Download - Physical examination
![Page 1: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/1.jpg)
PHYSICAL
EXAMINATION
www.drjayeshpatidar.blogspot.com
![Page 2: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/2.jpg)
Objectives of Health Assessment
Describe prehospital physical examination techniques
Describe examination equipment
Describe the general approach to the physical examination
Outline the steps of the comprehensive physical examination
www.drjayeshpatidar.blogspot.in
![Page 3: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/3.jpg)
Objectives
Detail the components of the mental status examination
Identify abnormal findings in the mental status examination
Outline steps in the general patient survey
Distinguish between normal and abnormal findings in the general survey
www.drjayeshpatidar.blogspot.in
![Page 4: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/4.jpg)
Objectives
Describe examination techniques for
specific body regions
Identify normal and abnormal findings in
the body region examination
Describe examination techniques specific
to children and older adults
www.drjayeshpatidar.blogspot.in
![Page 5: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/5.jpg)
Health Assessment
Component of Health assessment
Health History
Physical assessment
www.drjayeshpatidar.blogspot.in
![Page 6: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/6.jpg)
Purposes
Establish a nurse- client relationship.
Gather data about the client‟s general health
status, integrating physiologic, psychological,
cognitive, socio cultural, development and
spiritual dimensions.
Identify client‟s strengths.
Identify actual and potential health problem.
Establish a base for the nursing process.
To evaluate the physiological outcome of care.
www.drjayeshpatidar.blogspot.in
![Page 7: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/7.jpg)
Techniques of Physical Examination
www.drjayeshpatidar.blogspot.in
![Page 8: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/8.jpg)
Health History
Health history is a collection of subjective
and objective data that provide a detailed
profile of the client‟s health status.
www.drjayeshpatidar.blogspot.in
![Page 9: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/9.jpg)
History Taking
IDENTIFICATION DATA OF THE PATIENT
Patient's name:-
Age: - Sex-
Hospital Name:-
File No./MLC No.:-
Source providing history:-
Date/ Time of admission-
www.drjayeshpatidar.blogspot.in
![Page 10: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/10.jpg)
OPD No.:-
IPD No.:-
Ward-
Bed No.:-
Doctor‟s Unit:-
Provisional Diagnosis-
Surgery done/Date of Surgery:-
Name of the Surgery:-
Residential Address-
www.drjayeshpatidar.blogspot.in
![Page 11: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/11.jpg)
Mother Tongue:-
Marital Status-
Educational Status: -
Occupation-
Monthly income
www.drjayeshpatidar.blogspot.in
![Page 12: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/12.jpg)
DETAILS OF ADMISSION:-
Arrived via wheel chair / stretcher /
ambulatory: -
LOC – Conscious / Semiconscious /
Unconscious
From admitting room / emergency room.''
home / any others:-
www.drjayeshpatidar.blogspot.in
![Page 13: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/13.jpg)
ORIENTATION TO THE UNIT:-
Use of telephone / TV / call lights:-
Visiting hours:-
No Smoking:-
Patient is informed that hospital is not
responsible for the personal belongings: -
Yes/No
Valuable handed over to (Write relationship
With patient)
Written consent:-
www.drjayeshpatidar.blogspot.in
![Page 14: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/14.jpg)
BASELINE DATA
Weight:- Height:- Abdominal Girth:-
Temperature: - Oral: -
Axilla: - Rectal:-
Respiration:-
Pulse: -
Blood Pressure:-
www.drjayeshpatidar.blogspot.in
![Page 15: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/15.jpg)
REASON FOR ADMISSION
(Onset, duration, earlier treatments)
ALLERGIES AND MEDICATIONS
Drugs / Foods / dyes / Others:-
Sign and symptoms:-
www.drjayeshpatidar.blogspot.in
![Page 16: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/16.jpg)
VICES
