General Plan of PatientGeneral Plan of Patient‘s‘s ExaminationExamination

Clinical semiology is the science that studies signs and symptoms of disease, as are grouped into syndromes, with the goal of building diagnostics. Used as a work order is known as clinical method. This method includes• questioning,• physical examination,• analysis of laboratory and diagnostic imaging.• diagnosis• treatment The registration of this information is known as Medical Records.

Interview (questioning)Interview (questioning)

I. Identifications and vital statistics

•Name,

•Date of birth,

• Place of birth

•Sex,

•Residence,

•Marriage status, Occupation

•Source of information: patient, others

•Interpreter

ComplainsComplains

Main complains (are typically for one or Main complains (are typically for one or few diseases), for example cough, few diseases), for example cough, dyspnea, pain in the chest can be present dyspnea, pain in the chest can be present in pneumonia and acute bronchitisin pneumonia and acute bronchitis

General complains (can be meet in many General complains (can be meet in many diseases), for example fever, weakness diseases), for example fever, weakness (fatique), headache can present in many (fatique), headache can present in many diseasesdiseases

History of the diseases History of the diseases ( Anamnezis morbi( Anamnezis morbi))

Onset of the diseaseOnset of the disease

Evolution of the diseaseEvolution of the disease

Previous treatment and efficacyPrevious treatment and efficacy

Previous investigationsPrevious investigations

Cause of the last excerbationCause of the last excerbation

Cause of the present appearance in the Cause of the present appearance in the hospitalhospital

History of the life History of the life ( Anamnesis vitae)( Anamnesis vitae)

Essential biografical dataEssential biografical data

Past history

•Previous illnesses

•Previous operations, injuries

•Previous hospitalization

•Infectious diseases

•General health issues

Appetite, Body weight, Weight loss

Stool habits

Urine complaints

Social history

Social status

Economy status

Marital status

HabitsDietSmokingAlcoholDrugs

Family history

Parents, Relatives• Age and health• Death and causes• History of diseases

Hypertension, Hearth disease, Diabetes

Obesity, Endocrine disorders

Tuberculosis, Syphilis,

Malignancies

Alcoholism, Mental disturbances, etc.

Clinical examinationClinical examination

General examinationGeneral examinationPulmonary systemPulmonary systemCardiovascular systemCardiovascular systemDigestiv systemDigestiv systemUrogenital systemUrogenital systemBlood systemBlood systemEndocrin systemEndocrin systemNervous systemNervous system

Physical examinationPhysical examination

It is the process of examining the patient’s body It is the process of examining the patient’s body to determine the presence or absence of to determine the presence or absence of physical problemsphysical problems

The goal of the physical examination is to obtain The goal of the physical examination is to obtain valid information concerning the health of the valid information concerning the health of the patientpatient

The examiner must be able to identify, analyze, The examiner must be able to identify, analyze, and synthesize the accumulated information into and synthesize the accumulated information into a comprehensive assessmenta comprehensive assessment

Important aspects of physical Important aspects of physical examination----physicianexamination----physician

Elegant appearanceElegant appearance

Decent mannerDecent manner

Kind attitudeKind attitude

Highly responsibilityHighly responsibility

Good medical moralsGood medical morals

Important aspects of physical Important aspects of physical examination---patientexamination---patient

The patient should be made as The patient should be made as comfortable as possible during the comfortable as possible during the examinationexamination

The patient should be properly The patient should be properly drapeddraped

Important aspects of physical Important aspects of physical examinationexamination

Where is the bed placed?Where is the bed placed?

When possible, the examining table/bed be When possible, the examining table/bed be situated so that the examiner has access to situated so that the examiner has access to both sides of the patientboth sides of the patient

An ideal arrangement is to have the table An ideal arrangement is to have the table located in the center of the examining roomlocated in the center of the examining room

Important aspects of physical Important aspects of physical examinationexamination

Where does the examiner stand?Where does the examiner stand?

