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!E F E. - S$y h 'one
E!!. Done
7. Trigemin$l Opht $ %a&il '
%andi#le ' $ %
Sen"ory 8&nction: forehead, chee(s and
)a*
Doc: Mr. E, !>m going to t$ke thi"
g$&=e #$' $n' to&ch "ome #l$ce" on
yo&r ($ce with it, #le$"e clo"e yo&r
eye" Di' yo& (eel thi" 'i' it (eel
"imil$r or not.
7!!. 8$ci$l
Doc: Smile (or me #le$"e. 0ig
Smile
Doc: *o&l' yo& (rown (or me.
E!. S#in$l cce""ory +ra# ,ts shoulders
Doc: *o&l' yo& #&"h &# yo&r
"ho&l'er" $g$in"t my re"i"t$nce.
3
-CN2S
Doc: )le$"e let me &ntie yo&r gown "o
! c$n e%$mine yo&r l&ng"
)$l#$tion:
*he"t E%c&r"ion
Doc: Now ! $m going to hol' yo&r
b$ck, #le$"e t$ke $ 'ee# bre$th, $g$in,
$g$in, ok th$nk"
T$ctile 8remit&":
Doc: *o&l' yo& cro"" yo&r $rm" in
(ront. )le$"e "$y GG e,ery time ! #l$ce
my h$n'". GG., $g$in, $g$in
)erc&""ion
&"c<$tion
)erc&""ion:
Doc: ! $m going to t$# on yo&r b$ck
&"c<$tion: -arm the 'tethoscope
Doc: ! $m going to li"ten to yo&r l&ng",
#le$"e o#en yo&r mo&th $n' t$ke $
'ee# bre$th, in $n' o&t thro&gh yo&r
mo&th, $g$in, $g$in Ok, now
bre$th norm$lly, Th$nk".
HE:T
)$l#$tion:
Doc: Now #le$"e le$n (orw$r', let me
check yo&r he$rt 8ir"t, ! $m going to
#re"" on "ome $re$" on yo&r che"t to
(eel yo&r he$rt im#&l"e
ortic re$: 2 ./' (0eft), )&lmon$ry re$: 2
./' (Right)
Tric&"#i' re$: 1 ./' (00'2) Mitr$l $re$: 3
./' $ %idclavicular 0eft 0ine
&"c<$tion: On 4 cardiac areas
Doc: )le$"e le$n (orw$r'
0DOMEN
!n"#ection:
Doc: Mr. E, let me &nco,er yo&r belly
to e%$mine it *o&l' yo& #le$"e t&rn
yo&r he$' to the other "i'e F co&gh
(or me.
&"c<$tion: Now #le$"e, let me li"ten
to yo&r bowel "o&n'"
-i,er
)$l#$tion: 0oo( at the pts face e&pression
-ight #$l#$tion: One hand
Doc: ny ten'erne"" here.(5 points)
/hec( the reno ureteral points for pain
Dee# )$l#$tion: 2 hands, rolling motion
Doc: ny ten'erne"" 9#$in5 here.
Here.
Doc: ! know it (eel" $ little
&ncom(ort$ble, b&t i( yo& (eel #$in
#le$"e let me know
S#eci$l #$l#$tion: 0iver, 'pleen
-i,er )$l#$tion
Doc: T$ke $ 'ee# bre$th in o&t
'pleen 0eft to the navel
S#eci$l Te"t"
M&r#hy>" Sign *holecy"titi"
Doc: ! $m going to #re"" on the right
"i'e below yo&r rib" to (eel yo&r li,er,
#le$"e t$ke $ 'ee# bre$th in, in o&t.
Th$nk". ny #$in. ',: yes 9H5
%urphy Mc 0&rney
##en'iciti"
Doc: Now ! $m going to #re"" on the
le(t lower "i'e o( yo&r belly, #le$"e let
me know i( yo& (eel $ny #$in.
:o,"ingI" Sign.- (contr$ l$ter$l #$in)
Doc: ! $m going to #re"" on thi" "i'e,
where 'o yo& (eel the #$in, .
:ebo&n' Ten'erne"".- #$in when remo,ing
the #re""&re 9)eritoniti"5
Doc: Now ! $m going to 'o $ 'ee#
#$l#$tion, when 'o yo& (eel more #$in,
now or now.
)"o$" "ign.- ,ain on passive e&tension of the
right thigh
Doc: Mr. E, #le$"e l$y on yo&r le(t
"i'e, ! $m going to e%ten' yo&r right leg
b$ckw$r'" while #re""ing on yo&r right
hi#. Do yo& (eel $ny #$in.
