Introduction
What is a general physical examination?
General physical examination refers to the inspection and analysis of the patient’s body to get findings which help diagnose the disease.
How to start a general physical examination?
General physical examination starts when the patient enters the doctor’s clinic/room. Observe the general look of the patient and his gait assessing his behaviour, attitude and posture.

Steps of general physical examination
An examination pattern should be developed to avoid omitting some important steps. The sequence of general physical examination should be designed so that the examination can be conducted speedily but with minimum disturbance to the patient. The steps included in general physical examination are:
• General Appearance
• Physique
• Posture and attitude
• Level of consciousness
• Examination of palm
• Examination of nails
• Examination of fingers
• Examination of palm
• Examination of face
• Examination of neck
• Examination of lymph nodes of the body
• Examination of feet
General Appearance
You can assess the degree of the patient’s illness by looking at his/her face. Look if the patient seems well, mildly ill or severely ill. The patient looks dull in case of severe illness.
Physique:
A general visual impression a made about patients’ height and weight: but it is preferable to measure both of them to avoid any mistakes.
See the patient’s body, whether normal, unusually tall or short, obese or thin etc.
See the puffiness of the body, if any.
Level of consciousness

Note the level of consciousness of the patient. Note whether the patient looks alert, confused and drowsy or deeply unconscious. The level of unconsciousness is evaluated by using the Glasgow coma scale.
Posture and attitude
The posture and attitude also help in the diagnosis of some diseases. For example
Patients with severe airway obstruction prefer to sit up and bend forward and fix their shoulder girdle by supporting themselves with their arms.
In meningitis, the neck becomes rigid and bends backwards.
The patient with severe heart failure prefers to sit because his dyspnea(shortness of breath) worsens on lying flat.


Protocols for general physical examination


Introduction

Explain the procedure to the patient
Ask the patient if there is any pain in the body
Take consent from the patient
Exposure
Approach from the right side
It is important to reach the patient from the right side.
Introduction
Introduce yourself to the patient. It is important to build the trust of the patient.
You can introduce yourself as:
“I am doctor Angelia.”
Explain the procedure to the patient
It is important to explain the procedure to the patient so that he knows what you will do with him.
Note: Don’t use medical terms while explaining the procedure to the patient. Please describe the process in the patient’s language so that he can understand it well.
For example, while examining the hand of the patient, you can say,
“I am going to examine your hand. It will not hurt you.”
Ask the patient if there is any pain in the body
It is also important because if the patient has pain in some part of the body and you touch that part, it will cause more pain, and the patient’s trust in you will not be the same as before.
If the patient says he has pain, tell him you will be careful of it.
Take consent from the patient
This is also of the most important protocols for general physical examination. After introducing the procedure to the patient, take consent from him. For example if you are doing a physical examination of the hand of the patient, ask the patient:
I’m going to examine your hand. It will not hurt you. Am I allowed to?
Exposure
Proper exposure to the area whose examination is required is essential.
Vital Signs also come under the context of general physical examination

Vital signs are the parameters that must be normal to maintain the body’s normal state for the maintenance of life. These are :
• Blood pressure
• Pulse rate
• Respiratory rate
• Random blood glucose level
• Oxygen saturation

physical examination or at the end of the examination, it does not make any difference as long as it is not forgotten.

Two different types of blood pressure apparatuses are used for the measurement of blood pressure
• Mercury sphygmomanometer
• Arenoid sphygmomanometer
• Digital blood pressure apparatus
We will describe the measurement of blood pressure by using an Arenoid sphygmomanometer.
How to measure blood pressure in easy steps?
• Remove all clothing from the upper arm.
• Apply the cuff closely to the upper arm. Its lower border should not be less than 2.5cm above the cubital fossa.
Palpatory method
• Feel the radial pulse


• Inflate the cuff to a pressure above the level you feel the pulse becoming impalpable.
• Gradually deflate the cuff.
• Note the pressure at which the radial pulse becomes palpable again. This is systolic pressure.
Note: only systolic pressure can be measured by the palpatory method.
Auscultatory method
• Palpate the brachial artery on the medial side of the biceps tendon.

• Place a stethoscope over it.
• Inflate the cuff until the pressure reaches above the systolic pressure measured by the palpatory method.
• Release the pressure slowly.
• The pressure at which kortokoff sounds are heard is the systolic pressure.
• As the pressure is lowered, kortokoff sounds become faint and eventually disappear.
• The level at which sounds disappear is called diastolic pressure.
Pulse rate
Check the rate and rhythm of the pulse. Palate the radial artery and count the pulse for one minute. You can also count for thirty seconds and multiply it by two to measure the pulse date faster. The normal pulse rate ranges from 60-100.
Respiratory rate
It is measured by looking at the movements of the chest. Normal respiratory rate is 12-16/min. To divert patients’ attention, place your finger on the radial pulse giving the impression that you are counting the pulse rate and seeing the chest movements.
Temperature
Use a thermometer to measure the temperature of the body. It can be placed over various sites, for example, under the tongue, in the axilla, groin and rectum.
The mouth and the axilla are sites which are commonly used. The normal average temperature is

98.4 degrees Fahrenheit.
Note:
These are the vitals which are calculated during a general physical examination. Conclusion
This is a general overview of the general physical examination. I hope you enjoyed reading it.