Scribe Training - Physical Exam

Normal Finding: Alert Abnormal Findings: Somnolent, Obtunded, Unresponsive

Alert: Awake and responsive to all stimuli Somnolent: Abnormally drowsy, but able to be roused Obtunded: Awake, but not alert Unresponsive: Unconscious and unarousable to any stimuli

Body System: Neurological

All findings related to the brain and nerves Common findings: - A/O x4 - Normal speech - No focal neuro deficits - Normal sensation - Normal deep tendon reflexes - Cranial nerves II - XII intact - Normal gait - Normal finger-to-nose, heel-to-shin - Negative Romberg's - No meningismus

Body System: ENMT

All findings related to the ears, nose, mouth, and throat Common normal ENMT findings: - TMs clear - Normal nares - Moist mucous membranes - Normal oropharynx

Body System: Eyes

All findings related to the eyes, eyelids, and vision Common normal eye findings: - PERRLA - EOMI - Normal conjunctiva - Anicteric sclera

Body System: Head/Neck

All findings related to the head, neck, and C-spine Common normal head/neck findings: - Normocephalic - Atraumatic - No head tenderness - Supple - Trachea midline - No JVD - No cervical lymphadenopathy - No carotid bruit - No neck tenderness - No deformity

Body System: Cardiovascular

All findings related to the heart and vasculature Common normal cardiovascular findings: - Regular rate - Regular rhythm - No edema - Good capillary refill - Strong, equal distal pulses - Normal heart sounds

Body System: Respiratory/Chest Wall

All findings related to the lungs, respirations, chest wall and breasts in females Common findings: - Lungs CTA - Equal breath sounds - Non-labored respirations - No chest wall tenderness - No chest wall deformity - Normal breast exam

Body System: Lymphatics

All findings related to the lymphatic system Common normal lymphatic findings: - No lymphadenopathy

Body System: Skin

All findings related to the skin and integumentary system Common normal skin findings: - Warm - Dry - Pink - Intact - No signs of infection - No rashes - No signs of trauma

Body System: Respiratory/Chest Wall

All findings related to the stomach and intestines Common findings: - Soft - Nontender - Nondistended - Normal bowel sounds - No palpable masses - Normal rectal exam

Body System: Genitourinary

All findings related to the urinary tract and genitalia Common findings: - Normal external female genitalia - Normal bimanual exam - Normal speculum exam - Normal external male genitalia

Normal Finding: Anicteric sclera Abnormal Findings: Scleral Icterus

Anicteric sclera: Normal (white) sclera Scleral Icterus: Yellow discoloration of the sclera

Normal Finding: Appropriate mood and affect Abnormal Findings: Anxious, Tearful, Hostile, Flat, Paranoid

Anxious: Experiencing worry, unease, or nervousness Tearful: Unfriendly; antagonistic Flat affect: Diminished emotional expression Paranoid: An unrealistic distrust of others

Normal Finding: Atraumatic Abnormal Findings: Battle sign, Contusions, Lacerations, Hematomas, Ecchymosis

Atraumatic: Without trauma/injury Battle sign: Bruising to the skull behind the ear Contusion: Deep bruising

Normal Finding: Normal bimanual exam (female only) Abnormal Findings: Cervical motion tenderness, Adnexal tenderness

Bimanual exam: Method of evaluating the size, shape, and position of the uterus Normal bimanual exam: No pain with exam Cervical motion tenderness (CMT): Pelvic exam finding characteristic for pelvic inflammatory disease (PID) Adnexal tenderness: Pain caused by an adnexal mass, such as an ovarian cyst or ectopic pregnancy

Normal Finding: No deformity Abnormal Findings: Bony crepitus, Step-offs

Bony crepitus: Crackling sound produced by the rubbing together of fragments of fractured bone Step-offs: Malalignment of bones that can be felt or seen

Normal Finding: Nontender Abnormal Findings: Bony tender, soft tissue tenderness, calf tenderness

Bony tenderness: Pain with pressure applied over the bones Soft tissue tenderness: Pain with pressure applied over the soft tissues Calf tenderness: Pain in the calf muscle, indicative of DVT

Normal Finding: Equal breath sounds Abnormal Findings: Diminished breath sounds

Breath sounds equal: Sounds heard from the lungs are equal Diminished breath sounds: Lack of airflow in the lungs

