TABLE OF CONTENTS TOPIC 1. Comprehensive Health History Taking — 2. Approach to Symptom: Abdominal Pain --— 3. Approach to Symptom: Cough ----——- 4. Approach to Symptom: Fever 5. Approach to Symptom: Headache 6. Approach to Symptom: LBM — 7. Clinical History Writing ~ 8. Examination of Skin 9. Blood Pressure Taking 10. Mini Mental Status Examination 11. Head and Neck Examination 12. Eye Examination 13. Ear Examination 14. Chest and Lung Examination 15. Cardiovascular Examination ---RE Davao Medical Schoo! Foundation, Inc ARTS AND SCIENCE OF MEDICINE 2 RATING SCALE FOR EXAMINATION OF COMPREHENSIVE HEALTH HISTORY TAKING ume of Student Date: gend: ’3 points = Done COMPLETELY and CORRECTLY 2 points = Done CORRECTLY but INCOMPLETE, { point = Done INCORRECTLY and INCOMPLETE 0 point= NOT DONE (ESTABLISHING RAPPORT Oana aaa. REMARKS 7, Greets the patient politely Z Introduces self am 2" year medical student f Davao Medical School Foundation. | | min charge of taking comprehensive ceaith history. 3, Explains about the need for ‘comprehensive health history taking | Explains to the patient that the information be held confidential Asks the patient consent for the ‘comprehensive health history taking - SLIDENTIFYING DATA. 6. Asks the patient NAME, AGE, ADDRESS, CIVIL STATUS, RELIGION, OCUPATION CHIEF COMPLAINT 7. Asks about the patient's chief ‘complaint How may | help you?"; May | know the reason why you seek consultation today" | ‘Of PRESENT ILLNESS (Not included for now, separate session E. PAST MEDICAL HISTORY ’B. Asks about childhood jinesses F.ASKS ABOUT THE FOLLOWING ‘9. MEDICAL ILLNESSES — Diabetes, Hypertension, | Asthma, etc 10. Hospitalizations | 71. Surgeries 72. Obsteirics/ Gynecology history for female patient ~ Last | Menstrual Period, contraception, | ‘menstrual history. 73. Psychiatric ilinesses- if yes, T T diagnosis, hospitalizations, treatment 14 Health maintenance- vaccination, screening tests (if | yes when? What's the findings?)15. Asks about heredofamilal diseases in the family, like hypertension, coronary artery disease, elevated cholestero! levels, stroke, diabetes, thyroid oF renal disease, arthritis, tuberculosis, asthma or lung ease, headache, seizure disorder, mental iliness, suicide, Substance abuse, and allergies 16. Asks about any history of cancer: breast, ovarian, colon, or if male like prostate Cancer) 17. Ask about any genetically transmitted diseases. ——_ 4. PERSONAL AND SOCIAL STO 18. Asks about lifestyle, habits & diet, Exercise 79. Asks about history of smoking 20. Asks about history of alcoholic beverage intake. ‘Zi. Asks about the any alternative healthcare practices 22. Asks about the patient's interests, source of support, coping styles, strength and concerns _ REVIEW OF SYSTEMS 23. Asks completely about review of l systems _ J. SUMMARY AND CONCLUSION 724. Discusses the summary of the patient's history 725. Asks the patient for further Clarification and thanks the patient Jame and Signature of Preceptor SCORE Date. Jpdated and Revised by: Dr. Gladys Ogatis-SermonRATING SCALE FOR APPROACH TO SYMPTOM: Davao Medical School Foundation, I ARTS AND SCIENCE OF MEDICINE 2 ABDOMINAL PAIN ne of Student ints = Done COMPLETELY and GORRESTLY———— Date: enc 3 points = Done COMPLETELY and CORRECTLY roe 2 points = Done CORRECTLY but INCOMPLETE 1 point 0 point= NOT DONE one INCORRECTLY and INCOMPLETE - ESTABLISHING RAPPORT ND ASKS FOR CHIEF OMPLAINT REMARKS 1. Greets the patient politely 2. Introduces seif am . 2°" year medical student Davao Medical Schoo! Foundation. | nin charge of taking health history. 3. Asks for the identifying data NAME, AGE, MARITAL STATUS, OCCUPATION, RELIGION, ADDRESS. 