Physical Evaluation Checklist

Name of the Resident

Age

Date of Physical Evaluation

Serial Number Evaluation Remarks

1 General Evaluation
1. Patient orientation
2. Vital signs
3. Temperature
4. Heart rate
5. Blood pressure
6. Pulse oximetry
7. Respiratory rate
8. Pain

2
Head, Ears, Eyes, Nose & Throat
1. inspect teeth and gums
2. Examine tongue
3. Examine tonsils
4. Examine at uvula
5. Register the wetness and color of lips
6. Assess palate and buccal mucosa
7. Palpate nose
8. Assess nose symmetry
9. Check inside nostrils
10. Verify patency of nares
11. Check patient’s sense of smell
12. Palpate patient’s sinuses
13. Do a whisper test to examine patient’s
hearing
14. Perform Rinne test/Tuning Fork test/Weber’s
test
15. Look inside ear
16. Ear discharge and tympanic membrane
17. Check sclera and conjunctive
18. Assess eye symmetry
19. Eyebrow and eyelash distribution
20. PERRLA (pupils are equal, round, reactive
to light and accommodation)
21. Check vision with Snellen Chart
22. Check six cardinal positions of the gaze
3
Neck and Shoulders
1. Palpate lymph nodes
2. Observe and palpate trachea and neck
3. Check for Jugular Venous Distention
4. Check neck range of motion
5. Assess shoulder shrug with resistance

4
Lungs and Respiratory System
1. Assess respiratory expansion levels
2. Listen to lung sounds
3. Ask a patient about their coughing
4. Palpate thorax

5
Circulatory System and Abdomen
1. listen to the heartbeat
2. Palpate the carotid and temporal pulses
bilaterally
3. Examine abdomen
4. Listen to 4 quadrants of the abdomen for
bowel sounds
5. Palpate 4 quadrants of the abdomen for
pain/tenderness
6. Ask the patient about problems with bowel
or bladder

6
Pulse
1. Check radial, femoral, posterior tibial and
dorsalis pedis pulses in arms, legs and feet
7
Extremities

1. Assess a range of motion and strength in

arms, legs and ankles
2. Assess sharp and dull sensation in arms and
legs
3. Check capillary refill on toenails and
fingernails

6
Skin
1. Check is patient is pale, dry, cold, hot,
flushed or clammy
2. Check skin texture
3. Check skin for lesions, abrasions, rashes,
tenderness and lumps
4. Nails
5. Hair
6. Dandruff

7
Neurology
1. Check coordination
2. Check reflexes
3. Assess gait
4. Check Glasgow Coma Scale score

8 Genitourinary exam