Ultimate Guide to Head-to-Toe Physical Assessment

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Extremities

Inspection

• Observe for size, contour, bilateral symmetry, and involuntary movement.
• Look for gross deformities, edema, presence of trauma such as ecchymosis or other discoloration.
• Always compare both extremities.

Palpation

• Feel for evenness of temperature. Normally it should be even for all the extremities.
• Tonicity of muscle. (Can be measured by asking client to squeeze examiner’s fingers and noting for equality of contraction).
• Perform range of motion.
• Test for muscle strength. (performed against gravity and against resistance)
• Table showing the Lovett scale for grading for muscle strength and functional level

Functional level	Lovett Scale	Grade	Percentage of normal
No evidence of contractility	Zero (Z)	0	0
Evidence of slight contractility	Trace (T)	1	10
Complete ROM without gravity	Poor (P)	2	25
Complete ROM with gravity	Fair (F)	3	50
Complete  range of motion against gravity with some resistance	Good (G)	4	75
Complete  range of motion against gravity with full resistance	Normal (N)	5	100

Normal Findings

• Both extremities are equal in size.
• Have the same contour with prominences of joints.
• No involuntary movements.
• No edema
• Color is even.
• Temperature is warm and even.
• Has equal contraction and even.
• Can perform complete range of motion.
• No crepitus must be noted on joints.
• Can counter act gravity and resistance on ROM.

Navigation

1. Head Assessment
2. Neck
3. Thorax
4. Breast
5. Abdomen
6. Extremities