قياس الضغط والحرارة

General Examination

• Pulse - Edema - Resp: Patient should be alert, conscious, with intact memory, normal intelligence, and oriented to time, place, and people.

Vital Signs

• Pulse:
  • Rhythm: Regular
  • Rate: Count for 30 seconds, multiply by 2
  • Volume: Assess with rolling the finger
  • Artery Wall: Assess whether felt or not
  • Equality: Assess on both sides
  • Peripheral Pulsations: Assess Dorsalis Pedis and Posterior Tibial arteries (check both, not just one)

Neurological Examination

• Abnormal Gait: Inspect posture
• Motor System:
  • Tone (Upper Limb): Wrist shaking, Elbow flexion & extension, Shoulder shaking
  • Tone (Lower Limb): Ankle shaking, Knee flexion & extension, Roll on the thigh
  • Power: Assess against resistance
  • Reflexes (Deep): Biceps, Triceps, Brachioradialis using proper exposure technique and a reflex hammer

Neurological Examination (Continued)

• Brachioradialis: 3 cm above the wrist, elbow and wrist semipronated at 120 degrees by the patient
• Biceps: 120 degrees, semipronated, at the elbow, tap on the tendon
• Triceps: 90 degrees at the elbow, tap above the elbow
• Knee: Support knee, tap on the tendom below the patella
• Ankle: 90 degrees knee, 90 degrees ankle, tap on the tendon behind the ankle, focus on the calf muscles
• Superficial Reflexes: Corneal and Superficial abdominal reflex, using a cotton swab (for the latter), with patient supine, umbilicus as a landmark

Cranial Nerves (Facial Nerve)

• Frontal: Raising the eyebrows (frontal is muscles).
• Buccinator: Wrinkle the cheeks, puff out the cheeks
• Orbicularis Oculi: Blink
• Orbicularis Oris: Close the mouth and try to pucker the lips
• Retractor Anguli: Smile

Cardiac Examination

• Inspection & Palpation: Assess shape, skin, and presence of movement in various areas (e.g. apex, epigastrum, intercostal spaces)

• Apex: Locate the site, assess extent (normal vs. localized) and character (gentle tap or forceful)

• Epigastric Pulsations: Determine origin and character

• Left Parasternal Pulsations:Assess for pulsations or thrill at the 2nd intercostal spaces, right or left

• Palpable Sound: Assess character

• Auscultation: Listen for heart sounds (S1 & S2) and identify any murmurs (systolic or diastolic). Use specific areas (tricuspid area, apex, aortic area).

Blood Pressure

• Palpatory Method: Close cuff, press pump until pulse disappears (20-30 mmHg). Lower pump pressure until there is pulsation.
• Auscultatory Method: Measure pressure using stethoscope, following the palpatory method procedure to estimate sytolic.

Respiratory Rate

• Count inspiration and expiration cycle for one cycle

Temperature

• Measure rectal, axillary, or oral temperature.

Head & Neck Examination

• Head: Inspect for jaundice, central cyanosis, anemia (pallor)
• Carotid: Palpate
• Trachea: Palpate (symmetrical)
• Thyroid Gland: Examine, palpating in the area from the front of the side of the neck, under the thyroid cartilage
• Lymph Nodes: Examine in order submental, submandibular, ant. cervical, post. cervical, supraclavicular, pre-auricular, and post-auricular

Upper Limb Examination

• Window Test: Extend the patient's arm and look for swelling, ask the patient to make a fist and relax hands.
• Tremors: Assess fine tremors, and flapping tremors

Edema

• Palpate pitting or non-pitting edema at areas like medial malleolus, look for bilateral or unilateral.

Neck Veins Examination

• Inspection: Assess neck veins for pulsations or congestion.
• Congested Veins: If found, find highest point, then use a ruler parallel to ground to measure distance from this highest point on the neck veins to the Manibrium Sterni.

Chest Examination

• Inspection: SSM (Symmetry, Shape, and Movement),
• Skin: Inspect for scars, pigmentation, or dilated veins.
• Shape: Normal, symmetrical, elliptical
• Movement: Thoracic/abdominal (female); thoracic (male). Expansion, observe for symmetry.
• Pulsations: Identify apical, epigastric, and pulmonary pulsations (tangential method). (Identify any abnormalities)

Palpation (Chest)

• Tenderness: Assess areas for tenderness
• Palpable Rib: Palpate ribs
• TVF: Examine areas (ant/infra/axillary)
• Trachea: Palpate the trachea for midline position.

Percussion (Chest)

• Areas: Check ant. infra, mammary, inframammary, and axillary.
• Upper Border Liver: Identify upper border by using tidal percussion.

Percussion (Back)

• Vertebral Column: Examine for kyphosis and scoliosis

• Skin: Check for Scars

• Movement: Check for movement

• Palpation: Check if areas are tender

• Expansions: Assess expansions in areas (suprascapular, scapular and infrascapular)

• Trachea: Check trachea position.

Abdominal Examination

• Inspection: SSM, using the feet of the bed as a landmark, for shape (normal or scaphoid), skin (scars, dilated veins, gynecomastia), and movement (restricted or not).
• Shape: Normal, flat, scaphoid
• Skin: Check for scars, dilated veins, and gynecomastia.
• Movement: Assess for symmetry and any restricted movements.
• Subcostal Angle: Check acute angle. If not check for swelling.
• Epigastric Pulsations: Examine for any pulsations.
• Divarication of Recti: Check for presence.

Umbilicus

• Site: Midway between xiphisternum and symphysis pubis
• Shape: Inverted
• Discharge: Check for discharge like caput medusa, NO discharge, dilated veins, and pigmentations.
• Nodules: Check for presence of nodules
• Pubic Hair: Check pubic hair
• Genitalia: Check genitalia and look for hernia
• Back: Check scars, dilated veins, kyphosis, and scoliosis
• Palpation (Abdomen): Identify regions for palpation including Liver and Spleen
• Percussion (Abdomen): Identify for ascites

هذا الاختبار يغطي أساسيات قياس ضغط الدم ودرجة الحرارة، مع التركيز على الممارسات القياسية والمعايير الضرورية لتعزيز المساواة في الرعاية الصحية. كما يستعرض العناصر الأساسية للتفاعل البشري في السياقات الطبية. احصل على فهم أفضل لهذه المواضيع من خلال الإجابة عن الأسئلة المطروحة.