soles | pps K drordara piye 2° Steet : gk 4 > onset, domatte Ho healed loomne site, onset, priogries sek, pnogy lenation — continvc nLION ¢ Beato, + eganavoling g x eligving pock’s woond d y Sas On} Sogepstive Of “aR Hlo™intenndttent Clava + Ho 7eSt ‘pain - lo diccdounation of BeBe toes Hlo pain iy Vinnls cleat’ Blo HI! + lo TA Histony Sogqestive of Sd ee a tite cough. Recrettayss, loss of we, less Of OPP soil Perec ATT evening mise of; Eernpenatone 6 reonths Of FT HJo diabetes any Ho” Peaspherc\ ceoritts Hlo beven | palld) Aiea 3govleen — pomde ages, bh Hongo 6 amount . Smell, coloon aned Of vicen sts |skenctarert | eadernatoos cs ‘of Wali : Cana ‘rmegulan, never, PATA ecgematovs , pigmented reatignent: + any scons |stooses u beck HBboUS Veing — onound olen & \eq Fs ANCE Of; SO Papabions — Local wise of; bempenatone & Eendennres —kAN olcen Is seen oven — Homing , base ak vleen -ong ‘ndumatfons a z g the olen ““whethen wleds o8 boc. Hobitityy | bIxt = + Sonnounding sisin — fobtti a 3 = on taeda sensations | Motel depfst = any “ickened ]pedemataas|teratd so —¥ peniphenal nenves enovid ony absima) Athickerpg [erdeaness i ~ lateral popliteal =. ak “nec of filode. ; B+ heel main anteries supplying. thok pont e+ Teint forct fons — ne stmicked |pok —k. Exarsnation of Yroph nodes Caregiona\ = Exeriimatton ob J Exaripation of aledomeo = all lyephrales Of body, prcTHYROID Name Neve Addness » ' Hak ep cries Kxcling tng : Hlo PRESENE IlIne se A) Beevate IE lobmate tye compldint’s of; the pattent + Ai” Rj Swelling — ohee owt Me a tie 5 Set dunation , nate ob g 7 Hoomner“" ) S ASK aboot Important local potatis | pressone ebbecko+ KHle pain) ( Haemon: rage — local. pain only ) a anhage — d houevow sens Hle_distunbea Seep To Rude ort ee swyP4 Hilo palpitations * + Ho brecthtessness + Hlo digeottu dust s a Jo. oy culty during: swalteoing + Alo discombBlt in the necis 4 "HID hoamteness of voice ©) Hyperthypotd S4eptomns = bite | + Ho less of wosight inspite of aioe oppe Id Hlo intolemance to heat @& pmekenence 561 Ol + HlO excessive suecting H]O Ememors of handh ‘ + Hilo weakress of muscles + Ho soz) peer enph : + H]o a difypice tty iw oo ogtlids Hlo double Vision Hlo oedema Sl aly Oh, Conjonckiva + Hlo ornenomnohen + Hlo chest pain H]o Swelling of a°k #6 Hin Syinecrat atlijo., exrwaranian H]o oligomeronncheo Sunt complaints (- Misty Sepepntive a5 tickoxton's) beven ~ duration, grade, Eype. One ertlls eaigels 5 bore pains ATCT negnockive endls Migs Tego, i head ack ontiatera! | bilateral Hlo coughs Treatment ‘stony ony sinslan compioint d +. Ang He crildheod izmodiation 4. Hlo Te +. Hlo Bronchial oxthma Farnily eee + Hilo 9TD bH HT! =e. ON|H Hiv — lymphormos, , 4Herston ML hist ONY Haniota| hi a Pe os Sitting ® CohenenE : : ENE, Coopemative , unedl Biesked insiitobte anxtéog *. Eye Signs 2 — enophitrratnos | PECo™ preuidoptosi 5, ee anhydnosis Honnens, syndaom S—* - Built & noonishment? cing. Bremta . cppmosis clubting . joondiee. Uyrphadenopotng Pedal edema +. Skin Vital chonocke\ + pose mate — nate, aiygtnns , vane « + ep tempenatuone Reaezor oom Locol evomination os thuncid On iospection:— pigillo's method - SHBe Rr Goene’ people » S.cclling: — Site > brent of ess pant oh nse an ‘ ee shape AnyrOd oy, un ae ext scn eutent — supre steninal pokey «4 Suntpce — smostn| innegolan . 