 blood pressure 137/60, pulse 90 and regular without ectopy, respiratory rate 20 without unusual respiratory effort.  In general, she is well developed, well nourished, oriented, and alert and in no apparent distress.  Head, ears, eyes, nose, and throat are unremarkable.  Neck is supple.  No neck vein distention is noted.  No bruits are heard.  Chest is clear to percussion and auscultation.  Heart has a regular rhythm and rate without murmurs or rubs or gallops.  Abdomen is soft, obese, and nontender.  Musculoskeletal is intact without deformity.  However, the patient did develop severe cramp behind her left knee during her treadmill testing.  Neurologic:  Cranial nerves are intact and she is nonfocal.  Skin is warm and dry without rash or lesions noted.