Alcohol/ Tobacco/Cigarette/Drug Abuse:-
Amount of intake/Day:
Duration of intake (Since when) and
frequency of intake (How often in a day?):-
www.drjayeshpatidar.blogspot.in
![Page 17: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/17.jpg)
LEISURE ACTIVITIES /RECREATIONAL
ACTIVITIES (IN HOSPITAL)
PATIENTS ROUTINES HABITS (IN
HOSPITAL)
www.drjayeshpatidar.blogspot.in
![Page 18: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/18.jpg)
FAMILY INFORMATION
-Name of Family Members
-Relationship with patient
-Age
-Type of Family
-Education
-Occupation
-Marital Status
-Health Status
www.drjayeshpatidar.blogspot.in
![Page 19: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/19.jpg)
Family Income per Year:
Family interpersonal relationship / Any
Family Disharmony:-
Family History of illness: (Hypertension,
DM, Cancer, Arthritis, etc
www.drjayeshpatidar.blogspot.in
![Page 20: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/20.jpg)
ENVIRONMENTAL BACKGROUND
1) HOUSING
Type of house:-
Lighting :-
Ventilation:-
Water facilities:-
Sanitation:-
2) PETS/ANIMALS
3) FOOD HYGIENE PRACTICES:
4) PERSONAL HYGIENE PRACTICES:
www.drjayeshpatidar.blogspot.in
![Page 21: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/21.jpg)
5) COMMUNITY RESOURCES
a) Transport: -
b) Health facilities:-
c) Educational Facilities :-
PAST MEDICAL HISTORY
Hypertension, DM, Cancer, Respiratory,
Arthritis, stroke and others:
PAST SURGICAL HISTORY
PRESENT MEDICAL HISTORY;-
www.drjayeshpatidar.blogspot.in
![Page 22: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/22.jpg)
CURRENT MEDICATION:-
Current Medication
Dose/Frequency
Route
Last Dose Taken
LABORATORY/OTHER INVESTIGATION:-
Date
Investigations Name
Normal Findings
Patient’s Findings
www.drjayeshpatidar.blogspot.in
![Page 23: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/23.jpg)
SPECIAL ASSISTIVE DEVICES
Wheel Chair / Braces / Crutches /
Walkers / others:-
Contact lenses / Hearing aid / Prosthesis /
Glasses:-
Dentures:- Total / Partial
www.drjayeshpatidar.blogspot.in
![Page 24: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/24.jpg)
PSYCHOSOCIAL HISTORY
Any recent stress?
Who is with the patient in the hospital?
Does the patient have anybody who will
give financial support if needed?
Who will care for the patient at home?
Calm: Yes / No
Anxious: Yes / No
www.drjayeshpatidar.blogspot.in
![Page 25: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/25.jpg)
Skills of Physical Assessment
Inspection
Palpation
Percussion
Auscultation
Olfaction
www.drjayeshpatidar.blogspot.in
![Page 26: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/26.jpg)
Inspection
Visual assessment of the patient and
surroundings
Findings that may be significant:
– Patient hygiene
– Clothing
– Eye gaze
– Body language
– Body position
– Skin color
– Odor.
www.drjayeshpatidar.blogspot.in
![Page 27: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/27.jpg)
Nurse observe body part
Pay attention to client, watching all
movement & looking carefully at any body
part.
It help to know physical characteristics.
Quality of inspection depend on the
nurse‟s willingness to spend time during a
job.
www.drjayeshpatidar.blogspot.in
![Page 28: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/28.jpg)
If the emergency response was to the
patient's home, make a visual inspection
for
– Cleanliness
– Prescription medicines
– Illegal drug
– Weapons
– Signs of alcohol use
www.drjayeshpatidar.blogspot.in
![Page 29: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/29.jpg)
Principles
Make sure good lighting is available.
Position and expose body parts so that all
surface can be viewed.
Inspect each area of size, shape,
colour,symmetry, position and abnormalities.
If possible, compare each area inspected with
the same area on the opposite side of the body.
Use additional light to inspect body cavities.
Do not hurry inspection. Pay attention to detail.
www.drjayeshpatidar.blogspot.in
![Page 30: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/30.jpg)
Palpation
A technique in which the hands and fingers are used to gather information by touch.
