1 - Intro to Physical Assessment

Question 1

Subjective Data

Answer 1

Symptoms: What the patient tells you about his/her health

• Chief complaint
• History of presenting illness
• Review of systems

Question 2

Objective Data

Answer 2

Signs: What you detect during the examination

• general survey
• vitals
• lab tests
• physical exam

Question 3

List 3 things included in a quick assessment of the whole person

Answer 3

• level of consciousness
• age, weight, height, build
• skin color and obvious lesions

Question 4

Inspection

Answer 4

Observation of physical signs

ex. jaundice - drug-induced hepatic toxicity

Question 5

Palpation

Answer 5

Sense of touch

ex. skin lesion - drug induced skin rash

Question 6

Percussion

Answer 6

Density of structures 4-5 cm below the skin

ex. disappearance of dull sound (fluid accumulation) over lung - sign of antibiotic effectiveness

Question 7

Auscultation

Answer 7

Sounds originating within organ/body cavity

ex. bowel sounds - drug-induced gastroparesis

Question 8

Inspection is also known as ______ _______ of physical signs

Answer 8

concentrated watching

Question 9

Inspection:

What is used as the control?

Answer 9

Patient can be used as his/her own control

-Compare the right and left sides of the body

Question 10

Inspection may require use of ______

Answer 10

instruments (ex. otoscope, ophthalmascope, penlight)

Question 11

Palpation:

Fingertips used for?

Answer 11

Best for fine tactile discrimination:

• Skin texture
• Swelling
• Lumps or masses

Question 12

Palpation:

Fingers-thumbs used for?

Answer 12

Grasping action of fingers and thumb useful in detecting:

• Organ position
• Organ shape or consistency
• Organ mass

Question 13

Palpation:

Backs of hands and fingers used for?

Answer 13

Best for determining temperature

Question 14

Palpation:

Base of fingers or ulnar surface of hand?

Answer 14

Best for detecting vibration

Question 15

What does percussion involve?

Answer 15

Involves tapping the person’s skin with short, sharp strokes to assess structures 4-5 cm below the skin

Question 16

Percussion:

The stroke yields a palpable vibration and a characteristic sound that can depict what?

Answer 16

• Map the location and size of the organ
• Determine the density (air vs. fluid vs. solid) of the organ
• Detect a superficial abnormal mass (~5cm deep)
• Elicit a deep tendon reflex (using a percussion hammer)

Question 17

Percussion:

What is much more accurate?

Answer 17

Imaging tests (ex. ultrasound)
*But your hands are easily accessible and give you instant feedback

Question 18

See table on page 3 (characteristics of percussion notes)

Answer 18

ok ma dudes

Question 19

Auscultation: Involves listening to sounds produced by the body (list examples)

Answer 19

heart, blood vessels, lungs, abdomen

Question 20

Auscultation:

Most body sounds are soft and must be channeled through a _______

Answer 20

stethoscope

Question 21

Stethoscope:

Describe the diaphragm

Answer 21

• Flat edge
• High-pitched sounds (breath, bowel, normal heart sounds)
• Hold firm against the skin

Question 22

Stethoscope:

Describe the bell

Answer 22

• Deep cup-like surface
• Soft, low-pitched sounds (diastolic murmur of mitral stenosis, S3/S4)
• Hold lightly to skin