General inspection

Examination is the first objective method of examining a patient, its effectiveness is determined by a number of factors, among which the most important are the doctor's observation, pedantry and, of course, personal experience. That is why during training it is necessary to see the maximum number of patients with a variety of external signs of the disease. An important condition for a successful examination is, as already mentioned, creating maximum comfort for the patient - a sufficiently warm room where he is examined, eliminating prolonged nakedness of the body, uncomfortable positions, etc.

A general examination includes an assessment of the following elements:

1. state of consciousness;
2. patient's position;
3. physique (constitution);
4. facial expression;
5. body temperature;
6. anthropometric data.

Almost simultaneously with this, the skin on various parts of the body (head, neck, torso, limbs) is examined and studied, but in the medical history this information is presented in different sections.

Clinical anthropometry

Digital assessment of external morphological features includes measuring height and body weight. A widely known stadiometer is used to determine height, and most people know their height. Regular floor scales are used to measure body weight.

Measuring height in adults is important for establishing its relationship with weight. In rare cases, when measuring height repeatedly over several years, a significant decrease is noted due to a disease - spinal deformity - as a result of ankylosing spondylitis (Marie-Strumpell-Bechterew disease).

Regular measurement of body weight is of great importance. Increased weight is observed with accumulation of fluid in the body with formation of edemas as a result of diseases of the heart, kidneys, liver, as well as with overnutrition, metabolic disorders, endocrine system disorders ( obesity ).

Weight loss is observed in the following cases:

1. malnutrition;
2. malabsorption - diarrhea;
3. endocrine and metabolic disorders ( diabetes mellitus, thyrotoxicosis );
4. reduction of swelling;
5. malignant tumors;
6. diseases accompanied by heart failure, less often pulmonary failure;
7. chronic infections ( tuberculosis, bronchiectasis, chronic inflammatory processes - systemic diseases of connective tissue (for example, systemic lupus erythematosus ).

When measuring body weight in comparison with height, both deficiency and excess are detected. A simple formula is useful: body height (cm) should be equal to 100 plus body weight (kg). If the resulting sum is higher than the height indicator, the body weight is excessive, if significantly lower, it is insufficient. Many recommend specifying the patient's weight at 18 years of age, with which the maximum weight of an adult is compared. Excess weight is a risk factor for coronary heart disease.

To identify individuals with excess body weight for the purpose of its subsequent correction, the body mass index (BMI) - the Quetelet index is used. This indicator is especially convenient for epidemiological (population) studies and mass preventive examinations. The Quetelet index (BMI) is the ratio of body weight (kg) to the square of height (m ² ). With normal body weight, BMI is 20-25 kg / m ², with the initial form of obesity - 25-30 kg / m ². If the index exceeds 30 kg / m, then this condition corresponds to obesity, which requires a number of corrective measures (strict restriction of caloric content of food - up to 1200-1600 kcal / day, 1-2 fasting days per week), since such excess body weight is a risk factor for serious diseases (primarily atherosclerosis and arterial hypertension with the threat of heart failure).

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