4, Tells the patient the purpose of the interview '. Asks the patient's consent for interview. “6. Asks the CHIEF COMPLAINT | ABDOMINAL PAIN. ASKS ABOUTH THE FOLLOWING 7. Onset of ABDOMINAL PAIN When is the first time you fee! the bdominal pain? 8. Location of ABDOMINAL PAIN Zan you point to me the location/part your abdomen where the pain is?” ‘9. Duration of ABDOMINAL PAIN 1.g: During an episode of ABDOMINAL >AIN, how long will it last? Is it versistent?, 40. Character of ABDOMINAL PAIN San you describe to me the abdominal dain? E.g. Is it burning? Stabbing? Colicky? Or vague? 11. Aggravating factors Is there any factor, which can exacerbate the ABDOMINAL PAIN? 12. Alleviating Factors eg: Did you take any medication for ABDOMINAL PAIN? Or what ‘medication did you take? Or What factors can relieve your ABDOMINAL PAIN?———_ REMARKS 13. Associated symptom 14. Timing How often do you have your ABDOMNAL PAIN? When does 't occur? E.g After meal? It you skip meal? 15. Severity Can you tell me how severe is the abdominal pain, if 1 is avery minimal pain and 10 is the most painful, where is your pain right now? C. Explains to the patient the possible cause of the ‘symptoms D. Shares and explains the diagnostic and therapeutic plan E. Allows the patient to decide ‘on the diagnostic and treatment option F, Summarizes the pian to the ] patient G. Asks the patients for further clarification and questions H. Thanks the patient ame and Signature of Preceptor. ate, pdated and Revised by: Dr. Gladys Ogatis-SermonDavao Medical Schoo! Foundation, Inc ARTS AND SCIENCE OF MEDICINE 2 RATING SCALE FOR APPROACH To SYMPTOM: ‘couch no of Student ate fend: 3 points = Done COMPLETELY and CORRECTLY 7 2 poins = Done CORRECTLY but INCOMPLETE 4 point Done INCORRECTLY and INCOMPLETE 0 points NOT DONE ESTABLISHING RAPPORT PE Sy ‘S FOR CHIEF 0 2 3 REMARKS MPLAINT | ‘ 1. Greets the patient politely 2. Introduces seif om. . 2" year medical student Davao Medical Schoo! Foundation. | niin charge of taking health history. 3. Asks for the identifying data: NAME, AGE, MARITAL STATUS, OCCUPATION, RELIGION, ADDRESS “4. Tells the patient the purpose of the interview 5. Asks the patient's consent for | interview | 6. Asks the CHIEF COMPLAINT | | - COUGH. ASKS ABOUTH THE FOLLOWING: 7. Onset of COUGH 8. Duration of COUGH e.g: During an episode of ‘cough, how long will it last? Is it persistent? 9. Is your cough productive or dry? 70. Character of PHLEGM if productive ‘Asks about color and consistency of phlegm? If it is blood streaked or none blood streaked. 77. Aggravating factors Is there any factor, which can exacerbate your cough? 12. Alleviating Factors eg: Did you take any ‘medication for cough? Or what medication did you take? Or What factors can relieve your cough?13. Ass0Ciated symptoms ©.9: Aside from cough what ‘other symptoms do you have? 14. Timing How often do you have your ‘cough? Or Does your cough ‘occur in specific time of the day? 15: Severity 9: Is your cough progressive? Or do you already have difficulty of breathing (dyspnea) C. Explains to the patient the D. Shares and explains the diagnostic and therapeutic plan “E. Allows the patient to decide on the diagnostic and treatment option F. Summarizes the plan to the patient G. Asks the patients for further clarification and questions H. Thanks the patient ame and Signature of Preceptor. ate_ odated and Revised by: Dr. Gladys Ogatis-Sermon‘Davao Medical School Foundation, Inc ARTS AND SCIENCE OF MEDICINE 2 RATING SCALE FOR APPROACH TO SYMPTOM: FEVER ve of Student: and: 3 points = Done COMPLETELY and CORRECTLY LY but INCOMPLETE 2 points = Done CORRECT! ‘and INCOMPLETE ‘| point = Done INCORRECTLY 0 point= NOT DONE [ESTABLISHING RAPPORT =| AD ASKS FOR CHIEF | oj+{2]3 2MPLAINT 7, Greets the patient politely 2. Introduces seit m . 