1. THE PHYSICAL EXAMINATION
HEAD TO TOE ADULT ASSESSMENT

2. GENERAL SURVEY (OBSERVATION)
APPARENT SIGNS OF RESPIRATORY OR OTHER DISTRESS?
LEVEL OF CONSCIOUSNESS, AWARENESS
MOOD & BEHAVIOR
SPEECH CLARITY
ASSESS SKIN (COLOR, TEMP. , MOISTURE
ODORS (ALCOHOL, KETONE, URINE, ETC)

3. EXAMINING THE HEAD AND NECK (INSPECTION, PALPATION, AUSCULTATION)
FOR OBVIOUS INJURY/DEFORMITY
CHECK PUPILS
OBSERVE FOR DISCHARGE (FROM EYES, EARS, NOSE, MOUTH)
OBSERVE ORAL, PHARYNGEAL CAVITIES,TEETH
INSPECT NECK (VEIN DISTENTION, ENLARGED NODES, SYMMETRY)

4. Examining the head & neck (cont.)
PALPATE:
SCALP
FACIAL BONES
LYMPH NODE LOCATIONS (SUBMANDIBULAR, SUBMENTAL, PRE AND POST AURICULAR, CERVICAL)

5. Examining the head & neck (cont.)
AUSCULTATE:
CAROTID ARTERIES FOR BRUITS

6. EXAMINING THE CHEST AND BACK
INSPECT:
FOR OBVIOUS INJURY, DEFORMITY,SKIN ABNORMALITIES (SUCH AS DECUBITI)
OBSERVE RESPIRATIONS, CHECK FOR EQUAL CHEST EXPANSION BILATERALLY
OBSERVE FOR CONTOUR AND SYMMETRY

7. Examining the chest & back (cont.)
Palpate:
Clavicles, supra and sub clavicular lymph node areas
Axillae
Ribs, spine, check for sacral edema

8. Examining the chest & back (cont.)
Auscultate:
Breath sounds in all five lung lobes, resp-
iratory rate, depth,rhythm.Wheezing? On inspiration or expiration or both? Cough? Productive or nonproductive?
Heart sounds (aortic, pulmonic, Erb’s, tricuspid, mitral areas), S1 and S2. Check heart rate: regular? Regularly irregular? Irregularly irregular?

9. Examining the chest & back (cont.)
Percuss:
Chest periphery
Costoverterbral angles

10. EXAMINING THE ABDOMEN INSPECT: FOR OBVIOUS INJURY, SCARS, RASH
FOR DISTENTION
FOR ASYMMETRY, MASSES, HERNIAS
OBSERVE FOR PULSATIONS, VISIBLE PERISTALSIS
INSPECT EXTERNAL GENITALIA

11. Examining the Abdomen (cont.)
Auscultate:
All four quadrants for bowel sounds
For bruit over the abdominal aorta

12. Examining the Abdomen (cont.)
Palpate (gently!)
For pain, rebound tenderness, guarding
Liver margin, spleen
Carefully palpate any hernias
Check femoral pulses

13. Examining the Abdomen (cont.)
Percuss:
For fluid, motion
All four quadrants, noting sounds

14. EXAMINING THE EXTREMITIES
INSPECT:
OBSERVE FOR SYMMETRY, OBVIOUS DEFORMITY
FOR GAIT, RANGE OF MOTION
OBSERVE SKIN FOR COLOR, CONDITION
OBSERVE NAILS FOR COLOR, CONDITION
OBSERVE FOR INVOLUNTARY MOVEMENTS
OBSERVE FOR EDEMA

15. EXAMINING THE EXTREMITIES
PALPATE:
UPPER EXTREMITIES: RADIAL, BRACHIAL PULSES, COMPARE
CHECK GRIP, STRENGTH BILATERALLY
LOWER EXTEMITIES: PERIPHERAL PULSES:POPLITEAL, DORSALIS PEDIS, POSTERIOR TIBIAL; COMPARE BILATERALLY
EVALUATE SENSATION IN ALL EXTREMITIES
ASSESS FOR PITTING EDEMA
PERFORM HOMAN’S SIGN EXAM; CHECK FOR CALF TENDERNESS, PAIN, HEAT

16. EXAMINING THE EXTREMITIES
PERCUSS:
DEEP TENDON REFLEXES