Palmar surface of fingers and finger pads are used to palpate for– Texture
– Masses
– Fluid
--And assess skin temperature
Client should be relax and positioned comfortably because muscle tension during palpation impair its effectiveness.
Asking the patient to take deep & slow breath.www.drjayeshpatidar.blogspot.in
![Page 31: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/31.jpg)
Types of Palpation
Light palpation
Deep palpation
Bimanual palpation
www.drjayeshpatidar.blogspot.in
![Page 32: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/32.jpg)
Light Palpation
The nurse apply tactile pressure slowly,
gentely and deliberately.
The nurse‟s hand is placed on the part to
be examined and depressed about 1-2cm.
www.drjayeshpatidar.blogspot.in
![Page 33: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/33.jpg)
Deep Palpation
It is done after light palpation.
It is used to detect abdominal masses.
Technique is similar to light palpation
except that the finger are held at a greater
angle to the body surface and the skin is
depressed about 4-5 cm.
www.drjayeshpatidar.blogspot.in
![Page 34: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/34.jpg)
Bimanual Palpation
It involve using both hand to trap a
structure between them. This technique
can be used to evaluate spleen, kidney,
breast, uterus and ovary.
Sensing hand – Relax & place lightly over
the skin.
Active hand – Apply pressure to the
sensing hand.
www.drjayeshpatidar.blogspot.in
![Page 35: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/35.jpg)
Deep Bimanual Palpation
www.drjayeshpatidar.blogspot.in
![Page 36: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/36.jpg)
Percussion
Percussion involve tapping the body with the
fingertips to evaluate the size, border and
consistency of body organs and to
discover fluid in body cavity.
www.drjayeshpatidar.blogspot.in
![Page 37: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/37.jpg)
Percussion
Used to evaluate
for presence of air
or fluid in body
tissues
– Sound waves
heard as
percussion tones
(resonance)
www.drjayeshpatidar.blogspot.in
![Page 38: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/38.jpg)
Methods of Percussion
Mediate or Indirect Percussion
Immediate Percussion
Fist Percussion
www.drjayeshpatidar.blogspot.in
![Page 39: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/39.jpg)
Mediate or Indirect Percussion
It can be performed by using the finger
on one hand as a plexor (Striking finger)
and the middle finger of the other hand as
a pleximeter (the finger being struck).
Used mainly to evaluate the abdomen or
thorax.
www.drjayeshpatidar.blogspot.in
![Page 40: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/40.jpg)
Immediate Percussion
Used mainly to evaluate the sinus or an
infant thorax.
It can be performed by striking the surface
directly with the fingers of the hand.
www.drjayeshpatidar.blogspot.in
![Page 41: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/41.jpg)
Fist Percussion
Used to evaluate the back and kidney for
tenderness.
It involves placing one hand flat against
the body surface and striking the back of
the hand with a clenched fist of the other
hand.
www.drjayeshpatidar.blogspot.in
![Page 42: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/42.jpg)
Sounds Produced by Percussion
Sound : Tympany
Intensity : Loud
Pitch : High
Duration : Moderate
Quality : Drumlike
Common location : Air containing space,
enclosed area, gastric air bubble, Puffed out cheek
www.drjayeshpatidar.blogspot.in
![Page 43: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/43.jpg)
Sounds Produced by Percussion
Sound : Resonance
Intensity : Moderate to Loud
Pitch : Low
Duration : Long
Quality : Hollow
Common location : Normal lungs
www.drjayeshpatidar.blogspot.in
![Page 44: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/44.jpg)
Sounds Produced by Percussion
Sound : Hyper Resonance
Intensity : Very Loud
Pitch : Very Low
Duration : Longer than resonance
Quality : Booming
Common location : Emphysematous lungs
www.drjayeshpatidar.blogspot.in
![Page 45: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/45.jpg)
Sounds Produced by Percussion
Sound : Dullness
Intensity : Soft to moderate
Pitch : High
Duration : Moderate
Quality : Thudlike
Common location : Liver
www.drjayeshpatidar.blogspot.in
![Page 46: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/46.jpg)
Sounds Produced by Percussion
Sound : Flatness
Intensity : Soft
Pitch : High
Duration : Short
Quality : Flat
Common location : Muscle
www.drjayeshpatidar.blogspot.in
![Page 47: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/47.jpg)
Auscultation
Auscultation is listening to sound produce by the body.