Stand right side of the bedStand right side of the bed

Exam with one’ right Exam with one’ right

handhand

METHODS IN THE PHYSICAL EXAMINATION

General measures:

• Inspection

• Palpation

• Percussion

• Auscultation

InspectionInspection

Method of observation used during physical examinationMethod of observation used during physical examination

First step in examining a patient or body partFirst step in examining a patient or body part

It includes a general survey of the patient’s It includes a general survey of the patient’s

mental status mental status postureposture body movement gaitbody movement gait breath odor skin breath odor skin speech staturespeech stature state of nutritionstate of nutrition

How to inspectHow to inspect

Make sure the room is in a comfortable Make sure the room is in a comfortable temperaturetemperature

Use good lighting, preferably sunlightUse good lighting, preferably sunlight

Look and observe before touchingLook and observe before touching

Completely expose the body part you Completely expose the body part you are inspecting while draping the restare inspecting while draping the rest

Compare symmetrical body partsCompare symmetrical body parts

Consciousness of patientConsciousness of patient

ClearClear

StuporStupor

SoporSopor

Coma (for example – hepatic, Coma (for example – hepatic, hyperglicemic or hypoglicemic, uremic etc)hyperglicemic or hypoglicemic, uremic etc)

Hepatic comaHepatic coma

Posture (or position in the bed)Posture (or position in the bed)

ActiveActive

Passive ( for example – coma)Passive ( for example – coma)

Forced (for exampleForced (for example

in brocnchial asthma)in brocnchial asthma)

Skin AssessmentSkin AssessmentSkin characteristicsSkin characteristics– TemperatureTemperature

Compare upper and lower extremities, and bilaterallyCompare upper and lower extremities, and bilaterally

Excessive warmth may indicate fever, whereas Excessive warmth may indicate fever, whereas excessive coolness may indicate poor circulation, excessive coolness may indicate poor circulation, shock, or hypothyroidismshock, or hypothyroidism

– MoistureMoisture

Should be warm and dry (but excessively dry skin Should be warm and dry (but excessively dry skin may indicate dehydration)may indicate dehydration)

– ColorColor

Varies per age, culture, ethnicityVaries per age, culture, ethnicity

Mongolian spots = blue-black areas that are Mongolian spots = blue-black areas that are sometimes present on the lower back or buttocks of sometimes present on the lower back or buttocks of African American, Native American, and Asian babiesAfrican American, Native American, and Asian babies

Capillary hemangiomas (‘stork bites’) = small, Capillary hemangiomas (‘stork bites’) = small, irregular pink-red areas present around the face/neck irregular pink-red areas present around the face/neck of newbornsof newborns

Common Skin Color VariationsCommon Skin Color VariationsColorColor

VariationVariationDescriptionDescription SignificanceSignificance

PallorPallor Loss of pink/yellow Loss of pink/yellow tones or extreme tones or extreme paleness in light-paleness in light-skinned clientsskinned clientsLoss of red tones in Loss of red tones in dark-skinned dark-skinned clientsclients

Poor circulation, low hemoglobin levelPoor circulation, low hemoglobin levelAssess via oral mucosa, conjunctiva, Assess via oral mucosa, conjunctiva, nail beds, soles of feet, palms of handsnail beds, soles of feet, palms of hands

CyanosisCyanosis Blue-gray Blue-gray coloration of the coloration of the skin; ashenskin; ashen

Central cyanosis is R/T hypoxia Central cyanosis is R/T hypoxia May be seen in extremities after May be seen in extremities after exposure to extreme coldexposure to extreme cold

JaundiceJaundice Yellow-orange cast Yellow-orange cast to the skinto the skin

Associated with liver disordersAssociated with liver disordersAssess via sclera, oral mucosa, palms Assess via sclera, oral mucosa, palms and solesand soles

FlushingFlushing Widespread, Widespread, diffuse area of diffuse area of rednessredness

Results from fever, excessive room Results from fever, excessive room temperature, sunburn, polycythemia, temperature, sunburn, polycythemia, vigorous exercisevigorous exercise

