1. Hair and Head
- Inspection: black hair, brown, blonde, smelling.
- Palpation: Easy to fall, scalp dirty, smelly generally indicates the level of a person's hygiene.
2. Skin hydration forehead area
- Palpation: Pressing your thumb on the forehead skin, because they have the basic bones. Dehydration can be found on the "finger print" on the skin of the forehead.
- Inspection: Can be visible buildup of fluid or edema in the palpebrae, but it may also appear sunken in dehydrated patients.
- Palpation: With the touch by using three fingers on palpebrae to sense whether there is a buildup of fluid, or patient dehydration when palpable concave.
- Icterus sclera appear more clearly than in the skin. Check the sclera with palpation technique using both fingers pull palpebrae, the patient looked down inflammation in conjungtiva bulbi, or conjungtiva palpebrae. Anemic state can be checked on pale colors conjungtiva inferior palpebrae.
- With two index fingers, check to compare IOP ball left and right eye by changing the pressure in the eyeball with closed eyelids general awareness of glaucoma on patients aged more than 40 years.
- Inspection: Nose symmetrical, the cavity examined whether there is dirt nose, polyps or swelling.
- Oral cavity: bad breath examined, mocosa inflammation (stomatitis), and the aphtae.
- Dental examination: checked the food, tartar, caries, root rest, missing teeth, bleeding, abscess, foreign body, (false teeth), the state of the gums, inflamed.
- Tongue: dirty / coated, will be found in the state: the lack of oral hygiene, typhoid fever, do not like to eat, coma patients, note the type hipertemik tongue that can be encountered in patients typoid fever.
- Tonsils: measured.
- Tonsils examined whether there is swelling or not.
- Pharinx: back wall oro pharynx examined for inflammation, enlarged adenoids, and lenders / secret that there
- Enlarged lymph nodes can occur due to infection, toxoplasmosis infection provide symptomatic enlarged neck lymph.
- Inspection : shape and size when enlargement was real.
- Palpation : one hand or two hands on the side of the back, fingers touching the surface of the gland and the patient is asked to swallow feel if there is any swelling of the surrounding tissues.
- Inspection : the inspection needs to be listened to if abdomen swollen / bulging or flat, edges or protruding belly , protruding umbilicus or not , whether there is a shadow venous observe , observe whether the abdominal area looks lumps of mass . Report form and the positioning.
- Auscultation : bowel peristaltic hear , normal range 5-35 times per minute : peristaltic sounds were loud and long called borborygmi , found in gastroenteritis or intestinal obstruction in the early stages . Reduced peristaltic encountered in paralytic ileus . If after 5 minutes there was no sound peristaltic , at all , then we say peristaltic negative ( in patients post- surgery ).
- Palpation : palpate prior to first ask the patient whether the pain area if there is then it should be palpated last , general palpation of the entire abdominal wall to see if there are common pain ( peritonitis , pancreatitis ) . Then look for the presence or absence of palpability mass / lump ( tumor ) . Check also turgor Kullit stomach to assess patient hydration . After that check the pressure region suprapubika ( cystitis ) , Burney MC point ( appendicitis ) , region epigastrica ( gastritis ) , and region iliaca ( adnexitis ) then in particular we palpate the liver. Palpation of the liver is done with the right hand and fingers , starting from the bottom right kuadrant , gradually rising to the rhythm of the breath . Feel for any enlargement of the liver or not .
- Position the patient lying on her side with knees bent stick to the stomach / chest
- Examined the :
- Hemhoroid externa
- Fisurra
- Fistula
- Signs of malignancy
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