GENERAL EXAMINATION .
GENERAL EXAMINATION .
by Admin Mon Mar 15 2010, 00:16
General examination
Conscious , oriented to time place and person , build and nourishment , comfortable at rest /
tachypnaeic , febrile or not , dehydration status .
In addition make a note on the neuro cutaneous markers for cns case ,
congenital heart disease markers , markers related to lung disorder .. ( DON’T FORGET)
Lets discuss in detail
Conscious and orientation wil be separately dealt under CNS examn.
BUILD - the measure of the overall skeletal framework of the individual
Build of an individual is not jus said seeing the person ,there is a method to determine the build of an individual . make it a routine
just during regular case presentation so that u don’t forgot to do it while exams .
Build of an individual is said by measuring the WRIST CIRCUMFERENCE.
Reason ?
bcoz it’s the area of minimal subcut adipose tissue so that one can easily measure the built of an
individual, also continue to say in cases of extreme obesity this wont be helpful as fat gets deposited.
GRADES: reference LIC charts.
Small - < 13.5 cm wrist circumference
Medium – 13.5 – 16 cm
Large - >16 cm
The usage poorly moderately and well build is wrong . so better try to avoid that terminology.
NOURISHMENT –measure of the muscle and adipose tissue mass by measuring the weight of an
individual.
Make it a habit to measure the patients weight . if there is no weighing machine available in wards just say the examiner that its not
available so I asked the weight from the patient or got it with the help of staff.
NORMAL :
Males upto 154 cm – 50 kg Then for each 1 cm add 1.1 kg to the weight.
Females :Upto 154 cm – 47 kg then for each 1 cm add 0.9 kg .
Its better to calculate standard weight for each ten cm for men and women before hand and remember the values to avoid unwanted confusion during examination.
CALCULATE THE WEIGHT AND FIND THE PERCENTAGE OF NORMAL :
GRADES :
81 – 110 % - well nourished
71 – 80% - moderately nourished.
< 70 % - poorly nourished.
Better to calculate all these things after finishing the case sheet if time permits. If no time don’t hesitate to write moderately
nourishrd..
MALNOURISHED – term oly for under 5 . not to be used for
adults.
COMFORABLE AT REST / TACHPNOEIC:
Look at the patient while taking history , if the patient seems dyspnoeic ( using accessory muscle to respire) write the patient is “tachpnoeic” if not comfortable at rest .
TACHPNOEA IS A SIGN AND DYSPNOEA IS A SYMPTOM . SO ALWAYS MENTION PATIENT IS TACHPNOEIC AND NOT DYSPONEIC
STATUS OF HYDRATION:
WELL HYDRATED OR DEHYDRATED.
How ?
Pinch the skin over the temple region or the skin over forehead and see the time taken for it to go back .
Goes back within 2 sec – hydration is normal
>2 sec – dehydrated.
Conscious , oriented to time place and person , build and nourishment , comfortable at rest /
tachypnaeic , febrile or not , dehydration status .
In addition make a note on the neuro cutaneous markers for cns case ,
congenital heart disease markers , markers related to lung disorder .. ( DON’T FORGET)
Lets discuss in detail
Conscious and orientation wil be separately dealt under CNS examn.
BUILD - the measure of the overall skeletal framework of the individual
Build of an individual is not jus said seeing the person ,there is a method to determine the build of an individual . make it a routine
just during regular case presentation so that u don’t forgot to do it while exams .
Build of an individual is said by measuring the WRIST CIRCUMFERENCE.
Reason ?
bcoz it’s the area of minimal subcut adipose tissue so that one can easily measure the built of an
individual, also continue to say in cases of extreme obesity this wont be helpful as fat gets deposited.
GRADES: reference LIC charts.
Small - < 13.5 cm wrist circumference
Medium – 13.5 – 16 cm
Large - >16 cm
The usage poorly moderately and well build is wrong . so better try to avoid that terminology.
NOURISHMENT –measure of the muscle and adipose tissue mass by measuring the weight of an
individual.
Make it a habit to measure the patients weight . if there is no weighing machine available in wards just say the examiner that its not
available so I asked the weight from the patient or got it with the help of staff.
NORMAL :
Males upto 154 cm – 50 kg Then for each 1 cm add 1.1 kg to the weight.
Females :Upto 154 cm – 47 kg then for each 1 cm add 0.9 kg .
Its better to calculate standard weight for each ten cm for men and women before hand and remember the values to avoid unwanted confusion during examination.
CALCULATE THE WEIGHT AND FIND THE PERCENTAGE OF NORMAL :
GRADES :
81 – 110 % - well nourished
71 – 80% - moderately nourished.
< 70 % - poorly nourished.
Better to calculate all these things after finishing the case sheet if time permits. If no time don’t hesitate to write moderately
nourishrd..
MALNOURISHED – term oly for under 5 . not to be used for
adults.
COMFORABLE AT REST / TACHPNOEIC:
Look at the patient while taking history , if the patient seems dyspnoeic ( using accessory muscle to respire) write the patient is “tachpnoeic” if not comfortable at rest .
TACHPNOEA IS A SIGN AND DYSPNOEA IS A SYMPTOM . SO ALWAYS MENTION PATIENT IS TACHPNOEIC AND NOT DYSPONEIC
STATUS OF HYDRATION:
WELL HYDRATED OR DEHYDRATED.
How ?
Pinch the skin over the temple region or the skin over forehead and see the time taken for it to go back .
Goes back within 2 sec – hydration is normal
>2 sec – dehydrated.
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