Vomiting after eating usually expels

the contents of the stomach and

therefore the undigested contents of
the meal.
Depending on the time of the meal
and the interval between the meal
and the vomiting episode, the
contents and degree of digestion
vary.

 Sometimes the vomitus may be streaked in

blood and be a red and brown colour. This is
called blood vomiting or hematemesis.
Fresh blood in the vomit appears red and usually
comes from the upper gastrointestinal tract.
Blood that comes from the lower gastrointestinal
tract usually undergoes oxidation and may
appear brown in color.
Clotted blood appears dark red in color and is
usually seen when there is perforation of a
peptic ulcer.

 Contractions of the duodenum lead to the

secretion of bile in the vomitus. This gives
a greenish tinge to the vomit.
Severe vomiting may often yield green
coloured vomit, although a bile-containing
vomitus may also be yellow in colour.
In the case of intestinal obstruction, the
vomitus may contain faecal content.

 While the Eyes are

theWindowto the
Soul, theFace is the
Windowto theMind.

Hepatic Facies
Shunken eyes
Hollowed temporal fossa
Pinched up nose with malar symptoms
Parched lips
Muddy complexion of face
Icteric change of conjunctiva
Shallow and dry face

 Lips are no part of the

head, only made for a
double-leaf door for
the mouth.
JOHN LYLY

Signs
Look at upper and lower lips
Observe skin and vermilion borders
Observe for:
Symmetry, color, and texture
Pigment change
Keratosis
Atrophy
Subsurface abnormalities
Induration or swelling
Ulceration
Blistering

 Findings
Lip Ulceration (Suspicious forLip Cancer)
LipVesicles
Herpes Simplex (Cold Sore,Fever Blister)

Lip Fissures
Angular StomatitisorCheilosis
Cheilitis

Lip Pigmented Lesions

Mucous Retention Cyst(Mucocele)
Peutz-Jeghers Syndrome

Lip Swelling
Angioedema

 On physical examination, there are several characteristics of the

tongue that should be noted:
Color
Pink-red on dorsal and ventral surfaces. The ventral surface may have some
visible vasculature.

Texture
Rough dorsal surface owing to papillae, which have three types. There should
be no hairs, furrows, or ulceration.

Size
Should fit comfortably in mouth, tip against lower incisors. Sublingual glands
should not be displaced.

In general, the examination of the tongue should occur in the

following steps:
Have the patient touch the tip of the tongue to the roof of their mouth
and inspect the ventral surface.
Have the patient protrude the tongue straight out and inspect for
deviation, color, texture, and masses
With gloved hands, hold the tongue with gauze in one hand while
palpating the tongue between the thumb and index finger of the
other, noting masses and areas of tenderness.

Meri Aankhon Mein

Joh Tasveer Basi Hai,
Us Tasveer Mein Hi
Meri Taqdeer Basi
Hai.

Theabdomenis
calledPandora'sBox by
surgeons, because one never
knows what will come out of it
when one opens it.

 ThinkAnatomically:When looking,
listening, feeling and percussing imagine
what organs live in the area that you are
examining. The abdomen is roughly divided
into four quadrants: right upper, right
lower, left upper and left lower. By thinking
in anatomic terms, you will remind yourself
of what resides in a particular quadrant and
therefore what might be identifiable during
both normal and pathologic states.

Various Causes of Abdominal

Distension