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Head-to-toe Physical Assessment Assessment 1. Inspect skin color. 2. Inspect uniformity of skin color. 3.

Observe and palpate skin moisture. 4. Palpate skin temperature. 5. Note skin turgor. 6. Inspect fingernail plate shape. 7. Inspect fingernail and toenail texture. 8. Inspect fingernail and toenail bed color. 9. Inspect tissues surrounding nails. 10. Perform blanch test. Hair 1. Inspect evenness of growth over scalp. 2. Inspect hair thickness, thinness. 3. Inspect hair texture and oiliness. 4. Note presence of infection. Skull and Face 1. Inspect the skull for size, shape and symmetry. 2. Palpate the skull for nodules or masses and depressions. 3. Inspect facial features. Eye Structures and Acuity 1. Inspect the eyebrows. 2. Inspect the eyelashes for evenness of distribution and curl. Actual Findings Skin and Nails Analysis

3. Inspect the eyelids. 4. Inspect the bulbar conjunctiva for color, texture, and the presence of lesions. 5. Inspect the palpebral conjunctiva by everting the eyelids. 6. Inspect and palpate the lacrimal gland. 7. Inspect and palpate the lacrimal sac and nasolacrimal duct. 8. Inspect the cornea. 9. Perform the Corneal Sensitivity test. 10. Inspect the anterior chamber for transparency and depth. 11. Inspect the pupils for color, shape and symmetry of size. 12. Assess each pupils direct and consensual reaction. 13. Assess each pupils reaction to accommodation. 14. Assess peripheral visual fields. 15. Assess six ocular movements of the eye. 16. Assess near vision. 17. Assess distance vision. Ears and Hearing 1. Inspect auricles for color, symmetry of size, and position. 2. Palpate auricles for texture, elasticity, and areas of tenderness. 3. Assess the clients

response to normal voice tones. 4. Perform the watch tick test. 5. Perform Webers test. 6. Conduct the Rinne test. Nose and Sinuses 1. Inspect the external nose for any deviations in shape, size or color and flaring or discharge from the nares. 2. Palpate the external nose. 3. Determine the patency of both nasal cavities. 4. Inspect the nasal cavities. 5. Inspect the nasal septum between the nasal chambers. 6. Palpate the maxillary and frontal sinuses for tenderness. Mouth and Oropharynx 1. Inspect the outer lips for symmetry of contour, color and texture. 2. Inspect and palpate the inner lips and buccal mucosa for color, moisture, texture and the presence of lesions. 3. Inspect the teeth and gums. 4. Inspect the surface of the tongue for postion, color and texture. 5. Inspect the tongue

movement. 6. Inspect the base of the tongue, the mouth floor, and the frenulum. 7. Palpate the tongue and floor of the mouth for any nodules, lumps or excoriated areas. 8. Inspect the hard and soft palate for shape, texture, and the presence of bony prominences. 9. Inspect the uvula and mobility while examining the palates. 10. Inspect the oropharynx for color and texture. 11. Inspect the tonsils for color, discharge, and size. 12. Elicit the gag reflex by pressing the posterior tongue with tongue depressor. Neck and Lymph Nodes 1. Inspect the neck muscles. 2. Observe head movement. 3. Assess muscle strength. Lymph Nodes 1. Palpate the entire neck for enlarged lymph nodes. Trachea 1. Palpate the trachea for lateral deviation. Thyroid Gland 1. Inspect the thyroid

gland. 2. Palpate the thyroid gland for smoothness. Posterior Thorax 1. Inspect the shape and symmetry of the thorax from posterior and lateral view. 2. Inspect the spinal alignment for deformities. 3. Palpate the posterior thorax. 4. Palpate the posterior chest for respiratory excursion. 5. Palpate vocal fremitus. 6. Percuss the thorax. 7. Percuss for diaphragmatic excursion. 8. Auscultate the chest using flat disc diaphragm of the stethoscope. Anterior Thorax 1. Inspect breathing patterns. 2. Inspect the costal angle and the angle at which the ribs enter the spine. 3. Palpate the anterior chest. Palpate for respiratory excursion. 4. Palpate tactile fremitus in the same manner as for the posterior chest. 5. Percuss anterior chest systematically. 6. Auscultate the

trachea. Heart and Central Vessels 1. Simulateneously inspect and palpate precordium for abnormal pulsations, lifts or heaves. 2. Auscultate the heart in all four anatomic sites: aortic, pulmonary, tricuspid and apical. 3. Palpate the carotid artery. 4. Auscultate the carotid artery. 5. Inspect the jugular vein for distention. Breast and Axillae 1. Inspect the breast for size, symmetry, and contour or shape while the client is in sitting position. 2. Inspect the skin of the breast for localized discoloration or hyperpigmentation, retraction or dimpling localized hyper vascular areas, swelling or edema. 3. Emphasize any retraction. 4. Inspect areola for size, shape, symmetry, color, surface characteristics, any any masses or lesions. 5. Inspect the nipples for the size, shape, position, color, discharge, and lesions.

6. Palpate axillary, subclavicular, and supraclavicular lymph nodes. 7. Palpate the breast for masses, tenderness, and any discharge from the nipples. 8. Palpate the areola and nipples for masses. Abdomen 1. Assist the client to a supine position, with arms placed comfortably at the sides. 2. Inspect the abdomen for skin integrity. 3. Inspect the abdomen for contour and symmetry. 4. Observe abdominal movements associated with respiration, peristalsis or aortic pulsations. 5. Observe the vascular pattern. 6. Auscultate the abdomen for bowel sounds, vascular sounds and peritoneal friction rubs. 7. Percuss several areas in each four quadrants to determine the presence of tympany and dullness. 8. Percuss the liver to determine its size. 9. Perform light palpation to detect

areas of tenderness and/or muscle guarding. 10. Palpate the liver to detect enlargement and tenderness. 11. Palpate the area above the pubic symphisis if the clients history indicates possible urinary retention. Upper and Lower Extremities 1. Inspect the muscles for size. 2. Inspect for muscle fasciculations and tremors. 3. Palpate muscles at rest to determine muscle tonicity. 4. Palpate muscles while the client is active and passive for flaccidity, spasticity, and smoothness of movement. 5. Test for muscle strength. 6. Inspect for joint swelling. 7. Assess joint range of motion.