clerkship handbook - University of Hawaii – Department of Medicine

Steps Done Not
Done
Seq.
Incor
.
Tech
.
Incor
.
Comments
Auscultate anterior lung fields
bilaterally (starting with supraclavicular area)
with deep inspiration
C. Axillae (supine) Palpate axillae with
passive abduction- adduction
D. Breasts (supine)
Inspect & palpate breasts including
nipples
7. Cardiovascular (supine)
A. Neck Veins/arteries: Inspect, palpate,
auscultate carotid arteries bilaterally one at a
time
B. Heart (supine) Inspect precordium
Palpate PMI (apical impulse) &
precordium
Auscultate with diaphragm at aortic and
pulmonic areas, LSB and apex
Auscultate for splitting of S 2 in pulmonic
area
left
Auscultate with bell at apex (supine &
lateral decubitus)
8. Abdomen (supine; hips and knees flexed)
Alert patient to abdominal exam
Inspect abdomen
for
Auscultate epigastrium and over aorta
bruit, and bowel sounds
Palpate superficially/deeply in 4
quadrants
Palpate for liver
Palpate for aorta
Palpate for spleen - supine position
- R lateral decubitus
Inspect and palpate for inguinal nodes
and femoral pulses in inguinal areas
bilaterally
9. Extremities
A. Lower Extremities (supine)
Inspect and palpate legs and feet for edema
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