General Features
Age, gender, general comfort
Vital Signs
Heart rate, blood pressure, resp rate, temp
Conscious State
Alert, oriented, confused, obtunded
Body Habitus
Weight gain ( ↓ ) / loss ( ↑ ), BMI, shape
Mental State
Anxiety ( ↑ ),mental slowness ( ↓ )
The Nails
Onycholysis ( ↑ / ↓ ), peripheral cyanosis ( ↓ )
Clubbing
Increased soft tissue in distal phalanges (Graves)
Radial Pulse
Tachycardia ( ↑ ) / bradycardia ( ↓ ), rhythm
Pemberton's Sign
For thoracic outlet obstruction - retrosternal goitre
Patient lifts arms as high as possible for 1 min, look for facial congestion and cyanosis
Biceps / Triceps Reflexes
Reduced ( ↓ ) / normal / hyper-reflexive ( ↑ )
The Hair
Alopecia ( ↑ )
The Skin
Pigmentation ( ↑ ), thickening ( ↑ )
The Eyes
Exophthalmos (Graves)
The Eyelids
Lid retraction ( ↑ ), lid lag ( ↑ )
The Orbits
Periorbital oedema ( ↓ ), loss of outer 1/3 of eyebrow ( ↓ )
The Mouth
Swelling of tongue ( ↓ )
Inspection
Scars, veins, erythema, swelling, swallow
Palpation
Size, shape, nodules, thrill, fixation, consistency
Percussion
Upper part of manubrium
Auscultation
Over each lobe for bruits
Auscultate
Systolic flow murmur ( ↑ ), crackles, pericardial / pleural rub
Auscultate Lung Fields
Stridor, crackles, pleural rub
Pretibial Myxoedema (Graves)
Bilateral, firm, elevated dermal nodules
Non-Pitting Oedema ( ↓ )
Patellar / Ankle Reflexes
Reduced ( ↓ ) / normal / hyper-reflexive ( ↑ )