ErythemErythemaa

A reddened areaA reddened area Associated with rashes, skin infections, Associated with rashes, skin infections, prolonged pressure on the skinprolonged pressure on the skin

EcchymoEcchymosissis

Bruised (blue-Bruised (blue-green-yellow) areagreen-yellow) area

Bruising may indicate physical abuseBruising may indicate physical abuse

PetechiaPetechiaee

Tiny, pinpoint red Tiny, pinpoint red or reddish-purple or reddish-purple spotsspots

Extravasation of blood into the skinExtravasation of blood into the skinMay be associated with a disorder or May be associated with a disorder or medicationmedication

CyanosisCyanosis

Pallor Pallor

JaundiceJaundice

Types of jaundiceTypes of jaundice

MechanicalMechanical

HemoliticHemolitic

ParenchymatusParenchymatus

ErythemaErythema

PetechiaePetechiae

Skin Assessment (cont’d)Skin Assessment (cont’d)Skin characteristics (cont’d) --Skin characteristics (cont’d) --– TextureTexture

Should be smooth and softShould be smooth and soft

May be affected by exposure, age, endocrine May be affected by exposure, age, endocrine disorder, and impaired circulationdisorder, and impaired circulation

– TurgorTurgor

Refers to the elasticity of the skin, and indicates Refers to the elasticity of the skin, and indicates hydration statushydration status

Skin that takes 3 seconds or longer to return to its Skin that takes 3 seconds or longer to return to its original position is termed ‘tenting’, and indicates original position is termed ‘tenting’, and indicates dehydrationdehydration

– LesionsLesions

Primary = result of disease or irritationPrimary = result of disease or irritation

Secondary = develops from primary lesions as a Secondary = develops from primary lesions as a result of continued illness, exposure, injury, or result of continued illness, exposure, injury, or infectioninfection

Evaluate for size, shape, pattern, tenderness, pain, Evaluate for size, shape, pattern, tenderness, pain, etcetc

ASSESSMENT OF THE SKINASSESSMENT OF THE SKIN

Skin Skin Nodule--a solid mass extending into the dermis. Nodule--a solid mass extending into the dermis.

(2) Tumor--a solid mass larger than a nodule. (2) Tumor--a solid mass larger than a nodule.

(3) Cyst--an encapsulated fluid-filled mass in the dermis or (3) Cyst--an encapsulated fluid-filled mass in the dermis or subcutaneous layer. subcutaneous layer.

(4) Wheal--a relatively reddened, flat, localized collection of fluid. An (4) Wheal--a relatively reddened, flat, localized collection of fluid. An example is hives. example is hives.

(5) Vesicle--circumscribed elevation containing serous fluid or blood. (5) Vesicle--circumscribed elevation containing serous fluid or blood. An example is chickenpox. An example is chickenpox.

(6) Bulla-- large fluid-filled vesicle. An example is a second-degree (6) Bulla-- large fluid-filled vesicle. An example is a second-degree burn. burn.

(7) Pustule--a vesicle or bulla filled with(7) Pustule--a vesicle or bulla filled with pus. An example is acne. pus. An example is acne.

Skin characteristics (cont’d) --Skin characteristics (cont’d) --– EdemaEdema

Excessive amount of fluid in the tissuesExcessive amount of fluid in the tissues

Common in congestive heart failure, kidney disease, Common in congestive heart failure, kidney disease, peripheral vascular disease, or low albumin levelsperipheral vascular disease, or low albumin levels

Pitting edema is graded on a 0 to +4 scalePitting edema is graded on a 0 to +4 scale

Assessing Pitting EdemaAssessing Pitting EdemaTraTracece

Minimal depression noted when pressure appliedMinimal depression noted when pressure applied

+1+1 Application of pressure creates a depression of about 2 Application of pressure creates a depression of about 2 mm; no visible distortion; rapid return of skin to positionmm; no visible distortion; rapid return of skin to position

+2+2 Application of pressure creates a depression up to 4 mm in Application of pressure creates a depression up to 4 mm in depth that disappears in about 10-15 secondsdepth that disappears in about 10-15 seconds

