Look around the room to see if any accessories/ instruments like wheelchairs/ inhalers/ Sputum sample Once the child is seated, ask if you could expose the upper body. For lower body, you may need to ask permission from the examiner also General examination Level of consciousness- Alert/ Oriented/ cooperativeDecubitus (position in bed)GaitBuilt- Average/ small or […]
Most history taking follows the below format Details of the patient History Physical examination Summary Diagnosis Differential diagnosis Investigations Management History of presenting complaints 1) Details of the patient Name Sex Age Occupation Address Accompanying person and the relation 2) History Chief presenting complaints Past medical history Family history Treatment history Psychological history Obstetric history […]
There are 12 Cranial nerves. All of them arising from the brain and running down various pathways and performing the following functions.
Hypotonia Low muscle tone is a common finding. Remember the following points Causes of Hypotonia In newborns Anterior Horn cell disorders like Hypoxic-ischaemic myelopathy, Spinal muscular atrophy Congenital myelopathy like Charcot Marie Tooth disease Neuromuscular junction disorders like Congenital myasthenia Congenital myopathy like Nemaline myopathy Muscular dystrophy Syndromes- like Downs syndrome, Prader Willi syndrome, Hypothyroidism, […]
Cyanosis can be seen in most examination cases. It is a grave mistake to miss such a finding. The advice below will help you answer questions. There are 2 types of cyanosis Peripheral cyanosis and central cyanosis Causes of peripheral cyanosis Exposure to cold Raynaud’s phenomenon Congestive cardiac failure Hyperviscosity syndrome Shock Causes of central […]
Clubbing This is the swelling go the terminal part of fingers and toes It happens due to hypertrophy of the soft tissue in nail bed causing an increase in the anterior-posterior and transverse diameter of the nail Measurement It is measured by measuring the angle between the nail and nail bed – Its called the […]
Hypotonia Speech Dysarthria and slowing of speech with slurring and stuttering Knee jerk The knee jerk is pendular and on elicitation of the reflew, there are more than 3 pendular movements Tremor The child may have intentional tremor. Finger test can show this effect Dysmetria On finger nose finger test, the child may overestimate the […]
The two kidneys are palpated separately. It might be easier to palpate both the kidneys by standing on the right of the patient (in right-handed doctor) You can sit down if needed for your hands to be at the level with abdomen Now place your right hand over the exposed anterior abdomen at the right […]
Palpating the spleen There are many ways to palpate the spleen. Stand to the right side of the patient Expose the abdomen from the ribcage to the pubis symphysis Method Place the palm of the right hand on the right iliac fossa and move upward and laterally towards the left hypochondrium Palpate all the way […]
Common changes in nails are Clubbing Koilonychia Onycholysis Abnormal color like yellow, blue Nail bed changes Splinter hemorrhages Lines or bands- Beaus, Mees lines Clubbing It is the increase in the angle between the nail and the nail bed. Place the two index fingers of the patient against each other , look for the diamond […]
In cases of weakness, it is very important to differentiate between neuropathy and myopathy. This can be asked as a differential in weakness and confirming the below factors can help differentiate.
Examining muscle is fundamental in musculoskeletal conditions and neurology Muscles is examined in following 3 domains Nutrition of muscles Tone of muscles Power of muscles Nutrition of muscle Inspection Look for wasting or atrophy of muscles like deltoid or calf muscle Prominent bony prominences Prominent tendon ar foot and hand Palpation Soft and flabby muscle […]
When you are presented with a CNS case, a quick look at the movements of the patient can guide you to the site of lesion. Look below for the nerve supply for different areas of the body Upper body C1 to C6- Neck flexion C1 to T1- Neck extension C3 to C5- Supply to diaphragm […]