 The physical examination of the patient comes next, and at this stage one needs the presence of a well-trained chaperone because of litigation. And the patient must be disrobed but suitably draped so that the examination can go on smoothly. Now here I have with me PNO Mrs. Mensa as my chaperone. The examination itself starts with the general examination and there we start by looking at observing the patient for a general appearance, whether she is well or not. And then her build, the posture and the nutritional status are also important. Now one proceeds to measure the height and weight if not done previously. Then with this the body mass index may be calculated with the formula of BMI equals weight or mass in kilograms divided by the square of the height in meters. The arm span is also important for adolescents or those with endocrine problems. One then proceeds to look at the conjunctiva for palo or jaundice and then also the presence of cyanosis. Her state of hydration is equally important. Now the oral cavity must be examined, the lips and the tongue for palo or how pink it is or how pink they are. And then the teeth, is there any problem with the teeth? And what about the oral hygiene? It's very important to find out next whether there is a goiter, that means thyroid swelling. And one can find this by asking the patient to swallow saliva. Then the goiter moves up and then down after swallowing. The lateral neck swellings are also important such as enlarged lymph nodes. One then looks at the hands, the palms for the palo again. Then the nails, we want to look out for the nail bed filling and then the presence of clubbing. Which may be an important sign of cardiovascular disease. And then one also looks out for edema of the legs and the presence of varicose veins also on the legs. One examines the breast next and makes sure that they are of normal size, that means well developed. And then the state of the nipples whether they are invaded or evaded or whether they are flat. And then the areola for the presence of Montgomery's tubercles. Now one proceeds to pop it for any nodules. And then also tries to express discharge from the nipples. If there is, then one notes the color. For instance, clear colorless discharge may denote gallatoria. And the presence of blood may also mean the presence of Dr. Lectizia or Papilloma. One proceeds to examine the cardiovascular system. The pulse we are interested in the rate, the rhythm and the volume whether it's collapsing or not. And in fact all the other characteristics that we know of. And then the blood pressure must be taken in the middle. In the presence of severe anemia or suspected cardiovascular disease one should look at the jugular venous pressure. And then proceeds to the precordium to examine the heart. Inspection should give us the presence or the position of the apex beat. Usually located in the fifth left intercostal space in the mid-clavicular line. But when it is enlarged it's usually outside this line. And one purpose is for the presence of heaving or the presence of a palpable members. And then oscaltation will follow. Also at the same point the apex beat using the bell of the stethoscope to find the characteristics of the heart beats. One and two, if there are additional heart beats this should be detected. And then the presence of members is also very important. One then proceeds to listen to the left inner edge and then to the pulmonary area of the chest. And completes the cardiovascular examination. The respiratory examination is also important. And one has to go through all the signs to make sure that there is no evidence of chest disease.