Normal Finding: No neck tenderness Abnormal Findings: C-spine tenderness, Paraspinal muscle tenderness, Trapezium tenderness

C-spine tenderness: Pain with pressure applied to the bony spine Paraspinal muscle tenderness: Tenderness of the muscles connected to the spine Trapezius tenderness: Pain with pressure applied to the triangular shaped muscles on either side of the C-spine

Normal Finding: Good cap(illary) refill Abnormal Findings: Delayed cap(illary) refill

Capillary refill: The time it takes for the capillaries to refill after being compressed Good capillary refill: Capillaries take < 2 seconds to refill after compression Delayed capillary refill: Capillaries take > 2 seconds to refill after compression

Normal Finding: No carotid bruit Abnormal Findings: Carotid bruit

Carotid bruit: A vascular murmur heard in the carotid

Normal Finding: No cervical lymphadenopathy Abnormal Findings: Cervical lymphadenopathy

Cervical lymphadenopathy: Swelling of the cervical lymph nodes under the ear

Normal Finding: Cervical os closed, No blood or discharge in the vaginal vault Abnormal Findings: Cervical os open, Blood or malodorous/discolored discharge in the vault

Cervical os: Opening of the cervix, when open indicates fetus or egg will be passing through from the uterus Vaginal discharge: A mix of fluid and cells from the vagina that varies in color and consistency, possibly associated with an odor

Body System: Psychiatric

Common findings: - Cooperative behavior - Appropriate mood and affect - Normal judgement - Non-suicidal

Body System: Musculoskeletal/Back/Extremities

Common findings: - Nontender bones/muscles - Full range of motion (extremities) - Normal muscle strength - Distal neurovascular intact - No bony deformity - Nontender back - No back deformity - Full range of motion (back)

Normal Finding: Normal conjunctive Abnormal Findings: Injected conjunctiva, pale conjunctiva

Conjunctiva: Tissue that lines the surface of the eyelids and covers the surface of the sclera Injected conjunctiva: Redness of the conjunctiva Pale conjunctiva: Paleness of the conjunctiva

Normal Finding: Cooperative behavior Abnormal Findings: Uncooperative, Belligerent, Relaxed

Cooperative: Agreeable and participates in exam without issue Uncooperative: Unagreeable and refuses to participate in exam Belligerent: Hostile and aggressive Relaxed: Calm demeanor

Normal Finding: Cranial Nerves II-XII intact Abnormal Findings: Changes in neuro functions that affect eyes to upper shoulders, including the face. Right ptosis

Cranial nerves: II: sight III: eye movements IV: eye movements V: trigeminal nerve VI: eye movements VII: facial movements VIII: hearing and balance IX: oral sensation, taste, and salivation X: vagus nerve XI: shoulder elevation and head-turning XII: tongue movement

Normal Finding: Normal deep tendon reflexes Abnormal Findings: Abnormally fast or slow reflexes

Deep tendon reflexes (DTR): Muscle stretch reflexes Normal DTR: Reflexes are symmetric and rated as 1+, 2+, or 3+ Abnormal DTR: Reflexes are asymmetric or rates as 0, 4+, or5+ (too slow [hyporeflexia] or too fast [brisk])

Normal Finding: Distal neurovascular intact Abnormal Findings: Capillary refill delay, poor distal pulses, edema

Distal neurovascularly intact (NVI): Distal neuro and vascular functions are normal Capillary refill delay: Capillary refill time in the extremities >2 seconds Poor distal pulses: Reduced or absent arterial pulses that are a sign of impaired blood flow Edema: Swelling caused by excess fluid trapped in the body's tissues

Normal Finding: Strong, equal distal pulses (2+) Abnormal Findings: Absent pulse (0+) - Bounding (4+)

Distal pulses: Pulses in the extremities - Radial (arm) - Carotid (neck) - Femoral (thigh) - Dorsalis pedis (DP, top of foot) - Posterior tibialis (PT, back of ankle) Strong, equal distal pulses: 2+ pulses at the same location in bilateral extremities are similar and easily detectable Absent pulse: 0+ pulse, unable to be felt Bounding pulse: 4+ pulse, abnormally strong or fast

Normal Finding: Dry Abnormal Findings: Moist, Clammy, Diaphoretic

Dry: Normal skin condition, without moisture Moist: Slightly or moderately damp Clammy: Wet or sweaty skin Diaphoretic: Abnormally heavy sweating

