HEAD TO TOE EXAMINATION

HEAD TO TOE EXAMINATION
@PILCCOD

 Pallor
Icterus
Lymphadenopathy
Cyanosis
Clubbing
Oedema
Dehydration

 JVP

 Other signs of the system involved should also be included in head-to-toe examination. e.g. in case of Chronic Liver Disease, we should mention about the stigmata of chronic liver disease like spider naevi, palmar erythema, etc 

 DETAIL OF HEAD TO TOE EXAMINATION:

1. Pallor: palmar surface of hand, lower palpebral conjunctiva, dorsal surface of tongue, lips
2. Icterus: sclera, undersurface of tongue, hard palate, palms, nail bed
3. Lymphadenopathy(>0.5cm in cervical, >1cm in axillary and >1.5cm in inguinal region) : (cervical, axillary, inguinal, epitrochlear)
if found describe: side, site, group, number, matted/discrete, surface, consistency,temperature,  tenderness, mobility, overlying skin.
4. Cyanosis: central: lips, tip of tongue
Peripheral: nail bed, tip of nose
5.  Clubbing: >180° onychodermal angle/ obliteration of schamroths window/ fluctuation at nail bed/ drumstick appearance/ HPOA
?Grading            
6.  Oedema: site ?(pedal edema, sacral edema)
Pitting/non-pitting
up to which Level?
7. Dehydration: skin turgor, oral mucosa, sunken eyes, altered sensorium, eagerness to  drink, thready pulse, cold extremity
8.  JVP: ask the patient to rest on couh with flexion of 45° of trunk with head aligning sttaight with trunk. With 1 ruler perpendicular to ground at level of sternal angle and other scale sliding up and down on 1st ruler , measure the level of JVP in cms and add 5cm to it.
9. Findings related to involved system e.g. stigmata of chronic liver disease


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