Federal University of Espírito Santo

CENTER FOR HEALTH SCIENCES

NURSING DEPARTMENT
DIScipline OF SEMIOLOGY AND SEMIOTICS

DHERIK FRAGA SANTOS

FABRICIA BATISTI ZUCOLOTO
GLAYCE CRISLAYNE CARLESSO DE MOURA
MAXSON DE PAULA SOUZA

SCRIPT FOR PHYSICAL EXAMINATION

WASH HANDS

PREPARE THE MATERIAL: Stethoscope, measuring tape, pen, ruler, container with
cotton, alcohol, and watch.

PREPARE THE ENVIRONMENT:

Maca
Pillow
Sheet

CALL THE PATIENT

ANterior THORAX

INSPECTION
(patient sitting with chest exposed)

Biotipo:( ) brevelíneo normolinear ( ) longilinear

Posture: ( ) curved
upright

Simetria:( ) simétrico ( ) asymmetric bulges

Conformation: ( ) ( ) quilha (pigeon chest)
regular
( ) ton (barrel) funnel-shaped
Diameter:
Transverse: _____ (anterior axillary line to another)
Antero-posterior: _____ (anterior and posterior axillary line)

Skin conditions:
( )normocorad ( )hypocorad
( ) hypercored
Hydration: ( ) hydrated
( ) dry
Hair: ( ) present ( ) absent
. regular distribution irregular distribution
Injuries: ( ) present
( ) absent
Presence of: spots, scars, wart, macula, comedones, nevi,
pustules (describe the location, size, and color)
Thoracic muscles: ( ) eutrophic ( ) hypotrophic ( ) hypertrophic
Ictocordis:( ) visível ( )não-visível ( )normal ( ) aumentado ( )diminuído

PALPATION

Pele:
Painful sensitivity: ( ) present absent
Turgor: ( ) increased
( ) regular ( ) diminished
Elasticity: ( ) increased
( ) regular ( ) diminuída

Musculature:
Painful sensitivity: ( ) present ( ) absent
Tone: ( ) preserved
hypertonic ( ) hypotonic

Bones:
Painful sensitivity: ( ) present ( ) absent
Bony prominences: ( ) present ( ) absent
Bone integrity: present ( ) absent

Tactile fremitus: (3 times, starting at the clavicle)

( )perceptível ( )não-perceptível
 Apex: ( ) resonant
resonant medium absence of resonance
Mediana: ( ) ressonante ( ) médio ressonante ( ) ausência de ressonância
Base: ( ) resonant
resonant medium absence of resonance

Pulso apical: ( )presente ( )ausente

AUSCULTATION
Observe if there are murmurs

Aortic focus (2nd intercostal space on the right, in the para-sternal line)
more audible: B2):

Bulhas: ( ) normophonic
( ) hyperphonetic ( ) hypophones
Characteristics: ( ) ( ) arrhythmic ( ) clear
rhythmic

Pulmonary focus (2nd left intercostal space, in the parasternal line)

More audible: B2):
Bulhas: ( ) normophonic ( ) hyperphonetic ( ) hypophonetical
Characteristics: ( ) arrhythmic ( ) clear
rhythmic

Tricuspid focus (4th left intercostal space, at the parasternal line)

But audible: B1):
Bulhas: ( ) normophonetic ( ) hyperphonetic ( ) hypophonic
Characteristics: ( ) ( ) arrhythmic clear
rhythmic

Mitral focus (4th and 5th left intercostal spaces, in the midclavicular line,
But audible: B1):
Bulhas: ( ) normophonetic ( ) hyperphonetic ( ) hypophonetic
Features: ( ) rhythmic
( ) arrhythmic clear