2% year medical student Davao Medical Schoo! Foundation. | in charge of taking health history. | 3. Asks for the identifying data: NAME, AGE, MARITAL STATUS, OCCUPATION. RELIGION, ADDRESS ,_ Tells the patient the purpose of the interview , Asks the patient's consent for interview 6. Asks the CHIEF COMPLAINT "FEVER. ASKS ABOUTH THE FOLLOWING: 7. Onset of fever \ @ Duration of fever ‘e.g: How long is the duration of fever before it subsides? %. Character of fever ‘eg: “Can you describe your fever? Like is it ocourring the whole day? Or it is on and off? IOTE: know what it means by NTERMITTENT, REMITTENT, >ERSISTENT, RELAPSING 70. Alleviating Factors, | e.g: Did you take any medication for fever? Or what medication did you take? 77. Associated symptoms e.g: Aside from fever what other symptoms do you have? uTa Timing Can you describe the ming of YOU" Taver? Or Dows your lover SECU Specie tne othe €.9: Do you really fee! hot or not that much? 14 Documentation of Fever Did you check your temperature ‘with a thermometer? If yes, tell ‘me the range 15, Have you had a history of travel? If yes, where? 16. What infectious disease is resent in your locality? C. Explains to the patient the Possible cause of the ‘symptoms. D. Shares and explains the diagnostic and therapeutic plan E. Allows the patient to decide on the diagnostic and treatment option F. Summarizes the plan to the Patient G. Asks the patients for further clarification and questions Hi. Thanks the patient ame and Signature of Preceptor. ate. pdated and Revised by: Dr. Gladys Ogatis-SermonDavao Medical Schoo! Foundation, Inc ARTS AND SCIENCE OF MEDICINE 2 RATING SCALE FOR APPROACH TO SYMPTOM: HEADACHE 19 of Studont: _ ‘end: 3 points ® Done COMPLETELY and CORRECTLY 2 points = Done CORRECTLY but INCOMPLETE 4 point = Done INCORRECTLY and INCOMPLETE O point» NOT DONE A ESTABLISHING RAPPORT 0 | 4| 2 3 AND ASKS FOR CHIEF COMPLAINT | 1 Gros ne patent patty | 2 Introduces soit am. 2 yoar medical student Davao Medical Schoo! Foundation. | ‘Vin charge of taking health history. | ‘Asks for the dentlying data: | NAME, AGE, MARITAL STATUS, OCCUPATION, RELIGION, ADDRESS. “4. Tells the patient the purpose of the interview '5. Asks the patient's consent for interview Asks the CHIEF COMPLAINT \_ HEADACHE. ASKS ABOUTH THE Fi ee 7. Onset of HEADACHE ] @. Location: Where exactly the part of the ‘head with pain? Can you point # ‘9. Duration of HEADACHE ¢49: During an episode of HEADACHE, how long will it last? Is it persistent? 10. Character of HEADACHE 11 Aggravating factors Is there any factor, which can ‘exacerbate the HEADACHE?“iE. Aleviaing Factors ©. you take any "ection for HEADACHE? Or sat mediation ae you ae + Wha factor can foe your HEADACHE? = 13. Associated symptoms €.9: Aside from HEADACHE what other symptoms do you have? 14. Timing When do you usualy have your headache? 7 15. Severity Can you tell me how severe is the HEADACHE, if 1 is a very ‘minimal pain and 10 is the most painful, where is your pain right now? C. Explains to the patient the possible cause of the symptoms. . Shares and explains the diagnostic and therapeutic. plan E, Allows the patient to decide on the diagnostic and treatment option. F, Summarizes the pian to the patient G. Asks the patients for further clarification and questions 1H. Thanks the patient Jame and Signature of Preceptor___——— Date. Jpdated and Revised by: Dr. Gladys Ogatis-SermonDavao Medical Schoo! ARTS AND SCIENCE OF MI RATING SCALE FOR APPROACH TO. SYMPTOM: Foundation, Inc IEDICINE 2 LOOSE BOWEL MOVEMENT eof Student: ey Yand CORRECTLY nd '3 points = Done COMPLE" 2 points = Done CORRECTLY but Done INCORRECTLY an 4 point 0 point= NOT DONE A. ESTABLISHING RAPPORT AND ASKS FOR CHIEF COMPLAINT INCOMPLETE \d INCOMPLETE Date: ___— REMARKS: 7. Greets the patient politely 2. Introduces self m . 