+3+3 Application of pressure creates a depression of Application of pressure creates a depression of approximately 6 mm in depth that lasts about 1-2 minutes; approximately 6 mm in depth that lasts about 1-2 minutes; area appears swollenarea appears swollen

+4+4 Application of pressure creates a depression up to 8 mm in Application of pressure creates a depression up to 8 mm in depth that persists for about 2-3 minutes; area is grossly depth that persists for about 2-3 minutes; area is grossly edematousedematous

Differential diagnosis between Differential diagnosis between cardiac and renal edemacardiac and renal edema

Cardiac Cardiac RenalRenal

CyanoticCyanotic PallorPallor

Occurs in the eveningOccurs in the evening Occurs in the morningOccurs in the morning

ColdCold WarmWarm

HardHard Soft Soft

Diuretics +Diuretics + Diuretics - Diuretics -

From lower extremitiesFrom lower extremities Diffuse Diffuse

Assessing the HairAssessing the HairAssess for color, texture, condition, and distributionAssess for color, texture, condition, and distribution– Pediculosis = head lice infestationPediculosis = head lice infestation– Nits (lice eggs) may be found on the hair shaft close Nits (lice eggs) may be found on the hair shaft close

to the scalpto the scalp

Alterations in hair distribution may be the sign of Alterations in hair distribution may be the sign of diseasedisease– Alopecia = hair lossAlopecia = hair loss

ChemotherapyChemotherapy

Nutritional deficienciesNutritional deficiencies– Hirsutism = excess facial or trunk hairHirsutism = excess facial or trunk hair

Endocrine disordersEndocrine disorders

Steroid useSteroid use

Assess scalp (dandruff, dermatitis, psoriasis, etc)Assess scalp (dandruff, dermatitis, psoriasis, etc)

HirsutismHirsutism

AllopeciaAllopecia

Assessing the NailsAssessing the NailsCondition of Condition of Nail/Nail BedNail/Nail Bed

Indications or ConcernsIndications or Concerns

Pale or cyanotic Pale or cyanotic bedsbeds

Circulatory or respiratory disorders that result in Circulatory or respiratory disorders that result in anemia or hypoxiaanemia or hypoxia

Half-and-half nailsHalf-and-half nails Appears as a distal band of reddish-pink that Appears as a distal band of reddish-pink that covers 20-60% of the nail; caused by low levels covers 20-60% of the nail; caused by low levels of albumin or renal diseaseof albumin or renal disease

Mee’s linesMee’s lines Appears as transverse white lines in the nail Appears as transverse white lines in the nail bed; results from severe illnessbed; results from severe illness

Splinter Splinter hemorrhageshemorrhages

Small hemorrhages under the nail bed that are Small hemorrhages under the nail bed that are associated with bacterial endocarditis or traumaassociated with bacterial endocarditis or trauma

Black nailsBlack nails Related to blood under the nail--occurs after a Related to blood under the nail--occurs after a local traumalocal trauma

White spotsWhite spots Zinc deficiencyZinc deficiency

ClubbingClubbing Refers to an angle of the nail bed that is 180° or Refers to an angle of the nail bed that is 180° or more (normal is 160°); associated with hypoxic more (normal is 160°); associated with hypoxic states (i.e. chronic lung disease)states (i.e. chronic lung disease)

SpooningSpooning Iron deficiencyIron deficiency

Thickened nailsThickened nails Poor circulation or fungal infectionPoor circulation or fungal infection

Brittle nailsBrittle nails Hyperthyroidism, malnutrition, calcium and iron Hyperthyroidism, malnutrition, calcium and iron deficiencydeficiency

Soft, boggy nailsSoft, boggy nails Poor oxygenationPoor oxygenation

Clubbing (COPD, Cirrhosis, Clubbing (COPD, Cirrhosis, Congenital Valvular Lesions)Congenital Valvular Lesions)

Janeway lesions and splinter hemorrages Janeway lesions and splinter hemorrages (bacterial endocarditis)(bacterial endocarditis)

