[PEMERIKSAAN FISIK HEAD TO TOE]

Summary

This video provides a comprehensive guide on performing a physical examination on a patient, covering various areas of the body including the head, neck, thorax, abdomen, and extremities. The examination process involves multiple techniques such as inspection, palpation, percussion, and auscultation. Key procedures include checking for symmetry, abnormalities, and assessing organ conditions, such as the heart, lungs, and abdominal organs. Reflexes, muscle strength, and range of motion tests are also detailed. This step-by-step approach equips viewers with the knowledge needed to conduct thorough and accurate physical assessments.

Takeaways

• 😀 Head examination includes checking facial symmetry, puff or moon face, hair and scalp abnormalities, eye conditions, and nasal and ear secretions.
• 😀 For pupil reflex testing, a penlight is used to assess direct and indirect responses by shining light into each eye.
• 😀 Neck examination involves palpating 10 lymph node areas and checking jugular vein pressure to identify any abnormal lumps or swelling.
• 😀 Chest examination includes inspection, palpation, percussion, and auscultation to assess chest symmetry, lung sounds, and heart rhythms.
• 😀 Palpation of the thorax checks for abnormal sensations like fremitus and chest expansion to assess the patient's breathing and lung function.
• 😀 Percussion helps identify boundaries of organs such as the lungs, liver, and heart, using sound differences to determine the size and density of organs.
• 😀 Auscultation of the lungs is performed to listen for normal breath sounds and any abnormal sounds like wheezing or crackles.
• 😀 Heart auscultation involves listening for normal heart sounds (S1, S2) and checking for abnormal sounds like murmurs or extra heartbeats.
• 😀 Abdominal examination includes inspection, auscultation, percussion, and palpation to detect abnormalities like tumors or fluid retention.
• 😀 Extremity examination covers the range of motion, muscle strength, and reflex tests for both upper and lower limbs to detect neurological or muscular issues.

Q & A

What is the first step when performing a physical examination on a patient?

The first step is to examine the patient's head, checking for symmetry of the face, signs of edema, and conditions such as Puff Face or Moon Face.

What distinguishes Puff Face from Moon Face during the physical examination?

Puff Face typically shows swelling around the eyelids, while Moon Face presents swelling that causes the face to appear round, without focusing on the eyes.

What are the steps involved in examining the eyes of a patient?

The eyes are examined by checking for yellowing (jaundice) in the sclera, using a penlight to check direct and indirect pupillary reflexes, and ensuring that the conjunctiva appears normal.

What is the method to check Jugular Vein Pressure (JVP)?

JVP is measured by asking the patient to lie at a 30-45 degree angle, turning their head to the left. Using two rulers, the highest point of visible jugular vein pulsation is measured. A value greater than 3 cm is considered elevated.

What are the main components of thoracic physical examination?

The thoracic examination includes inspection, palpation, percussion, and auscultation. This involves checking for symmetry, palpating the chest for abnormalities, percussing to find lung boundaries, and auscultating to assess lung and heart sounds.

What is focal fremitus, and how is it assessed?

Focal fremitus is the vibration felt when a patient speaks (saying '77'). It is assessed by palpating specific points on the chest. Abnormal fremitus may indicate conditions like fluid buildup in the lungs.

What is the purpose of checking chest expansion during a physical exam?

Chest expansion is checked by placing the examiner's thumbs at the 10th rib and asking the patient to take a deep breath. This assesses the symmetry of chest movement during respiration.

What does percussion in the thoracic exam help to assess?

Percussion in the thoracic exam helps to assess the boundaries of the lungs, liver, and heart. It identifies whether the sound is 'sonorous' (normal) or 'dull' (indicating dense organs or fluid buildup).

What should be done if abnormal heart sounds are detected during auscultation?

If abnormal heart sounds, such as S3 or S4, are detected, it may indicate heart conditions like heart failure or valve issues. Further diagnostic tests may be required to understand the underlying cause.

What is the purpose of checking the abdomen during a physical exam?

The abdomen is inspected for lesions, abnormal shapes, or mass presence. Auscultation is performed to check for bowel sounds, and palpation is used to detect tenderness or organ enlargement, such as liver or spleen enlargement.