A Seminar About Examination

8/14/2019 A Seminar About Examination

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A seminar aboutexamination

Prepared by: Jamal Q Ahmed

Supervised by: Prof.Dr.Ali AlZubaidi


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General examination ofpatient

Vital signsThe temperature

The pulse rate

The blood pressure

The respiratory rate


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Contd

Temperature :measures with thermometer.

Oral 36.6c/ rectal 37.4c/axillary36.5c

Patients who have systemic involvement of infection

has elevated temperatures. The pulse measured from these sites

Radial /carotid/superficial temporal arteries

At rest pulse rate is,140 beats/min for infants and 60-80beats /min for adults

Pulse rate increased in exercise, anxiety, fear, somecardiac disorders, hyperthyroidism. pulse rate above100beats per minute may indicate a sever infection


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Contd

The respiratory rate: normally is14-16 breaths/min ,but in mild to

moderate infection may elevate to18-20

The blood pressure


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Other signs

Skin

Petechia or ecchymosis (blood dyscrasia)/cyanosis (cardiac or pulmonary

insufficiency) / jaundice, pigmentation.

Hands raynauds phenomenon, finger and joint swelling in

rheumatoid arthritis, palmar keratosis, Nails

Finger clubbing, koilonychia


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Extra oral head and neckexamination

General appearance Cachectic appearance, low mood, toxic appearance

Face Shape and symmetry/ cushingoid appearance/neurological

deficits/cyanosis/pallor/erythema/rash

Eyes Exophthalamus

Yellow sclera/pale sclera/ xanthoma of periocular skin Hair problems

Ectodermal dysplasia


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Inspection of neck

Looks particularly for swellings, sinuses

Carful palpation of all the lymph nodes

and salivary glands and thyroid gland Observe patient from front noting any

asymmetry or swelling, then standingbehind the seated patient to palpate thelymph nodes


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contd Swelling of neck

Side of neck

Middle of neck

Causes of cervical lymphadenopathy


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Examination of lymphnodes

Parotid, mastoid and occipital lymph nodes

Superficial cervical lymph nodes

Sub mental lymph nodes Submandibular lymph nodes

Deep cervical lymph nodes

The supraclavicular region


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TMJ and muscles ofmastication examination

Facial symmetry, masseteric hypertrophy Mandibular opening and closing paths Mandibular opening extent Lateral excursions Joint sounds Both condyles, finger in external auditory

meatus, finger placed over joints in front of ear The dentition and occlusion The mucosa


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Masticatory musclesexamination

Masseters, by intraoral-extra oral compression betweenfinger and thumb

Temporalis, palpate temporal origin of muscle by asking

patient to clench the teeth, palpate insertion of muscleintraoraly along the anterior border of ascending ramus

Lateral pterygoid, placing finger behind tuberosity.Examine muscle indirectly by asking patient to movejaw to one side while applying a gentle force

Medial pterygoid, lingual to mandibular ramus


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Salivary glandsexamination

Parotid glands: In front of patient ,two or three

fingers over posterior border ofascending ramus with light pressure,duct examined intraorally

Submandibular and sublingualgland s Bimanual palpation


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Examination of cranial

nerves Olfactory Optic

Visual acuity/visual field Pupilry reaction to light

Oculomotor,trochlear, abducent nerves Trigeminal

Sensory, motor, corneal reflex Facial,motor,special sense,parasympathetic

secretomotor

Vestibulocochlear Glossophareangeal and vagus Accessory hypoglossal


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Intraoral examination

Lips

Labial and buccal mucosa

Floor of mouth & ventrum of tongue Dorsal surface of tongue

Hard and soft palates

Gingiva &teeth

Documents

A Seminar About Examination