18 Questions
What is the recommended patient position for a cardiorespiratory examination?
45 degrees upright
In chest examination, what is assessed by observing the patient's level of comfort?
Breathing pattern
How is body built defined in a clinical examination?
Height to span relationship
What is the Glasgow Coma Scale used to assess in patients?
Consciousness level
What is one of the signs of vitamin deficiency that can be observed during a chest examination?
Central cyanosis
How is nutrition clinically assessed using anthropometric measurements?
Recording height and weight measurements
What is the normal ratio of the anteroposterior diameter to the transverse diameter of the chest?
$\frac{5}{7}$
Which of the following is NOT a characteristic of a normal chest shape?
Bulging during inspiration
Which of the following chest abnormalities is characterized by a depression in the sternum?
Pectus excavatum
What is the normal range for the subcostal angle in a healthy individual?
90° ± 20°
Which of the following techniques is used to assess the respiratory rate while avoiding voluntary changes by the patient?
Counting chest movements while distracting the patient
Which of the following chest abnormalities is characterized by a protrusion of the sternum?
Pectus carinatum
Which of the following observations is NOT a normal finding during examination of the jugular venous pulse (JVP)?
The JVP being visible above the clavicles on both sides
Which of the following findings during lower limb examination is suggestive of peripheral arterial disease?
Absent peripheral pulsations and cool extremities
Which of the following conditions is NOT a common cause of non-pitting edema?
Hypoalbuminemia
Which of the following findings during lower limb examination is suggestive of deep vein thrombosis (DVT)?
Tender calf muscle with redness and warmth
Which of the following statements regarding personal history taking is INCORRECT?
The patient's name should be recorded as their first name only
Which of the following statements regarding examination of the thyroid gland is correct?
Thyroid examination is performed after examining the jugular venous pulse
Study Notes
General Examination
- Introduce yourself, explain the purpose, obtain consent, wash hands, and position yourself and the patient
- Ensure adequate exposure while maintaining patient privacy
- Observe the patient's general appearance, including:
- Level of consciousness (Glasgow Coma Scale: 3-15)
- Level of comfort (pain, sweating, breathlessness, use of accessory muscles)
- Body build (relationship between height and span according to age, sex, and race)
- Any medical equipment nearby (oxygen cylinders, nebulizers, sputum pots, medicines, intercostal tube)
Nutrition and Anthropometric Measurements
- Measure Body Mass Index (BMI)
- Look for signs of vitamin deficiency
- Evaluate attitude and decubitus (position of the patient in bed)
Chest Examination
- Inspect the chest for:
- Shape (elliptical, symmetrical, AP diameter = 5/7 transverse diameter)
- Respiratory movement (rate, rhythm, depth, type of breathing)
- Pulsation, dilated veins, pigmentation, sinuses, fistula, scars, skin rashes
- Subcostal angle (90 ±20)
- Palpate, percuss, and auscultate the chest
Thyroid Examination
- Examine the thyroid gland for goiter
Lower Limb Examination
- Inspect the nails for clubbing, color, splinter hemorrhage, pitting, etc.
- Examine the skin for rashes, pigmentations, scars
- Check for edema (type, unilateral or bilateral, level, and test for sacral edema in bedridden patients)
- Evaluate peripheral pulsations, tender calves, and diabetic foot
Patient History Taking
- Take a thorough personal history, including:
- Name and surname
- Sex
- Age and occupation
- Marital status
- Residence
- Special habits
Learn about the important landmarks and steps involved in a local chest examination process, including inspection, palpation, percussion, and auscultation. Understand criteria for evaluating the shape of the chest, symmetry, and respiratory movement.
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