|Written by Dr.Md.Redwanul Huq (Masum)|
|Monday, 20 June 2011 12:23|
Pre-requisites of Clinical Examination(Physical examination):
- The room should be quiet and warm.
- There should be a couch, two or more chairs in the room.
- Well lighting of the room is a must.
- The examiner should have following equipments with him/her-
A thermometer, few pins, a hammer, a tuning fork, few cotton,a stethoscope, a sphygmomanometer, a soap/flower/any thing having smell,a Ishihara compatible color vision test plate/book, a fundoscope,few glass slides, a test tube, a test tube holder, a burner/candle.
- The examiner should maintain proper hygiene for clinical examination.
- The examiner should observe all the events & objects surrounding the patient.
- Firstly the examiner should introduce himself/herself to the patient and take permission of examination from him/her.
- Patient should have proper position for examination.
- Patient should be asked to undress accordingly.
- Examination should always be performed from the right side of the patient.
- Patient should be asked about having tenderness in any part of the body, if present- that part should be examined at last with care.
Instruments used in medicine practice:
I) Use of bell of the stethoscope-
2) To hear 3rd & 4th heart sounds
3) To hear fetal heart sound
4) To auscultate the apex of the lung.
Types of Catheters and use of Catheters:
Catheters are of following types-
1. Condom catheter: It is used when the patient can micturate voluntarily but disoriented & cannot move.
2. Foley’s bi channel self retaining catheter (Indwelling catheter):
Foley catheters have two channels, one is straight for passage of urine for storage .The other is oblique for introduction of fluid to inflate the balloon.
Use of catheters:
i) For continuous drainage of urinary bladder in cases of- unconscious patients with urinary retention or incontinence.
ii) Post operative patients who have undergone major abdominal, pelvic & perineal surgery.
iii) Patients with paraplegia, quadriplegia with urinary retention are also in need of use of catheters.
3. Plain rubber catheter:
Ends: One end is closed with eyes, the other end is open.
i) Catheterization for temporary drainage in cases of retention of urine, unconscious patients, hemiplegia, neurogenic bladder etc
ii) Urinary incontinence.
III) Naso-gastric tube (Ryle’s tube):
It Has two ends- one close end with a weight inside & few lateral eyes, the other end is open.
1) Therapeutic uses:
b) Nasogastric suction in cases of acute abdomen.
2) Diagnostic uses:- Gastric Juice analysis.
Use of Sphygmomanometer:
1. Measurement of Blood Pressure.
2. Examination for latent purpura- by Tourniquet test.
3. Examination for latent tetany (Trousseau’s sign).