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UNIVERSIDAD DE SAN CARLOS DE GUATEMALA

FACULTAD DE CIENCIAS MDICAS CUNOR-


SEMIOLOGA MDICA I SEGUNDO AO

ESTUDIANTE: ____________________________________CARN:_____________________________
FECHA: _________________________ GRUPO: _____________________________________________
HOSPITAL: ______________________________ SERVICIO: __________________________________

DATOS DEL PACIENTE


NOMBRE: __________________________________________________________________________

DATOS GENERALES: _____________________________________________________________________


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MOTIVO DE CONSULTA

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HISTORIA DE LA ENFERMDEDAD ACTUAL

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UNIVERSIDAD DE SAN CARLOS DE GUATEMALA
FACULTAD DE CIENCIAS MDICAS CUNOR-
SEMIOLOGA MDICA I SEGUNDO AO

REVISION POR RGANOS APARATOS Y SISTEMAS

Sntomas generales:____________________________________________________________________________
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Piel y Faneras:________________________________________________________________________________
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Cabeza:_____________________________________________________________________________________
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Ojos:_______________________________________________________________________________________
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Oidos:_______________________________________________________________________________________
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Nariz:_______________________________________________________________________________________
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Boca:_______________________________________________________________________________________
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Garganta:____________________________________________________________________________________
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Cuello:______________________________________________________________________________________
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Mamas:______________________________________________________________________________________
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Aparato Cardiovascular:_________________________________________________________________________
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Aparato Respiratorio:___________________________________________________________________________
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Gastrointestinal:_______________________________________________________________________________
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Uninario:____________________________________________________________________________________
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Genitales:____________________________________________________________________________________
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Vascular Perifrico:____________________________________________________________________________
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Locomotor:__________________________________________________________________________________
UNIVERSIDAD DE SAN CARLOS DE GUATEMALA
FACULTAD DE CIENCIAS MDICAS CUNOR-
SEMIOLOGA MDICA I SEGUNDO AO

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Psiquitrico:__________________________________________________________________________________
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Neurolgico:_________________________________________________________________________________
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Hematolgico:________________________________________________________________________________
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Endocrino:___________________________________________________________________________________
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ANTECEDENTES
FISIOLGICOS:_______________________________________________________________________________
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PATOLGICOS: ______________________________________________________________________________
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UNIVERSIDAD DE SAN CARLOS DE GUATEMALA
FACULTAD DE CIENCIAS MDICAS CUNOR-
SEMIOLOGA MDICA I SEGUNDO AO

PERFIL SOCIAL: ____________________________________________________________________________


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EXAMEN FSICO
S/V: FC: _______ FR:________ Temp:__________ P/A: ___________ Pulso:__________
ESTATURA: _______________ PESO: __________________ IMC: _____________________________
P/T_________________________ T/E:-________________________ P/E:_________________________

ESTADO GENERAL____________________________________________________________________________
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PIEL Y FANERAS_____________________________________________________________________________
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CABEZA: ____________________________________________________________________________________
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ORL: ________________________________________________________________________________________
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CUELLO: ____________________________________________________________________________________
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TRAX Y CORAZN OSTEOARTICULAR_______________________________________________________
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ABDOMEN:___________________________________________________________________________________
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GENITALES:__________________________________________________________________________________
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UNIVERSIDAD DE SAN CARLOS DE GUATEMALA
FACULTAD DE CIENCIAS MDICAS CUNOR-
SEMIOLOGA MDICA I SEGUNDO AO

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OSTEOARTICULAR:___________________________________________________________________________
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EXTREMIDADES: ____________________________________________________________________________

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SISTEMA LINFTICO: ________________________________________________________________________

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NEUROLGICO: _____________________________________________________________________________

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IMPRESIN CLNICA:________________________________________________________________________