Assessing the HeadAssessing the HeadObserve symmetry of features, facial expressionsObserve symmetry of features, facial expressions– Abnormal facial features may indicate genetic or Abnormal facial features may indicate genetic or

chronic disorder (i.e. Graves’ disease, chronic disorder (i.e. Graves’ disease, hypothyroidism/myxedema, Cushing’s syndrome)hypothyroidism/myxedema, Cushing’s syndrome)

Assess jaw motion for clicking, pain, or crepitus, Assess jaw motion for clicking, pain, or crepitus, which may indicate temporomandibular joint which may indicate temporomandibular joint syndrome (TMJ)syndrome (TMJ)

Measure head circumference if indicatedMeasure head circumference if indicated– Acromegaly, a disorder of excessive growth Acromegaly, a disorder of excessive growth

hormone, may result in enlarged head in hormone, may result in enlarged head in adolescents and adultsadolescents and adults

– Microcephaly is an abnormally small head size Microcephaly is an abnormally small head size that may accompany mental retardationthat may accompany mental retardation

– Hydrocephalus may present in infants and Hydrocephalus may present in infants and children, indicating an accumulation of excessive children, indicating an accumulation of excessive cerebrospinal fluidcerebrospinal fluid

AcromegalyAcromegaly

Assessing the EyesAssessing the EyesExternal structuresExternal structures– PERRLA (PERRLA (ppupils upils eequal, qual, rround, ound, rreactive to eactive to llight and ight and

aaccommodation)ccommodation)– Conjunctiva: smooth, glistening , and ‘peach’ in colorConjunctiva: smooth, glistening , and ‘peach’ in color– Sclera: smooth, glistening, and blue-white in colorSclera: smooth, glistening, and blue-white in color– Cornea: transparent, smooth, and moistCornea: transparent, smooth, and moist

Visual acuityVisual acuity– Snellen chart measures distance visionSnellen chart measures distance vision

Myopia = diminished distance visionMyopia = diminished distance vision– Near vision measured by having client read newsprint Near vision measured by having client read newsprint

from a distance of 14 inchesfrom a distance of 14 inches

Hyperopia = diminished near visionHyperopia = diminished near vision

Presbyopia = decrease in near vision due to the Presbyopia = decrease in near vision due to the aging processaging process

Assessing the EarsAssessing the Ears

Otic structuresOtic structures– External ear = collects and conveys sound waves; External ear = collects and conveys sound waves;

protects the middle ear from the external protects the middle ear from the external environmentenvironment

Otitis externa = infection of the outer ear that may Otitis externa = infection of the outer ear that may result in a painful auricle or tragusresult in a painful auricle or tragus

– Middle ear = consists of the tympanic membrane, Middle ear = consists of the tympanic membrane, eustachian tube, and the ossicles; conducts sound eustachian tube, and the ossicles; conducts sound waves from the external ear to the inner earwaves from the external ear to the inner ear

Otitis media = middle ear infection that may Otitis media = middle ear infection that may present as tenderness behind the earpresent as tenderness behind the ear

– Inner ear = hearing and equilibriumInner ear = hearing and equilibrium

Cerumen (ear wax) should be present, but should not Cerumen (ear wax) should be present, but should not occlude the ear canalocclude the ear canal– May be black, dark red, gray, or brown in colorMay be black, dark red, gray, or brown in color

Assessing the NoseAssessing the NoseSinus areas should be nontender Sinus areas should be nontender upon palpationupon palpation

Nasal passages should be pink and Nasal passages should be pink and moist, and free from drainage or moist, and free from drainage or lesionslesions

Septum should be symmetricalSeptum should be symmetrical

Assess client’s ability to breathe Assess client’s ability to breathe freely through both sides of the nosefreely through both sides of the nose

Sense of smell is diminished in older Sense of smell is diminished in older adults due to atrophy of olfactory adults due to atrophy of olfactory nerve fibersnerve fibers