2 year medical student Davao Medical Schoo! Foundation. | 1 in charge of taking health history. 3, Asks for the identifying data: NAME, AGE, MARITAL STATUS, OCCUPATION, RELIGION, ADDRESS 7, Tells the patient the purpose of the interview 5, Asks the patient's consent for interview &. Asks the CHIEF COMPLAINT i, LBM. ASKS ABOUTH THE FOLLOWIN 7. Onset of LBM 8. Duration of LBM eg; During an episode of LBM, how long will it iast? Is it persistent? ‘9. Character of STOOL ‘Asks about color and consistency (WATERY, SOFT) of STOOL? If itis blood streaked or none blood streaked. 10. Aggravating factors Is there any factor, which can exacerbate the LBM? 1SoO 1 244 REMARKS 71. Alleviating Factors ©.9: Did you take any Medication for LBM? Or what medication did you take? Or fat factors can relieve your LBM? = 16. Associated symptoms | | €.9: Aside from LBM what other symptoms do you have? 12. Timing How often do you have your LBM? 13. Severity e.g: How many times do you have the LBM for a day? Can you approximate the amount, a glass? A teaspoon? | 14. Do you have history of travel? 15. What did you eat prior to LBM? . Explains to the patient the possible cause of the symptoms | D. Shares and explains the diagnostic and therapeutic plan E. Allows the patient to decide ‘on the diagnostic and treatment option | F. Summarizes the plan to the patient G. Asks the patients for further clarification and questions H. Thanks the patient Name and Signature of Preceptor_——————— Date. Updated and Revised by: Dr. Gladys Ogatis-SermonDavao Medical Schoo! Foundation, Inc ARTS AND SCIENCE OF MEDICINE 2 RATING SCALE FOR BLOOD PRESSURE CHECKING Date: a Name of Student: Legend: 3 points = Done COMPLETELY and CORRECTLY 2 points = Done CORRECTLY but INCOMPLETE + point = Done INCORRECTLY and INCOMPLETE 0 point= NOT DONE REMARKS A. PARAMETERS 7. Greets the patient politely 2, Introduces self Lam . 2 year medical student ‘of Davao Medical School Foundation. | ‘am in charge of taking your blood pressure. 3. Asks for the identifying data: NAME, AGE, MARITAL | STATUS, OCCUPATION, RELIGION, ADDRESS . Explains the procedure thoroughly and completely &._ Asks patient's consent 6. Asks if the patient just walked and let the patient rest for 5 minutes 7. Asks if the patient just smoked cigarette or drink coffee and let the patient rest for 30 minutes . Makes sure the arm is free of | clothing, AV fistula scar and any | lesions Places the BP cuff snuggly at least 2.5cms/tinch from the antecubital crease 70. Making sure that the arm is at the level of the heart B. PALPATORY METHOD 11. Places 2 to 3 fingers at the level T of radial artery in the distal end of the radius 12. Inflates the cuff until the pulse disappear and read 13. Able to determine the maximum inflation of the cuff by adding ___30mmHg to the above reading _ ~ 14, Mentions to let the patient rest for 5-15 seconds for getting the(C. GETTING THE BLOOD PRESSURE REMARKS 15. Places the BP cuff snuggly 2.5 12 Ms from antecubital crease 16. The “arm where the cuff was Placed is at the level of the heart [AT Anflates the cut to the level just determined 18: Deflates the cuff slowly about 2 +- to 3 mmHg/second [18 Notes “at which you hear the sounds at least two consecutive