Appendicitis 

1. Wash Hands, Consent
2. Explain Procedure to patient, Drape, Position Patient 
3. Inspect the Abdomen(Assymetry, Color & Temp, Visible Peristalsis)
4. Ascluatate Abdomen for Normal bowel Sounds 
5. Palpation within the 4 areas. Guarding/Rigidity
6. Rebound Tenderness, McBurdy point. 
7. Demonstrate Rovsing, Psoas, Obturator Sign 
8. Knowledge

1.  Wash hands and Consent
2. Explain Procedure, Position and Drape Patient 
3. Inspect the Abdomen Umbilicus, Caput Medussa, Distened Abdomen & Full Flanks 
4. Percuss for Dullness Map
5. Shifting for Dullness 
6. Ascities Wave 
7. knowledge Question 

1. Wash Hands & Consent 
2. Explain Procedure, Position, & Drape 
3. Inspect for Systemic Liver Disease Manifestations 
4. Inspect for Abdomen 
5. Percuss the liver- Find lower boundaries 
6. Palpate for the lower Boundary 
7. Murphy Sign 
8. Knowledge Question 

1.Wash Hands, Consent 

2. Explain Procedure, Position And Drape Patient 

3. Inspect for Systemic Kidney Disease- Periorbital/General Edema, Uremic Fallor, Pallor, Xanthalesma. In Case of Male could ask if any enlargement of vein in  Left testicular area. Indication of Renal Venous Hypertension

4. Inspect Abdomen for Kidney Disease- Symmetry, Mass, Straie

5. Asculatate for Renal Bruit 

6. Bimanual Palpation of the Kidney 

7. Palpation and Percussion of the CVA on back

8. Knowledge 

1. Wash Hand & Consent 
2. Explain Procedure Position and Drape Patient 
3. Inspect for Systemic Splenic Disease- Pallor, Conjuctiva, 
4. Inspect Abdomen Straie, Scars,Symmetry, Buldging Flanks 
5. Palpate Spleen starting in the RIF--> Left CVA & Roll Patient to Right 
6. Percuss Traube Space Ressonance 
7. List 3 ways to differentiate between enlarged Kidney and Enlarged Spleen
8. Knowledge

1. Proffesionalism Wash Hands & Consent 
2. Explain Procedure & Position and Drape Patient 
3. Inspect the Eyes for Discharge, Subconjunctival Hemorrhage, & Aniscoria 
4. Inspect the Nose for Blockage(Polyps) & Discharge 
5. Examine Nose,- Before proceeding Ask Patient For any allergies, chronic Sinus issues, Deviated Septum. 
6. Examine Eyes- Visual Acuity Chart and Comment on Vision
7. Examine Eyes- Visual Field with Confrontation Examination 
8. Pupillary light reflex- Direct and Consensual- Mention Argyll, Horners, Marcus 
9. Accomidation Reflex 
10. Knowledge 

1. Wash Hands & Consent
2. Explain Procedure Position and Drape Patient 
3. Inspect eyes 3,4,6, Strabismus 
4. Examine 3,4,6 H technique- Mention Strabismus for Each Movement- Monocular/ Binocular Diplopia 
5. Knowledge Question 

1. Wash Hands & Consent 
2. Explain Procedure, Position, Drape Patient
3. Inspect Sensory V --> V1, V2, V3 Light Touch- Corneal Reflex- Explain
4. Inspect Motor V --> Muscles of Mastication
5. Inspect VII--> UMN/LMN Lesion
6. Inspect Motor VII--> Smile, Wrinkle Forehead, Puff Cheek, Close Eyes 
7. Knowledge 

1. Wash Hands & Consent 
2. Explain Procedure, Position and Drape Patient 
3. Inspect the Ear for lesions or discharge, Soft Palate, Neck 
4. Inspect CN VIII--> Webber Vs Rinne Explain Conductive Vs Sensorineural 
5. Inspect CN IX & X-> AAhhh, Gag Reflex(Explain) 
6. Inspect CN XI--> Motor Test Neck 
7. Inspect CN XII- Have Patient Protrude Tongue- Describe UMN 
8. Knowledge 

Normal- 

Color- Yellow Creamy Orange Pink

Disc Vessels are Tiny 

Sharp Margins of the Disc 

Physiologic cup is located centrally. the Diameter or the Physiological Cup Should be Half of the Disc 

Papilledema 

Causes- Increased Intracranial Pressure--> Swelling and Engorgment of the Optic Disc 

Appearance 

Pink Color, Hyperemic

Loss of Pulsation, More numerous amount of vessels Disc is Swollen with Blurred Margins 

No Physiologic Cup NOT VISABLE 

Seen in Intracranial Mass, Hemorrhage, Meningitis 

Glaucomatous Cupping 

Causes- Increased Intraocular Pressure--> Increased Cupping Backward Depression of the Disc 

Enlarged Pale Cup 

Small Amount of Vessels due to death of Optic Nerve Fibers 

Non-Proliferative Retinopathy - Severe 

2 Cotton wool Patches and and Large Retinal Hemorrhage 

Neovascularization 

Formation of new blood bessel which are more numerous tortuous- Red Arcades, 

Common Feature of Proliferative Diabetic Retinopathy

1. Wash hands And Consent 
2. Explain Procedure position and Drape Patient 
3. Inspect Both Upper Extremities- Deformities, Length, Symmetry, Fassiculations, Tremors. Etc
4. Examine Muscle Tone- Describe UMN/LMN
5. Examine Muscle Power- 
6. Reflex(Biceps, Triceps, Brachioradialis)
7. Hoffmans Response 
8. Knowledge Question

1. Wash Hands and Consent 
2. Explain Procedure Position and Drape Patient 
3. Light touch over both extemities within Dermatomes 
4. Pain 
5. Vibration 128hz 
6. Proprioception 
7. Knowledge