MOM
Static Inspection (sitting or standing position)
Tamanho: ( ) PequenaMédia ( ) Grande ( )
Simetria: ( ) Simétrica ( )Assimétrica Bulging Retractions
Forma : ( ) Convexa ( ) Pendular ( ) Cônica
Rede venosa periférica : ( ) Visível ( ) Não visível
Pele:
( )normocorad ( )hypocorad
( ) hypercorated
Nipples
Type ( ) Reversed Plan Inverted
Simetria ( ) Simétrico Asymmetrical
Note the presence of _____________________ (fissure
/scaling/ulceration/nipple retraction/supernumerary nipples

Areolas
Tamanho ( )Pequena ( ) Média Large
( )Round Oval
Simetria: ( ) simétrica ( ) assimétrica
Cor: ( ) rosada ( )marron

Dynamic inspection (sitting or standing position)

Arms along the body, observe the lower part of the breasts.
Simetria ( ) Simétrica ( ) Assimétrica ( ) com abaulamento ( ) Com retrações
Arms raised up, observing the upper part of the breasts.
Simetria ( ) Simétrica ( ) Assimétrica ( ) com abaulamento ( ) Com retrações
Hands on hips and arms forced forward, observing the inner part of the
mamas
Simetria ( ) Simétrica ( ) Assimétrica ( ) com abaulamento ( ) Com retrações
Hands on hips and arms forced back, observing the outer part of the
moms
["Symmetry ( ) Symmetrical ( ) Asymmetrical ( ) with bulging ( ) With retractions"]

Superficial Palpation (supine position)

Axilas: ( )linfonodos palpáveis ( )linfonodos impalpáveis
Mamas
Massas ( ) Ausentes ( ) Presentes
Size:___________
Forma: ( ) regular ( ) irregular
Consistência: ( )mole ( )duro
Mobility: ( ) mobileproperty
 Sensibilidade dolorosa ( ) Presente ( )Ausente
Quadrant: ___________
Pele
Hydration: ( ) hydrated
( ) dry
Textura : ( )Lisa ( )Aspera
Elasticidade: ( ) preservado ( ) não preservado
Turgor: ( ) preservado ( ) não preservado
Temperatura: ( )normotérmico ( ) hipotérmico ( ) hipertérmico

Nipples
Secreção : ( ) Presente ( )Ausente
Deep palpation
Linfonodos ( )Palpáveis ( ) Impalpáveis ( ) dolorosos
Painless

POSTERIOR THORAX

INSPECTION

Posture: ( ) ( ) bent
upright

( ) laterally shifted to the left ( ) lateralized to the right

Symmetry: ( ) asymmetrical ( ) bulges

symmetric

Pele:
{"normocorada":"normocorate","hipocorada":"hypocorate"} hypercolor
Hydration: ( ) hydrated
( ) dry
Fur: ( ) present ( ) absent
regular distribution irregular distribution
Lesões: ( ) presentes
( ) absent
Presence of: spots, scars, wart, macula, comedones,
blisters, pustules (describe the location, size, and color)
Thoracic muscles: ( ) eutrophic ( ) hypotrophic hypertrophic
Spinal Column:
 Desvios: ( ) presente ( ) ausente
Tipo de desvio: ( )cifose ( )escoliose ( )lordose

BREATHING:
Frequency: ______ RPM
Type: ( ) thoracic abdominal thoraco-abdominal
Rhythm: eupneic tachypneic bradypneic
Amplitude: ( ) superficial
( ) deep regular
Tiragem: ( ) presente ( ) ausente

PALPATION

Pele:
Painful sensitivity: ( ) present absent
Turgor: ( ) increased
regular ( ) diminished
Elasticity: ( ) increased
( ) regular ( ) diminuída

Musculature:
Painful sensitivity: ( ) present absent
Tone: ( ) preserved
hypertonic ( ) hypotonic

Bones:
Painful sensitivity: ( ) present absent
Bone prominences: ( ) present ( ) absent
Bone integrity: Present ( ) absent

