Mindmap
Examination
Inhalt der Mindmap
Examination
Initial things to do
- Wash Hands
- Introduce yourself & gain consent
- Position the patient and ask about exposure
- Inspection
- Is the patient well/ unwell?
- Do they have a walking aid?
- Are they nil by mouth?
- Are there any medications around the bed?
Outside of chest wall
- HANDS
- Nails
- Splinter haemorrhages
- Present with infective endocarditis
- Clubbing
- Tar Staining
- koilonychia
- Present with iron deficiency anaemia
- leukonychia
- Present with hypoalbuminaemIa
- Splinter haemorrhages
- Hands
- Palmar erythema
- Seen in liver failure
- Janeway lesions & Osler nodes
- Osler nodes on the fingers and painful
- Janeway lesions- palms, painless
- Dupuytren's contracture
- fixed flexion due to fibrosis
- seen in alcoholic liver disease
- fixed flexion due to fibrosis
- Tremors
- Hepatic flap
- CO2 flap
- Palmar erythema
- Nails
- ARMS
- Wrist
- Radial pulse
- Volume
- Rhythm
- Regular
- Irregular
- If so, state would investigate to see how is irregular
- Rate
- Measure over 15 or 30 secs
- Character
- Is it a bounding pulse
- RR @ same time
- Radio-radial delay
- Offer radio-femoral
- Collapsing pulse
- Indicates AORTIC REGURGE
- Radial pulse
- Blood pressure
- Wrist
- FACE
- Eyes
- Jaundice
- Ptosis and miosis
- Horners syndrome
- Damage to sympathetic trunk
- Miosis, ptosis, anhydrosis (decreased sweating)
- Horners syndrome
- Corneal arcus
- Xanthelasma
- Hyperlipidaemia
- Pallor in conjunctiva
- Anaemia
- Mouth
- Cyanosis
- Peripheral
- Lips
- Fingers
- Central
- Under the tongue
- Peripheral
- Poor dental hygene
- Risk factor for infective endocarditis
- Oral candida
- can get with Excess salbutamol
- Ulcers
- Can be present in Crohns disease
- Check the dentures
- Glossitis
- Cyanosis
- Neck
- JVP
- Any visible lumps and bumps/ lymph nodes
- Carotid pulse
- Better assessment of volume
- Cricothyroid distance
- Abnormal if >3fingers
- Tracheal deviation
- Tell pt will be uncomfortable but should be painless
- eg will be deviated in tension pneumothorax
- Eyes
- HANDS
Chest Wall
- Anterior chest wall
- Palpation
- Heaves & Thrills
- feel heart (eg due to hypertrophy)
- Palpable murmor
- Place hands in z shape
- feel for apex beat
- 5th intercostal space in midclavicular line
- chest expansion
- Heaves & Thrills
- Percussion
- tap clavicle without finger underneath
- work way down, compare like with like
- 4-6 places
- Auscultation
- All Patients Take Money
- auscultate for all 4 heat valves
- Left lateral Position
- Mitral stenosis/ regurge
- Sit forwards, breath out and hold out, listen on left sternal edge for aortic regurge
- Breath sounds
- ask to take a deep breath through open mouth
- vocal resonance
- decreased with consolidation
- All Patients Take Money
- Palpation
- Posterior chest wall
- sit with legs over side of the bed
- can do lymph exam here
- Palpation
- chest expansions
- in 2 or 3 locations
- chest expansions
- Percussion
- go with the shape of the ribs, not going over scapula
- 6-8 places, remember the axilla
- Auscultation
- sit with legs over side of the bed
- get appropriate exposure
- inspection
- Scars
- Chest deformaties
- eg barrel chest
- Spider Naevi
- (>5 significant) – chronic liver disease
- Symmetrical chest expansion
- Gynecomastia
- chronic liver disease
- Some drugs
- Anterior chest wall
Abdomen
- Inspection
- Scars
- Distension
- Obvious masses
- Palpation
- Superficial
- Tenderness
- Deep
- masses
- Be on level of pt
- The liver
- Start @ RIF work up
- Ask to breath in, put hand in place, pt breath out
- The spleen
- Start in RIF work diagonally across
- Ballot the kidneys
- Aorta
- Superficial
- Percussion
- For the liver
- For the spleen
- Shifting dullness
- looks for ascities
- for the bladder
- Auscultation
- Bowel sounds
- Renal Bruits
- Inspection
Informationen
- Beschreibung
- Mindmap am Examination, erstellt von Eve Barnes am 09/05/2017.
- Erstellt von
- Eve Barnes · Mai 2017
- Aktualisiert
- 9 Mai 2017
- Aufrufe
- 0
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