Assessing the Mouth and NeckAssessing the Mouth and NeckBuccal mucosa should be smooth, moist, Buccal mucosa should be smooth, moist, and pink:and pink:

Common Buccal/Oral VariationsCommon Buccal/Oral Variations

Condition of Condition of Mouth/Oral MucosaMouth/Oral Mucosa

Indications or ConcernsIndications or Concerns

PalenessPaleness Anemia or inadequate oxygenationAnemia or inadequate oxygenation

Canker soresCanker sores Painful vesicles that erupt with allergies and stressPainful vesicles that erupt with allergies and stress

GingivitisGingivitis Red, swollen or spongy, bleeding gingiva with Red, swollen or spongy, bleeding gingiva with receding gum lines; tenderness may be present; receding gum lines; tenderness may be present; this is a sign of periodontal diseasethis is a sign of periodontal disease

ParotitisParotitis Inflammation of the parotid salivary glandInflammation of the parotid salivary gland

StomatitisStomatitis Inflammation of the oral mucosaInflammation of the oral mucosa

LeukoplakiaLeukoplakia Thick, elevated white patches that do not scrape Thick, elevated white patches that do not scrape off; may be precancerous lesionsoff; may be precancerous lesions

ThrushThrush White, curdy patches that scrape off and bleed White, curdy patches that scrape off and bleed caused by a fungal infectioncaused by a fungal infection

Aphthous ulcersAphthous ulcers Small, painful vesicles with a reddened periphery Small, painful vesicles with a reddened periphery and white/pale yellow base; caused by viral and white/pale yellow base; caused by viral infection, stress, or traumainfection, stress, or trauma

Mouth and Neck Assessment Mouth and Neck Assessment (cont’d)(cont’d)

Mouth/lips should be symmetricalMouth/lips should be symmetrical– Assess for swelling or droopingAssess for swelling or drooping– Assess for difficulty swallowingAssess for difficulty swallowing

Assess teeth for dentures, obvious caries, loose Assess teeth for dentures, obvious caries, loose teethteeth

Tongue should be moist, symmetrical, slightly Tongue should be moist, symmetrical, slightly rough, smooth, pink, and freely movablerough, smooth, pink, and freely movable– Abnormal findings include deviation from Abnormal findings include deviation from

midline; glossitis (inflammation of the tongue); midline; glossitis (inflammation of the tongue); limited mobility; dry, furry tongue related to limited mobility; dry, furry tongue related to dehydration; black, “hairy” tongue associated dehydration; black, “hairy” tongue associated with fungal infections; swelling, nodules, or with fungal infections; swelling, nodules, or ulcersulcers

Palpate neck for tenderness/nodules, thyroidPalpate neck for tenderness/nodules, thyroid– Inspect for swelling, ROMInspect for swelling, ROM

Lymph nodesLymph nodes

Palpation of lymph nodesPalpation of lymph nodes

DimensionsDimensions

MobilityMobility

TendernessTenderness

ConfusionConfusion

Lymph nodesLymph nodes

Lymph nodesLymph nodes

Thyroid glandThyroid gland

Muscle system assessmentMuscle system assessment

Muscle system assessment (conMuscle system assessment (con'' d) d)

Shape (development of muscle)Shape (development of muscle)

TendernessTenderness

MobilityMobility

Muscle power (tonus of muscles)Muscle power (tonus of muscles)

Palpation of the bones and jointsPalpation of the bones and joints

Assesssment of joints and bonesAssesssment of joints and bones

ShapeShape

DimensionsDimensions

TemperatureTemperature

MobilityMobility

Very often joints are affected in diseases Very often joints are affected in diseases of connective tissue ( rheumatic fever, of connective tissue ( rheumatic fever, lupus erythematosus (SLE), rheumatoid lupus erythematosus (SLE), rheumatoid arthritis, sclerodermia, dermatomyositis)arthritis, sclerodermia, dermatomyositis)