Through auscultation the nurse note the following characteristics of sound.
Frequency or the number of oscillation generated per second by a vibrating object.
Loudness – Loud or soft
Quality – Blowing or Gurgling
Duration – Length of time that sound vibration last. Short / medium / long.
www.drjayeshpatidar.blogspot.in
![Page 48: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/48.jpg)
Auscultation
Best performed in a quiet environment
Requires a stethoscope– Body sounds produced by movement of fluids or
gases in patient's organs or tissues
Note:– Intensity
– Pitch
– Duration
– Quality
www.drjayeshpatidar.blogspot.in
![Page 49: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/49.jpg)
Stethoscope
Used to evaluate sounds created by
cardiovascular, respiratory,
and gastrointestinal systems
Position stethoscope between
index and middle fingers
www.drjayeshpatidar.blogspot.in
![Page 50: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/50.jpg)
Olfaction
While assessing a client, the nurse
should be familiar with the nature and
source of body odors.
www.drjayeshpatidar.blogspot.in
![Page 51: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/51.jpg)
Preparation for Examination
Infection control : If patient have any
open skin lesions and any drainage. Nurse
has to maintained infection control and
avoid infection.
- use gloves
- use apron
- use mask
- use gown
www.drjayeshpatidar.blogspot.in
![Page 52: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/52.jpg)
Environment
Privacy
Well equipped examination room
Adequate lighting
Sound proofed room
Comfort environment
Examination table
www.drjayeshpatidar.blogspot.in
![Page 53: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/53.jpg)
Equipment
All necessary equipments for procedure.
www.drjayeshpatidar.blogspot.in
![Page 54: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/54.jpg)
Physical preparation
Bladder and Bowel elimination
Draped properly
Dressed properly
Positioning
www.drjayeshpatidar.blogspot.in
![Page 55: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/55.jpg)
Psychological preparation
Explain procedure
If both are opposite sex then third person
is necessary.
Observe facial expression
Client should free from anxious feeling.
Clarify client doubt.
www.drjayeshpatidar.blogspot.in
![Page 56: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/56.jpg)
General examination
1.Gender and race :
Example – Skin cancer is 20% higher in
white than black people. Prostate cancer
is higher in African American than white
American.
2. Age : old age people and children's are
more prone to get infection.
www.drjayeshpatidar.blogspot.in
![Page 57: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/57.jpg)
3. Signs of distress :
Pain, Difficulty in breathing
4. Body type : Thin, Fat
5. Posture : Standing. Upright position,
Knee flexed
6. Gait : Co-ordination proper or not, person
normally walk with the arms swinging
freely at the sides, with the head and face
leading the body.
www.drjayeshpatidar.blogspot.in
![Page 58: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/58.jpg)
7. Body movement :
- Movement are purposefully.
- If any part is immobile.
8. Hygiene and grooming :
- Personal hygiene maintain or not.
- Cosmetic used or not
www.drjayeshpatidar.blogspot.in
![Page 59: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/59.jpg)
9. Dress : culture, life style, socio economic
status. It should be appropriate according
to weather condition.
10. Body odor :
- Unpleasant odor
- Poor hygiene
- Bad breath
- Poor oral hygiene
www.drjayeshpatidar.blogspot.in
![Page 60: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/60.jpg)
11. Affect and mood :
- Feeling‟s to other
- Emotionally expression
- Mood appropriate as per situation
12. Speech :
Pressure, tone, speed.
www.drjayeshpatidar.blogspot.in
![Page 61: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/61.jpg)
13. Client abuse : any problem during
growing and serious health problem during
childhood.
