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General Physical Examination.

Clinical methodology made easy for Undergraduates/Postgraduates. Before starting the examination, remember to: Hand sanitize (mnemonic: RICE) Approach from the right side Introduce yourself and greet the patient Obtain informed consent and ask about pain General Appearance Observe the patient from the foot end, noting: Age, height, weight, and overall appearance Position and comfort level (e.g., propped up with a pillow) Presence of lines, catheters, or IV cannulas Signs of visible stress, respiratory distress, edema, or other abnormalities Rule of 4, 4, 4 Remember to examine: 4 physical signs: cyanosis, clubbing, jaundice, and pallor 2 neck: JVP and thyroid 2 periphery: edema (feet) and lymphadenopathy 4 vitals: temperature, pulse, respiratory rate, and blood pressure #Hand Examination 1. Examine the palm, thenar eminence, and hypothenar eminence 2. Check nails for cyanosis, clubbing, koilonychia, or leukonychia 3. Palpate the pulps and look for Osler nodes 4. Palpate the fingers for Heberden nodes Pulse Examination 1. Count the pulse rate for 15 seconds (normal) or 30 seconds (abnormal) 2. Focus on rate and rhythm #Arm Examination 1. Examine the trochlear and epitrochlear lymph nodes (by partially flexing the arm) Eye Examination 1. Place the patient's palm on a lower level 2. Ask the patient to lower their eyes 3. Examine the conjunctiva by placing the palm upward. Oral Cavity Examination 1. Check oral hygiene 2. Ask the patient to move their tongue upward to check for cleft palate 3. Examine the dorsum of the tongue for cyanosis, pallor, or jaundice 4. Check the underside of the tongue for jaundice 5. Examine the lips for cyanosis or dehydration signs #Neck Examination 1. Ask the patient to look at a 45-degree angle 2. Check for thyroid enlargement (extend the neck) 3. Ask the patient to swallow saliva Lymph Node Examination 1. Examine the inguinal lymph nodes (in a T-shape) 2. Check for ankle edema by placing hands over the ankle for 10-15 seconds and then pressing with the thumb 3. Examine the lump nodes (submental, submandibular, omohyoid, anterior cervical, supraclavicular, posterior cervical, preauricular, postauricular, and occipital) 4. Examine the axillary lymph nodes (lateral, medial, apical, and posterior).