Tactile fremitus (8 times, on each side): clear tympanic sound

( ) perceptível ( ) não perceptível
( )simétrico ( )assimétrico
Apex: ( ) resonant
( ) resonant medium absence of resonance
Mediana: ( ) ressonante ( ) médio ressonante ( ) ausência de ressonância
 Base: ( ) resonant
resonant medium absence of resonance

Thoracic expansion (at the level of T9 or T10) (normal is 3 to 5 cm)

Spine:
Deviations: ( ) ( ) absent
present
Types of deviations: kyphosis scoliosis lordosis

Sensibilidade dolorosa: ( ) ausente ( ) presente

RESONANCE

GENERAL OVERVIEW

Sound quality: preserved ( ) not preserved

( )resonant{"hyper-resonant":"","massive":""}

Diaphragmatic excursion: _______ cm (the sound transitions from resonant to dull)

AUSCULTA starts at c7, 9 times, see what it's like to hear these sounds...
1st sound: bronchovesicular
2nd sound: vesicular murmur
Changes: ( ) murmurs
whistle snore
stridor pleural friction
Ressonância vocal: ( ) simétrico ( )assimétrico

References of the anterior and posterior thorax:

anterior axillary line
Hemiclavicular line
Mediosternal line
Mid axillary line
posterior axillary line
Scapular line
Spine
 ABDOME

MATERIAIS:estetoscópio, régua, fita métrica, caneta hidrográfica da pele, algodão,

alcohol and watch.

INSPECTION

Formato:( ) atípico ( ) em avental ( )escavado ( ) batráquio ( ) globoso

Symmetry: symmetric asymmetric Presence of: undulations
( )masses
Skin Conditions:
Cor: ( )normocorada ( )hipocorada ( )hypercolored
Umidade: ( ) Seca ( )Úmida ( ) Sudorenta
Textura: ( ) Lisa ( ) Áspera ( ) Enrugada
Hair: ( )present ( )ausentes ( )distribuição regular ( ) irregular
Lesões: ( ) Ausentes ( ) Presentes–Qual? ( ) Cicatriz ( ) Mácula
Papules ( ) Petéquias ( ) Outros:
Umbilical scar:
Location: ( )median
Derailed: ( ) to the right ( )to the left
Form: ( ) flat ( ) retraída ( ) protusa ( ) sinal de Cullen
Secretion: absent ( )present
Circulação Colateral: ( )visível ( )não visível
Pulsação aórtica: ( )visível ( )não visível ( )normal ( )proeminente
Abaulamentos ou retrações: ( ) presente ( ) ausente
Movimentos respiratórios:( )regular ( )irregular ( )superficial ( )profunda
["thoracic","abdominal","thoraco-abdominal"]
Movimentos peristálticos:( )visível ( )nao visível
Measurements:
Abdominal circumference: just above the iliac crest (H: up to 102 and M: up to
88)
The Man: >102 cm [ ] less than 102 cm [ ] 102 cm

The Woman: >88 cm [ ] <88 cm88 cm

Waist-hip ratio:
 Waist (midpoint between the costal arches and the hip)
Quadril (level of the iliac crests lower) - Women: < 0.8 and Men: <
0.9
Man: [ ] <0.9 [ ] >0.9 [ ] 0.9
Woman: [ ] <0.8 [ ] >0.8 [ ] 0.8
Dynamic Inspection (Ask the patient to lift their head while in bed)
( ) presença de hérnia ( )ausência de hérnia
presence of diastasis of the rectus abdominis muscles
absence of diastasis of the rectus abdominal muscles
( )presença de lesões ( ) ausência de lesões

AUSCULTATION

Hydroaeric noises: (auscultation in the 4 quadrants, with the diaphragm)

