REVIEW OF SYSTEMS The Review of Systems (According to the Guide) A briefer limited examination of: The anatomical and

nd physiological status of the cardiovascular/pulmonary, integumentary, musculoskeletal. and neuromuscular systems and The communication ability, affect, cognition, language, and learning style of the patient/client The physical therapist especially notes how these affect the ability to initiate, sustain, and modify purposeful movement for performance of an action, task, or activity that is pertinent to function Also assists the physical therapist in identifying possible problems that require consultation with or referral to another provider. Components (usual) Cardiovascular/Pulmonary System Integumentary System Musculoskeletal System Neuromuscular System Communication Ability, Affect, Cognition, Language, and Learning Style Musculoskeletal System Gross symmetry Gross range of motion Gross strength Height Weight Neuromuscular System Gross coordinated movement (e.g.. balance, locomotion, transfers, and transitions) Communication Ability, Affect, Cognition, Language, and Learning Style Ability to make needs known Consciousness Orientation (person, place, and time) Expected emotional/behavioral responses Learning preferences (e.g., teaming barriers, education needs) Components (according to Goodman & Snyder): General Survey Cardiovascular/Pulmonary Screening Examination Integumentary Screening Examination

Lymph Node Palpation Musculoskeletal Screening Examination Neurologic Screening Examination Regional Screening Examination Techniques of Physical Examination Inspection Palpation Percussion Auscultation Screening Examination Kit Contents Stethoscope Sphygmomanometer Thermometer Pulse oximeter Reflex hammer Penlight Safety pin or sharp object (tongue depressor broken in half gives sharp and dull sides) Cotton-tipped swab or cotton ball 2 test tubes Familiar objects (e.g., paper clip, coin, marble) Tuning fork (128 Hz) Watch with ability to count seconds Gloves for palpation of skin lesions Ruler or plastic tape measure to measure wound dimensions, skin lesions, leg length Goniometer General Survey Initial Observations of: Body size / type Facial expressions Unusual appearance / presentation Posture Movement patterns Gait Balance Coordination Mental Status Level of consciousness Orientation Ability to communicate Nutritional Status

Malnutrition / Overnutrition (Obesity) Body Mass Index (BMI) Body and Breath Odors

Cardiovascular/Pulmonary Screening Examination Vital Signs Pulse / heart rate Blood pressure Core body temperature (oral or ear) Respirations Pulse oximetry (02 saturation) Skin temperaturedigits (thermister) Pain (now called the 5th vital sign) Integumentary Screening Examination Skin Assessment Nail Bed Assessment Musculoskeletal Screening Examination Inspect for: Obvious deformities Abnormalities Disabilities Asymmetries Inspection and palpation of: Skin Muscles Soft tissues Joints Gross range of motion Gross strength Anthropometric Characteristics: Height Weight Neurologic Screening Examination Mental and Emotional Status Cranial Nerves Motor Function Gross motor Fine motor Sensory Function Light touch Vibration Pain Temperature

 Reflexes Neural Tension Regional Screening Examination Head and Neck Upper / Lower Extremities Chest and Back (Thorax) Abdomen Other Rheumatologic Psychologic Gastrointestinal Tract (GIT) Hepatic/Biliary Hematologic Genitourinary Gynecologic Immunologic Endocrine Cancer