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CLINICAL SKILLS UNIT

CLINICAL SKILLS UNIT. EDUCATIONAL LOOPS BY CHSE CSP 020401 GENERAL EXAMINATION. FIRST IMPRESSIONS. How sick does the patient appear ? - lying in bed - sitting up in bed - walking around Hair distribution Body habitus Posture. HYDRATION. approximate estimation

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CLINICAL SKILLS UNIT

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  1. CLINICAL SKILLS UNIT EDUCATIONAL LOOPS BY CHSE CSP 020401 GENERAL EXAMINATION

  2. FIRST IMPRESSIONS How sick does the patient appear ? - lying in bed - sitting up in bed - walking around Hair distribution Body habitus Posture

  3. HYDRATION • approximate estimation • mild, moderate, severe • Signs: • skin turgor (supraclavicular / back of the hand) • - mucous membranes • - sunken orbits • - collapsed veins • - dry cracked lips

  4. VITAL SIGNS • Blood pressure • Pulse • Respiratory rate • Temperature

  5. FACIES • Acromegaly • Cushing’s • Down syndrome • Marfan’s • Mitral facies • Turner’s • Thyrotoxic • Etc. etc. etc Acromegaly Cushing’s Thyroid stare

  6. HANDS & NAILS • abnormalities • muscle wasting • temperature • sweating • shape • infection Splinter haemorrhages Koilonychia Clubbing Leuconychia

  7. HEAD and NECK • EYES • arcus senilus • xanthelasma • jaundice (serum bilirubin > 2x upper limit normal; elastin) • pallor (anaemia) • cataracts • drooping eyelids xanthelasma

  8. HEAD and NECK 2. MOUTH central cyanosis pallor (mucous membranes; frenulum) angular cheilitis (Fe deficiency) smell: sweet breath – liver failure acetone - DKA cigarettes Deoxygenated Hb > 50g/L  bluish tinge

  9. NECK • LYMPH NODES 1 sub-mental 2 sub-mandibular 3 cervical (jugular chain) 4 supra-clavicular 5 posterior triangle 6 post-auricular 7 pre-auricular 8 occipital

  10. NECK • THYROID Inspection:scars, swelling, mass Palpation:enlarged / mass swelling

  11. NECK • AXILLARY NODES A – central / apical B – lateral / brachial C – medial / pectoral D – infraclavicular E – subscapular / posterior

  12. LYMPH DRAINAGE OF GROIN REGION • Horizontal or inguinal group • inguinal ligament From buttocks and back, Lower abdomen, umbilical region, penis, perineum, lower vagina and anus • Femoral or vertical group • femoral vessels The lower limb.

  13. EDUCATIONAL LOOPS BY CHSE

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