Normal frequency: 5 to 35 times per minute

Classificação: ( ) normais ( ) hiporreativos ( ) hiperreativos
Característica: ( ) agudo ( ) gorgolejante ( ) regular ( ) irregular
Freqüência: 1º quadrante–[ ] Ruído [ ] Sem ruído
2º quadrante–[ ] Ruído [ ] Sem ruído
3º quadrante–[ ] Ruído [ ] Sem ruído
4 º quadrante - [ ] Ruído [ ] Sem ruído
Vascular noises (searching for a murmur, with the bell)
Epigastric Region: Artéria aorta–[ ] Sem ruído [ ] Sopro
If the aorta artery does not produce noise, it is not necessary to listen to the
other arteries
Left renal artery - [ ] No noise [ ] Murmur
Right renal artery – [ ] No bruit [ ] Murmur
Mesogastric Region: Iliac renal artery – [ ] No noise [ ] Murmur
Femoral artery – [ ] No noise Blow
Right hypochondrium (Liver): Friction–[ ] Absent [ ] Present
Hipocôndrio esquerdo (Baço): Atrito–[ ] Ausente [ ] Presente

PERCUSSION (3 percussion points on each quadrant)

Percussion of the quadrants:
1º quadrante–[ ] Timpânica [ ] Maciça [ ] Presença de massa ou líquido
2º quadrante–[ ] Timpânica [ ] Maciça [ ] Presença de massa ou líquido
3º quadrante–[ ] Timpânica [ ] Maciça [ ] Presença de massa ou líquido
4º quadrante - [ ] Timpânica [ ] Maciça [ ] Presença de massa ou líquido
Liver: Size ______ cm (between 6 and 12 cm in the midclavicular line - adult)
Type of sound: ( )sub-massif ["massive","tympanic"]
Sensibilidade dolorosa: ( ) presente ( ) ausente
Spleen:
Type of sound: ( )sub-massif {"maciço":"massive","timpânico":"tympanic"}

SUPERFICIAL PALPATION (with one hand)

Pele:
Temperatura:( ) Normotérmica ( ) Hipertermia ( ) Hipotermia
Elasticidade: ( ) Preservado ( ) Diminuído
Turgor: ( ) Preservado ( ) Diminuído
Sensibilidade dolorosa:( ) presente ( ) ausente
Please present, region: ______________________________
Muscle: ( ) contracted relaxed
Nódulo:( ) presente absent
Mass: ( ) present absent
Present: Location __________________________
Size _______ cm
Format:
Superfície: ( ) lisa ( ) nodular
Pulsatilidade: ( ) presente ( ) ausente
Hipersensibilidade: ( ) presente ( ) ausente
Consistency: ( )softhardened
Mobility: ( )mobile ( )property

DEEP PALPATION (bimanual)

Liver (asks the patient to inhale):
Borda: ( ) regular ( ) irregular ( ) lisa ( ) irrugada ( ) amolecido (
stiffened injury
Sensibilidade dolorosa: ( ) presente ( ) ausente
Spleen: ( ) impalpable tangible
Rim:( ) palpável ( ) impalpável
Sensibilidade dolorosa: ( ) Presente Absent
Location:
Surface: ( ) Smooth ( ) Nodular
Vesícula Biliar:( ) palpável ( ) impalpável
Sinal de Blumberg:( ) positivo ( ) negativo
Teste do músculo ileopsoas:( ) positivo ( ) negativo
Sinal de Piparote(precisa de três mãos): ( )positivo ( )negativo
Decubitus Maceration:
Dorsal: ( )presença de ascite ( ) ausência de ascite
Lateral: ( )presença de ascite ( ) ausência de ascite
Reflexos abdominais:( )presente ( ) ausente
[Giordano Signal] Percussion fist (direct and indirect):
Painful sensitivity: ( ) present ( )absent

MEMBERS

MATERIALS
["Stethoscope","Cotton","Alcohol","Reflex hammer","Chair","Tape measure","Toothpick"]