beats (systolic BP) 20. Continues ‘to deflate the cuff until sounds is muffled and disappear (few mmHg below the muffied point is the diastolic BP 21. Able to tell the correct BP of the patient 22. Explains the BP of the patient 23. Advises the patient 24. Thanks the patient Name and Signature of Preceptor. Date. Updated and Revised by: Dr. Gladys Ogatis-SermonMedical Schoo! Foundation. Inc ARTS AND SCIENCE OF MEDICINE 2 RATING SCALE FOR MINI MENTAL STATUS EXAMINATION [thames Legend: 3 points = Done COMPLETELY and CORRECTLY 2 points = Done CORRECTLY but INCOMPLETE 1 point = Done INCORRECTLY and INCOMPLETE data? 3. Asks the patient's NAME, AGE, MARITAL STATUS, OCCUPATION, RELIGION, | 4 ADORESS ‘~& Explains the examination/procedure Explains what is MMSE, its purpose, now @ is done a 5. Asks the patient's consent & Prepares a MMSE tally for it STATUS EXAMINA’ ~ What COUNTRY are we right now? & What REGION/PROVINCE are we right now? ® What CITY are we right now? 70. Wrat BUILDING are we in right now? | Ti What FLOOR are we Fight now? aut before that, may 1 know your Tie: | 12. What is the YEAR now? 73. What is the MONTH now? + 74, What is the DATE now? ‘= 15. What DAY is today? 16. What TIME is right now? 25Mentions ; 7 3. unrelated objects {and instruct the patient to repset the 3 unreiated onan | the patient to remember thet |___-sbj0cts cause he/wil ask again 18. ATTENTION AND CALCULATION. ee ‘Asks the patient Serial subtract (E.G. SUBTRACTION " 100-7o9 7=86-7=79-7=72-7=65 49. ATTENTION AND CALCULATION. =. ¢ oR, SPELL WORLD FROM THE LAST LETTER (5POINTS) 20. RECALL. > ‘Asks the 3 objects that was __mentioned previously LANGUAGE: ~ 21.Asks the patient to name 2 ‘objects he/she points ____ (e.g. Penct 8 waten) ZH Telis the patient to repeat the words he/she mentions! (e.g. "No ifs, ands, or buts) ZB. Tels the patient io follow nisier instructions ‘ 5 mm), small mm), or unequal, measure: them. @ Inspect the shape of the pupils. | Sinspect the symmetry of the Pupils. } i q | 31. Asks the patient to [ook into the distance THE PUPILLARY REACTIONS T!ag Sines @ Bright Tighi 709 each PUPII inturee HEY + é “esti FOR EXTRA; oy “asks the patient to f 58 fnget OF pencil as pouen your snrough the six cardinal oe rections of gaze oige H in the air) (making a aE eee te COPY CULAR Musci oO” LES te he Darkens the room ganes the Tight on the bay hand to check the peer fant. its desired brightness, and (Go electrical charge of the gine tos tumihe lens disc to the 0 diopter the ophthaimosco; 5 7. pe i #70 ten examining the nat _ sate sight eye then vice versa gales the ophthalmoscope firmly against the medial aspect of your bony orbit @ Tits laterally the handle of thalmoscope at about a 20° slant from the vertical. =H nstrucis the patient to look sightly up and over your shoulder 31a point directly ahead on the wal. “TiPlaces yourself about 15 inches away from the patient and at an angle 15° lateral to the patient's ine of vision Places the thumb of your other hand across the patient's eyebrow Keeping the light beam focused onthe red reflex, move in with the | ophthalmoscope on th | toward the pupil until you are very close to it, almost touching the tient’s eyelashes. ae + Pr. Gla J dys Ogatis-Sermon ‘ame and Signature of eee oe aewashes hands bet tne examination, tore and after I ts the GZ Greets ine Patient politely _-qmiroduces Seif ti | | . 