Normal Finding: Normal speech Abnormal Findings: Dysarthria, Dysphasia, Aphasia

Dysarthria: Slurred or slow speech Dysphasia: Impairment of the power of expression by or ability to understand speech, writing, or signs Aphasia: Inability to speak, write, or understand language

Normal Finding: EOMI Abnormal Findings: Nystagmus, Entrapment

EOMI: Extraocular Movements are Intact Nystagmus: Involuntary horizontal or vertical eye movements Entrapment: Inability to move eye

Normal Finding: No edema Abnormal Findings: Peripheral edema

Edema: Swelling caused by excess fluid trapped in the body's tissues Peripheral edema: Swelling in the extremities

Normal Finding: Normal nares (nostrils) Abnormal Findings: Epistaxis, Rhinorrhea, Septal hematoma, Boggy turbinates, Nasal deformity

Epistaxis: Bloody nose Rhinorrhea: Clear or colored drainage from nose (not blood) Septal hematoma: Blood collection in the area between the nares Boggy turbinates: Swelling and discoloration of the nasal cavity Nasal deformity: Abnormality in the structure of the nose

Normal Finding: Normal finger-to-nose, heel-to-shin Abnormal Findings: Dysmetria

Finger-to-nose: The patient is instructed to touch the examiner's finger, then their own nose using the index finger Heel-to-shin: The patient is instructed to slide the heel of their foot down the top of the opposite shin as quickly as possible without mistakes Dysmetria: The undershoot or overshoot of intended position; type of ataxia

Normal Finding: No signs of infection Abnormal Findings: Fluctuance, Induration, Erythema, Purulent drainage, Lymphangitis

Fluctuance: Moveable and compressible. Squishy, wave-like Induration: Increase in fibrous tissue, resulting in loss of elasticity. Hardness Erythema: Redness Purulent drainage: Discharge of pus Lymphangitis: Streaking redness

Normal Finding: Full range of motion (extremities) Abnormal Findings: Decreased/limited range of motion

Full from of motion: Good flexibility of a join Decreased/limited range of motion: Poor flexibility of a joint; may be limited by pain or underlying disease/injury

Normal Finding: Full range of motion (back) Abnormal Findings: Decreased/limited range of motion

Full range of motion: Good flexibility of the spine

Normal Finding: No signs of trauma Abnormal Findings: Hematoma Ecchymosis

Hematoma: A solid swelling of clotted blood within the tissues Ecchymosis: Superficial bruising

Normal Finding: No hemorrhoids Abnormal Findings: Internal/external/thrombosed hemorrhoids

Hemorrhoids: Swollen and inflamed veins in the rectum and anus that cause discomfort and bleeding Thrombosed hemorrhoids: An internal or external hemorrhoid that has filled with blood clots

Normal Finding: Intact Abnormal Findings: Laceration, Abrasion, Avulsion, Lesion

Intact: Skin is without injury Laceration: Cut in the skin Abrasion: Scrape Avulsion: Injury from skin that was torn away Lesion: Can be used to describe any abnormal change to the skin

Normal Finding: Normal external female genitalia Abnormal Findings: Sores, Lesions, Rashes

Normal external female genitalia: Normal vulva (mons pubis, labia majora, labia minora, Bartholin glands, and clitoris) Sores/Lesions: Bumps on or around the vulva that may be itchy, painful, or produce discharge Rashes: A spread of bumps, lesions, or irregular patches of skin on the genitals

Normal Finding: No JVD Abnormal Findings: JVD

JVD: Jugular vein distention

Normal Finding: Lung CTA Abnormal Findings: Wheezes, Crackles, Rales, Rhonchi, Stridor

Lungs CTA: Lungs are clear to auscultation (listening) Wheezes: A high-pitched whistling sound made while breathing Crackles: Discontinuous clicking or rattling sounds. Sign of fluid overload, CHF, pulmonary edema. Rales: Crackling breath sound. Sign of fluid overload, CHF, pulmonary edema. Rhonchi: Rattling breath sounds. Sign of pneumonia. Stridor: Whistling, musical break sounds with inspiration

Normal Finding: No lymphadenopathy Abnormal Findings: Lymphadenopathy

Lymphadenopathy: Swelling of the lymph nodes

Normal Finding: No meningismus Abnormal Findings: Meningismus

Meningismus: Meningeal irritation with symptoms suggesting meningitis

Normal Finding: Normal gait Abnormal Findings: Ataxia

Normal gait: Ability to walk in a straight line without loss of balance Ataxia: Lack of voluntary coordination of muscle movements

