Chronic pancreatitis physical examination: Difference between revisions
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The presence of [finding(s)] on physical examination is highly suggestive of [disease name]. | The presence of [finding(s)] on physical examination is highly suggestive of [disease name]. | ||
==Physical Examination== | ==Physical Examination== | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
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===Vital Signs=== | ===Vital Signs=== | ||
*[[Hypothermia]] / hyperthermia may be present | *[[Hypothermia]] / hyperthermia may be present | ||
*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse | *[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse | ||
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[[Image:Cullen's sign.jpg|500 px|frame|center|By Herbert L. Fred, MD and Hendrik A. van Dijk (http://cnx.org/content/m14904/latest/) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons]] | [[Image:Cullen's sign.jpg|500 px|frame|center|By Herbert L. Fred, MD and Hendrik A. van Dijk (http://cnx.org/content/m14904/latest/) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons]] | ||
[[Image:Hemorrhagic pancreatitis - Grey Turner's sign.jpg|500 px|thumb|center|By Herbert L. Fred, MD and Hendrik A. van Dijk (http://cnx.org/content/m14942/latest/) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons]] | [[Image:Hemorrhagic pancreatitis - Grey Turner's sign.jpg|500 px|thumb|center|By Herbert L. Fred, MD and Hendrik A. van Dijk (http://cnx.org/content/m14942/latest/) [CC BY 2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons]] | ||
===Lungs=== | ===Lungs=== | ||
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===Heart=== | ===Heart=== | ||
* | * | ||
===Abdomen=== | ===Abdomen=== | ||
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*Buffalo hump | *Buffalo hump | ||
* | |||
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===Neuromuscular=== | ===Neuromuscular=== | ||
Revision as of 20:11, 11 December 2017
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Chronic pancreatitis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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American Pancreatic Association Practice Guidelines |
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Chronic pancreatitis physical examination On the Web |
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American Roentgen Ray Society Images of Chronic pancreatitis physical examination |
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Risk calculators and risk factors for Chronic pancreatitis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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
Appearance of the Patient
- Patients with chronic pancreatitis may assume a characteristic position in an attempt to relieve their abdominal pain:
- Lying on the left side
- Flexing the spine
- Drawing the knees up toward the chest
- Patients with steatorrhea or advanced disease may present as
- Subcutaneous fat
- Temporal wasting
- Sunken supraclavicular fossa
- Other physical signs of malnutrition
Vital Signs
- 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
Lungs
- Asymmetric chest expansion / Decreased chest expansion
- Lungs are hypo/hyperresonant
- Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
- Rhonchi
- Vesicular breath sounds / Distant breath sounds
- Expiratory/inspiratory wheezing with normal / delayed expiratory phase
- Wheezing may be present
- Egophony present/absent
- Bronchophony present/absent
- Normal/reduced tactile fremitus
Heart
Abdomen
- A palpable abdominal mass in the epigastrium
Back
- Point tenderness over __ vertebrae (e.g. L3-L4)
- Sacral edema
- Costovertebral angle tenderness bilaterally/unilaterally
- Buffalo hump
Neuromuscular
- 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
- Clubbing
- Cyanosis
- Pitting/non-pitting edema of the upper/lower extremities
- Muscle atrophy
- Fasciculations in the upper/lower extremity