Modalities of health assessment now.pptx

Modalities of health assessment now

1. Modalities of health assessment inspection & auscultation Group 5 members Patience Mwakalenga Madalitso Ddzandukira Cornelious B. Chavula Freeman Harawa

2. Learning objectives Define inspection and explain its purpose in physical assessment. Describe principles and techniques used during inspection. Identify normal and abnormal physical findings in various body systems through visual observation. Demonstrate correct inspection technique in a systematic manner

3. Cont….. Define auscultation and its role in health assessment. Describe proper use of the stethoscope (guiding principles) Identify normal and abnormal sound in the heart, lung, and abdomen. Demonstrate accurate auscultation technique with correct stethoscope placement. Interpret and report findings appropriately.

4. Introduction Health assessment is a systematic method of collecting and analyzing data about a patient’s health status. It involves a variety of techniques to gather both subjective and objective information, forming the foundation for accurate diagnosis, care planning, and evaluation. Among the core physical examination skills, inspection and auscultation are fundamental. These techniques enables health workers to detect normal and abnormal findings, guide clinical decisions and monitor changes in patient condition.

5. Inspection Is the visual examination of the body using the eyes to assess normal and abnormal physical characteristics. It involves observing the body's appearance, movement, behavior, and symmetry. The purpose of inspection is to gather objective data about a patients physical condition, helps to detect; Deviation from normal e.g skin colour changes, swelling, deformities. Signs of disease. Nonverbal cues such as pain or discomfort

6. Inspection

7. Principle of inspection Adequate exposure – Ensure the body part being assessed is fully exposed while maintaining patient dignity and privacy. Good lighting – Use natural or strong artificial light to clear view colour , shape, and movement. Compare bilaterally – Always compare one side of the body to the other for symmetry and consistency. Systematic approach – Inspect in a head to toe manner or follow an organized regional approach to avoid missing important signs. Focus on detail – Observe skin colour , texture, lesion, contour, shape, size, and movement.

8. Techniques of inspection Observe from general to specific – Begin with a general survey, then focus on specific body parts. Use of senses – primarily use sight, but also note odors (e.g. Breath or wound smell when relevant. Positioning – position the patient appropriately (sitting, supine, etc) for the body system being examined. Stay quiet and focused, - Do not rush; carefully observe even subtle changes.

9. Integumentary System Normal Findings Skin smooth, Intact, evenly pigmented Hair evenly distributed, clean Nail pink, film Abnormal Findings Cyanosis, pallor, jaundice, rashes, ulcers Alopecia, patchy loss, lice Clubbing, pitting, spoon nail, discoloration

10. Musculoskeletal System Normal findings Symmetrical posture, body alignment. Smooth coordinated movement Limbs equal in size and shape Abnormal Findings Scoliosis, kyphosis , lordosis Tremors, tics, unsteady gait Deformities, swelling, muscle wasting

11. Neurological System Normal Findings Alert facial expressions, coordinated movement Upright posture and steady gait Symmetrical body movements Abnormal Findings Facial dropping, rigidity, tics Abnormal gait, tremors, imbalance Hemiparesis , atrophy, involuntary movements

12. Respiratory System Normal Findings Chest rises symmetrically with breathing Even, quiet respiration Skin colour normal Abnormal Findings Use of accessory muscles, retractions Nasal flaring, labored breathing Cyanosis, clubbing of fingers

13. Cardiovascular System Normal Findings No visible pulsations (except apical area) No jugular vein distention (JVD) Normal skin colour and temperature Abnormal Findings Heaves, lifts, visible pulsations Jugular vein distention, peripheral cyanosis, edema Pallor, cyanosis, dependent edema

14. Gastrointestinal System Normal Findings Abdomen flat/rounded, symmetrical Skin intact with even tone Umbilicus midline and inverted Abnormal Findings Distention, bulging, hernia Visible peristalsis, scars, Everted or displaced umbilicus, masses

