Relevant General Physical Examination of GIT

Inspect from foot end:

• Look from foot end for symmetry.
• for abdominal mass
• Ask patient to take a deep breath

Hands:

-Stigmata of Chronic liver disease:

• palmar erythma
• clubbing
• leukonychia
• Dupuytren’s contracture
• flapping tremors

Pallor

Pulse

• check volume
• rate: tachycardia in case of shock (stage 1)

Eyes

• jaundice
• Anemia

Mouth:

• jaundice
• central cyanosis on the tip of tongue
• pallor

Jugular Venous Pressure

• Decreased or normal in chronic liver disease
• increased in congestive cardiac failure

Gynecomastia

• place you finger between nipple and areola to feel the disc, present in case of gynaecomastia.

Spider Naevi

• Expose the chest from front and back
• look for spider naevi in the area above the nipples, more than 5 spider angiomas are significant.
• found in conditions of increased estrogen conditions: pregnancy, Rheumatoid Arthritis, CLD, Thyrotoxicosis, Oral contraceptive pills e.t.c

Lymph nodes

• Check lymphnodes of head and neck
• Troiseir’s sign: Left Supraclavicular Node enlargement (metastasis from abdominal adenocarcinoma- esophagus, liver)
• Check Axillary lymph nodes – all 5 groups (metastasis from brest cancer)
• If lymph nodes are palpable: note number, consistency, size, tenderness

Pedal edema and sacral edema

By Dr Abdul Wahab – M3 (4/6/2023)