Physical Exam: Inspection – Basic Diagnostic Techniques

00:01 example, can you feel the liver? Is the liver enlarged? So let’s talk about the physical exam.

00:02 We’re going to first just inspect. We’re just looking at the patient. Number one: is there evidence of trauma? Is there any evidence that the patient has had previous surgery and, if so, ask what kind and what was it for? Is there muscle wasting or are the muscles asymmetrical – that is bigger on one side than on the other. Is there swelling or edema as we’ve talked about in the last lecture? Is there erythema or redness? Are there ulcers – that is areas where the skin has broken down and where sometimes there’s infection? Is the hair absent, particularly in the lower extremities where poor blood flow results in shiny, thin skin and loss of hair? Finally, are there brown spots on the lower part of the leg because blood has leaked out of capillaries into the surrounding tissues and results in this iron deposit that changes the colour from normal to brown? And finally, is there evidence of lipids in the tissues or is there evidence of areas where the tissue has really lost much of its vigour and its ability to feel normal where it becomes fibrous and scarred? Here’s an example of something that you can see on a physical exam. Did you notice this yellowish plaque, this little nodule on the eyelid of this patient? This occurs because of cholesterol deposition in the skin and this is a sign that the patient has hypercholesterolemia or very high blood cholesterol. And this is a very strong risk factor for atherosclerosis.

01:58 And you notice all you had to do was look in order to pick it up.