15. Genitourinary System Normal Findings No visible swelling or discharge (external structures) Symmetrical and intact skin in perineal area Abnormal Findings Edema, lesions, discharge, prolapsed Redness irritation, ulcers

16. Endocrine System Normal findings Normal body proportion and energy No visible thyroid enlargement Abnormal Findings Weight changes, fatigue, hair changes Goiter, exophthalmos (graves disease)

17. Lymphatic/immune System Normal Findings No visible lymph node swelling Skin free of infection signs Abnormal Findings Enlarged lymph nodes, redness, tenderness Lesions, rashes, delayed wound healing

18. Reproductive System ( visual inspection when appropriate ) Normal Findings No visible lesions or discharge External genitalia symmetrical Abnormal Findings Redness, ulcers, swelling, abnormal discharge Masses, irritation, asymmetry

19. Auscultation Is the act of listening to sounds produced within the body, primarily from the heart, lungs and abdomen, to assess the condition and function of various organs.

20. Role of auscultation in health assessment A. Assessment of health sounds detects normal heart sound (S1, S2, 0) and abnormal sounds like murmurs, gallops, and rub. Evaluates rhythm, rate and quality of heartbeats. B. Assessment of lung sounds Identifies normal breath sounds (vesicular, bronchial, bronchovesicular). Detects abnormal (adventitious) sounds like crackles, wheezes, pleural rubs, which may indicate conditions like pneumonia, asthma or fluid overload. C. Assessment of bowel sounds Determines presence, frequency, and character of bowel sounds. Helps in diagnosing conditions such as bowel obstruction, ileus or hyperactive digestion.

21. Proper use of the stethoscope (Guiding principles) A. Ensure a quiet environment Minimize background noise to clearly hear body sounds Ask the patient not to speak during auscultation B. Warm the stethoscope Rub the diaphragm or bell gently in your hand before placing it on the patients skin to avoid startling them and to enhance comfort. C. Use the appropriate side of the chest piece Diaphragm; for high pitched sound Bell; for low pitch sounds D. Place directly on skin

22. Cont…. E. Correct earpiece position Insert earpieces angled forward, pointing toward the nose to match the direction of the ear canal. F. Maintain proper hygiene Clean the stethoscope before and after each patient to prevent cross contamination and infection transmission. G. Maintain proper hygiene Clean the infection before and after used. H. Be patient and focused. Concentrate on identifying both normal and abnormal sounds.

23. Heart Sounds Normal S1 ( lub ) – closure of mitral/tricuspid valves. S2 (dub) closure of aortic/ pulmonic valves. Abnormal S3 & S4 - - Extra heart sound may indicate heart failure or hypertension. Murmur – swishing sounds from valve disorders.

24. Lung sounds Normal Vesicular – soft, over lung periphery. Bronchial – loud, over trachea. Bronchovesicular – medium pitch, over bronchi. Abnormal Crackles – popping sounds( e.g in pneumonia) Wheezes – high pitch whistling (e.g., asthma) Stridor – harsh inspiratory sound, airway obstruction

25. Abnormal sounds Normal Normoactive-5-30 gurgles per minute . Abnormal Hyperactive – frequent, loud, may suggest diarrhea or obstruction. hypoactive – few sounds, possible ileus or peritonitis. Absent – no sound after 3-5 mins ; critical sign

26. References Bickley , L. S., & Szilagyi , P. G. (2021). Bates’ Guide to Physical Examination and History Taking (13th ed.). Lippincott Williams & Wilkins. Swartz, M. H. (2014). Textbook of Physical Diagnosis: History and Examination (7th ed.). Elsevier.  Jarvis, C. (2020). Physical Examination and Health Assessment (7th ed.). Elsevier. McGee, S. R. (2018). Evidence-Based Physical Diagnosis (4th ed.). Elsevier. McPhee , S. J., & Appel , L. J. (2021 ). Current Medical Diagnosis and Treatment (60th ed.). McGraw-Hill Education. 

27. The end!