4} bBldenS— coell debsined | Ml defined + Movernent uatiin deggluticion (tt apa itis protmesion of torpoe ee ae naBghh veins sc S ing. - any Pp ogg + Skin oven the suellig = and Pi ¢ i 18. h nals * Trachea posit iH gue see tn the. neck y l, othe wisakionsror TWET: Rete ob earetibl Be eae >b rareible me. local mise cfs EEMPEPALLNE B Lendenness me. Swelling polpoble FONE Of Lowen” fart of neck + Tspectony pindiogS ~ SbOut site shape sige extert, alo baidens | Smface Off a) = conpinmed * consistency ‘the swelling consistency ob ng = bosch ndlti Plone 6 mosility pimasin See t Bn Teng pied on i iwlle’ F Hag wastit or : getting welow thynoid | = siin oven Swelling Pinchalnte. [not Sam, eo Prey if canotia polgattons = 00 Gath siden equal [nde uk. * Tracheo position Hana a neath 7 Ore temill-polpable seven glee us \ * Palpation of negonal \ympi nodes 2P percussion — On. Stennom — ‘Reasdnant | dull = Hetnostennal Ce PES CONE ae Bruit oven ae poles “ols Ahyrsia Sosbermic exonin. Ps Koduts, yt, at et ‘ Peppmatcry Syneern) Lobe candic Voscuion Syxtern wi cae QT CNS eee . Gerito oninaay sinters h-hh th e. Blal cautery G7 Gwellings oo came) Wder OF pastgrein since present lings *° . 7 a suanted Od Pain inthe gncin — backs The pmesgent tlhe ved the swelling tn the 9% —doyn loten pi oO q <9 an eur | Tote? nal vaiation ~ gtting etter a8 cay par S aggrennting, bOCEBS Catnaicing .Tiping ot exe 3) ing down] ying down) + nelievcg oko ( Se2alling: pt coserved Swelling — coy ack, Lorin as Prceeded by porn a O) How aid it stomt 7 — on stncining J\ipting agrk 1d in the groin &, gnoduall: extended into senotor & q Be rears vente \ J appeared bela groin cmeare and gnodually ancends above it — (yemomol tneaio. Duhat wos 4 * d) Seceling apptons ~ standing g exkenk ehenit win AT ddnga ws Be cegh Dt oy get soot ® doer ‘it dinoppeans avtomatt cally on \ ine, as — O% soon as p_ Nes down - Bece = bk Hime | as to be medgced —#+ Histor soane Skive oly Conmplicabtons: H]o episode of Inneducits Io colic abdominal poin OU kira Horst Teeetna) > * Trgeinal | 5 * Sertoce é + Xtent ‘ ory Vision HSH) oy sexo. PLO re level of Lestt le peristalsis, fen Seoellin. | {otto ob nvg TOSEY Of Serotom - mainkained | Mot Tmpetse 66 cought } POSTION of “the penis not \ PE On Ifo cdauon a suselling medoced comopicbely | \ _Zedvetion — 7 en 7 \ Pt is asked to pew the igh ob the opeocal” sce & badd Sand motate incennall ioneck ckwonds = ines z —&. Taxis .— dinection of reduction < dee envio. opisaads|packuensts|ostworss oe NEOGEO silent [ x gong fond TiOdinect hennio. ~ Bitist pant ety to medvee than last pant +omentoele fost pont cory Eo meduce thon blank, - enkencenele. a he op palpation :— #. Local mise of Eemmpenabone g, Eerdénness =e: loot ~ Secell 4 — “Site, Sige, Shope, evtent, sozpace , geese a aouah | gronwion + omertocele: Aortic — enkenocele * GeHting, obove dhe seellig -k. Polpotton of, cesta - (iN oF “e Topse on caging — 1 an evpansile ‘Impulse ‘ined | biriclon type) standing position ob pe Finges ploced onRotkunnal enonesis tntenmittent Skea eke emptying of bladden a dvibbitng of Onine ONS? aout BPH Pensistert eargn(ennosie tmondiis |peomoit raciog on depecot? abdominal distension ( ancities | intenng\ moa i x04) CAB menal diseare) ing. on mickumition a : HID» Similan complaint ‘i Bish Sol > Hip on) Soe appendisectormy - division oh lesing sO. J weak sno Cnot heleyont when thene « ee ee is hencia. on lebk side ) dineck hendia => Hlo Aiolgsis H]© chnonic cos Z Bet - + Addictions = pppebite, Sleep —-e-pH] HTN + Bowel & bladden habbits 1D — Gondcoacal’ Strickone Pensooal Dierowy orelona, in Bol nencia— commen io = parity Cte ie pees women) conacious“+: Tone blngen bet | aieman's be + Pee “nee HYERS oven deep «, supenpicial ain ond Sephencos opering : ‘ sMeeping. he ingens tr ane PG The binges tack ash pe