Pancreatic fistula physical examination: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
Line 19: Line 19:


==Physical Examination==
==Physical Examination==
Physical examination of patients with [disease name] is usually normal.
Physical examination of patients with internal pancreatic fistulas is usually normal or asymptomatic, on the other hand patients with external pancreatic fistulas can present with drainage of fluid.


OR
OR
Line 34: Line 34:


===Appearance of the Patient===
===Appearance of the Patient===
*Patients with [disease name] usually appear [general appearance].  
 
*Patients with pancreatic fistulas usually appear normal.


===Vital Signs===
===Vital Signs===
Line 48: Line 49:


===Skin===
===Skin===
* Skin examination of patients with [disease name] is usually normal.
 
*Skin examination of patients with [disease name] is usually normal.
 
OR
OR
*[[Cyanosis]]  
 
*[[Cyanosis]]
*[[Jaundice]]
*[[Jaundice]]
* [[Pallor]]
*[[Pallor]]
* Bruises
*Bruises


<gallery widths="150px">
<gallery widths="150px">
File:UploadedImage-01.jpg| Description {{dermref}}
File:UploadedImage-02.jpg| Description {{dermref}}
</gallery>


UploadedImage-01.jpg | Description {{dermref}}
===HEENT===
UploadedImage-02.jpg | Description {{dermref}}


</gallery>
*HEENT examination of patients with [disease name] is usually normal.


===HEENT===
* HEENT examination of patients with [disease name] is usually normal.
OR
OR
* Abnormalities of the head/hair may include ___
 
* Evidence of trauma
*Abnormalities of the head/hair may include ___
* Icteric sclera  
*Evidence of trauma
* [[Nystagmus]]  
*Icteric sclera
* Extra-ocular movements may be abnormal
*[[Nystagmus]]
*Extra-ocular movements may be abnormal
*Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
*Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
*Ophthalmoscopic exam may be abnormal with findings of ___
*Ophthalmoscopic exam may be abnormal with findings of ___
* Hearing acuity may be reduced
*Hearing acuity may be reduced
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Weber test]] may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
*[[Rinne test]] may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
* [[Exudate]] from the ear canal
*[[Exudate]] from the ear canal
* Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
*Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
*Inflamed nares / congested nares
*Inflamed nares / congested nares
* [[Purulent]] exudate from the nares
*[[Purulent]] exudate from the nares
* Facial tenderness
*Facial tenderness
* Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae
*Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae


===Neck===
===Neck===
* Neck examination of patients with [disease name] is usually normal.
 
*Neck examination of patients with [disease name] is usually normal.
 
OR
OR
*[[Jugular venous distension]]
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
Line 92: Line 100:


===Lungs===
===Lungs===
* Pulmonary examination of patients with [disease name] is usually normal.
 
*Pulmonary examination of patients with [disease name] is usually normal.
 
OR
OR
* Asymmetric chest expansion OR decreased chest expansion
 
*Asymmetric chest expansion OR decreased chest expansion
*Lungs are hyporesonant OR hyperresonant
*Lungs are hyporesonant OR hyperresonant
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
Line 106: Line 117:


===Heart===
===Heart===
* Cardiovascular examination of patients with [disease name] is usually normal.
 
*Cardiovascular examination of patients with [disease name] is usually normal.
 
OR
OR
*Chest tenderness upon palpation
*Chest tenderness upon palpation
*PMI within 2 cm of the sternum  (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
*PMI within 2 cm of the sternum  (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
Line 120: Line 134:


===Abdomen===
===Abdomen===
* Abdominal examination of patients with [disease name] is usually normal.
 
*Abdominal examination of patients with [disease name] is usually normal.
 
OR
OR
*[[Abdominal distension]]  
 
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant  
*[[Abdominal distension]]
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
*[[Rebound tenderness]] (positive Blumberg sign)
*[[Rebound tenderness]] (positive Blumberg sign)
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
Line 131: Line 148:


===Back===
===Back===
* Back examination of patients with [disease name] is usually normal.
 
*Back examination of patients with [disease name] is usually normal.
 
OR
OR
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Sacral edema
*Sacral edema
Line 139: Line 159:


===Genitourinary===
===Genitourinary===
* Genitourinary examination of patients with [disease name] is usually normal.
 
*Genitourinary examination of patients with [disease name] is usually normal.
 
OR
OR
*A pelvic/adnexal mass may be palpated
*A pelvic/adnexal mass may be palpated
*Inflamed mucosa
*Inflamed mucosa
Line 146: Line 169:


===Neuromuscular===
===Neuromuscular===
* Neuromuscular examination of patients with [disease name] is usually normal.
 
*Neuromuscular examination of patients with [disease name] is usually normal.
 
OR
OR
*Patient is usually oriented to persons, place, and time
*Patient is usually oriented to persons, place, and time
* Altered mental status
*Altered mental status
* Glasgow coma scale is ___ / 15
*Glasgow coma scale is ___ / 15
* Clonus may be present
*Clonus may be present
* Hyperreflexia / hyporeflexia / areflexia
*Hyperreflexia / hyporeflexia / areflexia
* Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
*Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
* Muscle rigidity
*Muscle rigidity
* Proximal/distal muscle weakness unilaterally/bilaterally
*Proximal/distal muscle weakness unilaterally/bilaterally
* ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
*____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
*Unilateral/bilateral upper/lower extremity weakness
*Unilateral/bilateral upper/lower extremity weakness
*Unilateral/bilateral sensory loss in the upper/lower extremity
*Unilateral/bilateral sensory loss in the upper/lower extremity
Line 167: Line 193:


===Extremities===
===Extremities===
* Extremities examination of patients with [disease name] is usually normal.
 