NEUROLOGICAL EVALUATION AND

SUBJECTIVE DATA
1. Joints:
Any problems with your joints? Any pain?
Location - Which joints? On one of the two sides?
Quality - What the pain feels like: constant, sharp burning or
dull, penetrating? Intensity - What is the intensity of the pain?
 Start–When did this pain begin?
Características temporais–A que hora do dia a dor se manifesta?
How long does it last? How often does it occur?
The pain is associated with: chills, fever, recent sore throat,
trauma, repetitive activity?
Is the pain worsened by: movement, rest, position, time? The pain is
relieved by: rest, medications, application of heat or ice?
Any stiffness in your joints?
Any edema, warmth, redness, in the joints?
Any limitation of movement in any joint? What?
articulation?
What activities cause problems.
2. Muscles:
Any problems in the muscles, such as pain or cramps? Which muscles?
If the pain is located in the calf muscles: the pain occurs with the
Does it go away with rest?
Are your muscle aches associated with fever, flu, chills?
Any weakness in the muscles?
Location - Where is the weakness? How long have you noticed it?
weakness?
Do the muscles look smaller in this area?
3. Bones
4. Functional assessment/Daily living activities:
5. Personal care behaviors:

EVALUATION OF SKELETAL MUSCLE

CEREBELLAR FUNCTION
Coordination
Rapid Alternate Movements
Finger-finger test
Nose-finger test (patient with eyes closed)
Heel-shin test
 Cerebellar function coordination preserved ( ) Coordination of
cerebellar function not preserved
Balance
Marcha: ( )regular ( ) irregular ( ) rítmica ( ) arrítmica ( ) com esforço ( )
effortlessly ( ) the oscillation of the opposite arm is coordinated

Romberg test
Romberg test: Stand with your feet together and arms at your sides.
ask to close the eyes (20 seconds)
Test jumping on one foot
( ) Cerebellar function balance preserved ( ) Function balance
non-preserved cerebellar
Sensitivity test
This light (sense of touch, patient with eyes closed): use a
ball of cotton. Ask to show where it passed.
( ) sensibilidade presente ( ) sensibilidade ausente
Round tip and sharp tip (patient with closed eyes)
( ) sensibilidade presente ( ) sensibilidade ausente
Vibratory (patient with eyes closed): use a tuning fork
( ) sensibilidade presente ( ) sensibilidade ausente

DEEP REFLEXES
Reflexo Bicipital: ( ) presente ( ) ausente
Reflexo Tricipital: ( ) presente ( ) ausente
Reflexo Braquiorradial: ( ) presente ( ) ausente
Reflexo do Quadríceps: ( ) presente ( ) ausente
Reflexo Aquileu: ( ) presente ( ) ausente

Scale of Reflex Response:

Very fast, hyperactive, and with clonus, indicative of disease
Faster than average, it may indicate illness
2+Middle, normal
1+Decreased, below normal
0No answer

SKELETAL MUSCLE JOINTS

SENIOR MEMBER

GENERAL INSPECTION:

Measurement of members:

Tamanho:( )simétrico ( )assimétrico

Circunferência:( )simétrico ( )assimétrico
Pele:
Heart: ( ) normocorate ( ) hypocorism hypercord
Hidratação: ( ) hidratada ( ) dry
Injuries: ( ) presentes ( ) ausentes
Presença de:( )manchas ( ) cicatrizes ( ) verruga ( ) mácula ( )
commendations ( ) nerves ( ) pustules
Tumefação: ( ) presente ( )ausente
Presence of masses or deformities: ( ) dislocation subluxation
contraction ankylosis
Muscles: ( ) eutrophic
hypotrophic hypertrophic
Proeminências ósseas: ( ) presente ( ) ausente
Rede venosa: ( ) visível ( ) não–visível

GENERAL PALPATION:

Temperatura: ( ) normotérmico ( ) hipotérmico ( ) hipertérmico

Turgor: ( ) preservado ( ) não preservado
Elasticidade: ( ) preservada ( ) diminuída ( ) aumentada
Hidratação: ( ) hidratada ( ) ressecada ( ) úmida
Bone joints
Painful sensitivity: ( ) present ( ) absent
Tumefação: ( ) presente ( ) ausente
 Presence of masses or deformities: ( ) dislocation subluxation
contracture ankylosis
Muscles: ( ) eutrophic ( ) hypotrophic hypertrophic

