Physical assessment steps, order follows the 'NUR 131/170/190: PHYSICAL ASSESSMENT'


Full List / Order for Reference:

General Survey
Introduce self, greet patient, shake hands, observe gait and posture
Ask purpose of visit and confirm appointment time
Assess orientation to person, place, time, and situation
Observe eye contact
(Note that "Observe posture" and "Observe gait" have been removed since they're included in the first step. They would normally appear here on the assessment list.)
Assess general appearance and signs of distress
Observe hygiene of hair, nails, and clothing
Assess speech clarity and appropriateness
Ask about diet and daily water intake
Assess skin during handshake
State skin will be assessed throughout exam
Ask about pain and instruct patient to report discomfort anytime

Head and Face & Eyes and Ears
Inspect hair texture, distribution, and amount
Inspect symmetry and external appearance of eyes and ears
Inspect eyelids, eyelashes, and eyebrows
Inspect sclera and conjunctiva
Assess visual fields / visual acuity
Test pupillary response to light and accommodation
Test extraocular movements in H pattern
Ask patient to open jaw and clench teeth; palpate masseter
Ask patient to raise brows, shut eyes, puff cheeks, and smile
Test hearing by whispered number with one ear covered

Mouth and Pharynx
Inspect lips, mucosa, gums, palate, floor of mouth, teeth, and pharynx
Note uvula, tonsils, posterior pharynx, and mouth odor
Ask patient to swallow, open mouth, and say “ah”
Ask patient to stick out tongue and move it side to side

Neck
Inspect neck and thyroid for symmetry and smoothness
Palpate thyroid while patient swallows
Test head, neck, and shoulder strength against resistance
Inspect right jugular vein at 45° with head turned left
Palpate carotid pulses one side at a time
Auscultate carotids for bruits with bell
Palpate trachea for midline position

Upper Extremities
Inspect and palpate shoulders, arms, and hands
Assess tone, temperature, color, hair distribution, and edema
Check capillary refill on one finger of each hand
Palpate brachial and radial pulses
Assess ROM of wrists, elbows, and shoulders
Assess grip strength and arm resistance