*Extremities examination of patients with [disease name] is usually normal.
 
OR
OR
*[[Clubbing]]  
 
*[[Cyanosis]]  
*[[Clubbing]]
*[[Cyanosis]]
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Muscle atrophy
*Muscle atrophy

Revision as of 14:37, 6 April 2021

Pancreatic fistula Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pancreatic fistula from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

CT

MRI

ERCP

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pancreatic fistula physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Pancreatic fistula physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pancreatic fistula physical examination

CDC on Pancreatic fistula physical examination

Pancreatic fistula physical examination in the news

Blogs on Pancreatic fistula physical examination

Directions to Hospitals Treating Pancreatic fistula

Risk calculators and risk factors for Pancreatic fistula physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

OR

Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

The presence of [finding(s)] on physical examination is diagnostic of [disease name].

OR

The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Physical Examination

Physical examination of patients with internal pancreatic fistulas is usually normal or asymptomatic, on the other hand patients with external pancreatic fistulas can present with drainage of fluid.

OR

Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

OR

The presence of [finding(s)] on physical examination is diagnostic of [disease name].

OR

The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Appearance of the Patient

  • Patients with pancreatic fistulas usually appear normal.

Vital Signs

  • High-grade / low-grade fever
  • Hypothermia / hyperthermia may be present
  • Tachycardia with regular pulse or (ir)regularly irregular pulse
  • Bradycardia with regular pulse or (ir)regularly irregular pulse
  • Tachypnea / bradypnea
  • Kussmal respirations may be present in _____ (advanced disease state)
  • Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
  • High/low blood pressure with normal pulse pressure / wide pulse pressure / narrow pulse pressure

Skin

  • Skin examination of patients with [disease name] is usually normal.

OR

HEENT

  • HEENT examination of patients with [disease name] is usually normal.

OR

  • Abnormalities of the head/hair may include ___
  • Evidence of trauma
  • Icteric sclera
  • Nystagmus
  • Extra-ocular movements may be abnormal
  • Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
  • Ophthalmoscopic exam may be abnormal with findings of ___
  • Hearing acuity may be reduced
  • Weber test may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
  • Rinne test may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
  • Exudate from the ear canal
  • Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
  • Inflamed nares / congested nares
  • Purulent exudate from the nares
  • Facial tenderness
  • Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae

Neck

  • Neck examination of patients with [disease name] is usually normal.

OR

Lungs

  • Pulmonary examination of patients with [disease name] is usually normal.

OR

  • Asymmetric chest expansion OR decreased chest expansion
  • Lungs are hyporesonant OR hyperresonant
  • Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
  • Rhonchi
  • Vesicular breath sounds OR distant breath sounds
  • Expiratory wheezing OR inspiratory wheezing with normal OR delayed expiratory phase
  • Wheezing may be present
  • Egophony present/absent
  • Bronchophony present/absent
  • Normal/reduced tactile fremitus

Heart

  • Cardiovascular examination of patients with [disease name] is usually normal.

OR

  • Chest tenderness upon palpation
  • PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
  • Heave / thrill
  • Friction rub
  • S1
  • S2
  • S3
  • S4
  • Gallops
  • A high/low grade early/late systolic murmur / diastolic murmur best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the stethoscope

Abdomen

  • Abdominal examination of patients with [disease name] is usually normal.

OR

Back

  • Back examination of patients with [disease name] is usually normal.

OR

  • Point tenderness over __ vertebrae (e.g. L3-L4)
  • Sacral edema
  • Costovertebral angle tenderness bilaterally/unilaterally
  • Buffalo hump

Genitourinary

  • Genitourinary examination of patients with [disease name] is usually normal.

OR

  • A pelvic/adnexal mass may be palpated
  • Inflamed mucosa
  • Clear/(color), foul-smelling/odorless penile/vaginal discharge

Neuromuscular

  • Neuromuscular examination of patients with [disease name] is usually normal.

OR

  • Patient is usually oriented to persons, place, and time
  • Altered mental status
  • Glasgow coma scale is ___ / 15
  • Clonus may be present
  • Hyperreflexia / hyporeflexia / areflexia
  • Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
  • Muscle rigidity
  • Proximal/distal muscle weakness unilaterally/bilaterally
  • ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
  • Unilateral/bilateral upper/lower extremity weakness
  • Unilateral/bilateral sensory loss in the upper/lower extremity
  • Positive straight leg raise test
  • Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
  • Positive/negative Trendelenburg sign
  • Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
  • Normal finger-to-nose test / Dysmetria
  • Absent/present dysdiadochokinesia (palm tapping test)

Extremities

  • Extremities examination of patients with [disease name] is usually normal.

OR

  • Clubbing
  • Cyanosis
  • Pitting/non-pitting edema of the upper/lower extremities
  • Muscle atrophy
  • Fasciculations in the upper/lower extremity

References

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Pancreatic_fistula_physical_examination&oldid=1696249"