,soas O#turator
Obt&r$tor "ign. @ ,assive internal rotation of the
fle&ed thigh
4
Doc: Mr. E, ! $m going to mo,e yo&r
leg to the "i'e while ! #re"" on the "i'e
o( yo&r knee, 'o yo& (eel $ny #$in.
E%tremitie"
:$'i$l F 0r$chi$l
:$'i$l F 8emor$l )&l"e": 9i( thinking on
*o$rct$tion o( o5
)o#lite$l )&l"e": place thum#s on the patella
)o"t Tibi$l )&l"e": press fingers against
malleolus
Dor"$li" )e'i$ )&l"e":
Ne&rologic$l E%$m
Ment$l St$t&" - *r$ni$l Ner,e" -
Sen"ory (&nction
Motor (&nction - :e(le%e" - *erebell$r
(&nction
Ment$l St$t&"
J&ick Miniment$l
Doc: Mr". Smith, ! $m going to $"k yo&
(ew K&e"tion"
to $""e" yo&r $ttention $n' memory
ok.
Orient$tion:
*$n yo& #le$"e tell me yo&r (&ll
n$me.
Bh$t i" the '$te to'$y.
*$n yo& tell me wh$t city $re we in.
Bhere $re yo& now.
Memory:
Mr". Smith #le$"e "$y the"e wor'":
bo$t, t$ble F #encil. 9!mme'i$te
rec$ll5. ! $m going to $"k yo& to rec$ll
the"e wor'" l$ter ok.
ttention F *oncentr$tion:
Now "#ell the wor' LBO:-DL
b$ckw$r'" (or me #le$"e.
-$ng&$ge Te"t
*$n yo& clo"e yo&r eye" #&t yo&r
h$n'" together $n' bring them on to
yo&r belly $n' then on to yo&r b$ck.
M Mr". Smith ! w$nt yo& to rec$ll the ;
wor'" th$t ! tol' yo& (ew min&te"
$go. 9Del$ye' :ec$ll5
S#$ti$l bility:
*$n yo& co#y the (ollowing
'r$wing.
Sen"ory 8&nction:
)o"ition Sen"e: )ro#rioce#tion
Doc: Mr. E, co&l' yo& clo"e yo&r eye"
$n' tell me where 'i' ! +&"t to&ch
yo&.66 7and, foot,
Doc: Di' th$t (eel "imil$r.
Hol' the (inger
Doc: Thi" i" &# $n' thi" i" 'own
Doc: Tell me, wh$t i" thi". ',666
7ibr$tion: 8se the 9uning for(
Doc: *lo"e yo&r eye" #le$"e. Do yo&
(eel $nything. Bh$t 'o yo& (eel.6
:i#ration
Doc: Bh$t $bo&t now.
Doc: Stronger now. Be$ker. Or the
"$me. toes
Sh$r# $n' D&llne"":
Doc: *lo"e yo&r eye", thi" i" '&ll $n'
thi" i" "h$r#
Doc: Bh$t i" thi". Sh$r# or '&ll. 8pp
$ 0o* lim#s
:e(le%e" DT:
0ice#" )$tell$ 91nee5 chille"
Motor (&nction
C##er -imb"
Doc: 2ri# my h$n', 'on>t let me go
rel$%
Doc: M$ke $ (i"t. Don>t let me o#en,
rel$%
Doc: bring yo&r $rm" in (ront, #$lm" &#
like thi", 'on>t let me #&"h yo& 'own,
now #$lm" 'own, 'on>t let me #&"h &#
ok rel$%
-ower -imb"
Doc: )&"h yo&r leg" (orw$r' $g$in"t my
re"i"t$nce, now b$ckw$r'"rel$% now
*erebell$r (&nction
8inger to No"e Te"t
Doc: ! $m going to #l$ce my (inger
here, #le$"e to&ch my (inger $n' then
to&ch yo&r no"e, now 'o the "$me
while ! mo,e my (inger in 'i((erent
#o"ition"
:omberg te"t
5
Doc: )le$"e "t$n' "till with (eet
together $n' o#en yo&r $rm" $"i'e .
*lo"e yo&r eye" $n' b$l$nce yo&r"el(.
Don>t worry ! will be behin' yo& in c$"e
yo& nee' "ome $""i"t$nce.
E%$min$tion o( 2$it
Doc: B$lk tow$r'" meN now, on yo&r
toe", now on yo&r heel" th$nk".
B$lk, one (oot in (ront o( the other in
$ "tr$ight line
6