2” year med) f ical 1a Zo medical Si studer va ‘choo! Foundation | 08 f di ‘narge of doing ph pete of your EAR! ‘Asks the patient's Ny 4 MARITAL STATUS, eee, OCCUPATION, REL occuPAr LIGION, Ee aepelis Nese] __-peamppaton procedure & Asks the patient's consent and __permission to do the procedure 5,INSPECTION 7, Inspects the auricle and surrounding tissue for deformities, lumps and skin Jesions _ c. PALPATION 8. Presses the tragus and does “TUG TEST" — movement of tragus. % Palpates the area surrounding the ear (anterior, infra and post auricular area) D. OTOSCOPY 10. Inserts the speculum gently into the ear canal, directing downward and forward 71. Inspects the ear canal 72. Inspects the eardrum 73. Identifies the handle of the malleus (noting its position 14. Inspects the short process of the malle WS TESTING FOR AUDITORY ACU! 16. Instructs the patient to repos what you will sa ICE TES’ WHISPERED VO!-gands behind the sea oe ane Patient a Bad your ocaudes the non-test ih Mager and gently rub the tre . ina circular motion to us Prey transfer of sound to nontyen™ _enales a full breath before wnispering to ensure a quiet woioe. @Wnispers a combination 3 t—_| | number and letters og.: 3-U-1 Uses @ different numberlleti fer = “combination for the other ear sesTING FOR LATERALIZATION (Wet E instructs the patient about the st BER'S TE: sT) T tes! Sets the fork into light vibration "py briskly stroking it between the thumb and index finger or _seping itn your knuckles i Piaces the base of the lightly vibrating tuning fork firmly on top of the patient's head or on the midforehead Zi Asks where the patient hears the sound: on one side or in both ears ¢. COMPARE AIR CONDUCTION AND BONE COND! JUCTION (RINNE’S TEST) @. instructs the patient about the test @ Set the fork into light vibration by briskly stroking it between the thumb and index finger or tapping it in your knuckles 77. Place the base of a lightly vibrating tuning fork on the mastoid bone, behind the ear and level with the canal @.When the patient can no longer hear the sound, quickly places the fork close to the ear canal @ Asks the patient if he can still hear the sound __ HSUMMARIZES THE RESULT OF THE TEST ‘30. Summarizes the result of the | tests to the patient and provides Interpretation ‘ane and Signature of ee Yat| Davao Mi ARTS A\ ‘edical Schoo! Foundation, Inc ND SCIENCE OF MEDICINE 2 RATING sc; "ALE FOR EXAMINATION OF CHEST AND LUNGS ae I Ae poo Student points = Done COMPLETE ———Cate: mobos a CONRERELY and CORRECTLY Pate: —__ 1 point = Done INOS ree oy But INCOMPLETE 0 point= NOT DONE ECTLY and INCOMPLETE |, ESTABLISHING RAPPORT REMARKS 7, Washes hands before and after the examination. 7, Greets the patient politely |-—3 Introduces Seif - 2" year medical tem __ student ‘Davao Medical Schoo! Foundation. | amin charge of doing physical examination of your chest and lungs. ‘4, Asks the patient's NAME, AGE, MARITAL STATUS, : OCCUPATION, RELIGION, ADDRESS 6. Explains the examination/procedure 6. Asks the patient's consent B. IDENTIFY THE DIFFERENT LANDMARI ANTERIOR CHEST 7._Head of the Sternum KS/ AREAS OF THE CHEST T 8._Sternal angle 9. Body of the sternum. 10. Xiphoid Process 14. Midsternal line 72. Midclavicular line 13. Anterior Axillary line 14. Supraciavicular area POSTERIOR CHEST 4. Scapula 16. Scapular line 47. Vertebral line 418. Posterior axillary line 19. Midaxillary line C. EXAMINATION OF CHEST AND LUNGS: INSPECTION 20. Makes a brief careful overall visual sweep of the entire body. Inspects the chest taking note of the following: 21. Deformities / Asymmetry 22. Abnormal retractions Impaired respiratory + movement U(lagging/ delay) on one sidepw? ATION ort | 2 REMARKS (he tne following: (ate render areas 2a. Bsse58 any Observed abnormalities (mass/ sir ets) sinus Test for chest expansion 76. Feel for Tactile fremitus _-77. Palate and compare ae “reas pare