Physical examination

1.Inspection

2.Palpation

3.Percussion

4.Auscultation

Inspection

• The inverted spider net

General survey

• Constitution (e.g. athletic, obese, asthenic)

• Nutritional status – BMI weight(kg)/height(m)2

– Underweight < 18.5– Normal 18.5-24.9– Overweight 25-29.9– Obese >30

• Biological age

General survey

• Apparent state of health

• Level of consciousness

• Facial expression

• Motor activity

Vital signs

• Blood pressure

• Heart rate and rhythm

• Respiratory rate

• Temperature

Investigation of the head and neck

• Shape of the head• Hair• Palpebra, periorbital region• Eye

– Conjunctiva– Sclera– Pupil– Eye movements– Field of vision

Investigation of the head and neck

• Cheek

• Periauricular region

• Nose and lips

Investigation of the head and neck

• Mouth– Tongue

• Fur (coated tongue)• Alterations• Movements

– Mucous membranes• Gingiva• Bucca• Pharynx

– Teeth– Tonsils– Uvula

Investigation of the head and neck

• Temporomandibular articulation• Lymph nodes (localisation, size, number, consistency, tenderness,

moveable or fixed, the skin above the lymph node)– Occipital– Periauriculars– Submandibular– Submental– Cervical (before and behind the sternocleidomastoid muscle)– Supraclavicular– Infraclavicular

• Thyroid gland– Size, consistency, nodules?