Normal Finding: Moist mucous membranes Abnormal Findings: Dry mucous membranes

Moist mucous membranes: Well-hydrated membranes, such as oral, nasal, and ocular (eyes) Dry mucous membranes: Abnormal dryness of membranes

Normal Finding: Negative Romberg's sign Abnormal Findings: Positive Romberg's sign

Negative Romberg's: No loss of balance while standing in place with eyes close versus open Positive Romberg's sign: Increased loss of balance while standing in place with eyes closed versus open

Normal Finding: No acute distress Abnormal Findings: Mild distress, Moderate distress, Severe distress

No acute distress: Stable and will not become unstable within 5 minutes Mild distress: Stable, but may become unstable Moderate distress: Stable, but likely to become unstable Sever distress: More unstable than stable

Normal Finding: No back deformity Abnormal Findings: Crepitus, Step-offs, Kyphosis

No deformity: No abnormal structural changes Bony crepitus: Crackling sounds produced by the rubbing together of fragments of fractured bone Step-offs: Malalignment of bones that can be felt or seen Kyphosis: Excessive outward curvature of the spine, causing hunching of the back

Normal Finding: No deformity Abnormal Findings: Crepitus, Seat belt sign, Ecchymosis, Emphysema

No deformity: No abnormal structural changes Crepitus: Crackling, crinkly, or grating feeling or sound under the skin Seat belt sign: Bruising/abrasions in the distribution of a seat belt Emphysema: Air that is abnormally present in the tissues

Normal Finding: No bony deformity Abnormal Findings: Joint laxity, Bony crepitus, Obvious deformity, Malalignment, Palpable cords, Homan's sign

No deformity: No abnormal structural changes Joint laxity: Excessive flexibility of the ligaments and tendons Bony crepitus: Crackling sound produced by the rubbing together of fragments of fractured bone Obvious deformity: Easily apparent misshapen appearance of a, body part, usually an extremity Malalignment: Incorrect/imperfect alignment of teeth or bones at a join Palpable cords: Dilated superficial veins caused by obstruction of the deep venous system that are felt through the skin Homan's sign: Calf pain with dorsiflexion of the foot, indicative of DVT

Normal Finding: Non-suicidal Abnormal Findings: Suicidal, Homicidal, Hallucinations, Tangential, Flight of ideas

Non suicidal: No thoughts of self injury Suicidal/Homicidal: Thoughts of hurting oneself or others Hallucinations: Hearing or seeing things that are not there Tangential: A pattern of speech characterized by oblique, digressive, or irrelevant replies to questions Flight of Ideas: A rapid shifting of ideas with only superficial associative connections between them expressed as a disconnected rambling from subject to subject

Normal Finding: Non-labored respirations Abnormal Findings: Tachypnea, Bradypnea, Apnea

Non-labored respirations: Normal breathing rate without exertion Tachypnea: Abnormally rapid breathing Bradypnea: Abnormally slow breathing Apnea: Absence of breathing Tripoding: A physical stance often assumed by people experiencing respiratory distress or who are simply out of breath. Bent over and hands on the knees.

Normal Finding: Nondistended Abnormal Findings: Distended

Nondistended: Abdomen is normal sized Distended: Occurs when substances, such as air or fluid, accumulate in the abdomen causing its expansion

Normal Finding: Nontender Abnormal Findings: Mild tenderness, Moderate tenderness, Severe tenderness, Rebound tenderness, Voluntary guarding, Murphy's sign, Mcburney's point tenderness, Psoas sign, Obturator sign, Rovsing's sign

Nontender: No pain with applied pressure Tenderness: Pain with applied pressure, can be anywhere between barely noticeable (mild) to debilitating (severe) Rebound tenderness: Tenderness that occurs upon release of pressure on the abdomen Voluntary Guarding: An involuntary or voluntary response to prevent pain caused by pressure applied to the abdomen Murphy's sign: Right upper quadrant sign of cholecystitis McBurney's point tenderness, Psoas sign, Obturator sign, Rovsing's: Right low quadrant sign of appendicitis

Normal Finding: Normal bowel sounds Abnormal Findings: Absent, Hyperactive, Hypoactive

