A comprehensive physical examination follows a systematic head-to-toe approach, systematically assessing each body region including head and neck (cranial nerves, lymph nodes, ears, nose, mouth), chest (respiratory and cardiac assessment), abdomen (inspection, auscultation, percussion, palpation), vascular system (pulses, temperature, capillary refill), and musculoskeletal system (spine, range of motion), with each assessment using specific techniques appropriate to the body region being evaluated.
Deep Dive
Prerequisite Knowledge
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Deep Dive
537 - Unintentional ASMR - Assessment / Exam / Head to ToeAdded:
Yeah.
Okay, hi, my name's Alana. I'm going to be your nurse practitioner doing your full physical exam today. I'm going to start by examining your head.
I'm just going to look at your scalp for any unevenness, bumps, or lesions.
Okay, now I'm going to start by I'm going to assess your submandibular joint. Open your mouth. Now close. Okay, no clicks.
Any pain? No. Okay, I'm going to do your cranial nerves. I'll have you raise your eyebrows.
Okay, now close your eyes tight.
Make a frown.
Okay, you can open your eyes. Now puff your cheeks out.
Okay, relax. And this is called the cotton whisp test. I'm going to have you close your eyes. When you feel it on your face, say now, okay?
Now.
Yes.
Yes.
Yes. Okay, I'm going to assess some of your lymph nodes. I'm going to do your preauricular, your postauricular, your submental, mandibular, your subclavicular, and your occipital.
Okay, I'm going to do your eye exam.
Okay, first I'm going to have you cover your right eye.
I'm sorry. Can you take your glasses off? Okay, I'm going to have you follow my finger.
Okay, I'm done.
Okay, very good.
Okay, I'm going to dim the lights. I'm going to have you cover your right eye.
Assess the pupil.
Getting smaller. Okay, now cover your left side.
Same thing.
Okay, I'm going to have Now I'm going to do it again and watch the other eye.
See their accommodation.
Good.
Now I'm going to assess some of the inner structures of your eye.
We go immediately for the cup and the disc.
Laterally for the macula and fovea. See the red light reflex.
Same thing on your right eye.
Medially for the cup and the disc.
Laterally macula fovea.
See the red light reflex.
Okay, now we're going to do I'm going to assess some of your ears.
Feel any pain or discomfort?
Okay, this is called the whisper test.
I'm going to whisper three words in your ear. Repeat after me, okay?
Boat, chair, couch.
Table, pillow, blanket.
>> Okay. Now I'm going to take a look at the inner structures of your I'm going to pull up, back, and out.
Okay.
Tympanic membrane intact.
Pearly gray, no cerumen.
Same thing on the other side. Pull up, back, and out.
Pearly gray.
Tympanic membrane intact. No cerumen.
Okay.
Now I'm going to assess your nose. I'm going to occlude one side and have you sniff.
Okay, other side sniff.
Okay.
Now I'm going to have you tilt your head up. I'm going to take a look inside.
Your mouth and your nose. Ah.
Okay, the turbinates are not red or inflamed.
Okay, and then I'm going to have you assess your mouth. Do a big smile.
Okay.
Relax.
Come inside tap and then pull your tongue back.
I'm going to have you stick your tongue out.
Stick your tongue out.
And get a deep breath.
Okay.
And one more thing with the cranial nerves and then have you shrug your shoulders.
Okay, good. Now I'm going to take a look at your neck.
Tracheal No tracheal deviation observed.
Can you hold this?
And I'm going to have you just trachea to the left. Tilt your head to the right a little.
Okay, now take a sip of water.
Okay.
And I'm going to assess your chest. I see you have a two to one AP diameter.
Okay.
I'm going to have you do a deep inhale and exhale every time I move position through your mouth, okay?
Go ahead. Breathe.
>> Okay, the same thing on your back.
This way a little bit.
Okay.
And what I was supposed to do before that stuff was stuff was percuss percuss your chest, so.
Face this way.
Okay, now we're going to assess your heart.
I'm going to do that again.
Okay.
Aortic side.
Pulmonic.
Herbs.
Tricuspid.
And mitral.
Same thing with the bell.
Okay, I'm sorry. Can you lay down?
Lay down? That's fine.
Okay, I'm going to need you to lay on the couch.
Okay. So, I'm going to put my head down?
I'm going to do it now. I'm going to do the uh abdominal assessing it now.
I'm going to and first inspect your abdomen.
Okay, now I'm going to auscultate in all four quadrants.
Okay, now I'm going to percuss in all four quadrants.
Okay, now I'm going to palpate.
Palpated all four quadrants. Light and deep.
And now I'm going to go up to the liver border right under last rib. Take an inhale.
And exhale.
Okay.
Okay, now I'm going to do your vascular assessment.
I'm going to look at both of your upper extremities for color, feel for temperature.
I'm going to feel the radial pulses.
Brachial.
Brachial and radial.
Same thing with your legs.
I'm going to feel for temperature.
Pulses. I'm going to feel down the tibia for edema.
Okay, I'm going to feel for the femoral pulse.
Bend at a 30-degree angle for the popliteal pulses.
And Okay.
And I'm going to do the cap refill.
Okay. Now for the final part, I'm going to have you stand up.
And I'm going to have you bend forward.
Okay, I'm going to observe that the spine is straight.
Okay, now I'm going to have you face me.
Put your hands on your hips. I'm going to have you twist right to left.
Okay, now bend right and left.
Okay, great. Thank you.
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