This is a case of an 82 year old man with pain in the neck, lower back, right knee and tingling sensation in his right arm
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Inspection :
Precordium :
No precordial bulges.
No engorged veins.
No scar/sinus.
JVP: https://youtu.be/EkoZDToSxVA
PALPATION :
Apex beat appears to be in 5th intracostal space half an inch medial to midclavicular line
AUSCULTATION :
S1 ,S2 heard.
Patient examined in sitting position
Inspection:-
Oral cavity, nose and nasopharyngeal appears normal
Chest appears bilaterally symmetrical and elliptical in shape
Respiratory movements appear equal on both sides and it's Abdominothoracic type.
Trachea appears central & Nipples are in 4th Intercoastal space
No dilated veins, scars, sinuses, visible pulsations.
Palpation:-
All inspiratory findings confirmed
Trachea is central
Apical impulse in left 5th ICS, 1cm medial to mid clavicular line
MEASUREMENTS-
AP diameter- 10 inches
Transverse diameter- 12 inches
AP/T ratio - 6/5
Respiratory movement's:- equal on both sides
Tactile vocal fremitus- equal on both sides
Percussion:-
Right left
Supraclavicular- Resonant (R) (R)
Infraclavicular- (R) (R)
Mammary- (R) (R)
Axillary- (R) (R)
Infra axillary- (R) (R)
Suprascapular- (R) (R)
Interscapular- (R) (R)
Infrascapular- (R) (R)
Auscultation:-
Auscultation:-
Right Left
Supraclavicular- Normal vesicular (NVBS)
Breath sounds (NVBS)
Infraclavicular- (NVBS) Wheeze
Mammary- (NVBS) (NVBS)
Axillary- (NVBS) (NVBS)
Infra axillary- (NVBS) (NVBS)
Suprascapular- (NVBS) (NVBS)
Interscapular- (NVBS) (NVBS)
Infrascapular- (NVBS) (NVBS)
Abdominal Examination :
P/A soft,non tender
No organomegaly.
CENTRAL NERVOUS SYSTEM :
Motor and Sensory functions intact,
No evidence of any focal neurological deficits.
INVESTIGATIONS
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