Recall back.....

Wanna refresh my memory on what I had learnt this afternoon.

PHYSICAL EXAMINATION ON GIT

1) For the general appearance, observe whether the patient is cachexic, obese, alert, concious, jaundice, pallor, or is he generally well and healthy.

2) Then examine the hands of the patient. See whether there are any clubbings, koilonychia, leuconychia, cyanosis, palmar erythema, Dupytren's contracture, pigmentation, and hepatic flap..

3) Next, see the face of the patient. For the eyes, look for any jaundice, Kayser-Fleischer rings, xanthelasma, periorbital purpura and anemia...Then, look for angular stomatitis, ulceration, glossitis, and pigmentation, leukoplakia, hypertrophy of gums, monilia..etc

4) Find any enlargement of supraclavicular nodes..(around the neck area)

5) Inspect the chest..Sought for spider naevi, acanthosis nigricans, gynaecomastia, bruises, petechiae, and scratch marks.

6) For the abdomen area, see whether there is any visible pulsation, pigmentation (again), distention, dilated veins, local swelling, visible peristalsis, skin lesions, striae, masses or any surgical scar.

7) Now come to palpation (yeah, can touch the patient haha).
Palpate the nine region areas of the abdomen..First palpate lightly, after that palpate deeply for any tenderness. Palpate for the liver, spleen, kidney and abdominal aorta.

8) Next is percussion. Percuss the liver, spleen and for any ascites..While patient is rolled on one side, spleen can be percussed again for any enlargement.

9) For auscultation, hear the bowel sounds. Is it sluggish? Is it tinkling? Or is there any loud gurgling sounds? Auscultate for the renal bruit, abdominal aorta bruit, and liver bruit.

10) Lastly, palpate for pedal oedema..

I know...I must had missed something..Nevermindlah..this is the first time..