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Questions and Answers
What is the primary purpose of a comprehensive physical examination?
What is the primary purpose of a comprehensive physical examination?
Which factors help determine the scope of the physical examination?
Which factors help determine the scope of the physical examination?
What is included in the general examination of a comprehensive physical assessment?
What is included in the general examination of a comprehensive physical assessment?
What does a focused examination primarily focus on?
What does a focused examination primarily focus on?
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Which of the following is NOT typically assessed during a comprehensive physical examination?
Which of the following is NOT typically assessed during a comprehensive physical examination?
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What is the normal range of Body Mass Index (BMI)?
What is the normal range of Body Mass Index (BMI)?
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At what waist circumference is there a high health risk for men?
At what waist circumference is there a high health risk for men?
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Which method is used to calculate Body Mass Index (BMI)?
Which method is used to calculate Body Mass Index (BMI)?
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What is the abnormal blood pressure reading that indicates high risk?
What is the abnormal blood pressure reading that indicates high risk?
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What is considered underweight based on BMI?
What is considered underweight based on BMI?
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Which of the following vital signs indicates a person's heart rate?
Which of the following vital signs indicates a person's heart rate?
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What is the normal oral temperature in degrees Celsius?
What is the normal oral temperature in degrees Celsius?
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Which sign is NOT part of assessing general appearance?
Which sign is NOT part of assessing general appearance?
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Study Notes
Lecture (3)
- Lecture 3 is referenced.
Physical Examination (1)
- Focuses on general appearance and vital signs.
- Includes comprehensive and focused examinations (problem-oriented).
- Patient symptoms, age, and health history determine the scope.
Comprehensive Physical Examination ("From Head to Toe")
- Includes general appearance.
- Includes vital signs.
- Includes skin examination.
- Includes head, eyes, ears, nose, and throat examination.
- Includes neck and back examination.
- Includes musculoskeletal system examination.
- Includes thorax and lungs examination.
- Includes cardiovascular system examination.
- Includes abdomen examination.
- Includes nervous system examination.
General Appearance
- Includes apparent state of health.
- Includes facial expression.
- Includes level of consciousness.
- Includes signs of distress.
- Includes odors of the body and breath.
- Includes skin color and lesions.
- Includes weight, height, body mass index, waist circumference.
- Includes posture and gait.
Vital Signs
- Includes heart rate (HR).
- Includes blood pressure (BP).
- Includes respiratory rate (RR).
- Includes temperature.
Body Mass Index (BMI)
- Method of calculation: Weight (kg) / Height (m2).
- BMI calculator available online.
- Normal range: 18.0 to 24.9.
- Underweight: BMI is less than 18.0.
- Overweight: BMI is 25 to 29.9.
- Obese: BMI is 30 or more.
Waist Circumference
- Men: Health Risk > 94 cm, High Risk > 102 cm.
- Women: Health Risk > 80 cm, High Risk > 88 cm.
Body Temperature
- Normal Oral Ranges: ≤37°C.
- Normal Rectal Ranges: ≤37.5°C.
- Normal Axillary Ranges: ≤36.8°C.
- Diurnal fluctuation: 0.3-0.7°C.
- Lowest temperature in the early morning.
- Highest temperature in the late afternoon.
Temperature Abnormalities
- Fever/Pyrexia: Elevated body temperature (37.5°C - 40.0°C).
- Hyperpyrexia: Extreme elevation in temperature (>40.0°C).
- Hypothermia: Abnormally low temperature (<35.0°C).
Heart Rate and Rhythm
- Radial pulse – count 15 seconds and multiply by 4 (if rhythm is regular and rate is normal).
- If the rate is unusually fast or slow, count it for 60 seconds.
- Normal Heart Rate: 60-100 beats per minute.
- Fast Heart Rate: >100 beats per minute.
- Slow Heart Rate: <60 beats per minute.
- Regular Heart Rhythm: Expected heart rhythm.
- Irregular Heart Rhythm: Irregular heart rhythm.
- Sporadically Irregular: Sporadic irregular rhythm.
- Totally Irregular: Totally irregular rhythm.
Respiratory Rate and Rhythm
- Rate: 14 to 20 breaths per minute (normal).
- Rhythm, Depth, Effort of breathing.
Additional Resources
- Bates' guide to Physical examination & history taking (video link)
- LearningTools: Blood Pressure Basics (video link)
- Bates's Guide to Physical Examination and History Taking 2013, pages 75-82.
Blood Pressure (BP) Measurement
- Classification: JNC-7.
- Normal: <120/80 mmHg.
- Prehypertension: 120/80 – 139/89 mmHg.
- Stage 1 Hypertension: ≥140/90 – 159/99 mmHg.
- Stage 2 Hypertension: >160/100 mmHg.
Blood Pressure Measurement Guidelines
- Posture: Sitting, supine, or standing.
- Circumstances: No caffeine or smoking.
- Equipment: Cuff size, manometer.
- Technique: Number of readings, performance, recordings.
Blood Pressure Measurement Steps
- Identify Obliteration Pressure.
- Identify target pressure (obliteration pressure + 20-30 mmHg).
- Inflate cuff rapidly (reach target pressure).
- Deflate cuff slowly (2 mm/sec).
- Identify systolic and diastolic pressures by Korotkov sounds.
- Repeat measurement.
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Description
This quiz focuses on the principles of physical examination, including general appearance and vital signs. It covers comprehensive and problem-oriented approaches based on patient history and symptoms. Test your knowledge on the key aspects of physical examinations from head to toe.