Muscle Strength Graduation:

Gray Description % normal Evaluation
5 Full ADM against gravity, full resistance 100 Normal
4 ADM full against gravity, some 75 Good
resistance
3 ADM full against gravity, 50 Regular
2 ADM full with gravity elimination 25 Precarious
1 Slight contraction 10 Trace
0 No contraction 0 Zero
Bones:
Sensibilidade dolorosa: ( ) ausente ( ) presente
Protuberância óssea: ( ) ausente ( ) presente
Brachial pulse:
Amplitude: ( ) superficial ( ) deep
Simetria: ( ) simétrico ( ) assimétrico
Ritmo: ( ) rítmico ( ) arrítmico
Força: ( ) forte ( ) fraco ( ) filiforme
Radial pulse:
Amplitude: ( ) superficial deep
Simetria: ( ) simétrico ( ) assimétrico
Ritmo: ( ) rítmico ( ) arrítmico
Força: ( ) forte ( ) fraco ( ) filiforme

Joints (shape, painful sensitivity, inflammatory signs, deformities)

the movement)
Shoulder:
Inspection:
. Size:
. Contorno: ( )regular ( ) irregular
 . Simetria: ( ) simétrico ( )assimétrico
. Sinais flogísticos: ( ) tumefação ( ) dor ( ) calor ( )edema
( ) ausentes ( )presentes
. Mass, nodules or deformities: ( ) present ( ) absent
Palpation: Assess skin (temperature, turgor, elasticity, hydration)
painful sensitivity, swelling, masses or deformities, muscles and
bones.
Amplitude of Movements: Internal rotation of the cuff,
external rotation of the cuff, flexion, extension, abduction and
translation.
Angle of approximately: _____°
absence of movement limitations
( )movimentos amplos ( ) movimentos presos
absence of pain sensitivity
presence of painful sensitivity
Redo all the movements now with your hand on your hip.
of the patient.
( ) articulações simétricas ( ) articulações assimétricas
( ) ausência de crepitações ( ) presença de crepitações
absence of pain sensitivity
presence of painful sensitivity
Muscle Strength Test:
Ask the patient to shrug their shoulders, make a forward bend and for
it's an abduction against your resistance. The shrug tests,
also, the integrity of the XI cranial nerve, the accessory spinal nerve.
Elbow
Inspection
. Size:
. Contorno: ( )regular ( ) irregular
. Simetria: ( ) simétrico ( )assimétrico
. Sinais flogísticos: ( ) tumefação ( ) dor ( ) calor ( )edema
( )presentes ( ) ausentes
. Mass, nodules or deformities: ( ) present ( ) absent
 Palpation Assess skin (temperature, turgor, elasticity, hydration)
painful sensitivity, swelling, masses or deformities, muscles and
bones.
Amplitude of Movements: flexion, extension, pronation and
supination
Angle of approximately: _____°
absence of restrictions on movements
( )movimentos amplos ( ) movimentos presos
absence of pain sensitivity
presence of painful sensitivity
Redo all the movements now with your hand on your hip.
of the patient.
( ) articulações simétricas ( ) articulações assimétricas
( ) ausência de crepitações ( ) presença de crepitações
absence of pain sensitivity
presence of painful sensitivity

