UNIVERSIDAD DE SAN CARLOS DE GUATEMALA

FACULTAD DE CIENCIAS MDICAS CUNOR-

SEMIOLOGA MDICA I SEGUNDO AO

ESTUDIANTE: ______________________________________________________CARN:___________________
GRUPO: _________________________________ FECHA: ___________________________________________
HOSPITAL DONDE REALIZA SU PRCTICA: ______________________________________________________

DATOS DEL PACIENTE

NOMBRE DEL PACIENTE:______________________________________________________________________
DATOS GENERALES:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

PERSONA QUE INFORMA:

__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
_____________________________________________________________________________________________

MOTIVO DE CONSULTA
_____________________________________________________________________________________________

HISTORIA DE LA ENFERMDEDAD ACTUAL

__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
_____________________________________________________________________________________________
 UNIVERSIDAD DE SAN CARLOS DE GUATEMALA
FACULTAD DE CIENCIAS MDICAS CUNOR-
SEMIOLOGA MDICA I SEGUNDO AO

REVISION POR RGANOS APARATOS Y SISTEMAS

Sntomas Generales:_____________________________________________________________________________
_____________________________________________________________________________________________
Piel y Faneras: _________________________________________________________________________________
_____________________________________________________________________________________________
Cabeza:_______________________________________________________________________________________
__________________________________________________________________________________________________
Ojos:_____________________________________________________________________________________________
__________________________________________________________________________________________________
Oidos:____________________________________________________________________________________________
__________________________________________________________________________________________________
Nariz:_____________________________________________________________________________________________
__________________________________________________________________________________________________
Boca:_____________________________________________________________________________________________
__________________________________________________________________________________________________
Garganta:__________________________________________________________________________________________
__________________________________________________________________________________________________
Cuello:____________________________________________________________________________________________
__________________________________________________________________________________________________
Mamas:___________________________________________________________________________________________
__________________________________________________________________________________________________
Aparato Cardiovascular:______________________________________________________________________________
__________________________________________________________________________________________________
Aparato Respiratorio:________________________________________________________________________________
__________________________________________________________________________________________________
Gastrointestinal:____________________________________________________________________________________
__________________________________________________________________________________________________
Uninario:__________________________________________________________________________________________
__________________________________________________________________________________________________
Genitales:__________________________________________________________________________________________
__________________________________________________________________________________________________
Vascular Perifrico:__________________________________________________________________________________
__________________________________________________________________________________________________
Locomotor:________________________________________________________________________________________
__________________________________________________________________________________________________
Psiquitrico:________________________________________________________________________________________
__________________________________________________________________________________________________
Neurolgico:_______________________________________________________________________________________
__________________________________________________________________________________________________
Hematolgico:______________________________________________________________________________________
__________________________________________________________________________________________________
Endocrino:_________________________________________________________________________________________
__________________________________________________________________________________________________
 UNIVERSIDAD DE SAN CARLOS DE GUATEMALA
FACULTAD DE CIENCIAS MDICAS CUNOR-
SEMIOLOGA MDICA I SEGUNDO AO

ANTECEDENTES
FISIOLGICOS:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
PATOLGICOS:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
PERFIL SOCIAL:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

EXAMEN FSICO
S/V: FC: _____________ FR:_____________ Temp:________________ P/A: _______________ Pulso:____________
ESTATURA: ____________________ PESO: ______________________ IMC: ________________________________
P/T____________________________ T/E:-______________________________ P/E:____________________________

ESTADO GENERAL________________________________________________________________________________
__________________________________________________________________________________________________
PIEL Y FANERAS__________________________________________________________________________________
 UNIVERSIDAD DE SAN CARLOS DE GUATEMALA
FACULTAD DE CIENCIAS MDICAS CUNOR-
SEMIOLOGA MDICA I SEGUNDO AO

__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
CABEZA: _________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
ORL: _____________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
CUELLO: _________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
TRAX Y CORAZN OSTEOARTICULAR____________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
ABDOMEN:_______________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
GENITALES:______________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
OSTEOARTICULAR:_______________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
EXTREMIDADES: _________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
SISTEMA LINFTICO: _____________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
NEUROLGICO: __________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

IMPRESIN CLNICA:____________________________________________________________________________