Normal bowel sounds: Consist of clicks and gurgles and 5-30 per minute Absent: No bowel sounds heard on auscultation Hyperactive: Increased bowel sounds hear on auscultation Hypoactive: Decreased bowel sounds heard on auscultation

Normal Finding: Normal breast exam (female only) Abnormal Findings: Masses, Nipple discharge, Tenderness

Normal breast exam: Bilateral breasts are symmetrical, nontender, without masses, skin or nipple changes Breast masses: Localized swelling that feels different from surrounding tissue Nipple discharge: Any abnormal fluid or other liquid that comes out of the nipple

Normal Finding: Normal heart sounds Abnormal Findings: Rubs, Gallops, Murmurs

Normal heart sounds: "Lub dub" sound that occurs in sequence Rubs: Sound caused by the rubbing together of two serous surfaces Gallops: Three distinct sounds with each heartbeat described as S3 gallop or S4 gallop Murmur: Sound made by vibrations from blood throw through the heart. 2/6 systolic ejection murmur. 1/6 holosystolic murmur.

Normal Finding: Normal judgement Abnormal Findings: Appears intoxicated

Normal judgement: Ability to evaluate aspects of a behavior or situation and act or react appropriately Appears intoxicated: Stimulation, excitement, or impaired judgement caused by a chemical substance, or as if by one

Normal Finding: Normal muscle strength Abnormal Findings: Muscle weakness

Normal muscle strength: - 0/5: no contraction - 1/5 muscle flicker, but no movement - 2/5 movement possible, but not against gravity - 3/5: movement possible against gravity, but not against resistance by the examiner - 4/5: movement possible against some resistance by the examiner - 5/5 normal strength Muscle weakness: Lack of muscle strength

Normal Finding: No focal neuro deficits: Normal (5/5) strength Abnormal Findings: Extremity, Weakness, pronator drift, Decreased grip strength (<5/5), Tremors

Normal strength: - 0/5: no contraction - 1/5 muscle flicker, but no movement - 2/5 movement possible, but not against gravity - 3/5: movement possible against gravity, but not against resistance by the examiner - 4/5: movement possible against some resistance by the examiner - 5/5 normal strength Extremity weakness: Lack of strength in the extremities; rated on the 0-5 scale Positive pronator drift: Drift in one arm when a patient holds their arms out in front of them, parallel Grip strength: The force applied by the hands to squeeze Tremors: An involuntary quivering movement

Normal Finding: Normocephalic Abnormal Findings: Craniectomy, Skull malformations, Large hematoma on the right scalp

Normocephalic: Normally shaped skull Craniectomy: Removal of part of the skull Skull malformations: Abnormally shaped skull or facial bones

Organomegaly

Organ enlargement

Normal Finding: Normal Oropharynx Abnormal Findings: Dental caries, Edentulous, Gingival abscess, tonsillar hypertrophy, pharyngeal erythema, pharyngeal exudates, cobblestoning

Oropharynx: The part of the throat that is at the back of the mouth Dental caries: Dental decay Edentulous: Without teeth Gingival abscess: Infectious fluid collection of the gums Tonsillar hypertrophy: Enlarged tonsils (1-4+) Pharyngeal erythema: Swelling of the throat Pharyngeal exudate: Gray/white coating of the throat Cobblestoning: Lumpy appearance of throat

Normal Finding: PERRLA Abnormal Findings: Sluggish pupils, Blown pupil, Dilated pupils, Fixed pupils

PERRLA: Pupils are Equal, Round, and Reactive to Light and Accommodation Sluggish pupils: Slow to react to tracking or light Blown pupil: One pupil is noticeably larger in size and doesn't react to light Dilated pupils: Larger than normal pupils that still react to light Fixed pupils: Pupils that are do not react to light

Normal Finding: No palpable masses Abnormal Findings: Hernia (umbilical, inguinal, etc/reducible, unable to reduce, etc)

Palpable masses: Any abnormal bulge felt through the skin Hernia: A bulging of an organ or tissue through an abnormal opening

Normal Finding: Normal sensation Abnormal Findings: Paresthesia's/decreased sensation

Paresthesia: Numbness/tingling sensation

Normal Finding: Normal external male genitalia: Circumcised/uncircumcised Abnormal Findings: Penile lesions, penile sores, urethral discharge, Indwelling catheter, Testicular tenderness, Scrotal swelling, Testicular mass, Inguinal hernia