14. Substance abuse :
- Drugs
- Alcohol
- Smoking
- Ganja
www.drjayeshpatidar.blogspot.in
![Page 62: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/62.jpg)
Vital signs
Temperature
Pulse rate
Respiratory rate
Blood pressure
www.drjayeshpatidar.blogspot.in
![Page 63: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/63.jpg)
Temperature Measurement
Oral temperature
Hold thermometer
firmly under tongue
Tell child to “kiss”
Caution to avoid
biting www.drjayeshpatidar.blogspot.in
![Page 64: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/64.jpg)
Axillary Temperature
Hold arm down
firmly
Should be
approximately 1 F
less than core
temp
www.drjayeshpatidar.blogspot.in
![Page 65: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/65.jpg)
Rectal Temperature
Risk of perforation
Avoid in
uncooperative, or
immuno-suppressed
patient
Stabilize
thermometerwww.drjayeshpatidar.blogspot.in
![Page 66: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/66.jpg)
Pulse
Rate
Rhythm
Quality
Consider ECG monitoring
www.drjayeshpatidar.blogspot.in
![Page 67: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/67.jpg)
Respirations
Adult rate
– 16-24 breaths per minute
Observe
Feel for chest movement
Auscultate
www.drjayeshpatidar.blogspot.in
![Page 68: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/68.jpg)
Blood PressureLocations
www.drjayeshpatidar.blogspot.in
![Page 69: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/69.jpg)
Blood Pressure Cuff
Sphygmomanometer
Measures systolic
and diastolic blood
pressure
Manual or electronic
www.drjayeshpatidar.blogspot.in
![Page 70: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/70.jpg)
Anthropometry
Height
Weight
Abdominal girth
Mid arm circumference
www.drjayeshpatidar.blogspot.in
![Page 71: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/71.jpg)
Height and Build
Descriptions include:
– Average, tall, short, lanky ( long & thin ),
muscular
May also be affected by age and lifestyle
www.drjayeshpatidar.blogspot.in
![Page 72: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/72.jpg)
Weight
Observe general appearance
– Obese to emaciated
Recent changes may be key finding
– Recent weight loss or gain
www.drjayeshpatidar.blogspot.in
![Page 73: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/73.jpg)
Head to toe Examination
Hair:
Hair type :
Terminal Hair : long, thick, found on axilla
and pubic area.
Vellus Hair : small, soft, found all over
body except palm or sole.
www.drjayeshpatidar.blogspot.in
![Page 74: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/74.jpg)
Colour:
Distribution:
Quantity:
Shiny:
Dry:
Curly:
Using dye:
Alopecia
www.drjayeshpatidar.blogspot.in
![Page 75: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/75.jpg)
Bittle hair
With puberty hair colour, distribution and
amount change.
Hirsutism
Lubrication of hair
www.drjayeshpatidar.blogspot.in
![Page 76: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/76.jpg)
Scalp
Unusual scalp
Lesions
Lump
Trauma
Mole
Lice
www.drjayeshpatidar.blogspot.in
![Page 77: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/77.jpg)
Dandruff
Reaction with shampoo
Wig
Using chemical for pediculosis treatment
Using chemical to color
www.drjayeshpatidar.blogspot.in
![Page 78: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/78.jpg)
Fore Head
Lesions
Mark
Head injury
www.drjayeshpatidar.blogspot.in
![Page 79: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/79.jpg)
Eyes
Visual activity:
Visual field:
Eye movement:
Eye structure:
Shape:
Symmetry:
Reactive to light
Redness and swelling
Eye chart reading ( snellen‟s chart )
www.drjayeshpatidar.blogspot.in
![Page 80: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/80.jpg)
Discharges:
Eye alignment:
Eye brows:
Eye lids:
Use of glasses or contact lenses:
Corneal reflex
Lacrimal function
Ophthalmoscope used to see any abnormalities in eyes
www.drjayeshpatidar.blogspot.in
![Page 81: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/81.jpg)
Ears
Structure:
Symmetry:
Obstruction:
Position and alignment:
Size:
www.drjayeshpatidar.blogspot.in
![Page 82: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/82.jpg)
Shape:
Discharge:
Inflammation:
Hearing AID:
Otoscope is used to see internal ear
structure
Hearing activity:
Weber‟s test:
Rinne test:
www.drjayeshpatidar.blogspot.in
![Page 83: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/83.jpg)
Nose
Shape:
Size:
Lesions:
Inflammation:
Deformity:
Edema:
www.drjayeshpatidar.blogspot.in
![Page 84: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/84.jpg)
Mucus colour:
Patency of Nair:
Epistaxis:
Discharge:
Polyp‟s:
DNS:
Pen light and nasal speculum is used to
see nose
www.drjayeshpatidar.blogspot.in
![Page 85: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/85.jpg)
Sinus
Frontal sinus
Maxillary sinus
www.drjayeshpatidar.blogspot.in
![Page 86: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/86.jpg)
Lips
Colour:
-Cherry :carbon-monoxide poisoning
-Pallor: Anemia
-Cyanosed: Respiratory or cardiac problem
www.drjayeshpatidar.blogspot.in
![Page 87: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/87.jpg)
Dryness
Smoothness
Crack lips With mouth closed the nurse
view the lips from end to end.