Muscle strength tests

Ask the patient to flex the elbow while you apply a force.
opponent. Next, ask him to extend the elbow against yours.
resistance.
( ) preserved muscle strength ( ) non-preserved muscle strength
Fist and hand:
Inspection
. Size:
. Contorno: ( )regular ( ) irregular
. Simetria: ( ) simétrico ( )assimétrico
. Sinais flogísticos: ( ) tumefação ( ) dor ( ) calor ( )edema
( ) ausentes ( )presentes
. Mass, nodules or deformities: ( ) present ( ) absent
. Number of fingers:
. Nail
Higienização: ( ) adequada ( ) inadequada
Perfusão: ( ) adequada ( ) inadequada
 Coloração: ( ) rosada ( ) aroxeada
Palpation (palpate each joint in the wrist and hands) Assess skin
(temperature, turgor, elasticity, hydration), painful sensitivity,
swelling, masses or deformities, muscles and bones.
Amplitude of Movements:
Hyperextension of the hand: bending the hand upwards at the level of

fist
Wrist flexion: bending the hand down at the level of the wrist
Flexion of the fingers: bending the fingers down
metacarpophalangeal joints
Hyperextension of the fingers: bending the fingers up at
metacarpophalangeal joints
Abduction of the fingers: to separate the fingers

Adduction of the fingers: to bring the fingers together

Angle of approximately: _____°

absence of movement limitations
( )movimentos amplos ( ) movimentos presos
absence of pain sensitivity
( ) presence of painful sensitivity
Redo all the movements now with the hand over the
patient's thigh.
( ) articulações simétricas ( ) articulações assimétricas
( ) ausência de crepitações ( ) presença de crepitações
absence of pain sensitivity
presence of painful sensitivity
Testes
Allen Test: With the patient's hand closed, block the radial and ulnar artery.
preventing the passage of blood. Ask the patient to open their hand, it will be
white. Unblock the blood flow and the hand will return to its color.
habitual, red.
Strength Test – Flex the wrist against resistance.

Lower limb
GENERAL INSPECTION:
Measurement of limbs:
Tamanho:( ) simétrico ( ) assimétrico
Circunferência: ( )simétrico ( )assimétrico
Pele:
heart: ( ) hypocorism hypercharged
normocorate
Hydration: ( ) hydrated
( ) dried out
Injuries: ( ) present
absent
Presence of: ( ) spots ( ) scars ( ) wart ( ) macula ( )
commendations ( ) nevos ( ) pustules
Tumefação: ( ) presente ( )ausente
Presence of masses or deformities: ( ) dislocation subluxation
contracture ( ) ankylosis
Muscles: ( ) eutrophic
( ) hypotrophic ( ) hypertrophic
Bone prominences: ( ) present ( ) absent
Rede venosa: ( ) visível ( ) não visível
GENERAL PALPATION:
Temperatura: ( ) normotérmico ( ) hipotérmico ( ) hipertérmico
Turgor: ( ) preservado ( ) não preservado
Elasticidade: ( ) preservada ( ) diminuída ( ) aumentada
Hidratação: ( ) hidratada ( ) ressecada ( ) úmida
Bone joints
Sensibilidade dolorosa: ( ) presente ( ) ausente
Tumefação: ( ) presente ( ) ausente
Presence of masses or deformities: ( ) dislocation subluxation
contraction ( ) ankylosis
Muscles: ( ) eutrophic ( ) hypotrophic ( ) hypertrophic
Bones:
Sensibilidade dolorosa: ( ) ausente ( ) presente
Protuberância óssea: ( ) ausente ( ) presente
Femoral Artery
Simetria: ( ) simétrico ( ) assimétrico
Ritmo: ( ) rítmico ( ) arrítmico
 Força: ( ) forte ( ) fraco ( ) filiforme
Popliteal artery
Simetria: ( ) simétrico ( ) assimétrico
Ritmo: ( ) rítmico ( ) arrítmico
Força: ( ) forte ( ) fraco ( ) filiforme
Pedal pulse:
Simetria: ( ) simétrico ( ) assimétrico
Ritmo: ( ) rítmico ( ) arrítmico
Força: ( ) forte ( ) fraco ( ) filiforme
Posterior tibial pulse
Simetria: ( ) simétrico ( ) assimétrico
Ritmo: ( ) rítmico ( ) arrítmico
Força: ( ) forte ( ) fraco ( ) filiforme
Joints (shape, sensitivity, inflammatory signs, and movement)
Quadrilateral
Inspection (patient lying in supine position)
. Size:
. Contorno: ( )regular ( ) irregular
. Simetria: ( ) simétrico ( )assimétrico
. Sinais flogísticos: ( ) tumefação ( ) dor ( ) calor ( )edema
( ) ausentes ( )presentes
. Mass, nodules, or deformities: ( ) present ( ) absent
. Simetria das cristas ilíacas: ( ) simétricas ( ) assimétricas
Palpation (patient lying in supine position) Assess skin
(temperature, turgor, elasticity, hydration), painful sensitivity,
swelling, masses or deformities, muscles and bones.
Assessment of Range of Motion: leg flexion,
{"flexão da coxa":"thigh flexion","adução da perna":"adduction of the leg","abdução da perna":"abduction of the leg","rotação":"rotation"}

