Advanced Health Assessment Check-Off

Question 1

Patient Instructions & Communications

DO NOT USE MEDICAL JARGON
TIME MANAGEMENT

Answer 1

Wash Hands
Introduce Self  by name and greet PT
Explain prior to exam for each part (system)
Verbally ensure PT comfort during exam
Assist with position changes PRN
Provide Privacy (draping )
Minimal repositioning during exam
Minimize discomfort (instrumentation, exam steps)
Eye Contact with PT frequently

Question 2

HEENT

Ears

Answer 2

Inspect External Ears
Otoscope Exam
     auditory canals 
      tympanic membrane
Test auditory Acuity

Question 3

HEENT

Nose

Answer 3

Inspect 
     nasal vault
      septum
Palpate frontal sinus for tenderness
Palpate maxillary sinus for tenderness

Question 4

HEENT

Mouth

Answer 4

Inspect
      lips, gums
      buccal mucosa
      teeth
Inspect 
      tongue
      posterior pharynx (back of throat)
Inspect 
      floor of mouth  (under tongue)

Question 5

HEENT

Neck and Thyroid

Answer 5

Inspect
      Anterior Neck for symmetry
Palpate carotid pulses
Auscultate carotid arteries bilaterally
Palpate isthmus of thyroid gland
Palpate lobes of the thyroid gland

Question 6

Cervical lymph nodes

Answer 6

Preauricular (front of ear)
Post auricular & occipital
Mandibular chain
Sternomastoid chains
Supraclavicular

Question 7

Abdominal

Use appropriate general exam techniques

Answer 7

Inspect
      symmetry, skin lesion, color
Auscultate bowel sounds
Percuss 
      localized tympany or dullness

Question 8

Abdominal

Answer 8

Palpate for tenderness 
      light  then deep
  *****obseve pt's face during palpation
Palpate lever edge
Palpate spleen tip
Examine 
      Murphy's sign
      Rebound tenderness
Percuss over costovertebral angle

Question 9

Lung and Thorax
Use appropriate general exam maneuvers
Correct use of Stethoscope
Listen throughout inspiration and expiration

Answer 9

***Instruct pt to take slow deep breaths with open mouth for auscultation.

Auscultate upper anterior chest
Check chest expansion bilaterally
Percuss posterior lungs/ thorax
Auscultate posterior lungs/thorax
Auscultate lateral lung fields

Question 10

Cardiovascular
Use appropriate general exam maneuvers
Correct use of Stethoscope

Answer 10

Inspect jugular venous pulsation
Palpate Cardiac Apical Impulse
Auscultate 
      Aortic area
      Pulmonic area
      Tricuspid area
      Mitral area
Tricuspid area
 Mitral area

Question 11

Vascular

Upper extremity

Answer 11

Palpate pulses
Radial
Ulnar
Brachial

Question 12

Vascular

Lower extremities

Answer 12

Palpate pulses
      Femoral
      Popliteal
      Posterior Tibial
      Dorsalis Pedis
Palpate Inguinal lymph nodes bilaterally
Inspect for cyanosis/vascular changes
Examine for leg edema

Question 13

Eye

Answer 13

Inspect external ocular structures
Check visual acuity
Evaluate extra ocular movement
Check convergence
Test visual fields
Check pupillary response to light
FUNDOSCOPIC EXAM (Retinal)
Identify Macula

Question 14

Musculoskeletal

Spine

Answer 14

Inspect Spine
      Cervical
      Thoracic
      Lumbar
Percuss over C/T/L/S vertebrae
Test ROM
      Cervical
      Lumbar
Perform Straight Leg Raise

Question 15

Musculoskeletal

Hips

Answer 15

Test hip flexion
Test internal/external rotation
Test Abduction/Adduction

Question 16

Musculoskeletal

Knees

Answer 16

Test flexion/extension
Palpate
      crepitus
      medial/lateral joint line tenderness
      patellar tenderness
Examine for joint Effusion

Question 17

Musculoskeletal

Shoulders

Answer 17

Test ROM

Palpate for crepitus

Question 18

Musculoskeletal

Elbows

Answer 18

Test ROM

Palpate medial/lateral epicondial tenderness

Question 19

Musculoskeletal

Wrists

Answer 19

Test ROM

Palpate for tenderness

Question 20

Musculoskeletal

Hands

Answer 20

Test hand/finger ROM

Palpate finger joints for tenderness

Question 21

Neurological

Motor Strength

Answer 21

TEST
elbow flexion (bicepts, C5-C6)
elbow extension (tricepts, C6-C8)
hand grip (C7-T1)
finger abduction (C8-T1)
hip flexion (illiopsoas, L2-L4)
hip extension (gluteus maximus, S1)
knee flexion (hamstrings, L4-S2)
knee extension (quadricepts, L2-L4)
ankle dorsiflexion (L5)
ankle plantarflexion (S1)

Question 22

Neurological

Motor Reflexes

Answer 22

Test reflexes
bicepts
tricepts
brachioradialis
patellar
Achilles
Plantar Response ( Babinski's)

Question 23

Neurological
Sensory
Proprioception

Answer 23

Test position or vibratory sensation i
Distal lower extremity
Distal upper extremity

Question 24

Neurological
Sensory
Pain & Temperature

Answer 24

Test pain or temperature sensation
Distal lower extremity
Distal upper extremity

Question 25

Neurological
Sensory
Light Touch

Other

Answer 25

Test light touch sensation
Distal lower extremity
Distal upper extremity

Test discriminative sensation

Question 26

Neurological

Coordination

Answer 26

Test
      Finger-to-nose
      Heel-to-Shin
      Rapid alternation movements
Test balance Rhomberg Maneuver
Test for pronator drift

Question 27

Neurological

Gait

Answer 27

Examine 
      Normal gait
      Tandem gait (heel-to-toe)
      Walking on toes
      Walking on heels

Question 28

Neurological

Cranial Nerves

Answer 28

Test Cranial Nerves 
      V sensory function
      V motor function
      VII 
            upper division
            lower division
      IX, X  gag reflex
      XI motor function
      XII