Descending Tracts
General Exam
General Observation
• 30 seconds - Look around
• Use bed side charts
• Eg:
o Moon face – cushings
o Large round eye – hyperthryoidism
Procedure
• Hands
• Lymphadenopathy
• Thyroid
• Oedema
Hands
Clubbing
• Ax stages eg
o Bogginess
o Loss of bed angle – 2 fingers diamond
o Curve of long axis of nail
o Drumsticks
• Causes of clubbing:
o Pulmonary:
▪ Bronchial Ca
▪ CF, bronchiectasis
▪ asbestosis
o Cardiac:
▪ Congen cyanotic heart disease
▪ Baterial endocarditis
o Other:
▪ Cirrhosis
▪ Coealiac/crohns disease
Others
• Splinter haemorrhages:
o sign of bacterial endocarditis
o Prox red streaks
• Palmer erythema - Sign of liver disease
• Spider naevi – sign of liver disease - best seen over shoulders
• Cyanosis – peripheral or cyanosis
( blue fingers/toes as more O2 extracted prior to reaching target peripheries
is a normal o2 content centrally
Head
Cyanosis
• Look at tongue
• ................
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