Penile lesions/sores: Bumps on or around the penis that may be itchy, painful, or produce discharge; may also be present on the scrotum Urethral discharge: Abnormal purulent or mucoid secretions from the penis Indwelling catheter: Aka Foley catheter, which can be left in the bladder to drain urine Pain when pressure is applied to on or both testicles Testicular/scrotal mass: An abnormal bulge or lump of the testicles inside the scrotum Inguinal hernia: Hernia that forms in the region of the groin

Normal Finding: Pink Abnormal Findings: Jaudinced, Cyanotic, Pale

Pink: Normally colored skin for ethnicity Jaundice: Yellowing of the skin Cyanotic: Bluish discoloration of the skin Pale: Loss of normal color of the skin

Normal Finding: Rectal exam: Normal tone, Brown stool, Guaiac negative Abnormal Findings: Decreased tone, Black (melanotic), red, white stool, Guaiac positive

Rectal tone: Strength of rectal muscles Melanotic stool: Black, tarry stool Guaiac positive/negative: Stool that is positive or negative for blood

Normal Finding: Regular rate Abnormal Findings: Tachycardia, Bradycardia

Regular rate: HR between 60 and 100 bpm Tachycardia: Fast heart rate (>100 bpm) Bradycardia: Slow heart rate (<60 bpm)

Normal Finding: Regular rhythm Abnormal Findings: Arrhythmia, Atrial fibrillation

Regular rhythm: Steady beating of the heart in typical "lub/dub" pattern Arrhythmia: Irregular rhythm Atrial fibrillation: Irregularly, irregular rhythm

Normal Finding: A/O x4 Abnormal Findings: Responsive only to voice/painful stimuli, Unresponsive, Does not follow commands

Responsive only to painful stimuli: Unresponsive except to pain Unresponsive: Unconscious and unrousable to any stimuli Does not follow commands: Awake and possibly responsive, but will not participate in exam as instructed

Normal Finding: No head tenderness Abnormal Findings: Skull tenderness, Sinus tenderness

Skull tenderness: Pain with pressure applied to the skull Sinus tenderness: Pain with pressure applied above the sinuses

Normal Finding: Soft Abnormal Findings: Rigid (involuntary guarding)

Soft: Abdomen is easily compressed Rigidity: Stiffness of the stomach muscles

Normal Finding: Supple Abnormal Findings: Nuchal rigidity

Supple: Neck can be easily bent Nuchal rigidity: Neck stiffness in meningitis

Normal Finding: TMs clear Abnormal Findings: Retracted TM, Bulging TM, Erythematous TM, Dull TM, Hemotympanum, TM obscured by cerumen

TMs clear: Normal tympanic membranes Retracted or Bulging TMs: Depressed or swollen tympanic membrane Erythematous TM: Redness of inner ear Hemotympanum: Blood behind the tympanic membrane Obscured TM: Hard-to-see TM, often due to too much earwax

Normal Finding: No chest wall tenderness Abnormal Findings: Tenderness

Tenderness: Pain with applied pressure

Body System: Constitutional

The patient's overall appearance and presentation Common normal constitutional findings: - Alert - No acute distress - Well-developed, well-nourished

Normal Finding: Nontender back Abnormal Findings: T/L - spine tenderness, CVA tenderness, Paraspinal muscle tenderness

Thoracic/Lumbar bony spine tenderness: Pain with pressure applied over the bones of the spine CVA tenderness: Pain in the costovertebral angle that overlies the kidney Paraspinal muscle tenderness: Pain in the muscles that surround and connect to the spine

Normal Finding: Trachea midline Abnormal Findings: Deviation

Trachea midline: Trachea is centered Tracheal deviation: Trachea is off-center

Normal Finding: No rashes Abnormal Findings: Urticaria, Petechiae, Vesicles

Urticaria: Hives Petechiae: Pinpoint flat, round, red spots under the skin surface Vesicles: Blister

Normal Finding: Warm Abnormal Findings: Cool

Warm: Normal skin temperature Cool: Lower than normal skin temperature

Normal Finding: Well-developed, Well-nourished Abnormal Findings: Cachectic, Ill-appearing, Obese/grossly overweight

Well-developed: Healthy weight and appearance Cachectic: Body wasting due to severe chronic illness Ill-appearing: Looks to be sick Obese: Grossly overweight