Encyclopedia of Ayurvedic Medicinal Plants

GENERAL EXAMINATION

           A general examination of the subject should be done before proceeding to proper examination of any system to get a general idea about the physical condition of the subject or patient. The general examination points which have bearing on a particular system, should be given more importance and those points should not be missed during general examination. The bio-data should be collected, which comprises the name, age, sex, occupation and address of the subject.

          While doing the general examination the following points should be noted. Any gross abnormality if present, should also be noted.

1. Build and nourishment:

Note whether the person is well built and well nourished, moderately built and nourished or thin built and malnourished. Note down the height and weight. As per Indian standard the average height of an adult male is about 170 cms and female about 160 cms.Weight of an adult male rages between 55-75 Kg and female between 45-65 Kg.

2. Pallor:

Look for the presence of pallor in th lower palpebral conjunctive and oral mucous membrane. Anaemia is defined as a reduction in the haemoglobin content of blood for the age and sex of the individual.

3. Jaundice:

Look for the yellowish discoloration of the sclera of the eye, skin and mucous membrane. The upper eyelid is elevated and the subject is asked to look down. Jaundice is the yellowish discolouration of body tissues due to increased serum bilirubin, more than 3mg/dI, in extra cellular fluids. It is easily detected in the sclera in day light. Jaundice can develop due to Pre-hepatic (haemolytic), Hepatic (hepato cellular and Post-hepatic (obstructive) causes.

4. Cyanosis:

Cyanosis is the bluish colouration of skin and mucous membrane due to increased concentration of reduced haemoglobin above 5 gm% in capillary blood. Cyanosis is of two types central and peripheral cyanosis.

Central cyanosis is due to reduction in PC2 in arterial blood. This can result from defective central oxygenation of blood as in

1. Pulmonary disorders like pulmonary fibrosis, pulmonary oedemas, Empyema & Bronchiectais.

2. Cardiac disorders like Congenital cyanotic heart disease, Congestive cardiac failure etc. Central cyanosis, when present can be detected in the mucous membrane of tip of the tongue.

The body extremities are warm.

Peripheral cyanosis is usually due to stagnation of blood in the peripheral capillaries leading to increased extraction of oxygen from haemoglobin. It is seen in conditions like exposure to cold, shock, Venous obstruction, congestive cardiac failure etc. Peripheral cyanosis can be detected by looking at the nail beds, ear lobes, or finger tips. The extremities are cold.

5. Clubbing:

It is the obliteration of the angle between the base of the nail and adjacent skin, in severe cases of hypoxia and cyanosis, due to the hyperplasia of subungual soft tissues. In extreme cases, the whole fingertip is swollen and drum stick shaped. Clubbing is usually seen in congenital cyanotic (eg: Bronchiectasis, Empyema) and Lung cancer.

6. Lymphadenopathy: Lymphadenopathy is the enlargement of lymph nodes.

The lymph nodes in the drainage area of any organ are prone to be affected in diseases of that organ. There may be enlargement or tenderness or both.

Palpate and feel for any enlargement of the cervical, ie., Vertical and Horizontal chain. Axillary i .e.apical anterior and posterior. Periaortic group, inguinal groups, popliteal group and Epitrochlear lymph nodes.

Generalised lymphadenopathy is seen in conditions like Lymphatic leukemia and Hodgkin’s disease. Local lymphadenitis is seen in inflammations affecting the drainage area.

7. Oedema:

Look for oedema in the subcutaneous tissue of the extremities. Qedema may be detected from the glossy appearance of the skin. If sustained finger pressure is applied against a bony prominence, pitting may be noticed.

Qedema is the swelling of tissues due to accumilation of fluid in tissue spaces.

In congestive cardiac failure, oedema of the dependent parts of the body may be noted i.e. the feet in an ambulant patient and in the presacral region in a recumbent patient. Qedema of the periorbital region is seen in acute nephritis and Nephrotic syndrome.

8. The pulse should be examined by palpating the radial artery at the wrist.

9. The arterial blood pressure should be determined using sphygmomanometer.

10. The body temperature should be assessed using a clinical thermometer. The oral temperature is preferable.

11. Respiratory rate:

12. Skin and hair: The colour and texture of skin and abnormalies, if any should be noted. Similarly the colour and distribution of hair also should be noted.

REPORT: