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General Survey, Measurement, Vital Signs


age, sex, level of consciousness, skin color, facial features


The person appears his or her stated age


Sexual development is appropriate for gender and age

Level of consciousness

the person is alert and oriented, attends to your questions and responds appropriately

Skin color

color tone is even, pigmentation varying with genetic background, skin is intact with no obvious lesions

Facial features

facial features are symmetric with movement


stature, nutrition, symmetry, posture, position, body build contour


the height appears within normal range for age, genetic heritage


the weight appears within normal range for height and body build; body fat distribution is even


body parts look equal bilaterally and are in relative proportion to each other


the person stands comfortably erect as appropriate for age. note the normal "plumb line" though anterior ear, shoulder, hip, patella, ankle. expectations are the standing toddler who has a normally protuberant abdomen and the aging person who may be stopped with kyphosis.


the person sits comfortably in a chair or on the bed or examination table, arms relaxed at sides, head turned to examiner

Body, Build, Contour

1. arm span (fingertip to fingertip) = height
2. body length from crown to pubis roughly equal to length from pubis to sole


Gait, range of motion


normally, the base is as wide as the shoulder width; foot placement is accurate; the walk is smooth, even, and well-balanced; and associated movements, such as symmetric are swing, are present

Range of motion

note full mobility for each joint and that movement is deliberate, accurate, smooth, and coordinated
no involuntary movement


facial expression, mood and affect, speech, dress, personal hygiene

Facial expression

the person maintains eye contact, expressions are appropriate to the situation

Mood and Affect

the person is comfortable and cooperative with the examiner and interacts pleasantly


articulation is clear and understandable
the stream of talking is fluent, with an even pace
the person conveys ideas clearly
word choice is appropriate to cultrue and education
the person communicates in prevailing language easily by himself or herself or with and interpreter


clothing is appropriate to the climate, looks clean and fits the body, and is appropriate to the person's culture and age-group

personal hygiene

the person appears clean and groomed appropriately for his or her age, occupation, and socioeconomic group.
hair is groomed, brushed, women's makeup is appropriate for age and culture


Weight, height, body mass index, waist circumference


use balance or electronic standing scale. remove shoes and heavy clothing. record in kilograms and in pounds


use wall mounted device or measuring pole on the balance scale. align with top of head, shoeless,l standing straight, looking straight, feet, head and shoulders should touch hard surface

Body mass index

practical marker of optimal healthy weight for height and and indicatior of obesity or malnutrition.
healthy is level of 19 or greater to less than 25

Note: BMI overestimates body fat in persons who are very muscular, and it underestimates body fat in older adults who have lost muscle mass

What is the BMI formula?

weight (in pounds)/height (in inches)^2 X 703

Weight (in kg)/height (in meters)^2

Waist circumference

with person standing, locate the hip bone and the top of its right iliac crest. place measuring tape around the waist, parallel to the floor, at the level of the iliac crest.


Temperature, pulse, respirations, blood pressure

What is normal oral temperature of resting person? How much higher does rectal temp measure?

37 C (98.6 F), with a range of 35.8 to 37.3 C (96.4 to 99.1 F)
rectal = .4 to .5 C higher (.7 to 1 F)

What core temperature does cellular metabolism require?

37.2 C (99 F)

What is unique about the oral sublingual site for taking temperature?

it has a rich blood supply from the carotid arteries taht quickly responds to changes in inner core temp

When is the tempanic membrane thermometer used?

unconscioius patients or with those in emergency departments, recover areas, labor and delivery units

stroke volume

the amount of blood pumped with every heartbeat

What is the average stroke volume in an adult?


What is the normal heart rate range?

50-90 bpm

After puberty who has a faster heart rate?


what is bradycardia?

heart rate <50 bpm

What is tachycardia?

heart rate >90 bpm

Sinus arrythmia

normally occurs in children and young adults; the heart rate varies with the respiratory cycle, speeding up at the peak of inspiration and slowing to normal with expiration

What is the normal respiration rate for adults?

10-20 breaths per minute

systolic pressure

the maximum pressure felt on the artery during left ventricular contraction, or systole

diastolic pressure

the resting pressure that the blood exerts constantly between each contraction

pulse pressure

the difference between the systolic and diastolic pressures and reflects the stroke volume

mean arterial pressure (MAP)

the pressure forcing blood into the tissues, averaged over the cardiac cycle

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