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From some of my notes and thoughts - please comment.
Will
Examination
Symptoms History has preceded examination and so there may be an indication of what the examiner expects to find.
Symptoms History has preceded examination and so there may be an indication of what the examiner expects to find.
- Note the age of the patient and hence the likelihood of arteriosclerosis and also if the patient is or was a trained athlete. If so a fairly slow rate may be normal or a "normal" rate may be a little fast.
- Is the patient taking drugs that may affect the pulse rate like beta blockers?
Signs note the warmth of the hand and the condition of the nails. A warm hand indicates a good peripheral circulation. It might be very warm suggesting a hyperdynamic circulation as in fever or thyrotoxicosis.
The nails may show a number of signs.
- There may be peripheral cyanosis.
- Clubbing may indicate other disease. Some clubbing is constitutional and benign.
- Koilonychia might indicate iron deficiency.
- Palpate the artery wall with the tips of the index and middle fingers. The tips are very sensitive.
- Does the wall feel soft and pliable or is it hard and sclerotic?
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