Remove lipstick before examination of lips.
www.drjayeshpatidar.blogspot.in
![Page 88: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/88.jpg)
Teeth
Arrangement:
Dental hygiene:
Loose teeth:
Colour of teeth:
Halitosis:
Dentures
www.drjayeshpatidar.blogspot.in
![Page 89: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/89.jpg)
Upper molar should rest directly on the
lower molar with upper incisors slightly
overriding the lower incisors.
Dental caries – discoloration of the enamel
www.drjayeshpatidar.blogspot.in
![Page 90: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/90.jpg)
Gums
Colour:
Edema:
Gingivitis:
Ulcer:
Healthy gums are pink, smooth and moist.
Spongy gums bleed easily ( vit-c
deficiency )
www.drjayeshpatidar.blogspot.in
![Page 91: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/91.jpg)
Oral mucosa
Color: Pinkish red
moist/dry:
Ulcer:
Lesion:
Leuckoplakia: thick white patches because
of smoking and alcohol.
www.drjayeshpatidar.blogspot.in
![Page 92: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/92.jpg)
Tongue
The client first relax the mouth and sticks the tongue out halfway.
Slightly rough on the top surface and smooth along the lateral margin.
Under surface of the tongue and floor of the mouth are highly vascular.
Observe for cyst, lesions, swelling and nodule on the back side of tongue.
Examination of tongue : Protrude the tongue, grasp the tip and gently pulls it to one side.
www.drjayeshpatidar.blogspot.in
![Page 93: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/93.jpg)
Movement:
Shape:
Ulcer:
Lesions:
Protrude of tongue:
Taste of tongue:
Colour:
Moist:
Glossitis:
www.drjayeshpatidar.blogspot.in
![Page 94: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/94.jpg)
Palate
Extend the Head backward and open the mouth
and inspect hard palate & soft palate
Hard palate: Anterior part of palate
Shape: Dome shape
Colour: Whitish
Soft palate: Posterior part of palate
Shape: „C” shape
Colour: Light pink
www.drjayeshpatidar.blogspot.in
![Page 95: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/95.jpg)
Pharynx
Procedure : Extend his neck slightly, open
the mouth widely and say „ah‟. Place
tongue depressor on the middle third of
tongue. Use penlight for inspection.
Inspect for edema, ulcer, inflammation,
lesions.
Gag reflex
Dysphagia
www.drjayeshpatidar.blogspot.in
![Page 96: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/96.jpg)
Neck
Examine the anatomical position of neck.
Function of sternocleidomastoid muscle :
the nurse ask the client to flex the neck
with the chin to the chest.
Function of the trapezius muscles :
movement of the head sideway so that the
ear moves toward the shoulder.
Neck should move freely without any pain.
www.drjayeshpatidar.blogspot.in
![Page 97: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/97.jpg)
Movement of neck :
Stiff ness:
Swelling:
Neck muscle:
ROM:
Lymph nodes : With the client‟s chin raised and head tilted slightly, the nurse first inspect the area where lymph nodes are distributed.