external, internal rotation, hyperextension (patient lying down in

ventral decubitus
Angle of approximately: _____°
absence of movement limitations
( )movimentos amplos ( ) movimentos presos
absence of pain sensitivity
 ( ) presence of painful sensitivity
Redo all the movements now with your hand over the
patient's thigh.
( ) articulações simétricas ( ) articulações assimétricas
( ) ausência de crepitações ( ) presença de crepitações
absence of pain sensitivity
presence of painful sensitivity
Muscle Strength Test

Knee:
Inspection
. Size:
. Contorno: ( )regular ( ) irregular
. Simetria: ( ) simétrico ( )assimétrico
. Sinais flogísticos: ( ) tumefação ( ) dor ( ) calor ( )edema
( ) ausentes ( )presentes
. Mass, nodules or deformities: ( ) present ( ) absent
. ( ) Joelho Varo (pernas arqueadas) ( ) Valgo (joelhos em X)
Palpation Assess skin (temperature, turgor, elasticity, hydration),
painful sensitivity, swelling, masses or deformities, muscles and
bones.
. Sensibilidade dolorosa: ( ) presente ( ) ausente
. Bulging signal: Strike the medial and lateral part of the knee to
identify swelling in the suprapatellar pouch.
. Patellar Rejection: Compress the suprapatellar pouch and push with the
the other hand the patella against the femur,

. Rejection: Palpate the infrapatellar fat pad and the patella while observing.
crepitation (placing the hand over the patella while the knee is
bent and extended.
Assessment of Range of Motion: flexion, extension and
hyperextension
Angle of approximately: _____°
absence of movement limitations
( )movimentos amplos ( ) movimentos presos
 absence of pain sensitivity
presence of painful sensitivity
Redo all the movements now with the hand over the
patient articulation.
( ) articulações simétricas ( ) articulações assimétricas
( ) ausência de crepitações ( ) presença de crepitações
( ) absence of painful sensitivity ( ) presence of
painful sensitivity
. Check wandering.
Muscle Strength Test: apply resistance during knee flexion
( ) força muscular presente ( ) força muscular ausente
Ankle and foot
Inspection (patient sitting)
. Size:
. Contorno: ( )regular ( ) irregular
. Simetria: ( ) simétrico ( )assimétrico
. Sinais flogísticos: ( ) tumefação ( ) dor ( ) calor ( )edema
( ) ausentes ( )presentes
. Mass, nodules or deformities: ( ) present ( ) absent
Palpation Assess skin (temperature, turgor, elasticity, hydration),
painful sensitivity, swelling, masses or deformities, muscles and
bones.
Range of motion assessment: flexion, extension
abduction, adduction, inversion and eversion

Angle of approximately: _____°

absence of movement limitations
( )movimentos amplos ( ) movimentos presos
absence of pain sensitivity
presence of painful sensitivity
Redo all the movements now with your hand over the
patient's quadriceps.
( ) symmetrical joints( ) asymmetric joints (
) ausência de crepitações ( ) presença de crepitações