Sandbox mk

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Introduction to the Physical Examination Page

• The page name should be "(Disease name) physical examination", with only the first letter of the title capitalized.
• Goal:To describe in detail the various aspects of the physical examination with attention to how the disease you are describing may present.
• Remember this section is to describe what characteristics may be found on physical examination, not how to do a physical exam (unless you are including specialized signs, eg Chvostek's sign, in which case you may give a brief description).
• You may describe a physical exam finding that is commonly present in a disease without adding additional information (e.g. appendicitis physical exam - RLQ abdominal tenderness). In some cases, some unique findings are suggestive of specific aspects / complications of the disease. If present, it is preferable that you mention what these unique findings suggest or when they may be present (e.g. appendicitis physical exam - rebound tenderness may be suggestive of peritonitis).
• As with all microchapter pages linking to the main page, at the top of the edit box put {{CMG}}, your name template, and the microchapter navigation template you created at the beginning.
• Remember to create links within Wikidoc by placing [[square brackets]] around key words which you want to link to other pages. Make sure you makes your links as specific as possible. For example if a sentence contained the phrase anterior spinal artery syndrome, the link should be to anterior spinal artery syndrome not anterior or artery or syndrome. For more information on how to create links click here.
• Remember to follow the same format and capitalization of letters as outlined in the template below.
• Below you will see examples of what you may describe as part of the physical examination.

Overview

• Peptic ulcer disease patient appears in severe stress due to severe abdominal pain

Template

• First Sentences:

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 peptic ulcer disease include epigastric tenderness , , and [finding 3].

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].

• Examples:

Example 1: Patients with shigellosis usually appear lethargic. Physical examination of patients with shigellosis is usually remarkable for high-grade fever and signs of dehydration, such as tachycardia, tachypnea, hypotension, and dry mucus membranes.

Example 2: Common physical examination findings of cholecystitis include right upper abdominal tenderness and a positive Murphy sign.

Example 3: The presence of both upper motor neuron and lower motor neuron involvement on physical examination is diagnostic of amyotrophic lateral sclerosis.

Example 4: The presence of facial tenderness and fever on physical examination is highly suggestive of acute sinusitis.

Preferred Template Statements

• 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].
• Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
• The presence of [finding(s)] on physical examination is diagnostic of [disease name].
• The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Physical Examination

Appearance of the Patient

• Patient usually appear in severe distress due to severe abdominal pain.

Vital Signs

• Patient has normal vital signs in initial stages of peptic ulcer.
• In peptic ulcer perforations vital signs may include :Bertleff MJ, Lange JF (2010). "Perforated peptic ulcer disease: a review of history and treatment". Dig Surg. 27 (3): 161–9. doi:10.1159/000264653. PMID 20571260.
  • Tachycardia with regular pulse
  • Weak pulse
  • low blood pressure with normal pulse pressure
  • High-grade fever is present at later stage of peptic ulcer perforation

Skin

• Pallor is present in patients presents with hematemesis and melena.

• 

  By Dr Graham Beards (Own work)

• 

  The hand of a person with severe anemia (on the left) compared to one without (on the right)By James Heilman, MD - Own work

HEENT

• Pallor on the lower conjunctiva can be seen.

Neck

• Supple ,trachea is centrally placed and no lyphadenopathy

Lungs

• Normal B/L vesicular breath sounds.

Heart

• S1 and S2 normal ,no murmur/rubs/gallops.

Abdomen

• Abdominal tenderness at the epigastrium
• Perforated peptic ulcer Bertleff MJ, Lange JF (2010). "Perforated peptic ulcer disease: a review of history and treatment". Dig Surg. 27 (3): 161–9. doi:10.1159/000264653. PMID 20571260.
  • Rebound tenderness
  • Decreased bowel sounds

Back

• NO redness ,visible deformity ,no tenderness

Extremities

• Pallor can be seen on hand

Neuromuscular

• Patient is usually oriented to persons, place, and time

References

• References should be cited for the material that you have put on your page. Type in {{reflist|2}}.This will generate your references in small font, in two columns, with links to the original article and abstract.
• For information on how to add references into your page, click here.