In this article, we will discuss the general physical examination of the patient with respect to the clinical aspect, and all types of general physical examination steps and procedures.
General Physical examination:
- General appearance
- Upper and lower look
- Sitting posture
- Posture and attitude
- Blood pressure
- Respiratory rate
We will discuss every point one by one.
- Young or old
- Healthy or ill
Posture and Attitude:
- A patient with severe heart failure prefers to sit in the propped position.
- Patients with severe airway obstruction will prefer to sit in the bending forward position.
- Alertness of patient
- Deeply unconsciousness
We will discuss hands in detail but before moving forward we have to learn the shape of hands.
- 4th metacarpal becomes short in females in Turner’s syndrome.
- In tetany, hands adopt specific shapes due to Carpal spasms.
- Broad and large hands in the acromegaly.
- Loss of angle between the nail and the nail base in clubbing.
- Space between the nails is absent in clubbing.
- Fluctuations are also present in the clubbing.
- Nails become convex-shaped.
- The curvature of the nails is increased in both longitudinal and transverse axis.
- Terminal phalanx becomes bulbous due to the swelling just like drumsticks.
- Shamroth’s signs (space between two nails) are also absent in the present.
- Sometimes the Splinter hemorrhages (streaks under the nails) are also present in clubbing.
- Leuco nychia ( white patches in nail plates) may be present in the clubbing.
- Sometimes pitting of nails is also seen. These are small and large pits in the nails.