Inspect for size, shape, inflammation and mobility.
www.drjayeshpatidar.blogspot.in
![Page 98: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/98.jpg)
Thyroid gland
It lies anterior lower neck, in front of neck and
both side of trachea.
Inspect for visible mass of thyroid gland,
symmetry and fullness at the base of neck.
Give water then see for bulging of the gland.
Palpation : Client flex the neck forward and
laterally toward the side being examined. The
client hold a cup of water and take a sip to
swallow.
www.drjayeshpatidar.blogspot.in
![Page 99: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/99.jpg)
Anterior Part : using the pads of the index
and middle finger, the nurse palpate the
left lobe with the right hand and right lobe
with left hand.
Posterior Part : Both hand of the nurse are
keep around the neck with two finger of
each hand on the side of trachea.
www.drjayeshpatidar.blogspot.in
![Page 100: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/100.jpg)
Breast
Female:
– Symmetry
– Pain:
– Lump:
– Discharge:
– Swelling:
– Trauma:
– History of breast disease:
– Surgery:
www.drjayeshpatidar.blogspot.in
![Page 101: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/101.jpg)
Male:
-Lump:
-Swelling:
- Gynecomastia
www.drjayeshpatidar.blogspot.in
![Page 102: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/102.jpg)
Thorax & Lung
Thorax size:
Thorax shape:
Chest movement:
Respiratory rate:
Rhythm:
Breathing pattern:
www.drjayeshpatidar.blogspot.in
![Page 103: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/103.jpg)
Breathing sound:
Chest pain with breathing:
Cough:
Productive & Nonproductive:
Hemoptysis:
www.drjayeshpatidar.blogspot.in
![Page 104: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/104.jpg)
Cardio vascular system
Apical pulse: To find the apical pulse the nurse locate the 5th ICS just to the left to the sternum and move the fingers laterally, just medial to the left mid- clavicular line.
Redial: Rt…………….. Lt…………….
Heart rate:
Rhythm:
www.drjayeshpatidar.blogspot.in
![Page 105: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/105.jpg)
Perfusion:
Edema: because of heart failure
Site of edema:
Cyanosis or Pallor: Because of MI
Fatigue: Because of decrease cardiac
output
www.drjayeshpatidar.blogspot.in
![Page 106: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/106.jpg)
Gastro- intestinal system
Abdomen
Size:
Shape:
Abdomen distention:
Surgical mark:
www.drjayeshpatidar.blogspot.in
![Page 107: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/107.jpg)
Stool frequency / Character:
Last movement :
Ostomy present:
Bowel sound
www.drjayeshpatidar.blogspot.in
![Page 108: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/108.jpg)
Reproductive system
Urinary complain:
Discharge:
Anuria:
Haematuria:
Dysuria:
Urinary Incontinence:
Urinary Retention:
www.drjayeshpatidar.blogspot.in
![Page 109: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/109.jpg)
Urine last voided:
Catheter present:
Any other:
Male
– Opening of penis:
– Penile Discharge:
If „Yes‟ describe
www.drjayeshpatidar.blogspot.in
![Page 110: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/110.jpg)
Female
-LMP:
-Vaginal discharge:
-If „Yes‟ describe
www.drjayeshpatidar.blogspot.in
![Page 111: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/111.jpg)
Skin
Colour:
Rashes:
Lesion:
Surgical scar:
Abnormal growth:
Secretion:
If „Yes‟ then describe:
www.drjayeshpatidar.blogspot.in
![Page 112: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/112.jpg)
Musculoskeletal
ROM:
Weakness / paralysis / contracture / joint
swelling / pain /other:
Extremity strength:
www.drjayeshpatidar.blogspot.in
![Page 113: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/113.jpg)
Wrist Extension
Flexion
www.drjayeshpatidar.blogspot.in
![Page 114: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/114.jpg)
Elbow Flexion
Extension
www.drjayeshpatidar.blogspot.in
![Page 115: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/115.jpg)
Shoulder Abduction
Adduction
www.drjayeshpatidar.blogspot.in
