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                                                                           عبدالكريم.د

General ex. 
 
Includes the following points(mental state+position of pt+JACCOL) 
 
1-Mental state:------------- 
 
2-position of pt:-------- 
 
3-JACCOL:    J:jundice: site where can be seen:-sclera 
                                        Points consider in checking it:1-ask pt to gaze downward 
                                                                                        2-daylight 
                                                                                        3- ------ 
Types of jundice((according to site(prehepatic-hepatic-post-hepatic)) 
 
                        Anaemia:sites where it can be seen in:    1-conjuctiva 
                                                                                          2-lip mucosa 
                                                                                          3-palm 
                                                                                          4-soft palate 
                        Clubbing:-how to check it 
                                        -common causes of it 
-Clubbing, particularly the congenital variety, may also involve 
the feet (Figure 1.14). Common causes of clubbing are carcinoma and purulent conditions of the lung 
(bronchiectasis, 
lung abscess, empyema), congenital heart disease and infective 
endocarditis. Less common conditions are pulmonary fibrosis, 
fibrosing alveolitis, pulmonary tuberculosis, pleural mesothelioma, cystic fibrosis, coeliac and 
inflammatory bowel disease, cirrhosis (Figure 1.15), malabsorption, thyrotoxicosis and bronchial 
arteriovenous malformations 

Beau’ s lines-stressful conditions such as fever, measles, pneumonia, DM. etc. 
                                         
 
                            Cyanosis: types :central& pirepheral 
 
 
 
                          Oedema: types:: 
              1- pitting(causes of it ):HF-RF-LF-Nephrotic syndrom------- 
                       
                        2-Non-pitting:causes; -lymphatic obstruction:also has causes :a-as sign &post.op 
complication of tumour(in upper limb*breast ca*-----in lower limb *pelvic mass*) 
                                                                                                            b-elephantiasis 
 
*normal mass=gravid uterus 
 
                            -     ذكرها  ما  هم  ثانية  اسباب  اكو
 
  LAP :lymph nodes  ةدوجوم  لكب  ناكم  ادعام  غامدلا  رعشلاو   
مسقنتو  بسح  قطانملا   
 


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Vital signs :1-pulse   
 
 
2-blood pressure   
3-respiration :male :thoraco-abdominal     بالفخر  يشعر
تلاضعب  ردصلا   
                                    Female:Abdomino-thoracic       
رعشت  رخفلاب  ب  pregnancy        so abdominal first 
                     
4-Tempreture:   
 
 
Abdominal ex 
 
-ةظحلام  نذه  طقف  تاظحلام  اهيلع  نلا  ام  ىجح  ليصفتلاب 
1-how to divide abdominal region 

 

 
 
 
*what is    the difference b/w mid inguinal point & mid 
inguinal ligment point 
-mid inguinal ligament point lie b/t Sup. Ant. Iliac spine 
&pubic tubercle & used for determination of Inguinal 
ring 
 
While mid inguinal point b/t AIS& pubic symphysis 
used for femoral artery landmark 
 
 
General Ex.        ( )مرتب  بشكل
1-general look(ABOPE) 
Middle age man,has average building,oriented to the time&place&person,in supine position,he looks 
sad,uncomfortable. 
 
2-general sign(JACCOL) 
3-Examination of head,neck,hand&foot. 
A-head:1-skin    2-hair      3-orifices 
B-neck: 1-thyroid 2-neck veins 3-any mass 
C-hand&foot:skin&nail&muscle&oedema 
 
4-vital signs:pulse 
                    Temp. 
                    Respiratory rate 
                    Blood pressure 
 
 
 
 
 
 
 
 


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Abdominal Ex. 
 
*inspection : 
1-From the foot of the bed((symetry&shape)}            the pt abdomon looks symtrical,scaphoid shaped, 
                                                                                      Moving w/t respiration,there is visible puls. 
                                                                                      No dilated vein,no scar,umbilicus located    in             
                                                                                  centre,inverted, no discharge ,I should ask pt to 
cough 
2-kneeling from side of the bed 
            Movements;move with respairation 
                                Visible pulsation 
                                Visible peristalsis 
 
 
3-from the side of the bed looks for any   
            A-Skin;;dilated vein 
                          Scar 
                           

Umbilicus

 

* Palpation 
a. Superficial and deep 
b. palpation for tenderness or masses 
c. palpation for organomegaly ( for any organomegaly look for 
span, edge , surface , consistency) 
 
Percussion 
Tympanic (Normal) 
Dull(fluid , Mass) 
Auscultation 
          For aortic bruit 
            For renal artery bruit 
            For bowel sound 
Then 
 
Inspect the abdomen from behind and do renal angle 
tenderness 
 
then 
Examine 
1. The genitalia 
2. Supra claviclar lymph node(virchow”s node-troisier sign ) 
3. Do PR examination 
4. do succession splach)

 

A characteristic sloshing sound 

(asuccussion splash) over the stomach may be heard with sudden movement of the patient seen in 
acute gastric dilatation) 




رفعت المحاضرة من قبل: Abdalmalik Abdullateef
المشاهدات: لقد قام 66 عضواً و 367 زائراً بقراءة هذه المحاضرة








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