WHAT IS THE OUTER HABITUS? - MEDICINE - 2024

The exterior habitus is the set of medical data collected through general inspection with the naked eye, without having performed any physical examination. It can also be defined as the external appearance of the patient.

In order to carry out the outer habitus, the patient's condition, the patient's sex, apparent age, constitution, attitude, state of consciousness, etc. are taken into account. In the patient's condition, the severity of the patient is assessed. It is usually done through two distinctions, if you walk or if you are bedridden.

If the patient can walk, we can rule out that he has something broken in his lower body. If the patient is bedridden, we can observe if there is any injury that prevents him from standing, or if his state of consciousness is altered.

Data observed in the exterior habitus

Sex

The sex of the patient is a factor to take into account since there are sex-specific conditions. The characteristic features according to sex, can also allow us to see the incidence of the disease.

Age

Apparent age is the age that the patient appears to the naked eye. It is also important in the face of diseases that have a higher incidence in an age range of the population.

The apparent age also reflects the patient's lifestyle or the pathological history that may have left a mark on the patient.

If the patient is unconscious and there is no person accompanying him who knows what has happened or the history, estimating his age may be recommended for some differential diagnoses.

If you are a pediatric patient, it is important to assess your apparent age as expected for growth and development.

Constitution

The constitution of the patient is also important due to its degree of robustness. It is based on 4 types of constitution. Strong constitution where muscle and bone tissue predominate; the mean, where there is a proportion between the three tissues.

The weak constitution where the bones predominate. And finally, the strong weakened constitution, where individuals are seen to have characteristics of strength but something has strongly weakened them.

Attitude

The patient's attitude is also a point to take into account in the outer habitus. If it is freely chosen, which means that the individual has control over their attitude and can change it at will or if on the contrary it is instinctive, where the attitude they have is to reduce a discomfort, for example, fetal position to reduce abdominal pain.

You can also have a forced activity, where you cannot change positions due to a physical injury. Or finally, a passive attitude where the individual's will cannot intervene and the attitude is governed by gravity, such as a coma.

Facies

The facies are the expressions of the individual's face, which can also help us in our examination of exterior habitus. The types of facies can be very varied.

They can be non-characteristic, are typical of a healthy individual and represent the mood of the patient at that time.

It can be feverish or voluptuous, where there is an appearance with ruddy cheeks, conjunctival congestion, increased respiratory rate, skin brightness, etc.

It can also be a face where the eyelids are semi-closed, the gaze vague, indifference and mental clumsiness, sharp features, peeling…

Continuing with our type of facies we have the leonine, which is characterized by sunken eyes with little movement, alopecia, protruding cheekbones and wide nose, dry lips, intellectual clumsiness… It occurs in diseases such as leprosy, tuberculosis or fungal diseases

Adissonian is another type of face, characterized by hyperpigmentation of the face and mucous membranes due to an excess of melanin. It usually occurs in irritable patients with weight loss and is related to adrenal insufficiency.

Abnormal movements

To continue with our study of the exterior habitus, we have to make sure that there are no abnormal movements, characterized by tremors, seizures and tics.

Choreic movements, which are irregular and disorderly involuntary movements, are also considered abnormal movements; the athetosics, which are very slow movements of great amplitude; dystonic, which are conscious movements that place the body in a forced position. We also include the hemibalistic movements that are abrupt and centrifugal, in addition to the parkinsonian ones.

March

Another feature to take into account in the study of the external habitus is the patient's gait.

Abnormal gaits can be unilateral when they only lean on one limb, and within this we distinguish hemiplegic, helcopod, and claudicant gaits.

Among the abnormal gaits are also the bilateral ones when the defect exists in both legs. They can be ataxic, spastic, polyneuritic, parkinsonian, hesitant, or myopathic.

Awareness

Finally we must take into account the state of consciousness of the individual. These can be differentiated between conscious, drowsy, confusion, drowsiness, stupor, drowsiness, coma or brain death.

The most important to take into account are those of drowsiness when the individual is able to stay awake even trying, the stupor where the patient does not react to painful stimuli; drowsiness, where you begin to see the alteration of vital signs, coma where consciousness no longer exists, and brain death where brain waves no longer exist.

References

1. BOURDIEU, Pierre. Structures, habitus, practices. The practical sense, 1991, p. 91-111.
2. SACKETT, David L.; HAYNES, R. Brian; TUGWELL, Peter. Clinical Epidemiology: A Basic Science for Clinical Medicine. Editions Díaz de Santos, 1989.
3. JIMÉNEZ MURILLO, LUIS; MONTERO PÉREZ, F. JAVIER. Emergency medicine and emergencies. Diagnostic guide and action protocols. Editorial Elsevier SL Barcelona, ​​Spain, 2009.
4. JIMÉNEZ, Luis; MONTERO, F. Javier. Emergency and emergency medicine: diagnostic guide and action protocols. Elsevier Health Sciences Spain, 2009.
5. MURILLO, Luis Jiménez; PÉREZ, F. Javier Montero (ed.). Emergency and emergency medicine + web access: Diagnostic guide and action protocols. Elsevier Spain, 2014.
6. MURILLO, Luis Jiménez; PÉREZ, Francisco Javier Montero. Emergency Medicine. Therapeutic guide 3 ed. © 2011. Elsevier Spain, 2011.