Tuesday, 29 November 2011

Tip2 penting sebelum exam

To complete physical examination, we should complete our medical instrument, which are:

1- stetehoscope
2- Mercury sphygmomanometer  (manual blood pressure)
3- Pen torch
4- Thermometer
5- Tongue depressor(wooden)
6- Measurement tape
7- Stop watch
8- Tendon hammer
9- Tuning fork
10- Cotton and new dress making pin
11-Snellen chart
12- Fundoscope/opthalmoscope

Before you are going to carry out your physical examination there are some point should be in your mind: 

  1.  -You have to wear your white coat and your I.D medical card.
  2. Proper exposure (e.g.: expose the patient from nipple to middle of the thigh in abdominal examination).
  3. Ask the patient to be in the correct position.
  4. When you start your examination; you should be in the right side of the patient.
  5. You should be systematic in your examination.
  6. Open the window or the carpet (natural daylight) when you examine the eyes for jaundice.
  7. Describe character of the pulse, JVP, murmurs, masses …etc.
  8. During abdominal examinations; it should be lax by asking the pt to flex his knees or breathing from his mouth.
  9. You have to compare between limbs or any double organs “two body side".
  10. And please … don't forget to be a good actor as possible.

All these things coming after presenting a good and complete history.
General appearance

  1. The patient is (young, middle-aged, old), (male, female), lying comfortably in bed.
  2. Well developed, well nourished.
  3. Not in pain or respiratory distress.
  4. Not connected to IV line or oxygen mask (any device or instrument e.g.: ECG, IV line, oxygen mask, IV or nasal cannula).
  5. Apparently not cyanosed, pale or jaundiced.
  6. Conscious, alert & oriented.
This stamp has to be mentioned in every general examination according to the patient current condition. However, in each system, certain points have to be particularly emphasized. It is debatable whether cyanosis, pallor & jaundice are mentioned in the general appearance or in their corresponding body parts.

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