symmetric. a : peRrcusSION 38. Abie to do percussion from interscapular areas to lung bases 79. Able to identify duliness, resonant, hyperresonant auSCULTATION ‘Ape to identify which areas the [plowing breath sounds are heard best '30. Vesicular sounds 31. Bronchovesicular 32. Bronchial (33. Tracheal [33 apie to locate where these adventitious sounds can be heard best 34. Crackles | 35. Wheezes and rhonchi p. EXPECTED PHYSICAL EXAM FINDINGS. Expected PE findings in terms of Tactile Fremitus / percussion / Vocal Fremitus 36. Consolidation 37. Fluid (e.g. Pleural Effusion) 38. Air (e.g. Pneumothorax) E. SPECIAL TESTS: TRANSMITTED. VOICE SUNES Able to determine when these tests ‘should be performed and how | 39. Bronchophony ‘40. Egophony 41. Whispered pectoriloquy | Name and Signature of Preceptor. ae | Updated and Revised by: Dr. Gladys Ogatis SermonDavao Medical Schoo! Foundation, Inc an ARTS AND SCIENCE OF MEDICINE 2 TING Sc, "ALE FOR CARDIOVASCULAR EXAMINATION student pont fi 2 fain = bone CORRLETELY ra CORRECTLY ne Done iNconeee but INCOMPLETE NOT BONCORRECTLY and INCOMPLETE ie ESTABLISHING RAPPORT [9 | 4 | 2 | 3 Ri EMARKS| LA washes hands before and after the examination. 1 Greets the patient politely L-yiiroduces Self | - 2" year medical student 120 go Medical Schoo! Foundation. | _d0e@arge of doing physical lf anit sion of your cardiovascular 382 ages the Patient's NAME, AGE, | MARITAL STATUS, | OCCUPATION, RELGION, ADDRESS Explains the 1 > gxamination/procedure L_-5-“sks the patient's consent and ;mission to do the procedure | 7 Drapes the patient appropriately JUS PRESSURE [MEASUREMENT OF JUGULAR VENO! @. Makes the patient lie in supine | ition comfortably |_ Raises the head slightly on a pilow to relax the stemocleidomastoid muscles 0 Raise the head of the head or ‘examining table to about 30 degrees 71. Tums the patient's head away |___‘from the side to be examined [TZ Use tangential lighting and examine both sides of the head TB ldentify the external jugular vein | on each side 4 | 14 Finds the internal jugular venous pulsations | 1S. Focuses on the right internal T ular vein hua | 16 Looks for the pulsations —— | T7identifies the highest pulsation in the right internal jugular vein | 18. Extends a long rectangular | | objects or card horizontally form this point and a centimeter ruleri j {i MOMSUTOS correctly the IS — | paStSSMENT OF THE Caron, sateen the neck for carn OTID PULSE 44 Pomnts Correctly the pr 3 osition of carotid pin. s idomastoid (1 I gy Place: rigl ) +B 9 middie finger or nee none carotid artery in the on af the neck and feels for thal sat ji Presses the medial boi stemocieidomastoid at the level of ericoids cartilage by slowly increasing the pressure your press until you fee! maximal jsations AND PALPATION carefully inspects the anter chest and noting for the PMC” @ Shines a tangential light across the chest wall to appreciate the apex %& if apex is identified, palpate the PMI to confirm its characteristic 7 Knows the normal location of the PMI 7% Checks for heaves, thrills and knows how to differentiate them [EPERCUSSION ‘® Starting with the left side of the chest, percusses from resonance toward cardiac duliness in the 3", 4”, 5" and possibly 6” interspace TATION ® Positions the patient properly (Left lateral decubitus position or sit up, leaning forward, exhaling completely and stopped breathing in expiration) ‘31 Uses the diaphragm of the stethoscope ‘@ Auscultates in the right position @ Provides summary of the result of the examination a | 4 Educates the patient |New and signature of Preceptor \- “eg and Revised by: Dr. Gladys Ogatis-Sermon 37