1 - Intro to Physical Assessment Flashcards
Subjective Data
Symptoms: What the patient tells you about his/her health
- Chief complaint
- History of presenting illness
- Review of systems
Objective Data
Signs: What you detect during the examination
- general survey
- vitals
- lab tests
- physical exam
List 3 things included in a quick assessment of the whole person
- level of consciousness
- age, weight, height, build
- skin color and obvious lesions
Inspection
Observation of physical signs
ex. jaundice - drug-induced hepatic toxicity
Palpation
Sense of touch
ex. skin lesion - drug induced skin rash
Percussion
Density of structures 4-5 cm below the skin
ex. disappearance of dull sound (fluid accumulation) over lung - sign of antibiotic effectiveness
Auscultation
Sounds originating within organ/body cavity
ex. bowel sounds - drug-induced gastroparesis
Inspection is also known as ______ _______ of physical signs
concentrated watching
Inspection:
What is used as the control?
Patient can be used as his/her own control
-Compare the right and left sides of the body
Inspection may require use of ______
instruments (ex. otoscope, ophthalmascope, penlight)
Palpation:
Fingertips used for?
Best for fine tactile discrimination:
- Skin texture
- Swelling
- Lumps or masses
Palpation:
Fingers-thumbs used for?
Grasping action of fingers and thumb useful in detecting:
- Organ position
- Organ shape or consistency
- Organ mass
Palpation:
Backs of hands and fingers used for?
Best for determining temperature
Palpation:
Base of fingers or ulnar surface of hand?
Best for detecting vibration
What does percussion involve?
Involves tapping the person’s skin with short, sharp strokes to assess structures 4-5 cm below the skin
Percussion:
The stroke yields a palpable vibration and a characteristic sound that can depict what?
- 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)
Percussion:
What is much more accurate?
Imaging tests (ex. ultrasound) *But your hands are easily accessible and give you instant feedback
See table on page 3 (characteristics of percussion notes)
ok ma dudes
Auscultation: Involves listening to sounds produced by the body (list examples)
heart, blood vessels, lungs, abdomen
Auscultation:
Most body sounds are soft and must be channeled through a _______
stethoscope
Stethoscope:
Describe the diaphragm
- Flat edge
- High-pitched sounds (breath, bowel, normal heart sounds)
- Hold firm against the skin
Stethoscope:
Describe the bell
- Deep cup-like surface
- Soft, low-pitched sounds (diastolic murmur of mitral stenosis, S3/S4)
- Hold lightly to skin
