
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

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

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)