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 –Overweight –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?