Rheumatic fever, Rheumatic fever,

ANTHROPOMETRYANTHROPOMETRY

Definition of Definition of "anthropometry“"anthropometry“ - - measurement and study of the human measurement and study of the human body and its parts and capacitiesbody and its parts and capacities

ANTHROPOMETRYANTHROPOMETRY

BODY MASS INDEXBODY MASS INDEX

BODY MASS INDEXBODY MASS INDEX

CELEBRITIES BMICELEBRITIES BMIAshley Judd: 5'7 125 bmi: 19.6Anna Kournikova, 5'8", 113 pounds, BMI 17.2Adriana Lima, 5'10", 125 pounds, BMI 17.9Britney Spears: 5'5", 105 bmi: 17.5Beyonce Knowles, 5'5", 150 pounds BMI 25Christina Aguilera: 5'2 100 bmi: 18.3Cameron Diaz, 5'9", 120 pounds, BMI 17.8Calista Flockhart, 5'6", 97 pounds, BMI 15.5Denise Richards 5'6", 119 pounds, BMI 18.8Faith Hill, 5'8", 121 pounds, BMI 18.4Fiona Apple, 5'3", 105 pounds, BMI 18.6Gwyneth Paltrow: 5'9", 112 bmi: 16.5Giselle Bundchen, 5'11", 115 pounds, BMI 16Geri Halliwell, 5'2", 99 pounds, BMI 18.2Heidi Klum: 5'9 119 bmi:18Heather Locklear: 5'5", 105 bmi:17Jennifer Lopez: 5'6", 120 bmi: 19.3Julia Roberts: 5'10", 120 bmi: 17.3James King, 5'9", 120 pounds, BMI 17.7

Jennifer Aniston, 5'6", 110 pounds, BMI 17.8Kirsten Dunst, 5'4", 100 pounds, BMI 17.2Katie Holmes, 5'8", 120 pounds, BMI 18Kate Moss, 5'7", 107 pounds, BMI 17.3Lisa Kudrow, 5'7", 123 pounds, BMI 18.8Mandy Moore, 5'8", 108 pounds, BMI 16.4Mayra Hornbacher, 5"1, 52 pounds, BMI 9.8Nikki Taylor: 5'10" 118 BMI 16.9Nicole Kidman: 5'10 120 bmi: 17.2Nicole Richie: 5’1” 83 lbs bmi: 15.3Naomi Campbell, 5'10", 110 pounds, BMI 15.8Neve Campbell, 5'5", 123 pounds, BMI 20.5Pamela Anderson: 5'7 105 bmi: 16.4Paris Hilton, 5'8", 115 pounds BMI 17.5Reese Witherspoon: 5'6", 122 bmi: 19.6Salma Hayek: 5'7", 115 bmi: 18Sandra Bullock: 5'8", 110 bmi: 16.7Sarah Michelle Gellar: 5'3", 98 bmi: 17

WAIST CIRCUMFERENCEWAIST CIRCUMFERENCE

Waist circumference (distance around the waist) Waist circumference (distance around the waist) is a common measure used to check for fat held is a common measure used to check for fat held around the stomach. Having extra body fat around the stomach. Having extra body fat around the stomach—more than 35 in (89 cm) around the stomach—more than 35 in (89 cm) for women and more than 40 in (102 cm) for for women and more than 40 in (102 cm) for men—increases your risk of heart disease and men—increases your risk of heart disease and diabetes.diabetes.How to measure waist circumference: Place a How to measure waist circumference: Place a tape measure around your body at the top of tape measure around your body at the top of your hipbone. This is usually at the level of your your hipbone. This is usually at the level of your belly button, as shown in the picture above.belly button, as shown in the picture above.

WAIST CIRCUMFERENCEWAIST CIRCUMFERENCE

WAIST CIRCUMFERENCEWAIST CIRCUMFERENCE

Temperature is a physical quantity and Temperature is a physical quantity and hence, measurable. hence, measurable.

The science of measurement of The science of measurement of temperature is known as temperature is known as thermometrythermometry. . The devices used to measure The devices used to measure temperatures are known as thermometers. temperatures are known as thermometers.