NORMAL PHYSICAL ASSESSMENT FINDINGS

General - Alert, appears stated age. Good historian

Skin - Good turgor. No lesions.
Nodes - No lymphaenopathy.
Head - Normocephalic
Eyes - Sclera and conjunctiva clear. EOMs intact (etra ocular muscles
intact! "E##$A (pupils round, regular, e%ual, and retract to light
and accommodation!. &und' (enign.
Ears - )anals and tympanic mem(ranes clear.
Nose - Mucosa deep pin*. Septum in midline. No discharge.
Mou! - +eeth in good repair. Gums and mucsa normal. +ongue ,ell
papillated. +onsils not visi(le or not enlarged.
Ne"k - &ull range o- motion. +hyroid palpa(le or not palpa(le. )arotids
e%ual and -ull (ilaterally. not (ruits. Nec* veins -lat.
C!es - Good epansion. )lear to " and A.
#reass - /ithout masses.
#a"k - No tenderness to percussion. No )0A tenderness (costoverte(ral
angle!
Cor$ - "M1 2th. 1)S in M)$ (point o- maimal impulse in 2th intercostal
space in midclavicular line.! No thrusts or heaves. #egular rhythm
,ithout murmurs or gallops. Normal S3 and S4.
A%do&en - Scaphoid (non5protruding! so-t, non5tender. No masses
organomegaly. &emoral pulses e%ual and -ull (ilaterally. Aorta and
-emoral ,ithout (ruits.
Genialia - Fe&ale - Eternal genitalia and 6S7 normal (6artholin and S*ene glands and
urethra!. Good vaginal support. Not i- rectocele or cystocele. 0ault
clear. )ervi -irm, non5tender and -reely movea(le. 7terus (midline,
ante-leed, retro-leed! and not enlarged. Adenea clear. #ecto
vaginal eamination negative.
Male - )ircumcised or not. No lesions. Scrotal sac ,ithout masses. "enis
,ithout lesions. +estes ,ithout masses. 8ernia eam negative.
"rostate smooth, -irm, and not enlarged.
Re"al - Good sphincter tone. No masses or hemorrhoids. Stool guaic
negative.
E're&iies - No de-ormity. &ull range o- motion. Good strength e%ual (ilaterally.
No atrophy. No termor. No cyanosis, clu((ing or edema. "eripheral
pulses -ull and e%ual (ilaterally.
Neurolo(i"al - Oriented 9. )ranial nerves 115:11 grossly intact. Gait, coordination
and #om(erg normal. Motor 5 muscle strength e%ual (ilaterally.
Sensory 5 light touch normal (ilaterally. ;+#s 5 (deep tendon
re-lees! some -ol* dra, a diagram.