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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
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 Swelling
Angioedema
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.
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.