HEAD TO TOE PHYSICAL EXAMINATION

HEAD TO TOE PHYSICAL EXAMINATION – General status, Mental status, Height and Weight, Skin Conditions, Head and Face, Eye, Ears, Nose, Mouth and Pharnyx, Neck, Chest, Abdomen, Neurological Tests.

NURSING PROCEDURES LIST CLICK HERE

The examination is carried out in an orderly manner focusing upon one area of the body at a time. The observation of the patient starts as the patient walks into the examination room, e.g. a limp may be noted as the patient walks in. the following observations are made:

GENERAL APPEARANCE

Nourishment: well nourished or under nourished
Body build: thin or obese
Health: healthy or unhealthy
Activity: active or dull (tired)

MENTAL STATUS

Consciousness: conscious, unconscious, delirious, talking incoherently
Look: anxious or worried, depressed, etc
Body curves: lordosis, kyphosis, and scoliosis
Movement: any limb

HEIGHT AND WEIGHT

Skin Conditions

Color: pallor, jaundice, cyanosis, flushing, etc
Texture: dryness, flaking, wrinkling or excessive moisture
Temperature: warm, cold and clammy
Lesions: macules, papules, vesicles, wounds, etc

HEAD AND FACE

Shape of the skull and fontanel
Skull circumference
Scalp: cleanliness, condition of the hair, dandruff, pediculi, infections like ringworm
Face: pale, flushed, puffiness, fatigue, pain, fear, anxiety, enlargement of parotid glands, etc

EYE

Eyebrows: normal or absent
Eyelashes: infection, sty
Eyelids: edema, lesions, ectropion, entropion
Eyeballs: sunken or protruded
Conjunctiva: pale, red, purulent
Sclera: jaundiced
Cornea and iris: irregularities and abrasions
Pupils: dilated, constricted reaction to light
Lens: opaque or transparent
Fundus: congestion, hemorrhagic spots
Eye muscles: strabismus (squint)
Vision: normal, myopia, hypermetropia

ARTICLES APPROPRIATE FOR SPECIFIC EXAMINATION

Eye: torch, ophthalmoscope, snellen chart, wisp of cotton
Ear: head mirror, light bulb fixed on the wall or a table lamp and a torch, a tuning fork
Nose: nasal speculum, forceps, a head mirror and a light bulb
Throat: tongue depressor, a laryngeal mirror, a kidney tray, a paper bag, throat swabs in a container. Torch, gauze pieces in a bowl
Chest and abdomen: stethoscope, tape measure
Vaginal: sterile vaginal speculum, gloves, a kidney tray, a bowl with swabs (sterile), an antiseptic lotion
Rectal: proctoscope, gloves, finger cots, a kidney tray, water-soluble jelly
Neurological: a percussion hammer, safety pins, a wisp of cotton, hot or cold water

EARS

External ear-discharges, cerumen obstructing the ear passage
Tympanic membrane: perforations, lesions, bulging
Hearing: hearing acuity

NOSE

External nares: crusts or discharges
Nostrils: inflammation of the mucus membrane, septal deviations

MOUTH AND PHARYNX

Lips: redness, swelling, crusts, cyanosis, angular stomatitis
Odor of the mouth: foul smelling
Teeth: discoloration and dental caries
Mucous membrane and gums: ulceration and bleeding, swelling, pus formation
Tongue: pale, dry, lesions, sores, furrows, tongue tie, etc.
Throat and pharynx: enlarged tonsils, redness and pus

NECK

Lymph nodes: enlarged, palpable
Thyroid gland: enlarged
Range of motion: flexion, extension and rotation

CHEST

Thorax: shape, symmetry of expansion, posture
Breath sounds: sigh, swish, rustle, wheezing, rales, crepitations, pleural rub, etc
Heart: size and location, cardiac murmurs
Breasts: enlarged lymph nodes

ABDOMEN

Obstruction: skin rashes, scars, hernia, ascites, distention, pregnancy, etc
Auscultation: bowel sounds, fetal heart sounds
Palpation: liver margin, palpable spleen, tenderness at the appendix, inguinal hernias
Percussion: presence of gas, fluid or masses

Extremities: movement of joints, tremors, clumbing of fingers, ankle edema, varicose veins, reflexes, etc

Back: spinal bifida curves

GENITAL AND RECTUM