Showing posts with label Examinations. Show all posts
Showing posts with label Examinations. Show all posts

Thursday, 20 May 2010

Causes of clubbing

Idiopathic

Lung
  • Suppurative lung disease (bronchiectasis, empyema, abscess)
  • Malignancy
  • Fibrosis
Cardiac
  • Infective endocarditis
  • Cyanotic congenital heart disease
GIT
  • IBD
  • Cirrhosis
Thyroid
  • Thyroid acropachy (due to autoimmune thyroid disease)

Monday, 17 May 2010

Examination of the cranial nerves



1
  • Smell
2, 3, 4, 6
  • Visual acuity
  • Visual fields
  • Eye movements
  • Pupillary reflexes (light + accomodation)
  • Fundoscopy
5
  • Cotton wool
  • Pinprick
  • Corneal reflex
  • Jaw jerk (motor component = CN 7)
  • Clench your jaw
7
  • Look up don't let me push down
  • Close your eyes don't let me open them
  • Smile
  • Make a ball don't let me burst it
8
  • Whisper in both ears metachronously
  • Rinne's test
  • Weber's test
9, 12
  • Tongue
11
  • Sternocleidomastoid
  • Trapezium

Examination of the neck




This video contains everything I would want to do in a neck exam. I am most comfortable with the following order:

Inspection
  • Visible lump
  • Scars
  • Swallow + look at lump
  • Stick out tongue + look at lump
  • Eyes (exopthalmos = appearance of protruding eyes; lid retraction)
  • Face: Non-pitting oedema in hypothyroidism (also in hands and feet)
  • Weight
  • Hair thinning = hyper; dry hair = hypo
  • Eyebrows - loss of outer third in hypothyroidism)
  • Clothes - temperature appropriate?
Touchy feely - ask about pain
  • Palpate. Tender?
  • Palpate with swallow
  • Palpate against muscles
  • Lymph nodes
  • Proptosis - Eyes protrude beyond the orbit
  • Percuss
  • Listen for thyroid bruits
Eyes
  • Eye movements
  • Lid lag
Hands
  • Acropachy
  • Sweaty
  • Tremor
  • Pulse
  • Reflexes
Pretibial myxoedema

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Remember: Lid lag and lid retraction are not exclusive to Graves', but all the other eye signs are exclusive to Graves'.