Examination

Physical examination of the state of nutrition entails a thorough clinical examination to look for:

• general signs of deficiency:
  • hair: frail, loose, lanugo
  • skin: petechiae, purpura, thinness
  • lips: cheilosis, angular fissure
  • papillae atrophy of tongue
  • salivary gland enlargement
  • peripheral oedema
• the stigmata of specific deficiencies e.g. poorly-healing wounds with vitamin C deficiency
• assessing body stores of fat e.g. tissue overlying biceps and triceps in the arm
• assessing body stores of protein e.g. temporalis, supraspinatus and interosseous muscles
• the extent of physiological dysfunction e.g.:
  • activity and mobility around ward
  • ability to blow match out as a crude measure of respiratory muscle function
  • hand grip dynanometry
• anthropometric measures.