![Page 116: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/116.jpg)
Knee
Extension
Knee
Flexion
www.drjayeshpatidar.blogspot.in
![Page 117: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/117.jpg)
Dorsiflexion
Plantarflexion
www.drjayeshpatidar.blogspot.in
![Page 118: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/118.jpg)
Spine
Curvature of spine observe for:
Lordosis: Increase lumber curvature
Scoliosis: Lateral spinal curvature
Kyphosis: Exaggeration of posterior curvature of thoracic spine
www.drjayeshpatidar.blogspot.in
![Page 119: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/119.jpg)
www.drjayeshpatidar.blogspot.in
![Page 120: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/120.jpg)
Mental status
Memory:
Knowledge:
Thinking:
Judgment:
Insight:
www.drjayeshpatidar.blogspot.in
![Page 121: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/121.jpg)
Neurological Examination
Orientation – To place / person / time
Level of conscious - confused / alert / restless / lethargic / comatose
Co-ordination to walk:
Equilibrium test:
Sensation test: Pain
Temperature
Vibration
Touch
www.drjayeshpatidar.blogspot.in
![Page 122: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/122.jpg)
Romberg Testwww.drjayeshpatidar.blogspot.in
![Page 123: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/123.jpg)
Pronator Drift Testwww.drjayeshpatidar.blogspot.in
![Page 124: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/124.jpg)
Reflexes
Biceps:
Triceps:
Patellar:
Achilles:
Planter:
Gluteal:
www.drjayeshpatidar.blogspot.in
![Page 125: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/125.jpg)
Biceps
Identify biceps tendon have patient flex
elbow against resistance while you palpate
antecubital fossa
Place arm so it‟s bent ~ 90 degrees
Place one of your fingers on tendon and
strike it.
Reflex : Flexion of arm at elbow.
www.drjayeshpatidar.blogspot.in
![Page 126: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/126.jpg)
www.drjayeshpatidar.blogspot.in
![Page 127: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/127.jpg)
Triceps
Flex client‟s arm at elbow, holding arm
across chest or hold upper arm
horizontally. Strike triceps tendon just
above elbow.
Reflex : Extension at elbow.
www.drjayeshpatidar.blogspot.in
![Page 128: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/128.jpg)
www.drjayeshpatidar.blogspot.in
![Page 129: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/129.jpg)
Patellar
Have client sit with leg hanging freely over
side of table. Tap patellar tendon just
below patella.
Reflex : Extension of lower leg.
www.drjayeshpatidar.blogspot.in
![Page 130: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/130.jpg)
www.drjayeshpatidar.blogspot.in
![Page 131: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/131.jpg)
Achilles
Have client assume same position as for
patellar reflex. Slightly dorsiflex client‟s
ankle by grasping toes in palm of your
hand. Strike Achilles tendon just above
heel at ankle malleolus.
Reflex : Planter flexion of foot.
www.drjayeshpatidar.blogspot.in
![Page 132: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/132.jpg)
www.drjayeshpatidar.blogspot.in
![Page 133: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/133.jpg)
Planter:
Have client lie supine with legs straight
and feet relaxed. Take handle end of
reflex hammer and stroke lateral aspect of
sole from heel to ball of foot, curving
across ball of foot toward big toe.
Reflex : Planter flexion of all toes.
www.drjayeshpatidar.blogspot.in
![Page 134: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/134.jpg)
www.drjayeshpatidar.blogspot.in
![Page 135: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/135.jpg)
Gluteal:
Have client assume side lying position.
Spread buttocks apart and lightly stimulate
perineal area with cotton applicator.
Reflex : Contraction of anal sphincter
www.drjayeshpatidar.blogspot.in
![Page 136: Physical examination](https://reader034.vdocuments.us/reader034/viewer/2022052207/556cb8b7d8b42ab70c8b4fd1/html5/thumbnails/136.jpg)
Thank You
www.drjayeshpatidar.blogspot.in