to stort Re Eee oe ha eo ee 0g opener TS Reckien ey swelling : Spentancoes | by p's monipuotion | Pmededvle ~ Abtem nedverton tnoh 899; + PCE the Hiogem In the sopenbicial 19 + x6 the pe bo me ste Bs tip Op Biogen Tiimpolse pel © on nee “eo 2 edtnec= ng eeclusion ‘best i Place bingem oven deep sing: Uv" above, the 4 inguinal lige eeping bingen totad, ay, the pe bo stond & com> Binect hernia — shows bolg medial to oesuing BUG Thdinect hentia — 0! _ Suse B09 = now nemove Lngen Ee anksithe pr bP cong” OPPEATS Eee eo n cele stnongdoted he: ae meawore rete Over Sine sentemoenie shnerg > ementocele day) ER Aoscttationt—, a somde ecw wert developer Ekerioation os YF «Bots Lenticlen ANE mn sengattrnguine) negion oppostke 11g'B2> Examination os oops Westomical 1 fe Pranination of Een 2b ™ eS S euruston of (Aen Abdomnér} — logs of Lone nave prone: - ies 8) as 3 down position . PE 1s asked to Tipe his eXtehdect legs & by raising shoukdesis, ad poor Eone fn toguindl mepton Systeme exassinakion:— ! =e. Pktomen e ‘aul eigen —-- 5 npg . ers Rectal euorisction 531 BPH. Fistsos, piesohes; pes, Oral strictones _ anol gneutns ek... Previstonal ing mes eee = Sided Complicated | vocomplintect SiedlocFole | innedoctvle “complete | incomplete — 2 — ~ “dindct | incinect hencta T any entenocele | omentoceleBeen ox 1 the 19 the > Siccho : HJO present ress. brom tne __ aipple sine "SNe MOH ce O SLeeltin « week, lore i Loree eee “BS ate of grout allem io — nen z "P94 Ho trauma * Hie pain = eleep 7 ite si Coretion , Severity Seyene — sien ~ type. ConkIOvEUS | Intenmittert : Ragrovering Racers - wekiesig poco * Relation = mensinuction Hlo discranee brom cipple cnecent. nekractioN Hlo retnactisn Of nipple lore sce FO Pea Sugppstive of Metastasis #— + Hlo sess "of, oxdight > Hlo Mle - Ho loss of appetite j Bore pain (Career Lary beris) Headache \venntmgs ( + Hlo cough | haemopiysis © HO pain oldomen metract — not iO cancinoma Tf Nipple is metradéd , try to ever 6 1 Supine position ENE Pome { Rotter&) polation gy b ce \yroph node SepMA cloviewion 4 TMB clavicug > <— Covi pectBial nodes Ofico\ nodes Nomaen | size constet ie sf os ¥ skency . epactitef FETIOSEON of opposite tusigast + Sypeentic exantinations HH . Regpintory Syston est —*- Huscuieskeletal gastere * Bdern i me Lomioon venteema — corners greinegt Oppen end of hemor ‘Thonasic venteono Rilos* : Sho!) Git Aodemes | ony pelvic 05% cvs nioeng's Emo”! IV 2 bmoke Je cvario, > Blal a 4 F Provisional diagcos'o*— iGO yg \ 1 avis Anotoonica\ly seeliog | orn A pothologically = Et skoging eo” fn the —ancomen Since — ointomen Since — 2 ine Site. inylved. of attacks pe acciAing, tor vaenation, PREQMIERSON ony pentose + hou lens each atfoels tasks atiock? gntine tokenvols obelip. HES: Bene ssyentors + Ste, er nadiotion eontinsces Jintenent tent , divmnc + melotion tT Bot — —Pggreveteg Say tector i Pesosclateat aceors + : \ voniatioN — peeting of puiiness obFem pot ie — belenin 2 — heostt bun? { y i = chamocten! orpoonte pregency, — mavsea, voritin = Hoernapakemesio ~ Smroll,|Propese £, enloo — Halena = oR Deeding: peat mector? ~ empoont & egioos" Bi mvcovs in tool = Fnbadice ~ 2. lo Teds99 — Hlo conekiparto® = plbesinate dfommehes & constipation = oo dislihe to potty poets wv = Hie of pever— rset duration, progressor rye As t chills & rigors [pot tempenatone one cos ofse Ob los oh UseigrePIM)o pay olbey Ho ony aloe F SSteningy ) Semgenties'- 6 'Nal olostmvekton * Volvos ~ Integy TO Re ] POPEMOMINA pot. ost UB OFF E fe o O°"g. BB ctusdena vices - @TA + brerketve heme wit pee ge * RMOmy Erect also