A seminar about

examination

Prepared by: Jamal Q Ahmed

Supervised by: Prof.Dr.Ali Al
Zubaidi
General examination of
patient
Vital signs
 The temperature
 The pulse rate
 The blood pressure
 The respiratory rate
Cont’d
 Temperature :measures with thermometer.
 Oral 36.6°c/ rectal 37.4°c/axillary36.5°c

 Patients who have systemic involvement of infection

has elevated temperatures.

 The pulse measured from these sites
 Radial /carotid/superficial temporal arteries

 At rest pulse rate is,140 beats/min for infants and 60-80

beats /min for adults

Pulse rate increased in exercise, anxiety, fear, some
cardiac disorders, hyperthyroidism. pulse rate above
100beats per minute may indicate a sever infection
Cont’d
 The respiratory rate: normally is
14-16 breaths/min ,but in mild to
moderate infection may elevate to
18-20
 The blood pressure
Other signs

 Skin

 Petechia or ecchymosis (blood

 dyscrasia)/cyanosis (cardiac or pulmonary
insufficiency) / jaundice, pigmentation.

 Hands
 raynaud’s phenomenon, finger and joint swelling in
rheumatoid arthritis, palmar keratosis,
 Nails
 Finger clubbing, koilonychia
Extra oral head and neck
examination
 General appearance
 Cachectic appearance, low mood, toxic appearance
 Face
 Shape and symmetry/ cushingoid appearance/neurological
deficits/cyanosis/pallor/erythema/rash

 Eyes
 Exophthalamus
 Yellow sclera/pale sclera/ xanthoma of periocular skin
 Hair problems
 Ectodermal dysplasia
Inspection of neck
 Looks particularly for swellings, sinuses
 Carful palpation of all the lymph nodes
and salivary glands and thyroid gland
 Observe patient from front noting any
asymmetry or swelling, then standing
behind the seated patient to palpate the
lymph nodes
contd
 Swelling of neck
 Side of neck
 Middle of neck
 Causes of cervical lymph
adenopathy
Examination of lymph
nodes
 Parotid, mastoid and occipital lymph nodes
 Superficial cervical lymph nodes
 Sub mental lymph nodes
 Submandibular lymph nodes
 Deep cervical lymph nodes
 The supraclavicular region
TMJ and muscles of
mastication examination
 Facial symmetry, masseteric hypertrophy
 Mandibular opening and closing paths
 Mandibular opening extent
 Lateral excursions
 Joint sounds
 Both condyles, finger in external auditory
meatus, finger placed over joints in front of ear
 The dentition and occlusion
 The mucosa
Masticatory muscles
examination
 Masseters, by intraoral-extra oral compression between
finger and thumb

 Temporalis, palpate temporal origin of muscle by asking

patient to clench the teeth, palpate insertion of muscle
intraoraly along the anterior border of ascending ramus

 Lateral pterygoid, placing finger behind tuberosity.

Examine muscle indirectly by asking patient to move
jaw to one side while applying a gentle force

 Medial pterygoid, lingual to mandibular ramus

Salivary glands
examination
 Parotid glands:
 In front of patient ,two or three
fingers over posterior border of
ascending ramus with light pressure,
duct examined intraorally
 Submandibular and sublingual
gland s
 Bimanual palpation
Examination of cranial
nerves
 Olfactory
 Optic
 Visual acuity/visual field
 Pupilry reaction to light
 Oculomotor,trochlear, abducent nerves
 Trigeminal
 Sensory, motor, corneal reflex
 Facial,motor,special sense,parasympathetic
secretomotor
 Vestibulocochlear
 Glossophareangeal and vagus
 Accessory
 hypoglossal
Intraoral examination

 Lips
 Labial and buccal mucosa
 Floor of mouth & ventrum of tongue
 Dorsal surface of tongue
 Hard and soft palates
 Gingiva &teeth