation (extremities) – pain

STUDENT NAME:
● Finger to nose test

● Check the gait (including heel to toe, on heels/on toes)

● The Romberg test