deneswater 2 chaitiniog’s RR: lo Typha pein OledoeNeO ciigdeer iO SOFOH™ “Ale Polmonony Te Bang codback “€ TE pe ' + Alo Tendree Pensonal histony:— = raed. Pees “Diet - preference 56l Spicy: poeds - Sto Fuceesivé smoking — any mevénse Smo 0G . : A 3, Vive ENE iS * Pleor\— cecostoro! |halcitool — _cimainesio Op fiven_ Pome” HTN | OM L 1 Sleep. bowe) @ Wadden robsits Appetite - T [+ E Fomly igzony = ry othen pereily enemies soppentng, prom ; Game ines : ict t eTAKWE Felon: — pk 1S congdidbs_ conement & COOP Gere conditi pl noumieienne ne Built & noomisemen ; i aa 4 one ricion + ribogue ~ bluish Smedih joss ob por Shine Che . Anguinn che Vibes eHuscle casking, “i . rf ‘ ersio jaundice cyerosit, clooning \yjmphoctenope a ANENIO | 2 z pectol ederna denydvet ion i+ any engdiged at! quodmants of abdomeh sem vedomen — Scophotd | distended ositi60 @- rAdway puke yore 2 — URPER abdomen puthclasieg pusmunme ers g ‘dovorsccods 1 upwards’ st wedotn - lower « yeing aMECNA EMtiliens - cape A er ors ecoms--Bi discharging —Sinwses At: on 2 lateral abdomen ane — deseriioe aS swell xt ricspination — as weer = pyloric obm™ liven Spon +004 pluid ton ~ eM Suet y c\tinge polpable an y menal Ongke Eendemne so ONY Seoelitng Ok henrtol Biyfcs — B 4 *- Polpation of; exkennal gpriitolios — ey Ace hs peavey, + Scnokum gtestio oo & + Testiwlon Sensations nt }pot 5 suprociovicdlo? horse costal ag”) an 5 aves >“ 2 Limits oly sotid ‘Bgpre pace car ley MOD) -—#. polpation o} Penevesion — OhifEing dullness ; —e. hydobid thafll 4 cae ue tO # —. mneno\ angle pencvssion — ® megpnont 4 oe ee Se. Pe liven Moves T nespinol Fa pesto nk Pvsevitotion:— Bowel sounds 5 hor i NOU ony jonefit ove! swelling: ong x 2 - he Si 1 otnoded pile mass Inspect’? — senting pie | Pr ia i 4 poke? t \oly sreckurn: eH y Pak. voll Oy ere Pose ual! — isore “9 * Y oust aq ecko - ang are veer examined {@ sooth pen yogrnem ©=e: Hilo pain — (oerteg )— whee lea Lowen pant: of leg toecond C amitient cra of the Jon : us S + Tee 10 & dumatten of pain gdm) PAO 95 Hee Of paras Bo tong Hine + meletye when he lies Bouon : R Hj any bumsting palo WHE eenlleing — Dvr —#- Hlo any sight cnamps g wo ols os orhie—totconde-the—end of the cage Fe Ue Toing ob axin of leg —> ecggrra Hyer vosteose Geen — GP Medial ‘ollectos tle Strdieing at stools — Blo any suoeliiog tn the Obdomen- apo _ keg St ins woo 0 & prognes a Histony sgpestive Oh corplcations: — + Hlo Enourea + Ho fever, malaise + Hilo Pigreeakca + Blo skin “Wickering _ ploxosis - Hlo ingvino\ nodes Any ‘injections into the seoditings | ng a openotion 81 Seeltings Ang dressing Eo caoonds ebc-> Bast Vistory:— ong Sinton complint: in “he pase a m4 Sorgenics Treo—ment pisses Pengonal Hiskony;— +Dick * Sleep halitS TENSOR ARES den hacitS wel E, bloddenae owen Urb - RELY &-Mosicose vetns ¢ teens tae +Extent ~ long Saphencos— inkront ob meio! malleolos bo SAENEM % Crocdfok aspect!) openings 7 SPBE saphere Benind latenal mallecies Eo popli=s! b Chostent&i aspect) Seellings tnt — locatisess | qunenaticed ‘ lg Vomicose VEINS TA SHED babe nia: coloon = nect/ write | ive *Eextone - stnctened | shiny . odernatoos i J ‘ ‘ aio\ molledos . Pa ob Skin “mostly anoved mredigh mol + any vleenation — deserts TE . GOs ScOns + any [oss of hain “ang > battiteness of Mls ay oe ‘he ‘Saphenso’ impencting Yenovs gory & tropolge on cough tg op palpation. — en Swneltings — + M20 brenden, cy “SKIN oven SwAling: + GoTibsccovert vein = Tropuge bE by sophencve opeving: cont dous iS & geoellinas Karsination of the e+ preg ye + Inene Plodenen+— pant 5 — persia v0? cyst @, neckom