GENERAL: , Alert, well developed, in no acute distress.,MENTAL STATUS: , Judgment and insight appropriate for age.  Oriented to time, place and person.  No recent loss of memory.  Affect appropriate for age.,EYES:  ,Pupils are equal and reactive to light.  No hemorrhages or exudates.  Extraocular muscles intact.,EAR, NOSE AND THROAT: , Oropharynx clean, mucous membranes moist.  Ears and nose without masses, lesions or deformities.  Tympanic membranes clear bilaterally.  Trachea midline.  No lymph node swelling or tenderness.,RESPIRATORY:  ,Clear to auscultation and percussion.  No wheezing, rales or rhonchi.,CARDIOVASCULAR: , Heart sounds normal.  No thrills.  Regular rate and rhythm, no murmurs, rubs or gallops.,GASTROINTESTINAL: , Abdomen soft, nondistended.  No pulsatile mass, no flank tenderness or suprapubic tenderness.  No hepatosplenomegaly.,NEUROLOGIC: , Cranial nerves II-XII grossly intact.  No focal neurological deficits.  Deep tendon reflexes +2 bilaterally.  Babinski negative.  Moves all extremities spontaneously.  Sensation intact bilaterally.,SKIN: , No rashes or lesions.  No petechia.  No purpura.  Good turgor.  No edema.,MUSCULOSKELETAL: , No cyanosis or clubbing.  No gross deformities.  Capable of free range of motion without pain or crepitation.  No laxity, instability or dislocation.,BONE: , No misalignment, asymmetry, defect, tenderness or effusion.  Capable of from of joint above and below bone.,MUSCLE:  ,No crepitation, defect, tenderness, masses or swellings.  No loss of muscle tone or strength.,LYMPHATIC:,  Palpation of neck reveals no swelling or tenderness of neck nodes.  Palpation of groin reveals no swelling or tenderness of groin nodes.consult - history and phy., mental status, ear, nose and throat, abdomen soft, nondistended, cranial nerves ii-xii grossly intact, physical exam, 